Simon Stevens is giving us the first glimpse of what he wants to do as the new chief executive of the NHS today. In a speech in Newcastle, he will warn that the service is facing its biggest challenge, and that a radical transformation of care is needed. Stevens will say:
‘I know that for the NHS the stakes have never been higher. Service pressures are intensifying and longstanding problems are not going to disappear overnight.’
So what are the radical changes that Stevens wants to set about working on? In this week’s Spectator, former Labour adviser John McTernan profiles the new NHS boss, and explains what this radical reformer wants to do with the health service. He writes:-
Stevens set out his vision for the NHS in an essay for a pamphlet published by the think-tank Reform. The current management fad for running the entire NHS as if it were ‘one big hospital’ is doomed, he says. To avoid a crisis, the NHS needs ‘political stewardship, managerial execution, clinical engagement, and public communication’.
He is scathing about the way that almost all NHS reorganisations focus on ‘rearranging the administrative deckchairs’ rather than transforming patient care. As he puts it: ‘How can a quarter of NHS trusts get away with having their “value for money” accounts qualified by their auditors? How can a fifth of hospitals treat their older patients without dignity or compassion? And how is it that a single hospital in mid-Staffordshire could have been responsible for killing its patients at a level equivalent to two or more Lockerbie air crashes, yet apparently no one noticed or did anything?’
Stevens’s passion is transparency. He wants patients to have access to the same knowledge as their doctors. At UnitedHealth, he developed a system for ranking 250,000 doctors against national standards of care, and then ranking them again on value for money. This meant, in effect, listing the best doctors by price. Such transparency makes NHS bureaucrats recoil in horror — but it works. This system, applied to organ transplants, has led to a 5 per cent improvement in outcomes — and halved costs. As he puts it: a good health system requires transparency, the sharing of data and empowered patients.
This agenda — better outcomes at half the price — has an obvious appeal for an NHS operating against a backdrop of austerity. It goes hand in hand with moving services out of hospitals and into communities.
You can read the full piece here.
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