WELLARDS CONFERENCE Chris Calkin
David Rogers
things that I don’t think are what we want to see: abandoning qual- ity and only going for short-term cost savings, not quality.”
The majority are probably some- where between the two, he said, adding: “Redesign is doing QIPP; shutting wards is not.”
Too often the NHS fails to harness the benefits of innovation, he said.
He concluded by saying that there were still “fantastic opportunities” for the NHS and the healthcare in- dustry to “unlock quality and value together”.
HFMA policy committee chair Chris Calkin – who is soon to re- tire from the NHS, though not the health sector – noted the vast range of responsibilities held by hospital finance directors.
But he was convinced that the PCT and SHA clusters will not ac- tually be abolished – just reformed and re-branded, and keeping at least some of the power they cur- rently have.
He said he did not underestimate the challenges faced by NHS trusts, saying that there was a view among finance directors that cost improvement programmes over 3% need external help – and the NHS could be facing 7-8% programmes.
He discussed payment by results (PbR) in detail, and noted the huge differences between the prices paid in different areas.
He also outlined what he called the key factors of the NHS market: patient choice; the implications of any qualified provider (AQP); the repatriation of care to primary
Jim Easton Mike Dixon
care; the huge entry and exit costs to/from the market; cherry- picking;
sub-specialisation; the
struggle of smaller hospitals to meet safety requirements; and the European working time directive.
As many of the audience came from a pharmaceutical and med- tech background, he concluded that any products that can de- monstrably reduce length of hos- pital stay will interest providers and commissioners.
Dr Michael Dixon, one of the country’s longest-standing pro- ponents of clinical commission- ing, was clearly delighted with the direction of travel.
He also noted the need to shift spending away from acute spend- ing – in the developed world, we are second only to the USA in our hospital spending, he noted – to diagnostics and care in the com- munity.
Too often, he said, hospitals were treating patients with long-term conditions just because they happened to live nearby – for ex- ample, in Exeter, the acute trust treats 80% of diabetics from just
20% of local GP practices.
Redesigning and integrating ser- vices simply has to happen, he said – but again, noted the broad- er dangers in the current reforms.
He said the NHS Commission- ing Board had the potential to become overpowerful and micro- managing, on the one hand – or the clinical commissioning groups themselves could push individual practices out.
Cllr David Rogers, in his session, discussed
the importance of
health & wellbeing boards (HWBs) and the increased importance of local government in terms of their new role in carrying out the public health function.
He said the HWBs could help the drive towards integrated services – but admitted that the details on how the boards will interact with the NHS Commissioning Board nationally are still murky.
Clearly, there is a strong desire among English councils to get more involved in healthcare and public health – nearly all of them signed up as ‘early adopters’.
Bridging the divide between so- cial services and health services remains vital, he said – especially as demographics mean that, more and more, those being treated by the NHS are also going to be cli- ents of social services.
Gordon Coutts, acting chief ex- ecutive of NHS Colchester Foun- dation Trust Hospitals, gave a personal view of the ‘new provider world’ that we are moving to- wards, and said that at the other end of these reforms and the ef- ficiency drive will be a radically different NHS.
He said that his trust is facing price cuts in the tariff of 2%, with inflation running at 5%, and 1,000 potential job cuts in the health economy of the region.
He gave a personal view that pro- viders should be able to compete on price, although acknowledged that is not policy at the moment, with quality the only criteria.
He concluded that the supplier and provider industries are full of people with the right kind of skills – those which the NHS will need in the coming years, like analytics, project management, finance and health economics.
national health executive Sep/Oct 11 | 13
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