'With' us rather than 'at' us

The coalition government needs to focus on cultural change, if it is to deliver on its health reforms, according to the NHS Alliance.

The NHS Alliance – a primary care coalition that brings together PCTs with practices, clinicians with managers and board members – believes that the Department of Health cannot take a top down approach and cascade instructions down to the frontline.

Dr Michael Dixon, chairman of the NHS Alliance said: “Command and control won't work. What we need now is distributed leadership and trust."

The new government has set a cohesive plan for health reform and is now reality checking it with senior managers and the Department of Health. But putting policy into practice is a completely different story. Unless the government is able to forge a meaningful relationship with the people who will carry the plan forward – i.e. frontline clinicians and managers – it will face real difficulties in delivering change.

Dr Dixon added: “A new relationship is needed. Structural and organisational changes alone won’t bring results, unless there is real a cultural change whereby frontline clinicians and managers are included and feel inspired to take the government’s agenda forward.

“Traditionally, the government has had a new idea, senior management has pushed it down the line and those at the working face of the NHS have tried to make practical sense of it or, on too many occasions, carry out the letter but not the spirit. Consequently, pay, pensions and personal life have come before any real commitment to see government policy succeed. All that must change.

“Effective health policy means connecting with GPs, nurses, allied professionals and managers – inspiring, engaging and empowering them to do their job better. Saying it is not enough, the new government will need to show by its actions that it wants to connect, engage and form a partnership with those on whom a successful health service now depends. The NHS Alliance looks forward to working with the new government to make these things a reality."