Accountability and autonomy in the NHS in England: priorities for the Hewitt review
Sir Chris Ham reflects on progress made against his recommendations on the conditions ICSs need to succeed and on next steps for the Hewitt review.
Download the report $Accountability And Autonomy In The NHS In England 141.8 kBKey points
- Progress has been made in acting on some of the recommendations in the NHS Confederation’s report, Governing the Health and Care System in England.
- This is most evident in plans to create a new NHS England (NHSE), reduce staffing at the centre and regions, and co-produce the operating framework.
- More work is needed to reduce the number of national NHSE programmes, ensure greater consistency in how these programmes work, and bring an end to constant bidding for funds tied to specific priorities.
- The Department of Health and Social Care’s (DHSC) 2020 report on Busting Bureaucracy should be revisited to release frontline staff to improve the delivery of care and enable senior leaders to look out more and look up less.
- High priority should be given to an organisational development (OD) programme to support the development of collaboration, mutual respect and trust and determine how peer support, shared learning and improvement collaboratives can play a bigger part in improving performance in future.
- Work is needed to define a high-performing integrated care system (ICS) and how data on performance can be used to stimulate improvements through transparent public reporting.
- The Hewitt review offers an opportunity for these and other issues to be addressed with priority being given to ensuring that planning guidance for 2023/24 is short and focused on a small number of national priorities, leaving scope for ICSs to add local priorities.
- Leaders in the DHSC and NHSE must recognise the exceptional pressures facing the health and care system and set out what a realistic set of medium-term objectives for ICSs looks like under current circumstances.