At the recent NHS Providers Quality and Improvement conference, members shared their insights on the goals and challenges they face with NHS resident artist who captured these into a visual representation building the story throughout the day. The open and honest discussions highlighted the multifaceted nature of the NHS and the various factors influencing service quality and planning. So, what were the key areas?
Hand-drawn visualisation of members' views on the goals and challenges they face in the health and care sector today.
NHS – Same but different
While the public often views the NHS as a single entity, those within the system understand that it is composed of numerous organisations, each with its own identity and priorities. This fragmentation sometimes leads to competition rather than collaboration. Members acknowledged that despite the push for system-wide cooperation, organisational boundaries remain strong. There was a consensus that newcomers to the NHS often struggle with understanding the culture, the importance of quality improvement, and the channels for effective communication.
Tensions were noted in community provisions, with inequities making service delivery more challenging. However, successes were also highlighted, and there was a call for not just avoiding racism but actively being anti-racist.
Finance vs quality
A significant conflict between financial constraints and quality care was identified. Many felt that financial considerations often drive decisions, creating a disconnect between care objectives and financial objectives. However, there was also recognition of the intrinsic link between finance and quality. Some suggested that hospitals' entrenched ways of managing limited budgets could be a barrier to exploring community-based solutions for issues like bed-blocking. The need for a deeper understanding of the relationship between performance, productivity, and financial investment was emphasised. Would increased funding necessarily lead to greater efficiency?
Patient-centred care
Placing the patient at the centre of care was deemed crucial. Engaging both healthcare colleagues and patients in the co-design of services was seen as essential for delivering safe care. The emotional aspect of change processes was also highlighted, with concerns about burnout and the need to protect clinicians. While there was a desire to use patient feedback as a catalyst for change, many felt this was currently done in a tokenistic manner.
Provider collaboratives and system working
Views on provider collaboratives were mixed. While they have the potential to be powerful, their varying levels of maturity and the added complexity they bring were concerns. It was questioned as to whether simplifying and integrating these structures could add more value. Additionally, concerns were raised about the effectiveness of integrated care boards and whether regional offices should have more oversight.
The consensus was that most provider collaboratives are in the early stages of their journey and could benefit from shared templates and neutral support materials to enhance their development.
Reflecting on the positives
Success in improving NHS services hinges on clarifying the organisation's purpose and embedding continuous improvement into strategic priorities. A sustainable workforce with the right skill mix is essential for delivering change. Effective communication, characterised by simplicity and clarity, is crucial. Missing information can hinder care and communication, so using data to demonstrate the impact of quality is important for gaining support at all levels.
Importantly, valuing staff was recognised as a key driver of enthusiasm and inspiration. Feeling valued is crucial for maintaining motivation and ensuring that the workforce remains committed to delivering high-quality care.
The finished artwork highlighted both achievements and areas needing improvement providing food for thought for trusts and the NHS in navigating challenges and continuing to deliver high-quality care to all patients.
If you need help with tackling your challenges and would like more information about working with NHS South, Central and West please get in touch.
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