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Time for action

In a speech to the NHS Confederation Conference in Manchester in June, Simon Stevens, the CEO of NHS England said the time for reviews is over and now it is time to start implementing plans for change.
“At NHS England, we are now out of the strategy business. We have the Forward View. We have a cancer taskforce report, and a mental health task force report, maternity, urgent and emergency care reviews. We are not doing any more reviews or strategy now; purely sleeves rolled up getting in to implementation, alongside you.”

Stevens acknowledged the ongoing good work within the NHS and the leadership that has been shown to keep it providing such a high standard of care. At the same time, steps have been taken to tackle issues such as growing anti-microbial resistance and improving the outcomes for patients. “The quality of care on offer to the people in this country, for the vast majority of conditions, is better now than it has ever been.”

However, he emphasised that the NHS has to make this year, 2016/17, start to count, in terms of stabilising finance and operational performance. He warned against expecting any additional financing – and cautioned that any extra money that may be found ought to be directed towards social care.

The time for talking is over, he said: “We have got to get our sleeves rolled up, and get delivering on some of the key national priorities and strategies that we have laid out.”

Stevens laid out his priorities. “So, the three things for this year: Stabilising finances and operational performance … Secondly, practical actions to implement the first phase of these national improvement strategies, similar in some ways to what we did with the National Service Frameworks in the early 2000s. And then thirdly, actually ‘landing’ these Sustainability and Transformation Plans – these STP processes – in every part of the country.”

Stevens was honest about the STP processes, describing them as “pulling people apart,” when what is actually needed is: “to hang together.” These processes have to be made to work, he stressed. Solutions won’t be the same in every part of the country, it is, he said, a case of “horses for courses,” and he also challenged: “If not now, when?” Often it is clear what needs to be done, but the ‘laissez-faire’ attitude or ‘the time isn’t right’ gets in the way. “We have actually got to face up to some of the changes that we can see are required.”

The workforce are important in any plan for change and Stevens recognised that it has been a difficult year, but he pointed out that staff need to feel they are being treated fairly. He urged everyone to examine the workforce race equality results for their organisation to act on what he described as “a huge difference in the experience between black and white staff across every part of the NHS.”

He also urged organisations to mainstream staff health programmes.
Innovations that are beneficial to front-line clinical practice will also be fast-tracked through a new programme to be launched in April 2017. “We will add a piece to the national tariff system specifically for new med tech innovations that have been shown to be cost-saving or help patients with supported self-management.” This initiative aims to remove the hassle of having to negotiate on a Trust-by-Trust or practice-by-practice basis.

“I think that, in our heart of hearts, we know what needs to get done. Our job nationally, as national bodies, is to seek to support you in doing that,” Stevens concluded.