01.02.15
FTN Conference: Providers can drive NHS transformational change
Source: National Health Executive Jan/Feb 2015
David Stevenson reports from the annual conference of the Foundation Trust Network, now NHS Providers.
More than 700 delegates attended the Foundation Trust Network (FTN) annual conference and exhibition in Liverpool in late November, with ‘change’ and ‘transformation’ the key themes. This applied to the FTN itself, which announced a name change as of 1 December to become ‘NHS Providers’, the association for foundation trusts (FTs) and trusts.
The organisation’s CEO Chris Hopson announced the re-brand during his opening speech saying the decision had been made to “make it clear who we represent but also the fact that the FT model sits at the heart of what we do”.
He thanked delegates, members and NHS staff for their hard work during the deepest and longest financial squeeze in the health services’ 65-year history. He added: “We’re also grappling with a centrally mandated, immediately required increase in the size of the workforce that, wholly unsurprisingly, has created a massive recruitment and financial headache for nearly every trust I visit.
“Because the money simply hasn’t followed the demanded staff increase, providers have had to absorb an extra £1.2bn on the wage bill at exactly the point, towards the end of this Parliament, when the financial pressure has been at its greatest.
“No wonder the FT sector was collectively in deficit for the first time ever, or that 60% of all acute trusts were in deficit at Q1.”
Transformation
However, it wasn’t all doom and gloom in Hopson’s address. He stated that if, as a sector, “we want to deliver transformational change we have to accept that this change can only be driven at a local level”.
In most local health and care communities, only NHS FTs and trusts have the capacity, capability and resources to act as the key catalysts of transformational change.
But if providers are to act as catalysts, there needs to be a shared, collaborative leadership model built. Also, system leaders need to recognise that it is just as important for them to support local providers as it is to regulate and risk-manage them.
“Current NHS funding does not adequately meet demand,” said Hopson, “we either need to increase funding or reduce the level of care we commission and provide and if we are to transform, that requires investment too.”
Hopson also criticised the sector’s regulatory regime, calling it “fragmented” and “increasingly interventionist”. There was further debate on regulation during the conference and, at a later plenary session, the heads of Monitor, NHS Trust Development Authority and the CQC gave their opinions (more on page 52).
Whole person care
Shadow health secretary Andy Burnham MP outlined Labour’s ‘whole person care’ policy proposals, promising to publish full details of his plans early in 2015.
Burnham predicted a “great potential future” for FTs as system leaders of population-based accountable care organisations, moving beyond the organisational silos of the current FT model.
However, he added that there were problems with the system which “must be acknowledged and addressed”.
“First, there is a risk that the FT model coupled with the activity tariff has reinforced a hospital-dominated model of care,” he said. “Second, the FT model – and the authorisation regime around it – has brought a focus on the viability of institutions rather than of whole health and care systems. It can perpetuate silos rather than breaking them down, and encourage organisational competition rather than collaboration.”
Burnham, who has called for a single budget approach to health and social care, believes this, along with the repeal of the competition regime, will free-up providers to start his 10-year journey towards ‘integrated care’ organisations.
He added that Labour won’t ‘recreate’ organisations and that CCGs will stay, but would be acting to support Health and Wellbeing Boards.
Human Factors
Professor Jane Reid, a non-executive director at Dorset County Hospital NHS FT and advisor to NHS England, gave a presentation on the importance of human factors in avoidable harms and errors in healthcare.
“’Human factors’ main aim is to optimise human performance by understanding the interface between humans, their environment and equipment, of note human factors science is the organising principle in many other safety critical industries,” she said. “In healthcare, we have not yet embraced human factors as a science in the way we best could.”
Professor Reid characterised compliance as simply a licence to operate, whereas “we should be aspiring towards excellence”. Providers must recognise the emotional labour of caring and compassion fatigue, she said.
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