Sir David Dalton has said the Carter review’s efficiency recommendations for providers will only take the sector ‘so far’. Providers should form groups in some areas to reduce variation in quality.
The chief executive of Salford Royal Foundation Trust said Lord Carter’s review offered NHS providers solutions to “do better what we do now”, but “a new approach is required” to ensure the sector provides quality care in future.
Sir David said: “The NHS must test the proof of concept [and] take the risk, if we are to have a reliable, sustainable and affordable NHS.”
Sir David published his own review looking at new options for NHS providers in December.
He recommended that the “multi-service chain or foundation group” model could be adopted.
This organisational form differs to a traditional merger because it has a separate “group” with a headquarters that sets the governance, standards and procedures, and could have centralised procurement and back office functions.
Sir David has called for these groups to be formed in some areas to “test the benefits of standardisation delivered at scale”.
He added that this should take place “the sooner the better… a number of us are raring to go and we have got some great ideas”.
Sir David said he “fully supports” the Carter review and believes it will make a “significant contribution to improving our productivity and efficiency”. However, he added: “If all we do is do better what we do now, then we will not be in the place that we need to be. That is why I believe a new approach is required to sit alongside and to add to the existing models of organisational delivery.”
Sir David added that industry would be more likely to work with a group to form “long term strategic partnerships”. He said patients could then benefit through the use of new technologies at scale.
The current number of NHS provider organisations is “no longer a sensible and affordable way of organising the delivery of reliable NHS care at lower cost”, Sir David said.
Six trusts could sit within a geographic group and deliver clinical services to a population of up to 2 million that are “consistent with the new care models”, he added.
He said while groups will not provide the solution in all areas, their contribution should be “tested and supported to test the benefits of standardisation delivered at scale”.
Sir David said: “Standardisation is going to be the way of the future. That’s how we deliver high quality care at lower cost. It is easier to do that across a group structure because there are lower costs through taking the waste out of variable clinical practice at scale, innovative ways of matching staff skills and numbers to patient dependency in real time, and in consolidating back office and clinical support functions.”
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