On Leading Change
“The NHS requires a new burning ambition that we can all get behind – one that will deliver a 21st century health and care system for the future. The Five Year Forward View provides many of the elements necessary, not least proof that a system that is true to the founding principles of the NHS is achievable. That will take funding, efficiency and service change at pace and scale.
“Much of the Forward View resonates with our members. It reflects the majority – but not all – of the vision and asks laid out by the strongest ever coalition of health and care sector leaders in the 2015 Challenge Manifesto, published last month.
“The commitment that the service has made, is that we will deliver if the conditions allow it. NHS England’s vision shows an appreciation of the commitment, talent and experience found throughout the health service and its leaders at all levels. The promise of a national framework with local delivery is welcome. It is vital that local leaders – clinical, managerial and patient/public leaders – are empowered to be bold. The promise of “place-based”, local approaches needs to be backed by a reformed performance and regulatory culture.
“We have some reasons to be cautiously optimistic – it is particularly good to see that NHS England has the support of other Arms Length Bodies, who should be given credit for their shared commitment. There is still work to do if we are to succeed and politicians now need to play their part to make the shared vision a reality.”
On The Vision
“The vision set out looks ambitious. The focus on prevention, supported self-care, mental health and the increased emphasis on supporting people to stay out of hospital is a strong indication that NHS England is genuinely committed to helping make this step change move from discussion to reality. Sustainable, world class provision that builds on our excellent hospital, community, mental health and ambulance services is also welcome. The service delivery models – in advance of the Dalton Review – also suggest an appetite for change and improvement.
“The contribution of significant parts of the service needs to be clearer. The document says little about the future and role of Mental Health, Community and Ambulance providers. These providers are closest in outlook and experience to the vision laid out in the document. They support millions of people each year and can point to many examples of innovative models of care, whole person approaches and personalisation. Their leaders can support the successful transition to the new world, alongside those in our hospitals and general practices. We need to make the most of the capacity and potential everywhere in the whole system to lead change: we cannot afford to ignore or under-use any type of provider.
“No part of the health service has a monopoly on delivering high quality, good value, person-centred care. NHS values can be found in the statutory, independent and voluntary sectors – so it is disappointing that today’s publication has not taken the opportunity to explicitly clarify and recognise the contribution of plurality in the NHS.”
“Funding is a political choice. We have for some time been warning of the impact of the emerging NHS funding gap on our members’ ongoing ability to deliver the high quality care patients want and need. So we welcome the messages that, even if we are able to rapidly make changes to models of care and address demand, the next Government will still need to make a decision on additional funding to close the gap.
“We particularly welcome a clear recognition of the need for a ‘pump priming’ funding for new models of care, and a commitment to enable the NHS to move forward with faster adoption of innovation. Innovation in the NHS is about much more than new drugs, machines or even medical procedures, however, and we look forward to working with clinical leaders, patient representatives, staff and service leaders to develop a culture throughout the health service, which not only allows but positively encourages innovative change that makes a real difference for all parties.
“We do need a commitment to increasing the pace of payment reform. This will be vital to enable the new models set out by NHS England.”
“This Five Year Forward View looks deliverable if we work together and address each of the asks in our 2015 Manifesto. We look forward to working closely with NHS England and the Arms Length Bodies on this in the coning months and will be setting out the areas where we are firmly aligned and those where gaps persist.
“We also look forward to ensuring that appropriate risks can be taken to secure our aims. We must take well-judged, properly managed risks, to make any progress. Without progress, the NHS will be history and this review demonstrates quite clearly that this doesn’t have to be the case.”
Gill Bellord, director of employment relations and reward at the NHS Employers organisation, said:
“This is a positive programme that can help local services to adapt and plan their care in ways that are best for patients. NHS Employers looks forward to working with NHS England on this programme.
“The emphasis in developing new roles as part of improving models of care is an important one and employers will want to engage and involve their staff early in any changes. At a national level NHS Employers will work to support Health Education England in this area.
“We welcome further development around its call for new incentives to support better health and well-being, and strongly support this in principle. Effective well-being programmes are expanding rapidly in the NHS but aren’t always prominent enough in board-level planning. There is a lot of good work in the NHS around staff health and well-being and this is an area where we can – and should – act as an example for employers in other sectors.
“Employers support the continued emphasis on expanding community services, which is where the greatest gains can be made for public health, but many will want to highlight the ongoing financial strain from expanding their clinical workforce both in hospitals and the community.
“We welcome its recognition that modernising pay terms and conditions for NHS staff is necessary to reward them for the quality of the care they give, encourage new ways of working, and make the provision of services effective and sustainable seven days a week.”
David Hare, chief executive of the NHS Partners Network, said:
“It is very welcome that NHS England recognises the importance of developing new models of care in order to protect and sustain a free at the point of use NHS. This will only be achieved by harnessing the skills and experience of all parts of the health service including independent sector providers. With more evidence available about the quality of NHS services delivered by the independent sector and the growing range of services being offered by independent sector providers it is clear that these organisations must play a big part in helping the NHS meet the demands of the future.
“NHS England’s renewed commitment to making good on patients’ legal right to choice is particularly welcome. Choice puts patients in control of the care they receive and when combined with meaningful comparative information enables patients to drive real improvements in the quality of local service provision. This issue must be put front of centre as NHS England and Monitor move to implement the proposals contained within the Five Year Forward View.”