richard sykes on leadership challenges in the nhs
DESCRIPTION
Sir Richard Sykes, former Chairman of NHS London. looks at the leadership and mangement challenges facing the NHS from a business perspective.TRANSCRIPT
Sir Richard Sykes, FRS, FMedSciformer Chairman of NHS London
LEADERSHIP AND MANAGEMENT – Challenges in the NHS
Lessons learned and implications for the future
Leadership
• The art of motivating a group of people to act towards achieving a common goal
• The leader is the inspiration and director of the action – the person that possesses the combination of personality and skills that make others want to follow
Main characteristics
• Clear vision• Sharing/communicating vision with others so they will
follow• Providing the information, knowledge and methods to
realise the vision – a strategy• Coordinating and balancing the conflicting interests of
members or stakeholders• Stand up for what they believe
Management
The creative and systematic pursuit of practical results by identifying and using available human and
knowledge resources in a concerted and reinforcing way.
– Get the job done
Normal business case
• Vision for the company• Strategy for reaching the vision• Guiding principles• Business plan• Timelines
– Financial implications
Example
• Glaxo 1994 – Zantac patent expiry• Merger with Wellcome• Global integration• Communication and action• Consultants and enablers• Clear lines of responsibility
Principles
• Services should be focused on individual needs and choices
• Services should be localised where possible but centralised where necessary
• Services should be built around truly integrated care and partnership working, maximising the contribution of the entire workforce
• Prevention is better than cure• Priorities should reflect health inequalities and diversity
Polyclinics are an opportunity for the NHS to deliver world class care closer to people’s homes
Polyclinics combine GP
Certain routine hospital services
X-rays and blood tests
Fully equipped with first-class facilities
Modern - DDA compliant
Polyclinics are open from 8am to 8pm every day including at weekends
Individuals and families are welcome to attend them, whether they live, work or are staying in London for a short time, even if they are not registered there
and routine hospital care
A range of useful well being and support services, benefits support and housing advice
Many nearby GP practices are linked to, and work with, the polyclinic as part of the system
Patients still choose to see their own doctor
The benefits include:
Giving people in London more access to doctors and routine care
More accessible, local and convenient
People can still choose to see their own doctor
A faster, more convenient, high-quality health service
Planned around those who need to use it and open for longer for everyone
Extended opening hours to fit around the busy lives of people in London
The vision for transforming primary and community care
London will be served by over 100 polysystems, delivering integrated health and social care services to local communities
The vision for transforming acute care Major acute hospitals will provide rapid access to emergency care for patients suffering from critical conditions. They will only take the most seriously ill patients, and will have all relevant services co-located on site.
Local hospitals will provide high quality, non-complex acute services – ensuring patient access and convenience without sacrificing quality of care.
Some transformation is already underway, with four trauma networks in place across London
London also has three of the UK’s five Academic Health Science Centres
Imperial Health Partners
UCL Partners
King’s Health Partners
‘Too much stuff’
• 31 PCTs• 32 councils• The Mayor• Local MPs• The Commissions • Department of Health
Following publication of the Healthcare for London vision, a major consultation exercise was undertaken led by London PCTs.
This concluded in June 2008 when a Joint Committee of PCTs committed to implementing the strategy.
• Over 5,000 responses, including 200 organisations
• Around 40,000 visitors to the website, meetings and road shows
• An emphasis on quality, safety, outcomes and patient experience
Healthcare for London vision
Lessons learned
• Never trust politicians• Strong leadership and good management will not always
prevail• Health care is based on emotion not logic• Clinicians must be on the front line• The organisation is risk averse• No clear lines of responsibility • Lack of incentivisation• Too many missives• A lot of very well meaning people but not enough leaders
Implications
1. Health care - Affordability- Quality- Standards- Delivery
2. Economy - NHS central role to play in UK Bioscience Industry- Critically important for the economy- Losing business
Clinical trials
A fragmented process characterised by multiple layers of bureaucracy, uncertainty and duplication
Rawlins Report AMS
Diffusion
Innovators
Early adopters
Earlymajority
Late majority
Time
NH
S U
pta
ke
Innovation
Basic research
Applied research
Targeted development
First human use
Clinical trials
Early adoption
Late adoption
Accepted practice (or disuse)
Development
RESEARCH COUNCILS, MAJOR CHARITIES, NIHR (CBRC, SBRC,BRU) AHSC, HIEC
The adoption dilemma remains
Challenges for 2010 and beyond
• Ageing population• Chronic conditions• Moving care out of
hospitals into other settings• Personalised medicine
• Need to use the NHS Reforms to tackle these issues
• Reforms must not inadvertently weaken UK’s position for wealth creation
The future: A Research, Education and Patient Care Cluster