Balancing quality and finance to deliver greater value

24th June 2014

Two Sides of the Same Coin

“The safety of every patient and the value of every penny…..”

“The terrible experiences came largely from wards lacking in strong, principled and caring leadership" - Robert Francis QC

Main messages1. NHS organisations are clear that quality and finance are

two sides of the same coin and they are working hard to balance these and deliver greater value [in the organisation]

• Enablers to this include:• Internal trust between professional colleagues• Direction and strong leadership• Responsive culture and shared understanding of service

improvement needs

Main messages2. The wider healthcare system has a big impact on an

individual organisation’s ability to deliver value and has the potential to reinforce a divide between quality and finance [in the whole healthcare system]

• Enablers to this include:• Working together through system leadership• Empowering environment and appropriate regulation• Aligned funding mechanisms and incentives to system-wide

solutions

Main messages3. Overall value in healthcare needs to be considered

across public services and tough choices about quality and finance need to be part of a wider public debate about the NHS [across public services]

• Enablers to this include:• No blame culture and shared ownership of challenges and solutions• Public engagement and openness on how services are and should

be run• Support for change and political courage to engage with the public

on the issues locally

Overall conclusions• We need to do more to bring clinical and financial

colleagues together in the NHS

• Regulation needs to change to stop organisations being forced to choose between quality and finance

• The next General Election is the perfect opportunity to engage political parties in an open and honest debate about the future of the NHS

Further work: 2015 Challenge

Further work: Decisions of Value

• Study with the AoMRC exploring decision-making and how to balance quality and finance

• Large amount of research and evidence from across the NHS, including staff interviews and site visits

• Findings show importance of cultural factors, such as relationships, behaviours and environments

• Briefing and findings planned to be published in the summer

Many NHS staff – from the blunt end to the sharp end - demonstrate every single day the values of safety, civility, and compassion, providing the highest quality of care to patients even in challenging circumstances. Their excellent work must be celebrated. More than that, their values must be continually reinforced through the commitment and actions of leaders.

Professor Michael West

This looks interesting……………….

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“Death by Indifference”