My mission statement

The times we are working in now need a great deal of accelerated change and there must be no negotiating that down. So my mission statement for this part of my consultancy career is to be clear that there needs to be and will be a lot of change from the work that I do with individuals and organisations and if organisations don’t want that, then it is probably best to go somewhere else.

Read my statement in full »

The National Commissioning Board is going to be potentially a very interesting organisation – with necessary conflict at its heart.

Filed Under (National Commissioning Board) by Paul on 26-06-2012

As I reminded readers last Thursday, about a year ago I commented that one of the problems with the NHS was caused by a belief that it could answer all of the questions posed to it from within its own resources. I pointed out that the belief that the answer was ‘in the room’ was one strongly held in the NHS. The evidence suggests however that, whilst it may be true that a lot of the answer is in the room, some very important parts of any answer MUST come from outside.

Last Wednesday four new non-executive director appointments to the NCB were announced to join the existing Chair, the Chair of the Audit Commission and the excellent Ciarán Devane (CEO of Macmillans) who are already non-executive members.

These new appointments all have extensive experience of the worlds of law and finance, and, in the shape of Lord Victor Adebowale, the provision of innovative health and social care services from the third sector. (To declare my own experience up front, I have worked with Victor for about 15 years on a variety of different boards from think tanks to a touring theatre company. He, alongside Ciarán Devane, will be a strong addition to the voices that need to be heard on the side of NHS patients in the NCB).

If I understood anything of what Andrew Lansley meant by his catchphrase ‘liberating the NHS’, I would think he would be very pleased with the way in which the non-executive members of the NCB are shaping up. They look like people from the outside who might want to bring about cultural change.

ALL of these non execs have interesting experiences that are external to the NHS.

But when you look at the senior executive staff of the NCB a very different picture emerges. With two (and a bit) exceptions scrolling down the list of staff the idea you can’t prevent from forming in your mind is that if Andrew Lansley meant anything by ‘liberating the NHS’ he probably had these people and their experiences in mind.

I have commented on this blog before about an experience I had in the summer of 2006. During that summer the new SHAs appointed 10 new CEOs. I went to speak to them the day after they were appointed and did some homework ahead of this discussion. I added up all the numbers in the press releases about their appointments and collectively all 10 of them had 173 years experience inside the NHS and 1 outside it. Individually these people were all experienced managers, but taken together these numbers demonstrate an almost total belief in a single culture as being the answer to everything.

It’s not that we don’t need NHS experience – but we need other experiences too.

So what does that mean for the new NCB?

The appointments of the non-executives have been made with a strong recognition of the need to bring outside experience to the National Commissioning Board.

The appointments of the senior staff in the NCB on the other hand show far too little understanding of the need for external experience.

So to sum up, if we look at the NCB to try and understand how far it is going  to be part of a new or an old NHS we will be puzzled. We see the ‘new’ being strongly advocated in the form of its non-executive directors struggling to ‘liberate the NHS’ from the old – in the shape of senior directors in the same body.

The struggle for the new or old NHS will now take place on a daily basis within the NCB Board.

This can only be a good thing.


2 Responses to “The National Commissioning Board is going to be potentially a very interesting organisation – with necessary conflict at its heart.”

  1. NHS management has always been a virtually closed shop. Charities, universities, central government (even local government sometimes) are prepared to entertain the possibility that someone from outside their world might be able to make a decent fist of a management role. NHS people basically think that only NHS lifers can do the job.

  2. On a similar note – some key exec posts in the board which on paper are very different from what has gone before are not open to those outside current SHA/PCT system

Leave a Reply