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HEALTHCARE DELIVERY


Delivering integrated and sustainable services


The Clinical Services Journal looks at the challenges and priorities which must be addressed to achieve more integrated, effective and sustainable care, as outlined by the NHS Confederation.


At the 2016 NHS Confederation Conference, Simon Stevens, chief executive of NHS England, acknowledged how demanding the past 12 months have been for frontline staff. Despite the media focus on the negatives, he said he believed that the quality of care in the NHS today, for the vast majority of conditions, is better now than it has ever been. “This is not just due to the quality of clinical care,” he said. “It is also down to the compassion and sensitivity with which care is offered.”


Since he took on his present role, Simon Stevens has been trying to establish a shared consensus about how health needs to evolve. He said: “We are creating more alignment nationally, between the various parts of the system and the creation of NHS Improvement, which I believe is an important building block and makes the argument for a stronger funding settlement for the NHS.” Focusing on the tasks facing the NHS in the coming years, Simon Stevens explained


the need to stabilise finance and operational performance. “We have had to strip out 1% – around £650 million – of spending from funding that would have been available from CCGs for mental health services, community health services, primary care and other things. We want to be able to release that funding.”


Rolling up our sleeves


Simon Stevens also emphasised the need to “get our sleeves rolled up,” to deliver on some of the key national priorities and strategies that have been have laid out and, to help achieve this, five operational managers have been appointed in the NHS. Pauline Phillips is leading implementation on urgent and emergency care review, Cally Palmer, chief executive at Royal Marsden, on cancer, Clare Murdoch on mental health; Sarah Jane Marsh on maternity services, and Sam Jones on vanguard sites. These five front line leaders have been tasked with connecting the national implementation


‘Stepping up to the place’ aims to bring health and social care together.


agenda with the local work, which has got to be delivered in every part of the country. So what does ‘getting our sleeves rolled up’ mean in reality? Using cancer services as an example, Simon Stevens said: “We need to find out the reasons behind endoscopy bottlenecks to speed up waiting times. Cally Palmer will be looking at this issue and will be talking to the re-formed cancer alliances about this and other issues. “Clare Murdoch will be doing the same on mental health. The practical things that need to be achieved include work to reduce out of area treatments and to connect secondary and tertiary mental health services. “Alongside this we need ‘open book’ transparency from CCGs, so that their mental health Trusts can see where mental health investment is – or is not – going. Then we can have an honest conversation,” he said.


Integrating health and care Simon Steven, chief executive, NHS England. MARCH 2017


Stephen Dalton, chief executive of the NHS Confederation, has introduced ‘Stepping up to the place’, a joint publication about integrating health and care services. Produced by the Association of Directors of Adult Social Services, the Local Government Association, NHS Clinical Commissioners and the NHS Confederation, the evidence- based document describes what a fully integrated, transformed system should look like, with the aim of bringing health and social care together. The imperative to integrate and transform has never been greater, said the report authors – from


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