Jim Easton talks about meeting the leaders of GP pathfinders and some great examples of innovation.
Things are moving.
The second reading of the Health and Social Care Bill was preceded by the Prime Minister not just making a connection between the QIPP challenge and reform, but arguing that without reform the efficiency challenge could not be met.
For those of you who are cynical about that statement, I have to say I was encouraged by attending the first meeting with all the leaders of the GP pathfinder consortia. I ran two sessions on QIPP where I met knowledgeable and committed colleagues, ready and willing to work on those key areas of QIPP delivery – especially service redesign – in which primary care is key. Of course there’s a long way to go from discussion to making it real, but it was a very encouraging start.
And in another part of Westminster I was a witness at the Public Accounts Committee on hospital productivity. They were pretty adamant that, although we had delivered on all the efficiency requirements over the last decade, along with remarkable performance improvements, and had been engaged in a deliberate strategy of growing staff and capacity, the fact that hospital productivity had declined was a significant failure. For me it was a mark of how little political forgiveness there will be in tackling the next stage of the journey.
We have now followed through on the commitment in the Operating Framework to sustain commissioning capability, and provide space for the consortia to develop by grouping management into teams serving clusters of PCTs. The cluster guidance has now been published. Most feedback I have heard is that people largely recognise it is sensible, but understandably find the process painful and concerning. Whether on money, or change, it is beginning to get real for many colleagues.
It’s tough, but the evidence of innovation continues to come in and that will help to deliver QIPP. For instance; the work of the Brompton hospital to get children on ventilators home more quickly, clinical staff setting up new services independently to achieve remarkable results in wound healing, or proposals from the third sector for a national campaign to tackle over use of anti psychotic drugs for people with dementia. These are saving tens of millions of pounds and improving lives.
As ever, the answers are out there, they are just not evenly distributed.
Jim Easton is NHS National Director for Improvement and Efficiency.
Jim has been an executive in the English NHS for more than 20 years and prior to his current role he was Chief Executive of NHS South Central, responsible for all health services for five million people in the South of England.