THE LOOP
Stolen lives
Ed Smith
Chairman,Trustee & Non-executive Director
I so much enjoyed my time with clinicians, managers, volunteers and trust leadership when I was privileged to chair NHS Improvement. Quite a few things irked me because they also irked the people working day in day out to deliver health and care to the people we serve. At the system level it was constant tinkering and micromanagement from the centre (in which of course I was involved, although not committed to the centrist style!) Another was the lack of alignment between incentives and purpose. This is evident both within the NHS and in other non-aligned “systems”- with a tariff mechanism and data that were outdated and outmoded but “experts” said would take five years to change. Well you have to start sometime and we are still in the mire - with tariffs often misaligned with costs both positively and negatively. Tinkering is not reform. The moves to population health models, and to vertical and horizontal alignment around local populations, are to be applauded but, as with actions to combat climate change, pace cannot glacial and actions must be seriously joined up. At the more local level there was a frustration about patients - often our senior citizens who were ready for discharge into community settings, but for whom the handover was elongated and often debilitating for them. 0028
