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In the words of Oliver Cromwell: Keep your powder dry...

2 November 2016

The STP process is an NHS initiative to address a challenge which it seems the NHS cannot solve – it is like driving a car whilst the wheels are falling off.

I have read one of the documents from cover to cover – it seems to me that this is a case of musical chairs – shifting the decks to solve an unsolvable problem given the money is running out and the financial challenge is becoming more intense and the pressure is gaining momentum – indeed, next year and the year following that will be even more challenging given the pension black-hole which needs to be funded and the flat-line in funding.

Call me a pessimist, but I don’t think this is going to work.

It is all a bit like Swiss cheese.

As with all complex organisational reform where context and form are being reviewed and overhauled, people are key in driving that agenda forward.

Given the capacity issues within the system and the need for experienced people to deliver the transformation agenda on top of their already burgeoning portfolio’s, there absolutely will be a need for experienced interim managers to work alongside NHS colleagues to drive the change the system is embarking upon.

It therefore begs the question, given the above, why NHSI would send out their latest letter to Chiefs, Chairs and Directors of Finance urging them to curb spending on interim resource.  With further rigour being applied and new controls being introduced almost daily on how to restrict the introduction of interims to NHS organisations with the edict that NHS organisations “should be aiming to radically reduce and ideally eliminate reliance of agency managerial staff and use interim NHS solutions”.

However…, having stated the above, NHSI are certainly not saying that interim managers cannot be used, they are merely introducing ‘rigour’.  Is this burdensome – time will only tell – I suspect there is very little change from the last 12 months.  Organisations still have the freedom to appoint interims, but if the daily rate exceeds that of £750 per day then a business case is required.  A business case was always required wasn’t it?

Perhaps the opportunity for Board colleagues to seriously reflect on ‘the need’ for an interim will prove positive for both the organisation and the individual given scope of delivery and outcomes are clearly defined and outputs can be measured against the business planning process.

Keep your powder dry – NHSI are not saying organisations cannot procure, they are merely stating that a non-verbose and clearly constructed business case should be produced before very senior managers are appointed on an interim basis. 

I haven’t seen a weakening interim market and I personally see this as an opportunity to work even more closely aligned with my clients in supporting them to achieve their organisational goals by constructing a solid business case in partnership and it is this partnership working that will set me apart from the competition.

Sarah Lovell, Partner

Sarah Lovell is a Partner in the Healthcare Practice, read Sarah's profile.

Categories: Healthcare


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