“We can work it out”

Sometimes it can be hard to find inspiration and positivity when it comes to writing any commentary about the NHS. And I would be the first to agree that people can be forgiven for thinking that it is all doom and gloom considering the glut of current news stories about cuts, squeezes, performance failures and staff protests.

So on an optimistic note I decided to review what came out of the Foundation Trust Network’s first annual conference and exhibition held last week. I thought it would be interesting to hopefully find inspiration and to hear comments and suggestions considering that the NHS is facing the challenge of finding an average of 4% productivity gains each year from 2012 to 2015. And to put this in context, an annual productivity gain of 2% is usually considered realistic for the private sector.

Chris Hopson chief executive of the Foundation Trust Network (FTN), welcomed the 500+ delegates, who had gathered in Liverpool, telling them the focus for the conference was one of exploring the theme of transition and transformation and to consider the seismic shifts that are currently affecting the NHS. Being in the home of the Beatles Mr Hopson was keen to promote the message as not one of “Help!” but “We can work it out”. I can only assume by this he meant sharing best practice to maintain and achieve foundation trust status in light of the new reforms.

It was clear that the FTN was particularly keen to showcase the spirit of enterprise, innovation and patient focus that apparently “characterises much of what the foundation trust sector is doing at the moment”, according to Hopson. So thinking that healthcare has much to learn from commercial practice in business and industry, this must have been the reason why two of the key conference speakers included entrepreneurs Luke Johnson and Nicola Horlick, who are best known for their enterprise and city backgrounds.

Both spoke eloquently, drawing not only on their medical experience but also on the lessons learned from their commercial careers, including suggestions as to how practices from the business world could be used to enhance the way that the NHS is run.

In particular Johnson, best known for leading the Pizza Express chain and as chair of Channel 4, inspired the audience “to avoid the temptation of playing it safe” and told them “if you are not innovating then you’re going backwards” and that “cowardly stuff will not do in the public service.” Bold words indeed!

Earl Howe, parliamentary under-secretary of state at the Department of Health, also appeared to rally the troops and spoke of the strong leadership that was necessary to bring about change in the NHS. He congratulated delegates on the great work they were doing whilst he reconfirmed how the new legislation “would give the NHS unprecedented autonomy and minimise the potential interference from the centre in the day-to-day activities of the health service.” So nothing new learnt there then!

But on the positive side some of the highlights I think included the presentations by General Medical Council’s Niall Dickson, who called for the “need to embrace data like never before”, and Mike Cooke, chief executive of Nottinghamshire Healthcare NHS Trust who said “we need to ignite clinicians – back them when they are stretched and be approachable, but also challenge the poor and variation”. Plus I welcomed the fact there was discussion around greater patient involvement and say in their own healthcare. For example, Dr Mark Newbold, CEO Heart of England NHS Foundation Trust and Patient Opinion’s Paul Hodgson, advocated listening to the patient as a ‘consumer’ demanding quality and service improvements and Tim Smart, chief executive King’s College Hospital NHS Foundation Trust spoke of “having a mature debate of talking to patients and involving them more in consultations.”

However, Paul Corrigan, former policy advisor to Tony Blair, managed to bring the conference back around to a resounding picture of reality when he reminded delegates that this year, only one trust across the country has made it to foundation trust status so far and that he believes only 35 – 40 of the 102 pipeline trusts will actually make it to foundation trust status. And to add to that, David Bennett, chair of Monitor outlined that 19 foundation trusts are currently in significant breach of regulations, 11 for finances, so “the future looks tough for foundation trusts, and fundamental redesign of services is inevitable.”

I could go on as there were many more presentations from the great and the good from the NHS and the commercial and political world, and there was certainly a lot for delegates to take away in terms of challenges that foundation trusts face. But I cannot help but think that much of what was said is not new or that the points and issues discussed were not ones that the audience wasn’t already aware of.

But removing the cynic in me, the positives to take away are that it has encouraged debate and hopefully inspired a shift towards innovation and change. So what is really needed now is strong leadership and direction, reduced levels of bureaucracy and greater sharing of experiences and best practice. The test will be to see what is on the agenda for the FTN’s second conference next year and how many of those pipeline trusts will have been converted to foundation trust status.

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