Leading improvement; national support for local missions

by Dr Robert Varnam

10 June 2019


The job of a NHS Chief Executive has never been an easy one.

However it has probably never been as challenging as it is right now. Providers are facing rising demands from a growing population with increasingly complex needs; working to balance workloads, finances and staffing pressures; and seeking to provide sustainable, high quality care. None of the challenges of the job look likely to recede any day soon, and several seem set to continue to grow in complexity.

At the September meeting of the HFMA’s CEO Forum, I’m looking forward to talking with you about how the new Improvement Directorate in NHS England and NHS Improvement can support you and your teams in your mission. We aim to be a major force in supporting trusts to succeed in delivering continuous improvement in quality, cost and experience for patients and staff. Under the leadership of the new national Director of Improvement, Hugh McCaughey, we have set an ambitious intent to change the approach and culture for improvement across the NHS. We wish to help national, regional and local leaders make effective use of the best of improvement science, while ensuring compassion and respect are lived out from board to ward and beyond.

The NHS Long Term Plan lays out an ambitious direction for the future of care. It signals a number of paradigm shifts for many, from healthcare to health, institution to system, from “I” to “we”. It will also require changes in the national approach to improvement, with a renewed focus on working respectfully with local leaders and empowering systems and teams to thrive. The national Improvement Directorate is seeking to raise our sights from inspection to improvement, from paternatlistic assumptions to partnerships, and from silo working to joined-up approaches. Our success will be measured in part by how well you feel we are doing.

Amidst all the plans and programmes for improvement, we recognise more needs to be done to support the people who make change happen. As the new Director of Professional Leadership for Improvement Science, I am part of our work to strengthen the focus on support for improvement leadership throughout the NHS. I look forward to sharing more of our emerging thinking about how best to do this, and to hearing your thoughts.

We are committed to supporting communities of practice like the CEO forum, but we are also asking what more we can do to ensure every provider and local system has a robust culture and sustainable capabilities for improvement. We see a need to ensure that plans for improvement always take account of the people who will implement them – recognising that how we lead improvement is as important as how we plan it. The shift to a whole system approach to planning and delivering care also creates a need to support boards and senior executive teams to work in collaborative networks for transformation, sharing purpose and responsibility with others and leading across multiple boundaries. Finally, I wish to challenge ourselves to ensure providers in every sector of the NHS have the capabilities in-house to lead transformation, innovation and improve, and reduce reliance on outside help.

There’s much to do! I look forward to talking more with you in September.

Dr Robert Varnam PhD MSc MRCGP

Director of Professional Leadership for Improvement, NHS England and NHS Improvement.

@robertvarnam

To book your place at the NHS CEO forum on 24 September, click here