On the 18th May The King’s Fund published a report entitled “The future of leadership and management in the NHS – No more heroes”. It is the result of nine months of research, seminars and consultation into the state of management in the NHS. Broadly, it is supportive of NHS managers and it is against too many cuts in management numbers.
There is a lot of interesting topics covered in the report and I will be writing more about it in the future, but I wanted to start by focusing in on one of the recommendations (on page viii), which reads:
There is appreciable evidence that the NHS is over-administered as a result of extensive, overlapping and duplicating demands from both regulators and performance managers. There has not been a substantive review of the information demands placed on the service and its providers for many years. A review leading to a rationalisation of those demands is essential.
The words “substantive review” should always strike fear into the reader. A substantive review always seems to be a centralised exercise. They are run from the centre, by the centre and usually promote the needs of the centre. Government studies into what information need to be gathered by Whitehall, start from the premise that they need to determine what Whitehall and the government need. It would be a breath of fresh air to see a study that started with the needs of local work and worked the other way.
How might that work?
Instead of a study group gathering submissions about what data is collected, the starting point would be what data is needed to run the service locally? What data is needed to improve the delivery of value to patients? I would go so far as to say that there is a place for separating the production of data for government and the production of data for local delivery. Most larger trusts have statisticians, they should take over all responsibility for reporting to the centre and relive local managers to collect the data they need. Then locally you can decide how the two data sets differ. Only then should government be notified of the differences. This would have the added benefit of quickly relieving local managers and clinicians of much data collection and reporting responsibility, giving them more time to deliver and improve the care of patients.
If the cause of localism is true then the government will welcome local decisions on what data is collected, for what purpose and what is then reported centrally.