Austerity, integration and transformation: people hold the key to NHS future

Austerity, integration and transformation: people hold the key to NHS future

As the NHS battles through what is set to be another challenging year – tackling the hurdles of a general election and another spending review – the organisation’s staff and its ability to build strong senior leadership will be at the heart of its response.

In recent years, the NHS has had to weather a perfect storm of budget cuts, an ageing and growing demographic and intense public scrutiny. As a result, resilience levels have been severely tested, which has left gaps in executive board positions.

No doubt, this will have significant ramifications for staff morale, financial performance, strategic direction and, most importantly, patient care. These factors have made the challenge all the more demanding, but also mean that the need to address boardroom structure and talent is an imperative.

At its core, NHS leadership teams face three significant tests in 2015 with austerity, integration and transformation leading the agenda.

Primarily, and no doubt the most well-known, is plugging the £22bn funding shortfall and respond to budget challenges. NHS Chief Executive Simon Stevens has the task of delivering his Five Year Forward View, which will entail extremely difficult choices for the future of UK healthcare provision.

The issue is further complicated by the lack of visibility over future policy as battle lines are drawn ahead of a highly uncertain election in May. Even now, following the Chancellor’s Autumn Statement that pledged over £8bn, NHS Trusts from across the country still require urgent financial support to ‘balance the books’.

Strong leadership is vital to any strategy to cut costs and achieve productivity gains. There are some extremely talented individuals in the public and private sector that can help steer an organisation in the right direction and get the NHS ‘back in the black’.

However, the challenges are not purely financial. The integration of health and social care is also dominating headlines. While the issue has been on the radar for some time, given the nation’s rapidly aging demographic, the pressure on A&E wards – exacerbated by cuts to social care funding – is becoming untenable.

Healthcare charity The King’s Fund is a leading voice on integration. In essence, the fund’s approach is focused on fostering collaborative leadership. It recognises senior executives as the most positive agents for change. The organisation is encouraging new strategies and tools to help leadership teams to better encourage the evolution of healthcare and integrate services.

With budget decisions now being made on a collective basis among health economies and managed by health professionals, support will be in desperate demand when managing and implementing this transformation. This possibly presents possibly the greatest challenge faced by the NHS.

Therefore, protecting existing expertise and bringing in the right skills in senior positions will be fundamental to the development of healthcare services over the next five years, particularly at such an  important and uncertain time in the NHS’s history.

It will be senior leadership that has to show the way as public healthcare evolves, but also provide much-needed direction and support to the army of committed frontline staff that make the NHS a national treasure.


Jon Hather at 03/02/2015 13:46 said:

As a senior executive who has recently left a large private provider of nursing homes and mental hospitals I agree with your comments above. However it is difficult to overestimate the divide that still exists between public and private provision and this is a big stumbling block to someone like myself who would like interim management work in the NHS

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