09.05.10
Challenges can be overcome through improvement and innovation
Bernard Crump, chief executive of the NHS Institute for Innovation and Improvement, on the challenges facing the NHS and the steps being taken by the NHS Institute for Innovation and Improvement to help overcome them.
I’m regularly asked about the challenges facing today’s NHS. What do I think they are? What is the root cause of all problems ‘NHS’? If I could change one thing, what would it be? And so on.
I think it’s important to make this point up front: the NHS is improving. We see this everyday at the NHS Institute for Innovation and Improvement and are constantly receiving feedback to this effect, from NHS staff we work with as well as from overseas visitors and stakeholders.
We’re not the only ones who think this either. The recent Lord Darzi Interim Report (NHS Next Stage review) points to “the clear progress made by the NHS over the last decade.”
It’s essential to be aware of the challenges though, to inform our work and therefore our priorities. In my opinion, there are four main challenges.
Dealing with variations in clinical care throughout the country is the first challenge. Widely varying productivity and efficiency measures make it difficult to understand the issues on a larger scale and to put into place improvements ‘across the board’.
A second challenge is ensuring patients receive safe care, in a healthcare system where unfortunately, things can and do go wrong. Patient safety must be tackled in the NHS collectively and as a priority.
Handing the rate of increased costs is another challenge, particularly at the same time as delivering improved quality and better value care. Patients increasingly expect to receive and benefit from both clinically effective and cost effective healthcare.
Finally, the challenge in improving the patient experience must be understood, and ensuring all innovation and improvement is patient-centred and patient focussed.
Innovation and improvement are at the forefront of what we do at the NHS Institute, and are essential in helping to overcome these challenges. Indeed, some of the most dramatic improvements come about from new ideas and innovation.
We know we have an innovative workforce in the NHS. Throughout the National Innovation Centre, we’re providing those staff on the frontline with a forum to express and potentially develop some of these ideas.
The improvement agenda is also more important than ever. It’s about making people in the NHS able to adapt and use other approaches from the NHS, other countries and other sectors. I am confident that those working in the NHS will start to become more aware of this agenda and most significantly, able to adapt to it in their day-to-day working life.
So how is the NHS Institute working towards overcoming these challenges?
The NHS Institute is a lean organisation and works in a focused way on what are called our ‘priority programmes’. These six programmes are agreed with the Department of Health and aligned with current targets.
The Patient Safety programme looks at developing the skills needed by staff to improve patient safety. With partners, we’ll be running a national campaign on patient safety, identifying processes and systems so that doctors and nurses make patient safety a priority in their jobs.
Our No Delays priority programme is focused on helping NHS trusts in England achieve the Department of Health’s objective of reducing delays in the health service – the 18-week patient pathway by December 2008.
The Care Outside Hospital priority programme is helping the government achieve its vision of shifting care closer to home. The programme looks at how the shift in care can be made by trusts – systematically, quickly and efficiently.
Our Delivering Quality and Value programme comes from the philosophy that well-delivered care should be right for the patient first time – and therefore should also ultimately be the cheapest and most efficient care.
The Building Capability programme looks at developing leadership, new skills and capabilities that will be needed at individual, team, organisation and system level.
Our final area comes in the form of the National Innovation Centre, which helps to develop individual’s ideas for innovation through the maze of regulation and the development process.
We’re not working alone in any of this. All these programmes are highly integrated with those working within the NHS – both clinicians and managers. Their experience is integral to many of the products, tools and processes that we develop. Our NHS partners, including so many chief executives and senior managers in the NHS, often lead the way in much of the development of our work since their knowledge is so vital.
This integration with the NHS is represented through various networks. We work closely with the ten SHA’s through a link director who spends some time working with us. We also have relationships with chief executives of both provider organisations and of PCTs.
Our Practice Partner Network is made up of various types of NHS organisations – 38 in total - who volunteer to test and help develop products from the NHS Institute. They are a sounding board, constantly providing us with feedback on what we’re doing therefore helping us keep what we’re doing in line with the real challenges out there.
So what does all this mean?
The NHS Institute is now becoming established as an important influence for innovation and improvement in the NHS and it’s my opinion that our work is helping the NHS overcome the current challenges it is facing.
For example, our Delivering Quality and Value products will potentially help the NHS save £2.2 billion through more effective management of resources. The No Delays Achiever tool is an online tool that helps NHS organisations achieve the December 2008 objective of waiting no longer than 18-weeks. And our priority programmes are directly linked to achieving the Department of Health objectives and therefore the current priorities for the NHS.
These are just some highlights, which I hope reinforce what I said at the start of this article. That it’s my opinion the NHS is improving at pace.
To reiterate something that Lord Darzi wrote in his Interim Report, inspiring everyone working in the NHS to embrace and lead change is so important in ensuring improvements continue to happen.
“The NHS Institute is now becoming established as an important influence for innovation and improvement in the NHS and it’s my opinion that our work is helping the NHS overcome the current challenges it is facing.”
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