At a time when Danny Boyle’s opening ceremony has led to much overseas interest in the National Health Service (NHS) model, the report from the inquiry chaired by Robert Francis QC on Stafford Hospital has many hard-hitting findings and recommendations (access to full report).

One of the factors identified in the report that contributed to the poor level of care in Stafford Hospital was the constant upheaval the NHS is in.

The CIPD/simplyhealth 2011 absence management survey (get report from CIPD) gives the average number of days absence for public services as 9.1 days per year.  Although this is a half-day reduction on the previous year, it is significantly higher than the private sector.  A particular challenge identified in the public sector is the sheer amount of major change and restructuring, and it is suggested this could be the root cause for the relatively high level of absence.

In analysing the report, the BBC make the following three observations, that are worth highlighting (BBC insight):

1. The inquiry report said Stafford was “not an event of such rarity or improbability that it would be safe to assume that it has not been and will not be repeated”.
2. To move forward, the report called for a “fundamental change” in culture whereby patients were put first.
3. This would require a commitment from all those working and connected to the health service to make sure they put this at the heart of everything they do.

This poses many real challenges for the various trusts in the NHS, which is where most of the changes need to be made, as the recommendation is that any necessary changes are done within the existing NHS structure.  Should the change be driven bottom-up, from the perspective of the individual patient, who typically wants a local service, within a general, national  framework?  If so, what would be the implications on change management skills within the local trusts?  Also, the need for successful delivery through projects and programmes is fundamental, given the number of reported unsuccessful change implementations in the public sector.

How will the NHS cope, given that successfully changing a culture is arguably the biggest change challenge.  But is there just one culture to change?

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PAshton

Paul ensures our clients, members and associates have electronic access to CITI’s intellectual property and services, which may require him providing technical consultancy on clients’ sites.

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