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Sir Alan Langlands: Leadership in the NHS

Sir Alan Langlands, former Chief Executive of NHS London, gives his opinion on leadership and management in the NHS.

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Sir Alan Langlands: Leadership in the NHS

  1. 1. The King’s Fund NHS Leadership‘an ongoing conversations between people who care deeply about something of great importance’ Anon Alan Langlands 24 March 2011
  2. 2. Perspectives from an old timer_____________________________________________________________________________________________________________________  background  context  substance  process
  3. 3. CONTEXTConstancy of purpose_____________________________________________________________________________________________________________________ … the purpose of the NHS is to secure through the resources available the greatest possible improvement in the physical and mental health of people:  promoting health  preventing ill health  diagnosing and treating injury and disease  caring for those with long-term illness and disability who need the service of the NHS.
  4. 4. CONTEXTResults_____________________________________________________________________________________________________________________ equity  measuring progress  finding the best trade-offs £ efficiency excellence responsiveness
  5. 5. CONTEXTAll change_____________________________________________________________________________________________________________________ legislative change  the economy  demography  science and technology  the swing from the collective to the individual  changes in the burden of disease  challenges for the professionssystem change organisational change
  6. 6. CONTEXTGovernment or market-led_____________________________________________________________________________________________________________________ government  the imperative of the cash limit and the need for control  the power and influence of the professionsmarket public
  7. 7. Avoiding victimhood andmaintaining control_____________________________________________________________________________________________________________________ Department of Health Monitor and ministers Care Quality Accountability Commission Strategic Health Funding Authorities Foundation Primary care NHS trusts trusts trusts
  8. 8. Thinking through anatomy ANDphysiology_____________________________________________________________________________________________________________________ Accountability Department of Health Funding and ministers Care Quality NHS Commissioning Monitor Board Commission Foundation trusts and other GP commissioning healthcare providers consortia
  9. 9. SUBSTANCEEquity and excellence_____________________________________________________________________________________________________________________  competition  choice  quality improvement  higher standards  a focus on outcomes
  10. 10. SUBSTANCEQuality_____________________________________________________________________________________________________________________  safe: avoiding harm  effective: proven benefits  person-centred: respectful and responsive  timely: avoiding harmful delay  efficient: avoiding waste  equitable: minimising variations
  11. 11. SUBSTANCESafer patients_____________________________________________________________________________________________________________________  clinical deterioration  ventilator Perioperative care General ward care associated management Critical care Leadership Medicines pneumonia Leadership  central line bloodstream infections  MRSA bloodstream  anti-coagulation medication Safer Patients  surgical site infections
  12. 12. SUBSTANCEHealthy lives, Healthy people_____________________________________________________________________________________________________________________  a life course framework for tackling the social determinants of health  local government and local communities at the heart of improving health and well-being  a cross government approach – mental health, tobacco control, obesity, sexual health, pandemic flu preparedness.
  13. 13. SUBSTANCENurturing the scientific basis ofhealth services_____________________________________________________________________________________________________________________ ‘… finally after 60 years, the NHS has ended its casual relationship with science and technology. The opportunity to translate basic and clinical research into local, national and global therapeutic and healthcare benefits, and to link information from a wide range of medical and non-medical sources using electronic patient records to ensure better treatments, improve patient safety and advance medical research, are opportunities which must not be squandered.’ Alan Langlands: 5 July 2008
  14. 14. MalariaPublic health expenditure HIV/AIDSPrivate health expenditure Diabetes
  15. 15. PROCESSAligning supporting strategies_____________________________________________________________________________________________________________________ Quality improvement Leadership and Governance Critical care Estates and equipment Leadership Financial stewardship Human Resources Management Information Management and IT
  16. 16. PROCESSHuman resources management_____________________________________________________________________________________________________________________ Quality improvement Employee Employee Leadership and Governance Resourcing Relations Critical care Estates and equipment Leadership Financial stewardship Effective Communications Education Pay and Reward Training and System Development Information Management and IT
  17. 17. PROCESSPromoting principles of good governance_____________________________________________________________________________________________________________________ Promoting values for the whole Leadership and Governance Performing effectively in organisation and Critical care Financial stewardship clearly defined demonstrating functions and good governance roles Focusing on the through organisation’s behaviour Engaging stakeholdersand on making purpose and accountability real outcomes for citizens and service users Developing the Taking informed, capacity and transparent decisions capability of the and managing risk governing body to be effective
  18. 18. Conclusion_____________________________________________________________________________________________________________________  clear purpose  carefully defined results  understanding the limitations of structural change  a focus on quality, outcomes and safety - public health  a wider perspective - science - global responsibility  align support strategies  invest in leadership and governance