Extra cash for the NHS will only ever be a short-term fix unless managers are encouraged to raise their aspirations and inspired to be bolder
The financial health of the NHS is rarely out of the news at the moment – with the chancellor’s confirmation in the Autumn Statement of £2bn extra funding for frontline services the latest case in point. This, allied with an extra £1.2bn for GP services partially funded from fines on the banking sector, is important and welcome news for our health services. But how big a difference will it make?
A quick survey of the landscape reveals a service facing major challenges. Demographic shifts, a growing population and the availability of new treatments and drugs are all adding to costs. At the same time, the government plans to name and shame failing hospitals, and bar those NHS managers who are responsible for failures from working in the health service.
These issues are putting NHS managers under increasing pressure of survival just when we need them at their most creative, and hindering their ability to make significant changes in performance, efficiency, innovation and operations.
So whilst the announcement of extra funding is welcome, if the mentality amongst the workforce remains one of tired scepticism then these additional resources will have only a very limited effect.
The key to transforming performance and productivity in the NHS is not funding in itself – it’s to bring about a change of mindset amongst its tens of thousands of middle managers, to unlock their potential so that creativity can be unleashed and new and better ways of doing things can be found whether in their organisation or with partners.
How can this be achieved? From my experience there are a number of key steps. Firstly, senior leadership and middle management need to re-invent what they believe is possible for them to accomplish. By raising their aspirations and inspiring them to be bolder, a new mindset can start to be born. Part of this process will help them blow up conventional wisdom and assumptions that we all get trapped in. So by encouraging open discussion, in which anything can be challenged, the middle layers can start to look with fresh eyes at new ways of working. And then it is vitally important to help them see that they can be accountable for delivering on things that are missing and essential. By giving them a sense of empowerment to change things, they will feel a new level of engagement and commitment to the business. Finally, there need to be open conversations about the future they want and can build. This is often overlooked as minds tend to be fighting the day to day pressures due to lack of time to focus on the long term. This vicious circle needs to be broken to move from surviving to the possibility of thriving.
If senior leadership can create the right environment, they could be genuinely astonished at the results they can achieve by unlocking the potential of their mighty middle. For example, one such programme that we helped to implement at one of the top 10 NHS Trust in England saw staff recommendation of the Trust as a place to work move from just 26% to 71%, whilst savings of over £25m were also delivered in 2012/13.
It can’t happen overnight, but with real commitment from leadership and an investment of time and energy, the potential is there to create an environment characterised by genuine innovation, the constant and productive challenging of the status quo, and collaborations across all the different elements of the healthcare pathway.
This can help the NHS become both more cost efficient and more innovative – a healthier state of affairs in anyone’s book.
Mike Straw is chief executive of Achieve Breakthrough, a consultancy that provides organisations with new ways of thinking and acting and has worked with a number of NHS Trusts, government departments, and local authorities
