• Sir Jim Mackey says he can’t explain system working to staff as they have other pressing concerns
  • Warns regional plans could be seen as “accountability avoidance measure”
  • Adds leaders should be “upfront… when it’s better to do our own thing”

The former NHS Improvement chief executive has said he cannot explain system working to staff as they “don’t care” and are more concerned about whether they have “enough colleagues to get through the workload of the day”.

Sir Jim Mackey, chief executive of Northumbria Healthcare Foundation Trust, said: “I can’t explain [what we mean by systems] to staff because they don’t care. They are bothered about, do they have enough colleagues to get through the workload of the day in a reasonable standard?”

Speaking at a Westminster Health Forum event in London on Thursday, he also said the NHS needs to “be upfront about when it’s counterproductive to do something together [for example, through a system] and when it’s better to do our own thing”.

He said: “The system stuff felt all along, since I was at NHSI [from 2015-17], like we were trying to find something to replace strategic health authorities and a way of airbrushing over the 2012 [Health and Social Care] Act without needing to change the law [and] making people go through contortions that were very difficult in very troubled places.”

Sir Jim stressed to delegates that NHS leaders need to remember “what we’re actually here for”. “When I’m being a system leader, I have to remind myself I’m legally responsible for my institution,” he said.

He said regional plans could be seen as an “accountability avoidance measure” to “avoid the fact we’ve got a service under stress and patients getting a bad experience”.

Sir Jim said last year his trust embarked on a staff happiness programme, which revealed the biggest thing was a “sense of belonging and feeling safe in an environment”.

“People are worried services will get closed or rationalised, or moved to work from there to somewhere over there,” he said.

In relation to the NHS long-term plan, published in January, Sir Jim said it was “not a plan, just a high-level description of something we want to achieve”. “Hopefully in this next phase, let’s get some ambition again,” he added.

He said it was too late for any current interventions to make a difference to winter pressures this year. “It’s just about managing,” he said. “The planning for this winter [if it were to be in time to have an effect] was two winters ago.”