NHS urged to take risks in care overhaul

Chris Smyth in The Times 12th April 2014 reports: NHS urged to take risks in care overhaul

See NHS PLC – I have seen it all now. Rationing by risk taking and further obfuscation. Should we all be taking the same risks, or will each Post Code take different risks?

Hospitals must set up chains and franchises or take over social care services even if means taking “controlled risks” with finances and care, the NHS economic regulator has urged.

Monitor said that bosses must “turbo-charge” efforts to change because the NHS needed “nothing short of a complete redesign of how care is delivered in England.” The call comes after Simon Stevens, chief executive of NHS England, used his first speech after taking over this month to urge the health service to abandon received wisdom and experiment with new ways of organising care.

David Bennett, chief executive of Monitor, which oversees competition and the finances of top hospitals, said: “If the NHS is to continue to deliver the universal health service to which we are all committed it needs to turbo-charge changes in the way health care is delivered to patients.

“In the short term that means improving quality and efficiency across the board so that all providers meet the standards of the best. And in the medium term it means redesigning how care is delivered, including inventing new models of care, so that we can provide quality care, with compassion, and make the money available to the NHS go as far as possible.”

Hospitals must not let fear of failure dissuade them from trying out new ideas, Monitor said, promising to do more to help them manage the risks of things going wrong. Setting out a fresh approach, it calls on hospitals to plan to mitigate risks rather than using them as an excuse to carry on with business as usual.

“If we do not allow them to take controlled risks then we could obstruct the innovation and change that the sector needs, leading to much greater long-run risks for the sector as a whole. However, this in turn means we must all accept that, from time to time, some provider organisations in some localities may fail,” its strategy document says.

The regulator said changes would be up to local health chiefs but said it would be “looking at a range of existing and new approaches such as merger or acquisition, clinical partnerships, joint ventures, provider chains and the use of management contracts or franchise arrangements to realise economies of scale, to improve the spread of best practice and to maximise the utilisation of our most talented leaders.”

Matt Tee, chief operating officer of the NHS Confederation, said: “Provided that regulators such as Monitor are willing to support organisations before they reach a crisis, we will have a better chance of rising to the challenges facing the whole system.”

Yesterday Sir Malcolm Grant, chairman of NHS England, warned that the family doctor system was “seriously fragmented” as he signalled a shift away from single-handed GPs. He told the Association of the British Pharmaceutical Industry annual conference that GPs should merge, federate and create “sets of chambers almost like barristers” into order to take more “collective responsibility for the health of the population”.

See NHS Plc: The Privatisation of Our Health Care Allyson M Pollock [2005]

and the Nhsreality books….risk

This entry was posted in A Personal View, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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