By Rachel Allan
On the 1st August Amanda Pritchard became CEO of the NHS.
Much has been made of the fact that Amanda Pritchard is a woman and the NHS is being led by a woman for the first time in its 75 year history, in spite of its workforce being “more than three quarters female”. It is a significant moment of course, but let us not forget that she did not get the job because of her gender.
Simon Stevens’s strategic vision and political nous made him an exceptional leader and what the NHS needed at that time. He will be remembered for prising billions of pounds of funding out of Treasury; for getting the NHS Bill to parliament; for the Long Term Plan and for setting the direction and timetable for moving us towards a more integrated health and care system.
What we need now is an arch operator. Amanda is a wise choice. As the NHS’s COO her job was to lead its operational performance throughout the last 16 months. Well-respected, experienced at both running an institution (Guys and Tommies) as well as NHS England, Amanda is tough but human and widely admired for her under-stated leadership style.
We don’t need a new vision or strategy at the moment. We need someone who can lead the NHS with determination and operational realism as it tackles under-funding, under-staffing and over-demand. Amanda will no doubt work hard to maintain the operational independence of the NHS, but I hope that she and her political counter-partner, Javid, will focus their energy not on fiddling with the plumbing, but on working out the still unresolved issues on longer-term funding models for the NHS and social care.
In a rare interview earlier this year, Pritchard also argued that tackling health inequalities was arguably the most pressing issue for the NHS as it comes out of the pandemic, and a way in which the NHS should orientate its post covid recovery. But arguably, the NHS workforce is the hardest and most urgent to resolve. Unless there is a real plan for how to stem the bleed, whilst shoring up NHS workforce, pay and career paths for future generations, all other plans will stay as plans as there won’t be the workforce to deliver them. These are big contextual issues that anyone would struggle to address, let alone when dealing with the largest elective backlog in decades. But as an NHS insider she has the foundations, and she will be all too aware of what this looks and feels like at the frontline.
At the top of her brand new official Twitter feed for the role, Pritchard has pinned a series of tweets that portray the important message she wants people to be able to read in the coming weeks. We’ve taken a look at these tweets in order to gain insight into what we can expect from the NHS under her rule. Here’s what we think:
Tweet 1/10: What a picture! Pritchard stands in a high-tech, clinical environment showing us that this is not someone who will be sitting around a board table or ‘meeting the people’. Here is the new NHS CEO – in a hospital, surrounded by state-of-the-art tech dressed to kill. This is not a giving warm fuzzies – she means business.
Pritchard puts her NHS credentials upfront – ‘I’ve always been incredibly proud to work for the NHS’ – demonstrating her lifelong commitment to the institution and speaks to the wider NHS team, management, and clinicians when she says she couldn’t be prouder of ‘what we’ve achieved’.
Tweet 2/10: Pritchard puts the qualities of ‘dedication, skill and compassion’ on level footing with ‘innovation, agility and a ‘can do’ spirit’. Here she is indicating that although this is a people business it is also about elbow grease, working smart and leveraging innovation. These are all the qualities the NHS will need in the coming years.
Tweets 3/10 – 6/10: This part of the tweet thread is very much centred on the NHS vaccine programme. There is no mention of the team of private sector support who together with scientists secured our supply of the vaccine.
‘Determination’ and ‘innovation’ – Pritchard repeats these phrases, she knows these are the keywords for the coming years.
Tweet 5/10 is a particularly strong tweet. The crux of the issue is the shared endeavor of LONG term improvements and prevention which is key to a sustainable NHS in the future.
Tweet 7/10: The power of innovation is referenced again. Here it is in reference to its potential to transform care and health.
Tweet 8/10 – 10/10: Finishing up Pritchard begins to reflect on the NHS staff, their commitment throughout the pandemic, and the resilience they will need in recovery. Interestingly she combines the health and wellbeing of staff and the future challenge – her realism and optimism. This might suggest things aren’t going to change significantly or imminently for staff.
Our final thoughts: Pritchards positions these thoughts, delivered on Twitter, as a message to NHS staff. As she outlines some of her key areas of focus, this is also a peep into her early thinking and key priorities. She reflects on staff efforts but is not shying away from the push required to drive recovery and prepare a health system that can cope with future demands.
Things worth noting:
Innovation – this concept gets four mentions and coupled with the picture demonstrate her view of how important it is to recognise and implement innovative care and ways of working
Determination – this word gets two mentions and is critical to the challenge ahead
Realistic optimism – it’s not going to be easy but working together is fundamental to getting the job done.
The lack of reference to other NHS services such as mental health, primary and community care is interesting and suggests the elective backlog challenge is looming and large. This, coupled with prevention, innovation, teamwork, and graft are clearly front of mind.