David Peat on turning health policy into action

David Peat

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One of the eternal dilemmas for a chief executive is to translate the words of policy documents into meaningful action on the front line

We all recognise the old problem of trying to energise staff who may have heard many of the same messages before, and who may have a perfectly understandable critical faculty that hovers between being worldly-wise and world-weary.

It is no use just sprinkling in the words challenge, teamwork and partnership working like confetti. You have to accept that staff are not naive: they can see a political initiative or imperative for what it is. They know the difference between a short-term objective for electoral reasons and a long-term objective with more altruistic motives. They are also pretty adept at sorting out management jargon and sloganising. They need real and tangible prospects, with proper resources and genuine intent.

My simple message to those who think they have heard it all before is to grab the opportunities that come your way. Take Lord Darzi's interim report Our NHS, Our Future. Of course, it is designed to mark next year's 60th anniversary of the NHS with something meaningful. And, of course, it will enter the political arena. Right or wrong, that is the nature of the NHS and public service.

Getting started

But critical faculty apart, what can we usefully take from this initiative? What words can we turn into action? For a start, Lord Darzi wants the NHS to be 'fair, personalised, effective, safe and locally-accountable'. 

We can work towards that. Fairness is about availability, and at East Lancashire primary care trust, we are well down the track with a programme aimed at making a serious impact on health inequalities over the next three years. It is ambitious, but we have set a target of saving one million years of life for local residents, in a bid to stop people dying before their time. NHS chief executive David Nicholson even launched our health summit, so there will be no back-sliding on this one.

A personalised NHS? That is about the needs and expectations of individuals, especially the vulnerable and those in greatest need. It is also about choice and access and initiatives such as the expert patient programme. So far, nearly 500 people have benefited from this inEast Lancashireand there are more in the pipeline.

An effective and safe NHS? Well for starters, there is lots being done around the issue of MRSA and Clostridium difficile, with steps taken to beat them in hospital and community settings.

But how do we go about the general task of delivering the best, most effective and safest outcomes for our patients? I think we should work on the fundamentals of care, the essence of care itself. It is about empowering our frontline health professionals and their line managers to reinforce the basic principles in which they were trained - the principles of applying tender loving care, maintaining the highest professional standards and using an approach that looks at the whole person.

For our part, we are putting our money where our mouth is by investing an extra £2.5m in frontline services, with substantial increases in resources, staffing and training over the next two to three years. 

That is the beauty of being in financial balance, having good staff, good information, and a firm strategic vision. New initiatives may sometimes appear to be just words, but they can be turned into action.