By Hilary Rowell, director, ZPB
What a warm welcome Simon Stevens has received from the twitterati – so far. There’s still plenty of time for the naysayers to get stuck in, as they most certainly will, because there’s nothing that the denizens of the NHS village like more than having a pop at a big cheese. What we need to acknowledge is that Stevens is taking on the near-impossible task of reconciling shrinking budgets with expanding demand and managing political noise while trying to steer difficult changes.
He will find that much has changed since he was in the thick of it – but it is not as if he has cut himself off in the past nine years. His involvement on the boards of the Nuffield Trust and Kings Fund has kept him well in the loop. He is a thinker and a doer, a man with political nous as well as managerial credentials – and an impressive knowledge of not only the NHS, but healthcare systems around the world. This is a good start.
The fact is that when you strip away a certain amount of botched implementation and pragmatic compromise, the direction of travel that started with the NHS Plan in 2000 (which he helped to architect) has changed relatively little – though the pressure has ramped up exponentially. With that long term perspective in mind, it is striking that conversations that seemed radical back then are now commonplace – publishing performance data, sharing information, giving people access to their records, making patient experience a central issue.
And if you look at some of the themes he has been pursuing at United, they have much resonance for the NHS now: transparency about quality, lining up the right kind of incentives and equipping and encouraging the public to exercise their rights as consumers (or put another way, their rights under the NHS constitution). His interview with Forbes on YouTube is worth a view. Arguably, NHS England is all over the first and third of those themes, but there is a desperate need for fresh thinking and clever action on the question of creating incentives that help clinicians and managers, commissioners and providers do the ‘right thing’. This could be where he really makes his mark.