Last week saw the publication of Trust Special Administrator’s report on South London Healthcare NHS Trust and the NHS in South East London. The 361 page document is the first of its kind.
While many of the points that were raised in the report will be very familiar to those who have worked in the NHS or are currently working in the NHS, it seems to me there are a number of important learning points from the document.
Financial and Operational Performance Are Linked
As is often the case, when an NHS organisation is struggling financially it also struggles operationally in terms of meeting targets.
Merging Struggling Organisations Does Not Solve The Problems
Mergers can create synergies and savings. At the same time bringing together organisations under any circumstances and creating a new culture, identity and organisation is always going to be problematic. When the organisations are already struggling the challenge is even greater.
When Organisations Don’t Work Collaboratively There Is Always Challenges
The report clearly states that organisations within the health economy have worked to manage their own financial pressures without regards to the impact on others. As we move more and more into a period of reducing resources in real terms, this silo working approach is only likely to make things more difficult.
If You Merely Focus On Short Term Then Strategic Issues Are Not Tackled
Of course it is vital that good services are provided day to day. At the same time not giving sufficient focus to bigger strategic issues means that key discussions are avoided or delayed.
There Is Little Point In Investing In External Help If You Don’t Implement
The Trust has had turnaround support from three of the biggest consultancies in the world McKinsey & Company, Ernst & Young and PricewaterhouseCoopers to advise on turnaround and performance improvement. Yet you can get the best advice around but you need to be willing to act on it.
Continual Management Changes Is Not The Answer
The temptation when organisations are not performing to the expected levels is to change the management team. Trouble is you are starting again in building relationships. Often it is those that have longevity of leadership that perform the best. This is perhaps in part due to the fact that clinical staff recognise that the people at the top are around for the longer term.
A Strategic Approach Is Needed To Workforce Planning
There are always going to be times when the use of agency staff is unavoidable. If however the level is running at a much higher rate than normal, a different, more strategic approach is needed to staffing.
The Real Reasons For Such High Levels Of Temporary Staffing Need To Be Established
Without doubt the geographical location of the Trust would be a factor. However, there may well be other reasons why it is difficult to recruit and retain staff. These insights are vital to tackling the issue.
There Needs To Be More Willingness To Learn From The Best
The report highlights areas where operationally performance is poorer than the best. Learning from each other surely presents great opportunities for the NHS.
The Bottom Line: While the report highlights many issues at the Trust, there is also lots of learning for the NHS more generally in my view.
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