The must-read stories and debate in health policy and leadership.

Shock but no surprise

Sir Ron Kerr has presented the Department of Health and Social Care with a demanding to-do list.

The Empowering NHS Leaders to Lead report, which Jeremy Hunt commissioned from the former Guy’s and St Thomas’ Foundation Trust chief executive, made sobering reading. It highlighted how the insidious pressures of leading in the NHS have resulted in bullying and discrimination becoming commonplace and led to troubled trusts with huge leadership gaps.

Sir Ron, who has 30 years’ experience occupying NHS leadership roles, has now called upon the soon to be aligned NHS England and NHS Improvement to set expectations and create a new support package between local stakeholders and an incoming chief executive to combat what he described as “bad behaviours” from the centre.

The review also recommends “a number of actions to build a modern working culture in which all staff feel supported, valued and respected for what they do and can challenge without fear”, including establishing a “leadership workstream” in the NHS long-term plan.

The clock is already ticking. Sir Ron has sent DHSC a metaphorical calendar invite for a year’s time to review how the implementation of his recommendations is going. 

Simultaneously, Matt Hancock has joined a long line of health secretaries in saying he wants to recruit future NHS leaders from external sectors, such as the military and education.

But whether soldiers and teachers would want to join the NHS is another matter. An organisation that, as the NHS Providers survey quoted in Sir Ron’s review puts it, “remains quite good at exploiting the passions and commitments of those brave enough to try” might not be a “trailblazer’s” vocation of choice.

Deloitte’s delight

Things are moving fast in the land of NHS procurement.

Since Lord Carter’s 2016 report into hospital efficiency, the scrutiny applied to how the NHS buys its goods and services has intensified significantly.

Lord Carter’s report was followed by the DHSC’s procurement transformation programme, which has led to a (currently ongoing) reconfiguration of the NHS Supply Chain

Now, a second – potentially larger – shake-up is on its way, under the guise of an NHS Improvement programme, thus far named the “targeted operating model”.

This programme wants to make the NHS better at buying things not provided by NHS Supply Chain, such as goods and services related to non-clinical functions like estates, facilities, IT, legal, and other corporate bits and bobs.

It excludes the purchasing of agency staff and pharmacy products, but still covers a non-pay expenditure pool worth up to £20bn.

Somewhat inevitably – the news was met with a sigh by some trust procurement heads HSJ spoke to management consultants have been brought in to provide private sector expertise.

The NHS Supply Chain work has been heavily influenced by EY. Now, NHSI’s model will feature ideas from Deloitte, which saw off a handful of other consultancies to win a £400,000 contract.

They have until March to draw up a blueprint for the model. According to NHSI, trusts will also be involved in the model’s design and appraisal. 

If the proposals are approved, Deloitte can look forward to another 18 months or so of assisting with the model’s implementation.