The NHS needs to focus on value and not look at quality and finance in isolation, say health leaders
Clinical and financial leaders in the NHS say that looking at quality and costs together will mean fundamental changes to services and lead to better value and improved care for patients.
Leaders from the NHS Confederation, the Academy of Medical Royal Colleges, the Healthcare Financial Management Association (HFMA) and the Faculty of Medical Leadership and Management say that it is important that the current programme of local service transformation continues. The group would also like to see the ‘disconnect’ between quality and finance removed, so that quality is delivered at the right cost.
Their report Two sides of the same coin published today (16 April), says that the NHS is too often used as a political football by parties who talk about rising demand for services, with no additional money available to spend, but are then very quick to criticise planned service changes or when patients’ expectations are not met.
The report also says that the public needs to understand the difficult decisions that are required so there is a better balance between finance and quality. Politicians must also be honest with the public about the quality and level of services that can realistically be achieved with the money available so that quality improvements are properly funded.
Collectively, the group want to see strong leadership from clinicians and managers to establish a clear approach to quality and cost improvement within their organisation, with a focus on how services will remain sustainable over the long-term.
Rob Webster, chief executive of the NHS Confederation, said: “This report is an important statement of the enablers that will allow change to happen in every NHS organisation, every local system and across public services. Every unified board in the NHS is currently looking at how it balances quality and finances. In doing so, they will be looking at both issues together and the role that others across the health and care system and the wider public service will play in their future success.
“Each of those Boards needs to be working in a national climate of support and system alignment. We need an honest debate about this and an alignment across systems that enable local leaders to deliver change. Only then will we be able to transform care to ensure that patients receive high quality services now and in the future. The alternative is a continuation of an unsustainable set of services, kicked around like a political football while patients and staff suffer. Our 2015 Challenge will support this honest debate. This report sets out some of the ways in which we can succeed.”
Paul Briddock, HFMA’s Policy and Technical Director, said: “‘It is vital that clinicians, managers and finance staff work together to ensure that the maximum value possible is gained from every pound spent in the NHS. In HFMA’s opinion this needs to happen across organisational boundaries. NHS boards need to work in partnership to agree how to spend resources to the best effect, rather than individual organisations making cost savings in isolation.
“High quality healthcare – valued by patients and the public and achieved through transforming the way services are delivered – will lead to cost savings that are sustainable and recurrent. Transforming services is not easy, but it an essential stepping stone to ensuring that the NHS delivers the best possible value.”
Professor Terence Stephenson, Chairman of the Academy of Medical Royal Colleges, said: “The NHS should always, be about providing the best possible care to patients. However, we cannot separate the need to continually drive up the quality of care while at the same time recognising the cost of care. As a profession we must be innovators, finding new ways to provide the best balance between the two by working closely with financial and managerial expertise.”
Dr Nikki Kanani, Quality Improvement Lead, and Dr Des Breen, Deputy Medical Director for Secondary Care, at FMLM said:
“Effective leadership is crucial to address the complex challenges facing the NHS. Healthcare staff must be valued and supported to work together to deliver quality, compassionate patient care whilst ensuring good business and financial management. FMLM supports a more open and honest discussion about the future of health and social care to ensure structures, policies and frameworks support the delivery of high value, sustainable care for patients.”