Health Service Focus

12.11.15

A ‘fighting chance’ for the future of providers

Source: NHE Nov/Dec 15

Jim Mackey, the new chief executive of NHS Improvement, outlined what providers can expect from the regulator in his first major speech. David Stevenson reports.

On day two of the NHS Providers Conference, Ed Smith, the new chair of NHS Improvement, took to the stage briefly stating that he wants to hear more from those who chair organisations across the NHS. “Often they are seen but not heard,” he said. 

Smith, the former global assurance COO and strategy chair of PwC, “truly believes” people are at the heart of any system of leadership, meaning it is behaviours and cultures that are important, not structures and processes. 

Since his appointment to the new regulator, which will come online in April 2016, he said the most important thing he has done is appoint Jim Mackey as CEO. 

Following this introduction, Mackey told delegates in his first major address that NHS Improvement will try to deliver more “realistic expectations” for the provider sector while making a distinction between support and regulation. 

The former CEO of Northumbria Healthcare NHS FT told the audience that the regulator 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, to enable providers to plan their recoveries, investments and disinvestments. 

However, unlike Chris Hopson, who said the biggest challenge is to get the sector back into financial surplus, Mackey believes the biggest risk is the workforce – a theme throughout the conference. 

“We have large chunks of professions where people are just not coming through,” he said. “In my old region, roughly half the GP training scheme is unfilled. If this is the scale of the problem now, what will it be like in five years’ time?” 

Discussing safe staffing, Mackey said there needs to be a look at the contribution of all staff, not just nurses. He aims to bring the safety team from NHS England across to the regulator without doing any damage. 

A recent Monitor board paper said the agency will support aligned patient safety priorities across the system, more effective and better-supported boards and leaders, locally-owned improvement methods and sustainable performance standards – including better financial control and governance. 

Realistic expectations 

After discussing the bleak situation providers find themselves in, Mackey added: “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.” 

Accessing additional funding 

Mackey thinks it “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. 

There is still a lot providers can do, he said: “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, and wants to give them freedom and flexibility to do this as they want to, while ensuring – with NHS England – that the payment system promotes quality. 

“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 about giving providers “a kicking” just because they have had an incident. 

After the conference, NHS Providers CEO Chris Hopson praised Mackey’s welcome shift in tone and approach, tweeting that he offered “realism, support and deliverable provider task”. Shane Degaris, CEO at The Hillingdon Hospitals NHS FT, added that Mackey came across as “honest, measured and supportive. Very refreshing”.

Tell us what you think – have your say below or email opinion@nationalhealthexecutive.com

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

First NHS trusts introduce NHS SBS’ The Edge4Health

16/01/2020First NHS trusts introduce NHS SBS’ The Edge4Health

A major new procurement platform developed by NHS Shared Business Services (NHS SBS), The Edge4Health, is being adopted by NHS trust staff across... more >
NHS mental health director demands urgent gambling action

16/01/2020NHS mental health director demands urgent gambling action

The director of NHS mental health, Claire Murdoch, has penned a written plea to the heads of top gambling firms, urging them to take action on im... more >
Transforming services: We need a left shift not a left drift

16/01/2020Transforming services: We need a left shift not a left drift

Dean Royles, strategic workforce advisor at Skills for Health and co-author of ‘An Introduction to Human Resource Management,’ discus... more >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital e... read more >

last word

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad, president of the Association of the British Pharmaceutical Industry (ABPI), sits down with National Health Executive as part of our Last Word Q&A series. Would you talk us th... more > more last word articles >

the scalpel's daily blog

Transforming services: We need a left shift not a left drift

16/01/2020Transforming services: We need a left shift not a left drift

Dean Royles, strategic workforce advisor at Skills for Health and co-author of ‘An Introduction to Human Resource Management,’ discusses the need to move the treatment of patients from primary to secondary care and how the NHS People Plan can help achieve this. Throughout my (overlong) career in the NHS, the national policy on modernising the way NHS services are delivered has been pretty consistent. All recent governments; ... more >
read more blog posts from 'the scalpel' >

comment

NHS England dementia director prescribes rugby for mental health and dementia patients

23/09/2019NHS England dementia director prescribes rugby for mental health and dementia patients

Reason to celebrate as NHS says watching rugby can be good for your mental health and wellbeing. As the best rugby players in the world repr... more >
Peter Kyle MP: It’s time to say thank you this Public Service Day

21/06/2019Peter Kyle MP: It’s time to say thank you this Public Service Day

Taking time to say thank you is one of the hidden pillars of a society. Being on the receiving end of some “thanks” can make communit... more >
Nurses named as least-appreciated public sector workers

13/06/2019Nurses named as least-appreciated public sector workers

Nurses have been named as the most under-appreciated public sector professionals as new research reveals how shockingly under-vauled our NHS, edu... more >
Helpforce to launch training programmes for NHS volunteers

10/06/2019Helpforce to launch training programmes for NHS volunteers

Kay Fawcett OBE, clinical advisor and education lead at Helpforce, and Lynn Twinn, talent development consultant, outline the new national traini... more >
Creating the Cardigan integrated care centre

10/06/2019Creating the Cardigan integrated care centre

Peter Skitt, county director and commissioner for Ceredigion Hywel Dda University Health Board, looks ahead to the new integrated care centre bei... more >

interviews

Mike Farrar, Swim England - Last Word

07/12/2019Mike Farrar, Swim England - Last Word

Mike Farrar Chairperson of Swim England Would you talk us through your previous roles within the NHS? I’ve held a number of ... more >
Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

24/10/2019Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

Today, speaking at the Royal College of General Practitioners (RCGP) annual conference, Matt Hancock highlighted what he believes to be the three... more >
NHS dreams come true for Teesside domestic

17/09/2019NHS dreams come true for Teesside domestic

Over 20 years ago, a Teesside hospital cleaner put down her mop and took steps towards her midwifery dreams. Lisa Payne has been delivering ... more >
How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

24/10/2018How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to surging demand burdening acute health providers over the winter months,... more >
RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

24/10/2018RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

The president of the Royal College of Physicians (RCP) has told NHE that the college’s new headquarters based in Liverpool will become a hu... more >