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NHS must tackle ‘tsunami of bureaucracy’

Published on 24/08/12 at 10:09am
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The NHS Confederation has expressed concerns that the government’s reform of the health service will lead to a 'tsunami of bureaucracy'.

The government’s reforms, which became law in April, created seven new bodies to help run the NHS day-to-day, including the Clinical Commissioning Groups, Public Health Watch, the NHS Commissioning Board and Monitor.

Writing in the Health Service Journal, Mike Farrar, chief executive of the NHS Confederation said the new bodies must help, rather than hinder NHS leaders in tackling major financial problems, reducing hospital admissions and moving care closer to people’s homes.

He worries that the sheer number of these bodies will lead to a ‘myriad of conflicting policies’ and a ‘tsunami of bureaucracy’.

Farrar highlighted the results of a major survey of NHS chairs and chief executives, which reveals significant concerns about the new organisations.

Over half (57%) of NHS managers who took the survey highlighted a lack of expertise or experience in the new organisations as the biggest risk to the government’s NHS reforms.

The majority of respondents were also concerned by the disruption caused by organisational restructuring and the financial pressures of cost saving targets.

Farrar says: “To be successful, these new organisations must listen - and keep listening - to NHS leaders. They must avoid overwhelming NHS organisations with complexity and instead focus on the critical overarching concerns that will matter most in the end.

“It’s essential that national bodies ensure they are driving towards the same goals, not subjecting the NHS to a myriad of conflicting policies. Otherwise the NHS will be pulled in different directions and unable to make progress.”

The government’s reforms are abolishing the old NHS management system, and along with it many of the Confederation’s members’ jobs. CCGs - who will become the new commissioners for the NHS from April next year - are set to replace them.

Farrar also urged the national bodies to empower these new local commissioners to do the right thing for patients.

“Clinical commissioning groups have the potential to make huge improvements to local services if - and it’s a big if - the new system gives them the freedom they need to get on with the job,” he said.

He concluded by saying: “Performance in many parts of the system will be patchy at first. So we need to ensure public and political expectations are realistic.

“All those involved will make mistakes. Those leading the change need to be open-minded and flexible to improve policy and practice as we go. We are losing many experienced leaders.

“We need to ensure that as new ones emerge, taking on these challenges, they are given the support and cover they need to succeed, even if that means tolerating some difficulty along the way.”

Ben Adams

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