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We need to talk about the NHS…

By Alex Metcalfe, account manager, ZPB

Matthew Swindells speaking at the CHN

On 28 September, Cambridge Health Network members had ‘A conversation with Matthew Swindells’. The event focused on the operational side of Matthew’s role as National Director for Operations and Information at NHS England.

Matthew spoke about the progress of the sustainability and transformation partnerships (STPs), variations in care models and the use of apps to improve self-care.

However, one of the most interesting points Matthew made was about the need for a “public conversation about the NHS”. Matthew said that the NHS is not currently giving “patients the proper conversation they deserve” in terms of making decisions about their conditions that best suit them, but also about the appropriate use of NHS resource.

Matthew said that there is a mind-set that everything is available, but the reality is that the NHS is a capped system. This needs to be a national conversation delivered locally, as the only people trusted to have it are the local clinicians.

Matthew recognised that it will be a hard conversation, as the public expect to have all health services available locally, regardless of need. So the NHS needs to highlight to the public the errors in the current system and how changes being made a successes and improvements.

A key driver of those changes are the STPs and Matthew explained that the NHS is trying to move from to a population health management system, but it is hard to pull off in reality.

Matthew said that when the STPs kicked off NHS England asked them to identify the five hardest things they wanted to solve in their system and come up with how they were going to solve them. He noted that some of the local system leaders already knew each other well, but others had never met.

He commented that the STPs haven’t yet answered the challenge of how to manage the care of the frail elderly in non-acute settings, but they now have better questions to ask to identify potential improvements.

In Matthew’s opinion such improvements can only be delivered through the power of a collective leadership and if STPs had been imposed on them it wouldn’t have worked.

Matthew said the STPs are making the leaders face up to the problems, have difficult conversations, and revealing tensions between NHS and local authorities. Although he said this is appropriate to the situation they are in and if the conversations weren’t hard it would mean that they weren’t having the proper conversation.

Encouragingly Matthew noted that local leaders are now seeing that they are “all in this together”, which is a first for some of the local health and care systems.

The event, kindly hosted by McKinsey and Company, was part of the Cambridge Health Network’s Autumn Programme. To find out more, visit the network’s website.