People often say that “you had to be there” to appreciate a really good event. And it’s tempting to say the same of the Foundation Trust Network’s first annual conference in Liverpool. But while all those on the ground listened to some great speakers, wandered around the exhibition, and networked like mad, there was a parallel conference going on in the ether.
Tweeters and bloggers beamed out the messages far beyond the shores of the Mersey and the networking was almost as intense as the chatter on the ground. Looking back on some of the tweets and blogs gives a flavour and a glimpse into some of the knotty and complex themes debated and unpicked at the conference - #ftn2012.
One theme to emerge was how delivering high quality patient centred care has to sit at the heart of all that the Foundation Trust movement does. Three priorities were identified here:
- Ara Darzi’s dictum that we need to make quality the key organising principle of how we run the NHS. How far have we really got with this?
- Breaking the logjam around ensuring patient feedback gains traction as a means of driving improved care. Are we doing enough here?
- Ensuring our culture, systems and processes reflect the fact that we operate in a safety critical industry. Are we doing as well others who operate in similar “safety critical” sectors?
I was struck by the overwhelming need to do things differently if the NHS is to meet the significant challenges it faces. And that the FT movement, with its freedoms and relative sense of stability compared to the rest of the service, is in pole position to drive the innovation required. This will require a greater degree of risk and a willingness to embrace disruptive change than all of us will feel instinctively comfortable with…particularly in a safety critical industry.
One of the themes I personally stressed was the importance of celebrating success - particularly when it involves innovative approaches, is driven by front line staff and improves the quality of patient care. I deliberately made one such story the centre piece of my speech - you can read it here.
The ever perceptive Paul Corrigan, in his blog from the conference, highlighted what he saw as the surprising reticence of the Foundation Trust movement to really take advantage of the freedoms FTs have been given. In his words “One of the main questions asked about NHS architecture, post the creation of the first FT in 2004, has been why FTs have not all been much more separate from the NHS hierarchy. Throughout the period Strategic Health Authorities have usually been trying to tell FTs how to operate as a part of the wider NHS - and sometimes that has been intrusive. Why haven’t more FTs told SHAs where to get off?”
He speculated that the reasons for this included a lack of trust that these new freedoms are permanent and that at some date in the near future, they will be taken back and retribution for any overly independent behaviour will take place. He pointed to this as an important example of how strong the dominant NHS culture really is. But, in his words, there was a law which changed the ownership of FTs and it was passed. For eight years FTs have had experience of being a different legal entity. The model has worked. There was no debate in the recent Health and Social Care Act about abolishing FTs. In fact, far from it, the Government has decided that all NHS Trusts should reach foundation status as quickly as possible.
In the words of Earl Howe, the Minister responsible for NHS providers, in his speech to the conference: “[The Government] wants strong, autonomous foundation trust boards that take responsibility for delivering change … There is always going to be a balancing act between the powers of the centre and the autonomy of local providers and commissioners. But this Government’s instincts are to decentralise. And we now have the Health Act to underpin those instincts”
Earl Howe’s and Paul Corrigan’s challenge to the FT movement to grow into and use the freedoms to deliver the change the NHS needs is well made and one that we need to rise to.