Editor's Comment


Where’s the time?

Source: NHE Jul/Aug 16

In recent editions of NHE we have focused on the change taking place in the health sector, but one of the important pillars to deliver new models of care and financial sustainability is time. 

Unfortunately for the NHS, as we all know, ‘time waits for no man’. 

As you’ll see in this magazine we have coverage from the recent Commissioning Show and the NHS Confederation Annual Conference. At both these major events, sustainability and transformation plans (STPs) were the hot topic. However, many delegates started raising the issue of time or, more accurately, the lack of it to deliver the ambitious aims of the project. 

The Five Year Forward View (FYFV) is now a three-and-a-half-year plan, but as Professor Paul Corrigan, former director of strategy and commissioning of the NHS London Strategic Health Authority, told delegates at the Commissioning Show, we are currently investing in “propping up” models of care that are not fit for purpose, and we are not making the progress required on new models of care, like the Vanguards. 

While Prof Corrigan welcomes the overall aim of the FYFV, he says that some people have been lulled into thinking the problems of 2020 are that: problems in 2020, but they are not. The problems are here and we need to invest now if we are to remedy them. 

However, in order to deliver a step change, it is likely we’ll need to give local health economies the time, space and headroom to ensure their efforts are fruitful. Unfortunately, this might not be the case. 

For instance, the STPs, which were submitted at the end of June, have become soundboards and discussion documents to start with. But in the same breath, by the end of July, NHS Improvement, which I do believe wants to support trusts and FTs, has said that the footprints must come up with outline plans to consolidate back-office and pathology services. This is not a simple task and to have just a month to come up with a plan is a big ask, no matter who you are. 

The Local Government Association’s portfolio holder for community wellbeing, Cllr Izzi Seccombe, recently said that bringing the partners of integrated care together can be done quite quickly, but I agree with Dr Amanda Doyle, co-chair of NHS Clinical Commissioners and an STP lead, who says that once they are round the table it can feel like bringing up the children. 

Throughout this edition we question whether the sustainable and financial change needed in the NHS is deliverable in the timescales set, especially following the UK’s decision to leave the European Union. While we might not be able to provide the answers, one thing is clear, as NHS England’s CEO Simon Stevens said: “It is going to be bloody tough.”

David Stevenson



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