Richard Sykes on leadership challenges in the NHS


Published on

Sir Richard Sykes, former Chairman of NHS London. looks at the leadership and mangement challenges facing the NHS from a business perspective.

Published in: Health & Medicine
1 Like
  • Be the first to comment

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

Richard Sykes on leadership challenges in the NHS

  1. 1. Sir Richard Sykes, FRS, FMedSci former Chairman of NHS London LEADERSHIP AND MANAGEMENT – Challenges in the NHS Lessons learned and implications for the future
  2. 2. Leadership <ul><li>The art of motivating a group of people to act towards achieving a common goal </li></ul><ul><li>The leader is the inspiration and director of the action – the person that possesses the combination of personality and skills that make others want to follow </li></ul>
  3. 3. Main characteristics <ul><li>Clear vision </li></ul><ul><li>Sharing/communicating vision with others so they will follow </li></ul><ul><li>Providing the information, knowledge and methods to realise the vision – a strategy </li></ul><ul><li>Coordinating and balancing the conflicting interests of members or stakeholders </li></ul><ul><li>Stand up for what they believe </li></ul>
  4. 4. Management <ul><li>The creative and systematic pursuit of practical results by identifying and using available human and knowledge resources in a concerted and reinforcing way. </li></ul><ul><li>– Get the job done </li></ul>
  5. 5. Normal business case <ul><li>Vision for the company </li></ul><ul><li>Strategy for reaching the vision </li></ul><ul><li>Guiding principles </li></ul><ul><li>Business plan </li></ul><ul><li>Timelines </li></ul><ul><ul><li>Financial implications </li></ul></ul>
  6. 6. Example <ul><li>Glaxo 1994 – Zantac patent expiry </li></ul><ul><li>Merger with Wellcome </li></ul><ul><li>Global integration </li></ul><ul><li>Communication and action </li></ul><ul><li>Consultants and enablers </li></ul><ul><li>Clear lines of responsibility </li></ul>
  7. 7. Principles <ul><li>Services should be focused on individual needs and choices </li></ul><ul><li>Services should be localised where possible but centralised where necessary </li></ul><ul><li>Services should be built around truly integrated care and partnership working, maximising the contribution of the entire workforce </li></ul><ul><li>Prevention is better than cure </li></ul><ul><li>Priorities should reflect health inequalities and diversity </li></ul>
  8. 8. Polyclinics are an opportunity for the NHS to deliver world class care closer to people ’s homes  Polyclinics combine GP  Certain routine hospital services  X-rays and blood tests  Fully equipped with first-class facilities  Modern - DDA compliant  Polyclinics are open from 8am to 8pm every day including at weekends  Individuals and families are welcome to attend them, whether they live, work or are staying in London for a short time, even if they are not registered there and routine hospital care  A range of useful well being and support services, benefits support and housing advice  Many nearby GP practices are linked to, and work with, the polyclinic as part of the system  Patients still choose to see their own doctor The benefits include:  Giving people in London more access to doctors and routine care  More accessible, local and convenient  People can still choose to see their own doctor  A faster, more convenient, high-quality health service  Planned around those who need to use it and open for longer for everyone  Extended opening hours to fit around the busy lives of people in London
  9. 9. The vision for transforming primary and community care London will be served by over 100 polysystems, delivering integrated health and social care services to local communities
  10. 10. The vision for transforming acute care Major acute hospitals will provide rapid access to emergency care for patients suffering from critical conditions. They will only take the most seriously ill patients, and will have all relevant services co-located on site. Local hospitals will provide high quality, non-complex acute services – ensuring patient access and convenience without sacrificing quality of care. Some transformation is already underway, with four trauma networks in place across London
  11. 11. London also has three of the UK ’s five Academic Health Science Centres Imperial Health Partners UCL Partners King ’s Health Partners
  12. 12. ‘ Too much stuff’ <ul><li>31 PCTs </li></ul><ul><li>32 councils </li></ul><ul><li>The Mayor </li></ul><ul><li>Local MPs </li></ul><ul><li>The Commissions </li></ul><ul><li>Department of Health </li></ul>
  13. 13. Following publication of the Healthcare for London vision , a major consultation exercise was undertaken led by London PCTs. This concluded in June 2008 when a Joint Committee of PCTs committed to implementing the strategy. • Over 5,000 responses, including 200 organisations • Around 40,000 visitors to the website, meetings and road shows • An emphasis on quality, safety, outcomes and patient experience Healthcare for London vision
  14. 14. Lessons learned <ul><li>Never trust politicians </li></ul><ul><li>Strong leadership and good management will not always prevail </li></ul><ul><li>Health care is based on emotion not logic </li></ul><ul><li>Clinicians must be on the front line </li></ul><ul><li>The organisation is risk averse </li></ul><ul><li>No clear lines of responsibility </li></ul><ul><li>Lack of incentivisation </li></ul><ul><li>Too many missives </li></ul><ul><li>A lot of very well meaning people but not enough leaders </li></ul>
  15. 15. Implications <ul><li>Health care - Affordability </li></ul><ul><li>- Quality </li></ul><ul><li>- Standards </li></ul><ul><li>- Delivery </li></ul><ul><li>Economy - NHS central role to play in UK Bioscience Industry </li></ul><ul><li>- Critically important for the economy </li></ul><ul><li>- Losing business </li></ul>
  16. 16. Clinical trials <ul><li>A fragmented process characterised by multiple layers of bureaucracy, uncertainty and duplication </li></ul><ul><li>Rawlins Report </li></ul><ul><li>AMS </li></ul>
  17. 17. <ul><li>Development </li></ul>Diffusion Innovators Early adopters Early majority Late majority Time NHS Uptake Innovation Basic research Applied research Targeted development First human use Clinical trials Early adoption Late adoption Accepted practice (or disuse) RESEARCH COUNCILS, MAJOR CHARITIES, NIHR (CBRC, SBRC,BRU) AHSC, HIEC The adoption dilemma remains
  18. 18. Challenges for 2010 and beyond <ul><li>Ageing population </li></ul><ul><li>Chronic conditions </li></ul><ul><li>Moving care out of hospitals into other settings </li></ul><ul><li>Personalised medicine </li></ul><ul><li>Need to use the NHS Reforms to tackle these issues </li></ul><ul><li>Reforms must not inadvertently weaken UK’s position for wealth creation </li></ul>
  19. 19. The future: A Research, Education and Patient Care Cluster