Editor's Comment


We must learn from the inevitable change

STPs represent the one thing that many people, organisations and systems do not like: change. However, the highly ambitious plans, which have been criticised for their lack of early engagement and top-down approach, are a necessity if the health and care sector is to address the unprecedented challenges it faces. 

Whether it is through service redesign, financial savings, back-office consolidations or greater moves towards integrated care, the STPs affect everyone in the sector, from the board to the ward. It is slightly worrying, then, that many of the plans have not had the clinical buy-in that you would expect from such a fundamental change programme.

Hopefully, the period of consultation that NHS England has promised will help strengthen the process and make sure the ambitions of the footprints are achievable. The King’s Fund’s call to ‘stress-test’ a number of the plans is also a welcome recommendation. 

But the one thing that the NHS, the DH and policymakers must do is learn from the STPs, as Lord Adebowale told NHE on page 28. It is inevitable that not everything in the 44 footprints will work, but we shouldn’t necessarily say that the programme has failed if this is the case. Despite the plans having to be drawn up in such a short space of time, their long-term impact could be substantial in unlocking the door to fully integrated care. Only time will tell. 

Unsurprisingly, the main themes that run throughout this issue of NHE are STPs, integration and change. We look at the impact that the footprints have on governance, the workforce, decision-making, finances and even IT.

We also feature two fascinating articles on workforce development. Jill DeBene, the recently-appointed CEO of the Institute of Healthcare Management, and a new member of NHE’s editorial board, argues that there needs to be a radical change in the climate of the NHS to encourage future leaders to take up top-level jobs. And Professor Michael West, who has been involved with the National Improvement and Leadership Development Framework, explains how there will be a concerted effort to drive compassionate and inclusive leadership going forward. 

Other highlights in this edition focus on the use of benchmarking to improve hospital pharmacy and medicines optimisation; we learn about the ambitions of the new Cancer Drugs Fund; the Information Commissioner’s Office discusses the need to tackle both old and new threats to data security in the system; and much more. 

Finally, we also feature the regional winners for the Our Health Heroes Awards (page 20), of which NHE is the official media partner. I would like to say a big thank you to everyone who put forward colleagues for this year’s awards, and a massive congratulations to all those who have been shortlisted for the two national accolades. 

I hope you all enjoy this edition of NHE.


Stephen Slator   14/12/2016 at 21:15

The STPs may have some good ideas, such as better integration of health and social care. But they are clearly cost-driven and founded on massively unrealistic budgets: West Yorkshire and Harrogate STP for example proposes a 19% cut in funding by 2020-21. And particularly at a time of growing demand that will prove totally inadequate. This will lead to disruption and probably destruction of a universal health service. This is not, as the piece suggests, 'inevitable change'. But it is likely to happen unless loudly and publicly resisted by all people of goodwill to the NHS. Including 'the editor' one would hope!

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