As part of our ‘What If’ series on change in the NHS, we spoke to Director of Financial Sustainability Tim Tebbs and asked him: “Putting all politics aside, if you could change one thing about the NHS, what would it be?”
If I could change one thing…
We’ve been talking about integrating health and social care for many years now – and yet evidence of meaningful progress is rarely seen.
Truly joined up services means seamlessly integrated clinicians and service professionals, working efficiently and effectively together – as one team, communicating freely across primary, community and secondary care, embracing technology and treating patients and their families as respected and valued ‘customers’. It’s part of a vision that we all sign up to. And yet despite STPs and the like – this vision often seems as elusive as ever.
What stands in the way? Well many things I’m sure – but in my view one ‘culprit’ is the clumsy and ineffective way that funding is allocated via the ‘contracting process’. Having observed several adversarial lose:lose contracting rounds, this is the one thing I would change in an instant.
Systems need to recognise the affordability envelope that they are given – and all parties within that system need to own this. Fruitless hours are spent arguing and the debate achieves nothing – not to mention the industry surrounding contract management that then perpetuates the energy sapping arguments for the remainder of the year. If only the public knew what went on behind the scenes…
Where energies should be focused is on working together to create modern, integrated services. Jointly working to manage demand, jointly agreeing where finite clinical and physical resource is prioritised, and jointly identifying and taking out excess costs driven by excess demand. None of this is easy – and structured turnaround discipline is needed to make any complex change happen. But let’s help ourselves by finding a better way of allocating resource – sharing control totals – putting an end to mistrust and suspicion. It’s in our gift to do so. And let’s redirect our energies to making meaningful progress towards that vision of integration that all of us should feel it is our duty to deliver.
Tim has held a number of CFO roles for PCTs and CCGs – on a substantive and then an interim basis – and has gained a wealth of experience from working with organisations and health systems across the country. Recently, Tim has focused on supporting financially challenged CCGs. Whilst financial recovery is often perceived to be cost cutting and punitive, Tim’s approach is to use financial pressure as a lever to deliver much needed transformational change. Though it adds to the challenge, Tim believes it is important to pursue demand management on a mutual benefit basis to take cost out of the system. Part of that challenge is persuading providers that this is possible…
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