Farrar calls for 10-year plan for NHS

The NHS Confederation chief executive said the sustained issues with A&E must be “the wake-up call of all wake-up calls” after “successive governments” ignored pleas from NHS chiefs for substantial changes in the way services are delivered.

Mr Farrar said: “This is really the wake-up call of all wake-up calls in terms of action.

“My view is that we were not listened to [by successive governments]. My view now is that we simply can’t be ignored.”   

He set out a four-point strategy which he said should underpin a 10-year strategy for the NHS.

He said changes to overall strategy, financial incentives, culture and leadership would all be required to support the action required to deliver a “bright, sustainable NHS”.

While policy makers have talked about putting more money into primary, community and social care services for a number of years, he said the rhetoric had not been matched by action.

He also suggested changes to staff management to make sure that troubled trusts were given access to the brightest managers.

“We have a very laissez-faire approach to the way in which our workforce is distributed so people go to where they want to work. In the main, people don’t want to go and work at [failing organisations],” he said.

He cited a system used in American football whereby the teams that finish bottoms of the leagues get “the first choice of the new talent”.

“That is something to think about. If we are serious about sorting out some of our problems where we have failing systems, what are we actually doing to deploy our resource to try and tackle that. Shouldn’t that be part of the design of the way our processes work,” he added. 

Mr Farrar, a potential contender for the vacant NHS England chief executive’s role, said the “greatest” recommendation in Robert Francis QC’s report on Mid Staffordshire was the call for greater openness and transparency.

He said: “Transparency is a great friend to the service but…it will expose variation. We have not told people about that. We know variation because we see variation. There is a risk that [people will say the variation] is about bad management.”

However, he added that the variations exposed by greater transparency would do to make the case for “reconfiguration and improvements of care than years and years of consultation”.

Mr Farrar called for a “brave” style of leadership built within the NHS but he did not directly address the issue of Mr Francis’ desire to introduce criminal sanctions in cases of serious patient neglect.