NHS Improvement Fails to Recognise the Importance of Pronouncement

We wrote last week about the Carter Report on NHS Efficiency, which contained a whole range of procurement and supply chain recommendations. We said then that one concern was the responsibility for implementation was being put onto a brand new organisation, not even formed yet – NHS Improvement (NHSI). It is formed via the merger of Monitor, previously the sector regulator, and the Trust Development Agency (TDA).

So Jim Mackey, the CEO designate for NHSI, announced his top team the other day, and we were pleased ot see a well-known and respected procurement leader from the sector was one of the Board members. “We recognise how important procurement and supply chain activities are, and we will put in place a detailed programme plan to implement the Carter recommendations within the time frame he identified. We’re delighted with our new appointment, who joins us after doing a brilliant job in their Trust …”

OK, sorry, I seem to have dropped off there for a moment. Just one of those daydreams, unfortunately. Sorry, in fact Mackey named a Board of ten people, not one of whom has the slightest bit of procurement or supply chain experience as far as we can see. (They are all Monitor and TDA bosses, so no new blood at all).

And even more damningly perhaps, there will be no executive director of cooperation and competition on the Board, even though there currently is within in Monitor, although NHS Improvement will carry out the cooperation and competition functions it will inherit from Monitor. In theory anyway. That role was designed to support and regulate the dynamic new world of market-driven competition introduced to the NHS by ex Minister Andrew Lansley in 2012, who is in danger of going down in history as the biggest villain in UK health history since the Black Death.

Actually, Mackey did say this when Carter published.

“We will do everything to help trusts implement these recommendations, but those that fail to do so will face closer scrutiny from NHS Improvement until they can demonstrate appropriate grip.”

So “everything to help trusts implement” means everything short of actually having a Board member who knows something about the topic? The lack of focus is very disappointing and it makes us wonder whether this marks a new record for kicking a report into the proverbial long grass. Just six days between the Carter report being published and Mackey apparently placing it firmly well down the priority list.

And if you are a private health provider, you really need to look at whether your future strategy for winning NHS work is feasible. Whilst there will be work around the edges for the likes of Virgin – which does add up to a lot of money, so let’s not be too negative - the idea of core health services being competed in a public / private mixed economy is disappearing rapidly. We’re moving back to a planned economy, we suspect, which many will applaud.

Back to the Carter report - so just who is actually accountable and responsible for implementing it? Who will be fired if it doesn't happen? Anyone like to volunteer?

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Voices (2)

  1. Taughttofish:

    This doesn’t really answer your question ‘Who will be fired if it doesn’t happen’ from an executive perspective however Jeremy Hunt told parliament in written statement – HCWS515
    “I welcome Lord Carter’s non-executive director role at NHS Improvement and look forward to his ongoing input into the implementation of his review.
    In light of Lord Carter’s report, I can now announce that we will act upon all his recommendations and have asked Lord Carter to report back on progress with implementation by spring 2017.”

    1. LM:

      Dear fisherman, this does not mean anything. Lord Carter has been asked to input. And to report back. He will be NED with no accountability. The only accountability Jeremy Hunt has is to Cabinet, the PM and his local constituents. The NHSI, Jim Mackey, and the DoH will be accountable. Jeremy Hunt will be fired (if he is fired) by the PM through the reshuffle or if he says anything that is simply not true in front of the health committee or PAC (i.e.: in the Commons).

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