Leaders are already thinking about what their organisations must do to deliver the best possible health outcomes
In just two weeks, clinical commissioning groups take up their full responsibilities as we shift from a managerial to a clinical commissioning-led system for the NHS in England. While clinical commissioning may be on a developmental journey, as leaders we are already thinking about the skills we need to do the day job, some of the challenges we will face and how we can overcome them to make sure that our patients, our people and our practices deliver the best possible health outcomes for our area.
What are the skills we need?For me, they are about listening to our patients and population about what they want and how they want it. From that, we can understand our population's healthcare needs and develop our vision so we can see the future and how to set about achieving it. We also need to inspire the team so that we are helping others to give of their best, and to see how they can deliver "best". Communicating our values to all we work with is important as well as striving, unremittingly, to make it happen for our patients.
The challengesI don't want to downplay the challenges we face, but we must confront them if we are to change how things happen. For me, the priorities are:
• Persuading our clinicians and staff of the need to change their behaviours to focus on our population and patients
• Engaging with our population to accept that how they use the NHS will determine its future success in delivering the quality they seek
• Encouraging providers to transform and deliver efficiencies that both drive quality and improve working lives
• Re-modelling the NHS into an innovative "excellence generator" that automatically delivers patient-centred improved outcomes
• Achieving wide societal consensus on health and social care priorities, and engaging with the conversation about what the taxpayer should/shouldn't fund
• Making all of us hungry for change as the way we deliver great outcomes in a sustainable system
How will we meet the challenges?I recognise that it will take time, drive and commitment, but we must:
• Learn to communicate clearly, skillfully and unambiguously
• Develop our teams to have the skills they need
• Give our patients and population the stake in the system they need to understand their power and its relevance
• Work towards consensus through a "national health and social care conversation"
• Recognise the shared civic responsibility all citizens have to strive for a truly excellent healthcare system
• Rule 001: We include everyone – no one gets left behind.
How will we deliver?We have used education as the primary tool in Slough. We have worked with our specialists and patients to develop consensus across the clinical spectrum, developed new pathways and guidance, explained to our patients why this was of value, succeeded in changing the behaviour of GPs and other clinicians, and reduced referrals to secondary care from 25,000 to under 16,000 in three years. We have moved from 121st lowest referrer to tenth nationally in two years.
This is just the start, but we can do it and clinically-led commissioning can make the difference.
Dr Jim O'Donnell is chair of NHS Slough CCG and part of the NHS Clinical Commissioners Leadership Group.