In this final article for the #Transformation2019 series, Sue James shares her thoughts on what the game changers for hospitals and leadership will be in the next five years

Chess pieces

Chessboard and chess pieces

There are three more points I’d like to make to complete my series on the transformation challenge in the five years ahead.

Understand the gap

To successfully transform, we need a clear understanding of the affordability gap between unmitigated demand and the funds that will be available. The better care fund might be a major disruptive change agent, but trusts – and in particular clinical leaders – need to believe that the money won’t be there to continue to support the status quo.

At present, I don’t think anyone really believes the changes will happen because there are no lived examples. Understanding the gap will change the game.

Adopt IT

IT will also be a game changer once we can share data much more effectively, both within a health system and across systems. This will make it much easier to coordinate care and to deliver care remotely, thus enabling levels of partnership working that have been impossible in the past. Telehealth and integrated communication and information systems will change the game.

Quality and financial sustainability

Eradicating unwarranted clinical variation is the next driver for quality and cost improvement. We are only in the foothills of this opportunity, but it must be led by clinicians, and delivered to improve safety and reliability, with cost reductions dropping out as a by-product.

I would like to know the reaction of others driving hospital transformation to these game changers and I look forward to the debate.

Sue James is chief executive of Derby Hospitals Foundation Trust

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