Are you reactive or proactive? After 65 years it’s about time the NHS got one step ahead of the game

I started in clinical leadership development and management in the 21st century and in those years have witnessed dramatic changes in the NHS which have culminated in the recent reforms.

Over the last 65 years the NHS has had to deal with a variety of external macro-environmental and internal pressures and although having managed to get through, it is always responding to these pressures in a reactive way.

We have got through and have reached the 65 year milestone which is to be celebrated, but reacting to change is not going to deliver us the next 65 years.

Part of this reactive history is seen in how the NHS has been delivering an ‘illness’ service with the focus of resource and targets on how to treat and support those who are ill and need help. This was one of its original aims and to act as a safety net for those in acute need. Over the last 65 years this has exponentially become less fit for purpose and now is failing to deliver what we need to sustain the service for the future.

As leaders we must strive for a new mind set, stop reacting both to the environment and to illness and move to a proactive approach to delivering the service and meeting the needs of the population.

We are reacting to the ageing population, yet we know it is coming. We react to illness, yet we know how to prevent much of it. We react to the effects of health inequalities, yet we know how to correct them. We are currently reacting to the financial pressures of a global recession, but this is part of a larger picture that we should be preparing for and pro-actively working together, both the NHS and global healthcare leaders.

Healthcare professionals around the world generally share the same challenges and need to work much better together to meet higher patient healthcare expectations.

We have the opportunity to put work together more and I would make two observations that I think are true: one is that there’s always another way of doing something and two, is that there’s always a better way of doing something.

In short, doing the same thing repeatedly is not going to be the answer to our problems. There’ll be ways we haven’t thought of and there’ll be ways that are novel and innovative. 

There’s huge experience and expertise out there, in healthcare and the wider sector, but it must be a two-way street. Effective integration involves multiple parties, both the current NHS providers and those entering the sector as new providers and partners. Each of those parties needs to develop and nurture a burning desire to work together for the best quality care.

This will involve much more commitment to improvement and we must train the next generation of NHS employees to be confident and committed to innovation and challenges and not tolerate the status quo. Within this is the need to develop networks and positive relationships.  Innovations and ideas can and should be shared, maximising the economies of scale within the NHS for improvement purposes.

My experience has shown me the speed of change is faster in the independent sector and there is better ability to predict and control which offers wider benefits to the NHS as a whole.

Supporting this, and a change I have witnessed in the last 15 years, is the enthusiasm to engage and involve patients and the community in designing and delivering the service they need and want. This has grown considerably and must continue to ensure our main stakeholder, customer and purpose for being here is involved.

Leaders must ensure that users of their services are both satisfied and engaged and staff have a commitment to serving the patients they care for.

Above all, our role as clinicians and leaders is to ensure that patients remain at the heart of everything we do and continue to reinvigorate the landscape, in an ever changing and resource challenged environment.

Objectives and focus can be eroded by politics, chaos, change and pressures, but the patients must be the reason for all of us taking this challenge head on for the next 65 years.

Dr Richard Jenkins, is Group Medical Director at One Medical Group which provides patient and GP focussed primary healthcare solutions.