The Abolition of NHSE
This week’s announcement of NHS England's abolition has been met with mixed reactions and represents a significant shift in how the NHS will be run in the coming years. This blog sets out some thoughts from the Digital healthcare Council, drawing from various perspectives across our community.
“If you try to do too much, you will not achieve anything” Confucius
The problem with NHSE had become quite existential – it lacked a clarity of purpose and therefore the levers to make change happen. While there were helpful individuals there, and staff trying their best, as an organisation it just didn’t work. Coupled with seemingly intractable operational challenges, this was fatal.
We had arrived at a place where the system is fundamentally stuck – many aspects of the NHS not working well; all parts of the NHS looking to NHSE for permission (and funding), while NHSE would say decisions were for local systems. Apparent frustration in the Department of Health and Social Care. A deadlock creating the perfect storm for change.
The Current Reality - Frustration and Bureaucracy
Our collective experience of trying to engage with NSHE has at times been frustrating, although there are some notable exceptions.
It could take innovative and helpful companies weeks or months to secure a meeting with senior staff, who might delegate to more junior staff or simply cancel at the last minute. Meetings would then be rescheduled for weeks or months hence. Next steps agreed during meetings would not happen. This would leave people with a strong feeling they weren’t a priority.
The Transition - Messy but Necessary
The consensus among many is that this restructuring has been a long time coming and should have happened a few years ago. Despite the poor communication and inevitable uncertainty of a transition to a new way of doing things, there's a recognition that change was needed.
For organisations with services commissioned through NHSE, there's understandable concern about what happens next.
A worry for many is that relationships that have been positive may be lost. The restructuring threatens to disrupt established connections and workflows, potentially setting back progress on various initiatives.
The transition will be challenging for Integrated Care Board (ICB) teams facing cuts, potentially impacting planned technology implementations this year.
Looking Forward - Cautious Optimism
If this restructuring brings about an environment which embraces genuinely different thinking and welcomes new models of care, then it must be positive. There's hope that with fewer layers and less bureaucracy, the system might become more responsive and effective.
The risk with the new approach is that when health policy sits within Government it tends to be very focussed on the electoral cycle. It can be tempting for each new Secretary of State to create new policy. This can make medium and long-term planning (and delivery) difficult.
The Path Forward
A sensible long-term plan becomes critically important in this context.
For those working in and with the NHS, the coming months will require patience and adaptability. While the restructuring may be challenging in the short term, there's reason for optimism provided organisations can weather the transitional storm.
The hope is that merging NHSE with DHSC will ultimately lead to a more agile, responsive healthcare system that can better serve patients and embrace innovation. Only time will tell if this restructuring achieves its intended goals but it’s clear that change is needed.