05.12.13
Finding their feet
Source: National Health Executive Nov/Dec 2013
It has certainly been an important couple of months for the NHS, for health managers and for the medical profession.
The government’s response to the Francis Inquiry and his 290 recommendations will mean a number of changes to training, the complaints system and transparency, while the duty of candour and the ‘wilful neglect’ crime will surely result in a different atmosphere on some wards and in some boardrooms.
Meanwhile, the quest for truly seven-day services has advanced, with more backing from important royal colleges and an apparent change in stance from the BMA. The new GP contract will also involve some major changes and more care personalisation. If it works in practice as it’s meant to in theory, it could reduce the pressure on emergency admissions (though of course GPs deny, with some evidence, that the earlier contract changes were a cause of today’s A&E problems).
We’ve had announcements of the new men in charge of NHS England and the NHS Confederation, both of whom received widespread praise – unlike Dominic Dodd, chair of Royal Free London Foundation Trust, who withdrew his application to become the new chair of Monitor after the Health Select Committee refused to endorse him at the end of October, on a party-line vote. A month on, the Department of Health told NHE there is no update, as it is ‘still considering its options’ on what to do next. Monitor itself called it “disappointing” – it is keen to end the situation whereby Dr David Bennett acts as both chief executive and chair, hardly a model of good governance.
Health secretary Jeremy Hunt said back on 29 October 2012 that he would appoint a new chair “in due course”. Considering Monitor’s expanded and vital role since the reforms, it’s vital that this is made a priority.
Getting to grips with the reforms is an important theme in this edition of National Health Executive, and we have updates on the work being done by health and wellbeing boards, CCGs and CSUs as they all try to find their feet (HWBs more successfully than CSUs, it must be said). There is a definite need for clarity about competition law for CCGs – and exactly which contracts need to be put out to tender.
Things aren’t much clearer for CSUs – how much are they independent, private enterprises fighting for business, and how much just creatures of NHS England?
They seem trapped in a strange limbo at the moment.
I’d also recommend taking a look at our interview with Myles Howell, director of staff engagement at Hull & East Yorks Hospitals NHS Trust, on p58-60. It really gets across the message that improving staff engagement is not a woolly HR exercise, but has measurable impacts on patient safety, clinical outcomes, service delivery – and cost savings. Professor Michael West makes a similar point on p19. His article on quality and safety is an important read.
Adam Hewitt - Editor
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