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New NHS boss warns that health service is facing its biggest challenge

1 April 2014

Simon Stevens is giving us the first glimpse of what he wants to do as the new chief executive of the NHS today. In a speech in Newcastle, he will warn that the service is facing its biggest challenge, and that a radical transformation of care is needed. Stevens will say:

‘I know that for the NHS the stakes have never been higher. Service pressures are intensifying and longstanding problems are not going to disappear overnight.’

So what are the radical changes that Stevens wants to set about working on? In this week’s Spectator, former Labour adviser John McTernan profiles the new NHS boss, and explains what this radical reformer wants to do with the health service. He writes:-

Stevens set out his vision for the NHS in an essay for a pamphlet published by the think-tank Reform. The current management fad for running the entire NHS as if it were ‘one big hospital’ is doomed, he says. To avoid a crisis, the NHS needs ‘political stewardship, managerial execution, clinical engagement, and public communication’.

He is scathing about the way that almost all NHS reorganisations focus on ‘rearranging the administrative deckchairs’ rather than transforming patient care. As he puts it: ‘How can a quarter of NHS trusts get away with having their “value for money” accounts qualified by their auditors? How can a fifth of hospitals treat their older patients without dignity or compassion? And how is it that a single hospital in mid-Staffordshire could have been responsible for killing its patients at a level equivalent to two or more Lockerbie air crashes, yet apparently no one noticed or did anything?’

Stevens’s passion is transparency. He wants patients to have access to the same knowledge as their doctors. At UnitedHealth, he developed a system for ranking 250,000 doctors against national standards of care, and then ranking them again on value for money. This meant, in effect, listing the best doctors by price. Such transparency makes NHS bureaucrats recoil in horror — but it works. This system, applied to organ transplants, has led to a 5 per cent improvement in outcomes — and halved costs. As he puts it: a good health system requires transparency, the sharing of data and empowered patients.

This agenda — better outcomes at half the price — has an obvious appeal for an NHS operating against a backdrop of austerity. It goes hand in hand with moving services out of hospitals and into communities.

You can read the full piece here.

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Show comments
  • startledcod

    The NHS is too big, R(Regional)HSs would be much better. Postcode lotteries are a good thing as they encourage comparison and competition.

    Reform, especially that which delivers value for money, is almost impossible as there is no driver or impetus for reform amongst the majority of NHS staff.

  • Holly

    ‘Health service facing it’s biggest challenge’….

    Bloody patients!
    How very dare they keep using it, in ever increasing numbers?

  • Alexsandr

    we need to move away from the hospital mentality. As much care as possible should be at home or in the community. Get the consultants to see patients close to home rather than in a hospital, perhaps borrowing a room in a GP surgery for odd sessions.
    Many old people get carted to A+E because that’s what ambulance crews have been trained to do. But A+E is a bad environment for old people – if possible they should be kept at home. (To be fair this happens already to some extent)
    Smaller A+E units should stop doing the serious cases. They don’t have the resources or experience to deal with them. Patients would have a better outcome in a unit that sees their conditions more often
    The GP service needs radical reform. It should be the first point of call except for the very serious cases (That still go to A+E) Too many end up in A+E because the GP service is poor, especially out of hours. And is inflexible for those who work away from home.
    And too many nurses are clerks, not nursing. or doing simple checks that could be done by anyone, like recording a patients weight.

    • telemachus

      “we need to move away from the hospital mentality. As much care as possible should be at home or in the community”
      This is Andy Burnham’s vision
      He will begin to deliver next year

      • Nicholas chuzzlewit

        On his paper round. And he will make a mess of that as well.

      • Alexsandr

        Andy Burnham should not be allowed anywhere near healthcare because of his negligence over Stafford.

    • HookesLaw

      That is what is happening. That was the point of the govt reforms. There is a move to larger ‘trauma unit’ A&Es.
      The political problem comes when you lose hospital beds and then start to close hospitals.

  • Kitty MLB

    I am waiting for the all knowing sage named Telemachus, to turn up
    and say we are only safe in the sainted hands of Andy Burnham and
    that the NHS is ‘ our NHS’ he means Labours property and not the property
    of those it cares for.

    • Holly

      The NHS is OURS.
      WE fund it, WE work in it, and WE use it.
      Labour have no claim over it whatsoever.
      When they thought they did, they killed people, through neglect, cruelty and total ineptitude.
      Burnham or Labour should be allowed anywhere near it.

  • Colonel Mustard

    Labour and their Borg army are in denial about the NHS as their perennial troll demonstrates whenever this subject comes up.

    • Andy

      The little Fascist isn’t here yet !

      • Kitty MLB

        Who is that man in the picture above being resuscitated,
        that we cannot see… maybe a little well known socialist, you never know.

        • telemachus

          qv Neil Kinnock

          • Kitty MLB

            Not Andy Burnham ? what a shame.
            It might be Ed Balls, all round and red faced looking
            as if he is about to explode…and things are not too
            good between him and Milipede.

            • anyfool

              Its actually Labour trying to bring its corpse back to life.

              It only has the NHS to go to the country on, the bloated body of the NHS is on the trolley and this new angle by Simon Stevens is part of its desperation to raise the dead.

  • DavidL

    Stevens is right. Poor quality and patient care cost money. I wish him success. But he will struggle to get to grips with the NHS professional lobbies’ inbuilt resistance to change and local hospitals’ “not invented here” syndrome.

