Having gone through several years of year on year increases in funding, the NHS is now facing a period where for the foreseeable future funding in real terms is likely to fall.
At the same time there is greater demand for services through a combination of longer life expectancy and people generally being more conscious about their own health and well being.
Recent reports from organisations like Dr Foster indicate that in many parts of the country hospitals are running at a level that makes providing the quality of care that we expect even more challenging.
Against this backdrop of reduced funding and rising demand, what big decisions do leaders in the NHS need to take?
What Can Be Provided With The Resources Available
Yes in the ideal world, the NHS would be able to provide every single service free at the point of the delivery. At the same time most would recognise that this is becoming more and more difficult to do. It would be hugely challenging to decide one priority over the other without doubt.
However, if clinical professionals were at the heart of these decision making processes it would make it much easier to make progress. By that I mean clinical professionals from all parts of the healthcare system sitting down and working out priorities.
What Changes Can Be Made To Make Out Of Hospital Provision A Reality
This has been talked about for close to 10 years now and in reality progress has been really slow. Talking and tinkering at the edges helps but perhaps we are at the point where we need to think far more radically about the way services are set up, organised and staffed throughout the day and night.
With a huge increase in day case activity for surgical procedures, the best return may well come from focusing on care of the elderly.
What Kind Of Skills Are Going To Be Needed
The NHS has an abundance of people who are brilliant in their field of expertise and that will continue. The NHS Leadership Academy is making a significant investment in developing leaders. Part of that is a focus on collaborating.
A real good look at the skills needed not just to deliver great services at present but for the future is vitally important.
How Do We Get Different Groups Of Staff To Recognise The Contribution Of Each Other And Utilise Strengths
The common rhetoric is that all those not in the front line care delivery are unnecessary overhead.
On the other hand without these people no member of staff gets paid, no supplies are available to provide patient care, theatre lists don’t get organised, appointments don’t get made and much more.
The reality is that without people doing all of the activities that support patient care, vital clinical time would be spent doing non clinical activities and impact on the service provision.
How Do We Make Sure We Never Lose Sight Of Our Core Purpose
The Francis report into Mid Staffordshire NHS Foundation Trust shows what happens when organisations lose sight of the core purpose of serving patients.
The Bottom Line: Leading in the NHS is a really tough role, What big decisions do you think the NHS needs to take?
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