What the NHS really needs

A report in today’s FT suggests that the savings from the government’s latest NHS reorganisation will be quite a lot lower than promised.  That does not come as a great surprise.  Every NHS restructure is costly and time-consuming.  As they happen every few years it means, as one senior manager told me, that as soon as the new organisations it creates are mature and actually achieving something they are abolished in favour of a different configuration.  And back to square one we go.

It is not that the current changes and the many previous ones do not make some sense or have not contributed to some improvements.  My experience is that NHS Trusts are far more focused on efficiency, for example, than they once were and the separation of commissioning (Primary Care Trusts at the moment) and provider functions (hospitals, community health staff and so forth) may have helped to achieve that.

But restructuring never delivers what is promised because it cannot.  Continue reading