  • Kitty MLB

    The NHS is the largest employer for the Labour Party and it shows,
    which is why they were against Andrew Lansley’s much needed health reforms
    and Cameron proved himself to be a coward and disloyal to a minister who had the best interests of the NHS as heart. Its not a sacred cow, but the nations main health provider. You mention the elderly, it should be a case of are they and us safe in their hands. I know we have some very good hospitals, but as we know ,if we have a
    bad one then people will die. And the elderly are treated worse then in a third world
    country at times. The new boss must realise, its about patient care and not those the NHS employ.

    • Mynydd

      Your employer doesn’t dictate who you vote for, at least not in this country. I would remind you that GP doctors are self employed, also many hospital doctors and consultant have private clients, so I doubt that these groups vote Labour.
      During their period in office Labour introduced health reforms including the requirement to save some £20bn. They also replaced Victorian hospitals with modern hospital equipment with the latest technology.
      Having promised no more top-down reorganisation, the first thing Mr Cameron did was to start a top-down reorganisation at the cost of £3bn, even when he was told the reforms he wanted could be achieved using the existing structure
      On a personal note; I am an elderly type 1 diabetic since 1980, and have received nothing but first-class care, and this goes for the cancer treatment my father, mother and brother received. One should assess the NHS on the care you and your family receive rather than by Mr Cameron/Hunt’s propaganda.
      Finally with respect to third world countries, if you knew what the medical facilities were in these countries you would not make such a statement. I know having worked in Africa and around the world.

      • HookesLaw

        The 20 billion savings only appeared in the 2010 manifesto – they never talked about it in office. I have to ask – if the money is there to be saved then why was it spent in the first place.

        The fact is that the NHS faces its current problems because Labour wasted money on it by inefficient spending – but hey that made it look good in winning 2 further elections.
        Now, lying deceitful hypocritical Labour moan about the consequences of making savings which they admitted in 2010 are needed.

    • HookesLaw

      No Cameron stayed loyal to Lansley who did not argue his case very well. And remember that the govt is a coalition.

      • Kitty MLB

        Well I apologise then, I was not aware of that.
        Andrew Lansley was an excellent chap who really cared about the NHS but unfortunately he could not sell water heat wave and others
        took advantage.

  • sir_graphus

    It doesn’t seem to matter how much money the NHS gets, someone will always claim it is on the brink of collapse unless it gets more.

    • telemachus

      Not the party of reason

      The coalition made the mistake of ringfencing the budget then imposing an expensive orgnisation

      First get rid of expensive private healthcare from provision

      “In my view, the market is not the answer to 21st century healthcare. The demands of 21st century care require integration, markets deliver fragmentation”

      Second apply vision to the changing age demograpohic that has so distorted health funding

      “The exclusion of the social side of care from the NHS settlement explains why it has never been able to break out of a ‘treatment service’ mentality and truly embrace prevention. It is a medical model; patient-centred, not person-centred.

      But, in reality, it’s even worse than that.

      For 65 years, England has tried to meet one person’s needs not through two but three services: physical, through the mainstream NHS; mental, through a detached system on the fringes of the NHS; and social, through a means-tested and charged-for council service, that varies greatly from one area to the next.

      One person. Three care services.”

      Burnham has the vision to fix this

      • Nicholas chuzzlewit

        Burnham did not have the vision to prevent 1,200 needless deaths at Mid Staffs. Anybody with a scintilla of integrity would have resigned from politics completely but not Burnham. His sense of entitlement and the burning need to boss other people about and spend their money has ensured that this amoral waster is still an MP. Disgusting.

        • telemachus

          He began the process Chuz


          You clearly missed my pearls on the Esther thread


          I really cannot accept this malicious garbage you peddle about Andy just because you fear him because he is good
          You folks absolutely need to understand what has gone on here
          Universal free health, one of the great triumphs of our project had lost its way because of the age demographic and the march of medical technology

          Fowler, Clarke, Bottomley, Dorrell and their political masters had failed to understand this and the access to health and standards of care progressively fell

          As I have reminded you half of all patients died on cardiac waiting lists and elderly folks were racked in pain for five years before their new hips

          Gordon’s magnificent efforts began to reverse this and co-incident with this Andy recognised the need to drive up quality instituting inquiries and effective regulation

          Thank God he will be back

          • HookesLaw

            He brushed it under the carpet.

            • saffrin

              As the ward shower cubicle was already full with the cleaner’s buckets and stuff.

          • Colonel Mustard

            “The CQC is getting its house in order – ordering and publishing the inquiry, holding hands up, and clearing-out the bad apples on the board. By contrast, Labour has refused to account for Baroness Young’s allegations, refused to apologise for Labour’s cover-up culture, and has stubbornly opposed the Conservatives’ overhaul of their failed tick-box inspection regime. In fact, Andy Burnham derided the appointment of a powerful chief inspector with the authority and judgement to call out problems as ‘heavy-handed regulation’. He calls it ‘heavy-handed’; I call it ‘speaking truth to power’, and my constituents rue the day he stamped this out at a time when babies were dying at Morecambe Bay.”

          • Nicholas chuzzlewit

            Did the 1,200 deaths at Mid Staffs occur while Andy Burnham was Secretary of State for Health? Yes or No.

            • saffrin

              Did Andy Burnham order his staff to remove all reference to him regards the Staffordshire Hospital trust from wiki?
              Oh yes.

      • sir_graphus

        He didn’t have much vision, nor do much fixing last time. Has he got better or something?

      • HookesLaw

        Private healthcare is not expensive – it is efficient.
        Labour promised more use of private provision in the NHS in their 2010 manifesto.
        Burnham’s ‘vision’ is just gobbledegook.

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