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2016 all change...or is it ?
Recommendations, Junior Doctors strikes & contracts, mental health overhaul and care revolutions; all have been big headlines in the NHS this month. We’ve also had more scrutiny of the NHS’ finances and targets – oh and did I mention that the new ‘NHS Improvement’ senior management team has also been revealed?
Following his independent review, Lord Carter has now published 15 recommendations to help improve operational productivity and performance in the acute hospital sector. The focus is of course all about value for money against annual budgets, which could save a healthy (no pun intended…) £5bn a year by 2020. Recommendations of note include better use of clinical staff & rostering, reducing spend on front line agency staff and tackling high levels of absenteeism. There is also a focus on improving ‘poor’ and ‘average’ performance across the service through effective leadership and a ‘best practice’ approach to management.
NHS Procurement has long been seen as ‘low hanging fruit’ for making significant cost savings. An institution the size of the NHS ought to wield enormous buying power in the market, but successive leadership regimes (both at NHS and Government level) have failed to harness it; Lord Carter’s recommendations seek to address this. Transparent procurement measures will now come to the fore, with the monthly publication of the 100 items ‘most bought’ by the NHS. The deployment of staff is another key area of focus, as is use of floor space, the impact of delayed transfers of care and an increase in working and learning from other neighbouring hospitals – sharing resources and services to improve efficiencies and reduce costs.
It goes without saying that this does take time, but the ‘mood music’ coming from Government is that the status quo is no longer acceptable or even viable in the medium-to-long term. The NHS will need to embrace the efficiencies, as this will ultimately make operational productivity, performance and finances head in to the right direction. Collaboration and staff engagement is paramount and of course support at a national, central level is essential. That said, without the right people in the right places, delivering these crucial reforms to reach the £5bn savings target will be very difficult indeed.
Demand for staff, both interim and permanent, remains consistently high across the board in the NHS, albeit with the government’s rate caps adding an extra layer of complexity. Whilst demand is high, Trusts are finding their hands tied in many instances; they are unable to make key appointments due to top-down cost controls. From the Board to the ward, the challenges at hand are so vast, it is easy to see why interim resource is constantly needed. There has also been a notable increase in senior managers looking to become interim managers - individuals are increasingly considering the ‘portfolio career’, as this enables them to apply their considerable skills to a variety of organisations, making a difference at rapid pace.
It is a shame for the NHS that despite the fact that interim resource continues to be needed, the system has been publicly slammed many a time because of the cost of an individual interim manager, or a few isolated cases of overpaid interims and/or consultants. Of course, many interims are tasked with saving their client Trusts a vast amount of money, and are able to save amounts which far exceed their own cost to the organisation. However a high daily rate makes an excellent headline, and rates paid to senior interims have now also become conflated with nursing and locum spend, which only muddies the waters further. Despite this, we must focus on the positives - clients who understand the value of using interim managers appropriately will continue to reap the rewards which come from a short-term injection of high-level experience & expertise, and Odgers Interim remains uniquely positioned to provide this.