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Consolidating the future of the NHS

Oliver Barnes

The NHS England planning guidance was published at the end of March, and the key word in the document is ‘consolidation’. The foreword by Amanda Pritchard states the view that the NHS Is making ‘significant progress’ in delivering on its priorities for patients, so the aim of the game is to build on this progress through the year.

Productivity is another key word, because funding will be flat in 2024/25 which means that the NHS has to ‘deliver more for patients with the resources that we have’. This is bound to have a major impact on a workforce which is already under significant pressure.

I am struck that this guidance was published almost simultaneously with the 2023 British Social Attitudes survey which found the lowest ever levels of public satisfaction with health and care services.  52% of BSA respondents were dissatisfied with the NHS; the main factors driving this are the time it takes to get a GP or hospital appointment, and that ‘there are not enough NHS staff’.

I think there is a real risk that the narrative of ‘consolidation’ reinforces the factors driving dissatisfaction, and indeed consolidation does not do justice to the innovation we at IMPOWER see in the systems we are working in.

We have seen clinicians in Manchester driving forward the implementation of a Hospital at Home model which reduces the time patients spend in hospital and generates a highly positive patient experience. One patient told us that Hospital at Home had ‘restored my faith in the NHS’.

In Surrey have seen how empowered clinical leadership drove improvements to hospital flow, through the Let’s get you home programme. A core part of this work was designing, implementing, and holding to the core principles of ‘a good hospital discharge’. The results of this was a 25% reduction in patients with no criteria to reside, and an 18% ED performance against the 4 hour target.

In these examples, clinical leaders, with the right support, have implemented innovative approaches to service delivery which have improved on key productivity metrics, at the same time as delivering a better experience for patients and empowering frontline staff to take positive decisions.

So, how we ‘consolidate’ matters; if we embed innovation, empowerment, and an outcomes-focus, then we’ll get a more resilient health and care system.

If you want to more about how IMPOWER can help your system to consolidate then get in touch, we’d love to talk.


Written by

Oliver Barnes

Senior Manager, IMPOWER



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