Stephen Dorrell, chairman of the NHS Confederation, gave the opening speech at Confed17 today and told the audience of more than 1,000 NHS leaders that a thorough review of long term demand patterns in health and care is needed. His speech follows.
“Wonderful professional care …. on a daily basis”.
The words of Alex on the film you have just seen.
Alex expressed far more eloquently than I ever could the reason why we are here.
We shall talk about challenges and targets and budgets and deficits, but we do ourselves and our patients a great disservice if we allow those important but secondary concerns to cloud or obscure the central fact of our health and care system, which is that it provides to those who need it “wonderful professional care …. on a daily basis”.
So before we degenerate into management speak, let us begin by saluting those who have chosen to devote their lives to providing care and support to their fellow human beings.
I think of the young nurse who has accepted the personal responsibility of dealing with her contemporary who suffers from an eating disorder; I think of the healthcare assistant who has accepted the personal responsibility of caring for the elderly man who was once a sporting hero, but now suffers from advanced dementia; and I think of the doctor who has to break the news to the young couple that their newly born baby will never enjoy the life chances we all want for ourselves and our families.
In the aftermath of the terrorist attacks in Manchester and London, I also think of the staff who were doing a routine A&E shift, and were presented without warning with young people who had been on a night out and found themselves in a battle zone. I think of the staff who were themselves off duty on those nights but who saw what was happening and ran not away from but towards the danger; and I think particularly in that connection of Kirsty Boden, the off duty nurse from Guy’s hospital whose selfless courage cost her her life.
The extraordinary thing about these examples is precisely that they are not extraordinary – they are the daily practice of those who work in the health and care system; their commitment is an inspiration and we should never ever allow ourselves to take it for granted.
There is also something else that we should not take for granted.
Each clinician takes personal responsibility for the care they provide; but they are part of a team, and the effectiveness of the team depends on both its clinical and non-clinical members. The hospital Chief Executive, the practice manager, together with the porters, the estates staff, the catering and administrative staff, as well as those who working in the management hierarchy, are all part of the team which delivers healthcare.
So, as we open our conference, we must be clear that healthcare is a people business.
It must be more than an incantation. We must mean it.
At the most basic level we need to ensure that we have enough people, and that they have access to the right skills and personal development.
We need to ensure that our workforce reflects the diversity of the society that it serves – which is why the Confederation is a strong supporter of Yvonne Coghill’s work in promoting the NHS Workforce Racial Equality Standard.
We need to ensure that the NHS continues to be part, as it always has been, of the global health community and continues to recruit in and contribute to the global health talent pool. We do that both because it is a way of meeting specific workforce requirements, and because we know that our patients benefit when we ensure that our version of best practice reflects experience elsewhere in the world.
We need to ensure that our people work in a culture which empowers and motivates them. Too often our organizations and structures feel like obstacles to great care; we must ensure they are redesigned when necessary to make it easy for our staff to do the right thing.
And, critically, we need to ensure that our staff are fairly rewarded for the commitment they make. We all know that financial resources are stretched, but we cannot expect to benefit from the continued commitment of our staff if they feel that public sector pay policy offers them no reasonable prospect of meeting their private needs and aspirations.
Which brings me neatly to the role of the NHS Confederation.
It is not an accident that NHS Employers, as part of the Confed, organized the workforce summit yesterday – so that our meeting this week opened with a focus on workforce issues. We all know that unless we address those issues our fine words will be just that – fine words.
As Shakespeare put it “a tale, told by an idiot, full of sound and fury, signifying nothing”.
It is the role of the Confed to ensure that the tale is heard – and acted on.
It was heard and acted on last autumn when we spoke up about the urgent need to respond to the issues facing social care.
We welcomed the steps taken before the election to address the short term needs of the sector, and most particularly we welcomed the commitment to a longer term review of social care funding options.
The election debate highlighted the complexity of issue, but Pandora’s box is open and cannot be closed.
Nor can it be confined to considering funding options purely for social care. At the beginning of the election campaign the Confederation set out our view of the priorities which would face the incoming government.
The parliamentary arithmetic changes none of that.
Most fundamentally it does not change the need to undertake a thorough review of long term demand patterns in health and care – and the associated resource implications.
I well understand the pressures which ministers face, particularly in a difficult parliamentary situation. I have the T shirt.
But real life will not wait; we all know that demand pressures within the system are building and it is a key part of the role of the Confederation to ensure that uncomfortable facts are understood and acted on.
It is also not just a matter of resources.
We know that part of the answer lies in the need to develop better structures which allow the NHS to become more integrated into the full range of local public services.
We need to build on the work done by STPs and local authorities which offers the prospect of more joined up services which reflect local needs.
At a time when Whitehall will continue to be distracted by other priorities, we are beginning to see new partnerships with local government in which people are willing to make decisions which our traditional structures find difficult. We need to build on those partnerships, and implement solutions which work.
The Confederation will continue to facilitate these developments. It is where the breadth of our membership and networks give us a unique opportunity.
We bring together the whole range of the health and care system – the NHS provider community; NHS Commissioners, NHS Primary Care together with Public Health, Local Government, the ambulance service, and the independent sector.
None of us can any longer work in isolation; it is time for all of us to smell the coffee and change the way we work.
The key for us is to engage with members. That means we bring members together to learn from each other, and we provide external stimulus to ensure that it does not become a closed conversation. It also means we ensure that the results of those conversations are shared with decision makers, in private when appropriate and in public when necessary.