The Keogh review published last month highlighted issues in 14 Trusts that had higher than expected mortality. While the review may well have focused on certain trusts, there were many leadership lessons too.
Lesson 1: Resources Need To Be Used Appropriately
One of the issues highlighted in the review was that the performance of majority of the trusts was much worse than expected for their emergency patients, with admissions at the weekend and at night particularly problematic.
As people who work in the service know, hospitals are in effect only operating with full staffing during the hours of 8am to 6pm.
What this means is that there is a huge amount of pressure on less experienced staff for 12 hours plus each day during the week and longer at weekends.
To change this will require a very different approach to hours of work and realistically is only something that can be tackled on a national basis.
Lesson 2: The Culture Needs To Be Supportive
Complaints are a form of feedback and should be welcomed. At the same time if the culture is not supportive and sees complaints as a basis for improvement, then nothing changes.
Lesson 3: Workforce Needs A Much Greater Focus
I was personally saddened to see that a lot of the hospitals were still hugely reliant on temporary staff. Having worked in a Trust in the past where there was significant reliance on temporary staff from 2001 to 2005, it is sad to read that little progress appears to have been made in strategic workforce planning.
Lesson 4: Whole Health Economies Need To Collaborate To Address Capacity Issues
Rightly or wrongly A&E becomes the default when other services are not available. With an ageing population this issue is not going to disappear. While there might be challenges and structural issues that get in the way, ultimately there is only one patient. If different parts of the health economy collaborate and innovate there is more likelihood of getting the best outcome for patients.
The Bottom Line: While Keogh may well have focused on 14 Trusts, there are many lessons for leaders across the NHS.
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