New head of the NHS Confederation appeals to managers to work together to tackle the ‘forest fire’ of healthcare reforms
In Mike Farrar's first speech as chief executive of the organisation, he said that, despite continuing concern over the implications of the Health and Social Care Bill, it was managers who were in the best position to take the plans forward.
Likening the challenge they face to that of Olympic hopefuls in 2012, he told delegates: "Last week I was asked at the Bill Committee's second stage reading if the NHS wanted to move forward after the pause. I said that, while few of us would have chosen 12 months ago to start from here, the NHS needs certainty, clarity, recognition of the enormous job we face and a desire to help us rather than hinder us in delivering it. I said that, as far as the NHS is concerned, organisations at a national level are trying to see the wood for the trees, while NHS leaders are watching the forest fire moving towards them.
We have to act now and that means sheer hard work, an ability to deal with the ambiguity, yet take brave decisions, and to do today's day job while safely bringing the new system into place
"Like those Olympians facing their own personal mountains next year, we have two choices - to be daunted by the scale of our challenge, or to be inspired by it. It's the latter we must choose; to use the motivation of the toughest year in our careers to excel, to achieve our own personal bests, and to sit calmly afterwards in the glory of our achievements and think 'we did that and we did it for our friends and families and for the NHS'.
"We need to take our destiny back into our own hands by delivering long-term transformation, not more short-term fixes. We need the confidence to shape our own destiny, to innovate from within, not to wait for others to do it, and to challenge our own outdated business models."
My prescription is: value managers, support reconfiguration, focus on today as much as tomorrow, find intelligent solutions to complex problems, and finally take our destiny back into our own hands.
While he said the NHS Confederation would continue to demand clarification from ministers over issues such as excessive centralisation, bureaucratic restrictions, and the freedom to act of the new GP commissioning groups, he also laid out a four-point plan for the future. This included a plea to the Government to value NHS managers and to managers to embrace innovation.
As far as the NHS is concerned, organisations at a national level are trying to see the wood for the trees, while NHS leaders are watching the forest fire moving towards them.
Speaking at the confederation's annual conference in Manchester last week, he said: "There are many things that are good in principle about the health reforms and we have consistently supported these. They include the increasing role for clinicians in leading the NHS, the new relationship with local government on health improvement, and the desire to move towards measuring quality and outcomes. But, while I have no doubt we are in a better place as a result of the 'pause', there is still much to worry about.
"First, we need to persuade the Government to stop attacking and start valuing management. Great management, irrespective of whether you are from a clinical or an administrative background, creates the context for great clinical care. No one disagrees with the need to find efficiencies, but an organisation the size of the NHS needs a proper level of management to succeed. The latest management reductions bring us dangerously close to undermining the advantages we have. High-quality management is the solution, not the problem."
He went on to call for politicians to publicly voice their support for NHS managers when they have to make tough decisions on service transformation, saying: "I have talked to MPs who fully acknowledge the case for change in private, but say that they will be at the front of the protest march when it comes to change in their local hospital. We need to engage the public in a more sophisticated conversation about moving care into bigger specialist centres or out of hospitals into local communities so that we have their backing, and this will take strong leadership and significant courage from politicians as well as NHS managers."
We need the confidence to shape our own destiny, to innovate from within, not to wait for others to do it, and to challenge our own outdated business models.
And he said managers needed to find intelligent solutions to complex problems and focus on the present rather than looking too far into the future.
"We need an intelligent framework that helps us deal with the complexity of competition and collaboration and that balances the need for national consistency and local flexibility and proper governance with the freedom to act swiftly without burdensome bureaucracy," he added. "In each of these areas, we need to make sure there is ongoing dialogue between policymakers and NHS leaders on the frontline whose experience and expertise can help them to get the balance right."
The latest management reductions bring us dangerously close to undermining the advantages we have. High-quality management is the solution, not the problem
"Many of the proposed reforms kick in from 2013, but the decisions and support provided over the next 18 months will determine whether the NHS is a going concern for future leaders to inherit. We have to act now and that means sheer hard work, an ability to deal with the ambiguity, yet take brave decisions, and to do today's day job while safely bringing the new system into place. It is essential in my view that we stick together as an industry. We need a strong voice and you don't get that by pulling apart. My prescription is: value managers, support reconfiguration, focus on today as much as tomorrow, find intelligent solutions to complex problems, and finally take our destiny back into our own hands."