What healthcare managers can expect in 2013: As the NHS prepares for restructuring, health service leaders will experience difficulty, uncertainty and instability.
As the NHS stumbles towards the formal start of the new, reorganised structure in April, some of the big issues the service faces seem barely changed from a year ago.
We are still waiting for the report by Robert Francis QC into the Mid Staffordshire scandal, many managers still don't know if they will have a job in the new system, the Care Quality Commission is still in difficulty, and the overwhelming majority of clinical commissioning groups still have a long way to go before they are truly ready.
The NHS Commissioning Board's most pressing priority is to get the remaining 177 clinical commissioning groups through the authorisation process. Only 34 have completed it. Among those in the pipeline will be some barely fit to begin work. Neighbouring groups might have to take on the work of the stragglers. While those in difficulty will doubtless attract a great deal of attention, it is in no one's interests for their weaknesses to undermine confidence in the whole system.
According to the Health Service Journal, 3,500 managers from strategic health authorities and primary care trusts have begun the new year still not knowing if they have a job in the new system. Among staff who have, supposedly, secured a post, there appear to be many hundreds who have not yet been told what they will be doing, where they will be doing it or whether they have the right skills.
While sorting this mess out is the commissioning board's responsibility, it is not its fault. It was inevitable that the monstrous upheaval created by the reforms would leave a large number of managers in difficulty and uncertainty. A good proportion of those still in limbo will eventually be given jobs, but their late arrival at their new organisations will create yet more pressure in the system.
The Francis report has started to leak. According to the Sunday Telegraph, Francis will paint a picture of the NHS gripped by a "culture of fear" as managers fixate on meeting targets. It has long been suspected that the months of delay in publication have been caused in part by senior NHS managers disputing the severity of some of the criticisms that Francis is planning to make. In particular, what the report says about Sir David Nicholson, either in his role as chief executive of the Mid Staffordshire trust's strategic health authority or as chief executive of the NHS, could be a pivotal moment. Whatever it says, the Francis report is likely to be seen by some, however unfairly, as the verdict on Nicholson's career and the management style he personifies.
What is certain is that the report will unleash another round of NHS manager bashing in the media. The team supporting Jeremy Hunt, the health secretary, is obsessed with communications. He will be telling a story about how the NHS reforms are wrenching control of the health service out of the hands of the bureaucrats and giving it back to the doctors and nurses.
The Telegraph is also predicting "radical" recommendations for changing the way the health service is regulated. On Wednesday, the health select committee reported that the Care Quality Commission has "a long way to go". Recently installed chief executive David Behan had already worked that out. A post-Francis lurch in yet another new regulatory direction would only create further instability. (The fact that David Prior, the new chair of the Care Quality Commission, lost his parliamentary seat in 2001 to Norman Lamb, who as minister for care and support oversees the CQC, is just a bit weird.)
Meanwhile the government has been pursuing its obsession with the so-called friends and family test for NHS services, extending it from acute hospitals to GPs' surgeries, district nursing and community hospitals. It may well provide ministers with some modest protection against claims that the reforms are harming patients' interests, but virtually everyone in the NHS knows the test is vacuous and misleading. The government knows it, too, but doesn't care. Guardian Professional.
As the NHS stumbles towards the formal start of the new, reorganised structure in April, some of the big issues the service faces seem barely changed from a year ago.
We are still waiting for the report by Robert Francis QC into the Mid Staffordshire scandal, many managers still don't know if they will have a job in the new system, the Care Quality Commission is still in difficulty, and the overwhelming majority of clinical commissioning groups still have a long way to go before they are truly ready.
The NHS Commissioning Board's most pressing priority is to get the remaining 177 clinical commissioning groups through the authorisation process. Only 34 have completed it. Among those in the pipeline will be some barely fit to begin work. Neighbouring groups might have to take on the work of the stragglers. While those in difficulty will doubtless attract a great deal of attention, it is in no one's interests for their weaknesses to undermine confidence in the whole system.
According to the Health Service Journal, 3,500 managers from strategic health authorities and primary care trusts have begun the new year still not knowing if they have a job in the new system. Among staff who have, supposedly, secured a post, there appear to be many hundreds who have not yet been told what they will be doing, where they will be doing it or whether they have the right skills.
While sorting this mess out is the commissioning board's responsibility, it is not its fault. It was inevitable that the monstrous upheaval created by the reforms would leave a large number of managers in difficulty and uncertainty. A good proportion of those still in limbo will eventually be given jobs, but their late arrival at their new organisations will create yet more pressure in the system.
The Francis report has started to leak. According to the Sunday Telegraph, Francis will paint a picture of the NHS gripped by a "culture of fear" as managers fixate on meeting targets. It has long been suspected that the months of delay in publication have been caused in part by senior NHS managers disputing the severity of some of the criticisms that Francis is planning to make. In particular, what the report says about Sir David Nicholson, either in his role as chief executive of the Mid Staffordshire trust's strategic health authority or as chief executive of the NHS, could be a pivotal moment. Whatever it says, the Francis report is likely to be seen by some, however unfairly, as the verdict on Nicholson's career and the management style he personifies.
What is certain is that the report will unleash another round of NHS manager bashing in the media. The team supporting Jeremy Hunt, the health secretary, is obsessed with communications. He will be telling a story about how the NHS reforms are wrenching control of the health service out of the hands of the bureaucrats and giving it back to the doctors and nurses.
The Telegraph is also predicting "radical" recommendations for changing the way the health service is regulated. On Wednesday, the health select committee reported that the Care Quality Commission has "a long way to go". Recently installed chief executive David Behan had already worked that out. A post-Francis lurch in yet another new regulatory direction would only create further instability. (The fact that David Prior, the new chair of the Care Quality Commission, lost his parliamentary seat in 2001 to Norman Lamb, who as minister for care and support oversees the CQC, is just a bit weird.)
Meanwhile the government has been pursuing its obsession with the so-called friends and family test for NHS services, extending it from acute hospitals to GPs' surgeries, district nursing and community hospitals. It may well provide ministers with some modest protection against claims that the reforms are harming patients' interests, but virtually everyone in the NHS knows the test is vacuous and misleading. The government knows it, too, but doesn't care. Guardian Professional.
No comments:
Post a Comment