In conversation with Matthew Taylor — Chief Executive, NHS Confederation

This week, WA was delighted to host NHS Confederation Chief Executive Matthew Taylor. WA’s Head of Health Caroline Gordon led a discussion exploring Matthew’s perspective on how to tackle the big challenges facing the NHS, and how partners can work together to support the system.

Bringing decades of experience from both inside and outside government, Matthew expanded on his agenda-setting NHS Confed Expo speech which outlined five key ways to improve the UK’s health.

A few things we learnt:

Big change is possible, but it needs a big political vision

Matthew’s ambition for the UK to have a cross-cutting ‘health strategy’ – not just a set of policies for the NHS – is a hefty aspiration, particularly when government departments tend to work in vertical silos. Getting health policy into housing, criminal justice and levelling up policy is challenging.

But it can be achieved if the Prime Minister owns it from the centre, owns the mission, and insists on a cross-government structure that is focused on delivery. A clear vision is key.

Show the savings

The argument for investing in prevention and out of hospital care – often described as upstreaming – is well established and widely shared. However, persuading those holding the purse strings, whether centrally in the Treasury or locally in Trusts, is challenging. Too often ‘invest to save’ arguments are rejected, because in the past, new investment has not always led to the promised savings.

Two possible solutions: First: make the case by modelling the long-term savings. The NHS Confederation has been working hard to demonstrate the cost effectiveness and productivity benefits of investing in smarter healthcare. Second: know how the savings will be realised – ideally within a reasonable timeframe. Reassure the budget holder that you have real evidence that investment will pay off.

Integrated Care Systems (ICSs) – one year on

As the dust settles on the Hewitt Review, the emerging ICSs continue to evolve. There is significant variation in their size, approach, and progress (not necessarily a bad thing if we want to experiment with different models) and the system is learning together all the time.

It was recognised that it can be challenging for stakeholders to engage with the new structures, even when they want to share ideas that could help ICSs achieve their ambitions.

Some ideas for reaching new local decision makers:

• Securing local clinical endorsement can unlock doors – and bringing together enthusiastic clinicians from different ICSs to form ‘coalitions of the willing’ can be a great way to cultivate collaboration with the NHS and share best practice.
• Utilise networks like the NHS Confederation’s ICS Network.
• Accept that the new system doesn’t respond to one-size-fits-all – it’s going to require a more tailored approach than before.

The discussion was practical, realistic, and thought provoking, providing lots of new ideas for engagement with the NHS as it changes.

To find out more, or to discuss how WA can support your engagement with the NHS, please contact Caroline Gordon at carolinegordon@wacomms.co.uk.