Will 2016 push the NHS over the edge of chaos? The health service could tumble into a zone where organisations do not innovate, but instead disintegrate.
Complexity theorists point to the importance of system environment on organisational performance – at one end of the spectrum there is a stable and low change setting, at the other an unstable and high change setting. Since 2010 the NHS has been anything but stable, and the NHS community must be desperate for a spell of stability in 2016. Unfortunately, it is likely to get the opposite – turbulence bordering on chaos.
First, there is the ongoing financial turbulence. The pledges of protection for the NHS budget during the 2015 general election have swiftly unravelled. The widely promised extra £8bn would have been delayed by the Treasury but for the calculated intervention of NHS England boss, Simon Stevens, who managed to get some frontloaded concessions. Even so, the settlements anticipated between 2018 and 2020 are historically low and the £22bn of efficiency savings are still expected to materialise. On top of this, public health spending is being cut, social care continues to be financially crucified and calls for transformation funding to ease the process of change are going unheeded. Meanwhile, patients and service users continue to turn up in their droves and carers quietly buckle under the strain of unsupported care. Continue reading... The Guardian
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