NHS Chief Executive, David Nicholson

Two posts today, properly making up for that empty Monday,

During a speech to the recent Chief Professional Officers Conference, the Chief Executive of the NHS, David Nicholson, detailed the challenge facing the NHS in the coming months and years. Emphasising how far the NHS has come, especially in the last three to four years, David noted the rate of increase in public satisfaction with the service - an improvement rate of which, he said, many commercial organisations would be jealous!

His specific theme was co-operation. High Quality Care for All brought together all NHS staff under a clearly defined, and clinically led, concept of quality, he argued. The key to meeting the unprecedented challenge ahead - and this speech was a stirring call to begin to change the NHS culture to one which strongly aligns productivity with quality - is in different NHS teams working more closely and efficiently. He identified in particular primary and community care as instrumental in achieving this service-wide synergy.

“If you look at the evidence around about where the potential real productivity gains are,” he said, “they are actually at the interfaces of services. They’re at the link between self-care and primary care, primary care and secondary care, and between health care and social care. They’re the places where patients get the rawest deal - where they get the duplication.” Not coincidentally, he also pointed out that these areas are where NHS staff do “probably the majority” of their work!

Crucial to improving the efficiency of these interfaces - and in so doing reducing the amount of time patients, particularly those with longterm conditions, need to spend in hospital - will be local leadership. Identifying local challenges, and pushing through local solutions, is the best way for the NHS to transform to meet the quality and productivity challenges ahead. David said in his speech that he wouldn’t have chosen the huge scale of that challenge - but that the opportunity it presents to create the innovative, quality-centred, patient-focused NHS of the future is one that he relishes.