Published: 09/12/2004, Volume II4, No. 5935 Page 9
NHS chief executive Sir Nigel Crisp has brought together 100 key NHS stakeholders to establish a new collective vision to prevent the service from 'splintering' when payment by results and patient choice kicks in.
Speaking to HSJ after launching his end-of-year report to the national press, Sir Nigel revealed that stakeholders were meeting in London this week to ensure the survival of long-term relationships.
'What I want to get out of [this meeting] is a sense that, while people have their individual roles at a trust or primary care trust, actually There is a lot that still binds us, ' he said. 'The purpose of this meeting is to say, as we go into this next stage, what do we want to do together?
What are the things that will keep us together?' He went on: 'One of my worries is the NHS will splinter. So you have the foundation trusts over here, saying things in your magazine at various times, and you could get to a system where PCTs are attacking foundation trusts, and it could go to mental health trusts taking another position. So It is terribly important that as we go through these changes we keep the NHS together.'
Sir Nigel said that it was time to update the collective vision established by the Modernisation Board when the NHS plan was written four years ago.
'There is a management guru at Harvard called John Cotter who talks about managing change and having a guiding coalition, and to have that you have to bring the stakeholders together, then come up with a shared vision, ' he said.
'We had that when we put together the NHS plan with the modernisation board. What we need now is a new guiding coalition that includes the new players that were not around four years ago.' Last week he used his report to acknowledge the scale of reform that has been expected of the service in 2004 - from the introduction of the first foundation trusts at the beginning of the year to December's starting pistol for national Agenda for Change roll-out.
Looking ahead to 2005, Sir Nigel told HSJ that managers needed to see IT as their most important challenge: 'The people who will be best positioned over the next two-and-a -half to four years are the people who take IT seriously.
'We are getting to the stage where IT is going to make a difference.
People are going to have choice, We are going to have electronic booking. Hospitals that represent themselves best, those that gain better efficiency gains will be those with the best IT systems. So if I was advising individual chief executives, the thing that would have the most long-term impact next year is focusing on building IT infrastructure.' Although he emphasised the continuing progress towards decentralising control, he acknowledged that 2005, as a likely election year, will mean more political pressure.
'What we need to do as people leading the NHS is keep our minds on the job, do the job well and keep away from political issues as much as we can, ' he advised. 'But I think it also means we need to be quite vigilant over this period to think about things that might get us into trouble, if you like - things that perhaps in previous elections became the big issue. People might want to think about how they manage to avoid that happening.' However, despite potential shortterm discomfort, Sir Nigel says managers need to remember what a 'fantastic' time it is to be in the NHS with sustained investment.
'What's on my mind now is that in four years' time we will come to the end of this period of big increases in funding. The thing I am saying to managers is, this is a fantastic time to be in the NHS with all this extra money.
'Our predecessors would envy the chances We have got, and our successors in the future will actually say: 'what did you do with it?' That is the real challenge to managers: in 2008 we need to show we have made real progress.
'So we need to keep this gear up.
Although We are doing very well, we need to keep a sense of urgency, and keep up the pace.'
Among this year's achievements. . .
A 12 per cent reduction in the number of patients on the waiting list: a 35 per cent drop from its peak six-and-a-half years ago.
Waiting times have fallen across the board.
Delayed discharges from hospitals are down by more than a third this year - 36 per cent.
The NHS is getting more efficient - productivity is rising and better purchasing deals on drugs and IT are saving the NHS millions of pounds.
Patient satisfaction levels are high.
The NHS has a new focus on health promotion and improvement - death rates from cancer have fallen by more than 12 per cent in the last six years and from coronary heart disease by more than 27 per cent from 1995-1997 and 2001-03.
www. dh. gov. uk
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