COMMENT
the scale of the increase needed, and from a candid debate about what it would mean to make such a level available.
Realistically, that will only happen after the general election. So NHS Providers – representing over 94% of NHS acute, mental health, community and ambulance services – is setting out our plan to take us from day one of the next Parliament.
By then, the NHS will be under even greater pressure: it is then that we must fight hardest to be true to the NHS’s founding principles, and change the way we deliver health and care.
Funding
The NHS needs significantly more money from the government, and the NHS needs to do better with it. Local health systems – with providers and commissioners working in partnership – need to invest in improvement and in working towards shared objectives.
How funding flows through the NHS can be improved, too. The NHS funding cycle currently asks those on the frontline to say what they’re going to do before they’ve been asked to do anything, and before they know what resources they’ll have to do it. This must stop. We need an adequate multi-year NHS funding deal, to invest efficiently and effectively in current and future care.
Workforce
The board of directors of an NHS foundation trust or trust is responsible for the care provided. An engaged workforce that feels valuable is essential for successful, consistent
Yet the centrality of the NHS to everyday life and political narrative drives a level of risk- aversion that incentivises regulatory over- reach and performance management. The rate, cost and burden of regulatory intervention and reporting are growing at pace, without clear patient benefit.
The right role for regulation is making sure that the systems and standards are in place for good care to happen; ensuring good governance; and removing barriers to quality and performance.
NHS providers
NHS providers need freedoms – to innovate, design and deliver the care that patients need. If they are given the money, time and space to achieve, they – and their commissioner partners – can be held accountable for the results. Through that balance of autonomy and accountability, the NHS becomes truly high performing.
and compassionate high-quality care and boards must be able to create the necessary conditions.
A board must set the tone, empowering staff to fulfil a shared vision, while ensuring the right staff are available and have their pay matched with their performance.
Regulation
Regulation alone cannot prevent poor care, or impose good care. Regulators can only look at what has happened: they do not pretend to hold the clinical expertise of those on the frontline.
NHS providers have the clinical and operational expertise we need to transform the NHS into the 21st-century service we need. Professionals and policy makers visit to learn how we can do so much with the money we have, which is lower proportionately than that invested by the largest comparable countries. Our comparative performance and leadership is down-played by politicians and the media. As citizens we trust the NHS every day with our lives. We forget that over seven decades it has changed radically, and must continue doing so.
Our ‘Programme for the next Parliament’ sets out the path for changes in these four areas. As we move to new models of care, there are barriers and distractions to remove, and capabilities and capacities to enable.
As we do so, we need to renew our confidence in the NHS, a world-class investment that cares for one million people every 36 hours.
More than just money, it is a truly inspirational social construct. The vision of giants.
A lot of rhetoric is used about our beloved service. It’s time to make it real.
We all want the NHS to be fit for purpose, to be here today, tomorrow, for you, for me and for our children. Let’s make it so.
FOR MORE INFORMATION
W:
www.foundationtrustnetwork.org/ influencing-and-policy/public-affairs/2015- general-election/
national health executive Nov/Dec 14 | 21
Dame Gill Morgan
© Design Council and Simon Turner
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