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12.11.15

New NHS Improvement body offers a ‘welcome shift in tone’

NHS Improvement will try to deliver more “realistic expectations” for the provider sector while making a distinction between support and regulation, according to the organisation’s first chief executive

Speaking at the NHS Providers Annual Conference yesterday [11 November] in his first major address, Jim Mackey, until recently CEO of Northumbria Healthcare NHS FT, told delegates that NHS Improvement aims to make changes to give the sector a “fighting chance for the future”. 

He hopes to secure a good settlement in the upcoming Spending Review and push for multi-year tariffs, possibly three. 

After discussing the bleak situation providers find themselves in, Mackey said: “There is recognition that providers need even more realistic expectations going into the next year and next few years. 

“We want to get back into balance within a reasonable period. We are probably looking at a two-stage process. 

“Hopefully, an agreed Spending Review and tariff and then agreeing a fairly quick and simple plan that shows how to start stabilising the individual institutions. Then, in the spring, there will be a longer-term, patch-based, place-based planning process that addresses what the long-term issues are.” 

Mackey also noted that it is “highly likely” that access to a share of the £8bn promised by the government will depend on participation in that process and getting the right results. 

He added that there is still a lot providers can do: “The Carter Review shows there is ridiculous variation in efficiency and productivity – sometimes within the same institutions or those next door to each other. We need to grasp the nettle in terms of long-term planning and we need to reflect that in spending and the tariff.” 

NHS Improvement will try to support providers in improving quality, as largely defined by the CQC. It will also support changes to allow providers to enable productivity improvement, and ensure with NHS England that the payment system promotes quality. 

A theme throughout the conference, and which Mackey reiterated, is that the NHS workforce challenges are the sector’s biggest risk. 

“Fundamentally, what we are aiming for is to restore hope in the provider system with a challenge that is challenging but possible, and within reach for most,” he said. 

Despite offering support to providers, Mackey added the organisation is still a regulator, inheriting those functions from Monitor. “We need to be honest about that,” he said. 

“We will do our best to support you, but at the end of the day there is still accountability: we are still accountable and you will be, but I think we can be grown up about that.”But he did note that NHS Improvement won’t be just about giving providers “a kicking” because they have had an incident. 

Following the conference, NHS Providers CEO Chris Hopson took to Twitter, saying: “Immediate reaction to Jim Mackey speech @#NHSP15: welcome shift in tone & approach - realism, support and deliverable provider task.” 

Shane Degaris, CEO at The Hillingdon Hospitals NHS Foundation Trust, added that Mackey comes across as “honest, measured and supportive. Very refreshing”. 

Richard Beeken, chief executive at Wye Valley NHS Trust, said there was “hugely refreshing realism and practical actions signalled by Jim Mackey in his address”.  

Earlier in the day, Paul Burstow, the former care minister, called for “less stick and more help” from regulators. 

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