Convergence 2.0: Mackey calls for narrative change

Mr Mackey (pictured), chief executive of Northumbria Healthcare NHS Foundation Trust and former chief executive of NHS Improvement, said most people’s perception was that the NHS was in deficit. ‘The NHS is in surplus overall,’ he said, with a provider deficit of around £1bn balanced by a commissioner surplus of the same amount. ‘But we are just very bad at reporting it overall.’

He said this ‘scared the public’ and called on the finance profession to find ways to communicate the state of whole local systems as well as organisations. He suggested the current situation of reporting provider and commissioner finances separately – and at different times – was like Marks & Spencer separately reporting the financial positions of its food and clothing service lines. 

In general, he said the NHS had to ‘try to shift the negative narrative’.

However, he acknowledged that the service had been through a ‘really hard’ few years followed by ‘horrendous’ pressures last winter, with many emergency departments still experiencing significant demand. ‘For you to have stabilised finances [in this period] is fantastic,’ he said.

He insisted that the NHS remained a world leader in terms of delivering value for money and reducing costs, highlighting the reduction of the agency staff bill by a third as a particularly noteworthy achievement. But he said there was still significant variation and the NHS had to get better at scaling up and spreading good practice.

He urged organisations to overcome ‘local competitiveness’ and get better at learning from ‘next door’. ‘If we just did all the things that we know are working in another place, we’d all be better off. Let’s do what we know works before we get onto the new stuff as well.’

Mr Mackey also called on the finance profession to support the adoption of new technology. ‘Artificial intelligence, genomics and some cancer technologies mean we will be in a completely different space in quite a short space of time,’ he said. ‘As a finance community, you need to think about how we get ahead of that and facilitate some of those changes.’ 

And he called for the 10-year plan that will be developed to sit alongside the new settlement to be built around realistic commitments.