On Tuesday I was asked to speak at a Parliamentary dinner with guests including a number of Peers from the House of Lords and backbench MPs. I was able to tell stories about the difference that community teams and services make to people’s lives every day. All things I have witnessed first hand or been told by patients, carers and staff. As a “value based leader” this is something I reinforce with my team regularly. It is why we exist – to deliver the best possible care.
I then asked them to do two things as the regulations supporting the reforms go through.
Firstly – make it a given and always keep in mind that communities matter and most NHS services are delivered outside of a hospital. We need to look at both if we are to secure effective hospitals and better outcomes for local people.
Secondly, as the NHS reforms are implemented we need:
- An improved financial regime which moves beyond the current arrangements where hospitals are paid for activity – an appropriate lever when hospital waiting times were the biggest issue in the NHS – towards a system that rewards better outcomes for people. This would allow hospitals to be supported and services in communities to be more appropriately funded ;
- Regulators in their new roles (particularly Monitor) that are ready for “integrated” health and social care organisations and services that work with local charities and businesses too ;
- A clear definition of what it is “in the public interest” – Monitor has to promote integration over choice when it is in the public interest. Without such a definition, we will enter a legal minefield and be fearful of collaboration.
- Support for system leadership – we should all be accountable for making sure the system works as well as engaging in our NHS organisations.
- To capture and measure the ‘social value’ of high quality community services (not just the costs and activity) – the differences we make keep people functioning in communities or active or working and so on.
Leaders in Leeds are actively involved in each of these developments. We have a “year of care” tariff pilot going on across the City. System leadership is driven through the Health Hub, Medical Senate and opur programme itself. Social Value is part of a CIHM pilot with my organisation. And we lobbyon everything else.
Apologies for the technocratic nature of this piece – we work in a technocratic, rule based system! – and this is not meant to be a comprehensive set of issues to better manage reform. Otherewise I would talk of self supported care; caring; dignity; respect; diversity and difference; eliminating waste and so on. It is though a set of issues that need to be grasped, if we are to be successful