Praise for progress but tough times ahead, says Mackey

Jim Mackey

The head of NHS Improvement has praised system leaders for their efforts to bring the NHS’ books back into balance, but warned that tough times lie ahead.
Addressing an audience of senior health and care leaders at Confed17, Jim Mackey revealed that the NHS had broken even in the fourth quarter of 2016/17 – a ‘fantastic achievement’ for a system under incredible pressure. 

He added that NHS provider organisations had delivered cost reductions ‘virtually impossible anywhere else in the world’. 

But he cautioned that issues around money are likely to be harder in 2017/18. The ‘incredible effort’ seen in 2016/17 came on the back of ‘short-term instruments’, he said.
He revealed that the regulator will shortly publish details of financial plans, making clear that this  would not be another ‘financial reset’.
He also revealed  that more details are to come on the NHS delivery plan and that there will be a big push on productivity. And, to support the service to be better prepared for winter, the national bodies will agree and issue a winter plan before the summer holidays. 

A new hybrid

Delivering a frank final conference speech as chief executive of NHS Improvement, Mr Mackey talked of the need to usher in a shift towards earned autonomy and distributed leadership.
In a keynote address touching on money, leadership, quality, workforce and transformation, he spoke of blurring the lines between commissioners and providers. And he said that far less central control was needed.
Questioned on whether the ‘new hybrid’ – commissioners and providers – would need new legislation, he said the NHS can get ‘90 per cent of the way within the law’, but a robust evidence base is crucial. The NHS needs to reduce transactional boundaries, he said.
On the issue of quality, he warned that despite progress, occupancy rates are ‘too high to be healthy’. He asked the audience to stay focused on RTT, cancer and mental health targets. He also added that quality will be much more central to NHS Improvement’s work.

'We all need to be concerned'

Mr Mackey was vocal on the need to prioritise the NHS workforce, a main pressure for leaders across the country. It something we all need to be concerned about, he said. 
He also addressed the issue of bullying within the workplace, saying unequivocally that it is not acceptable. 

Watch Jim's speech in full.

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