NHS England Lesson 8 – Getting things done – the bias to inertia

A past CEO of the Kings Fund once described the NHS as being dynamically conservative, it shifts its shape to make resistance look like progress.

Lesson 8 – Here are 12 steps to getting something done:

  1. Know the change you want shape, don’t ask a committee to work it out for you

  2. understand the business priorities and frame your change in these terms

  3. get it into the Business Plan

  4. find academic evidence to support the change – harder than you think, but only new ideas have to have evidence, all the old ideas are just taken on trust .. bad luck!

  5. get the backing of a senior clinical leader (your choice here is important)

  6. take your case through the committees personally, don’t rely on the apparatchiks.

  7. find a supplier/delivery partner on “G-Cloud”. I advise against an internal delivery organisation.

  8. make sure you have it complete to stage 1 within 3 months

  9. Set up a cross ALB stakeholder group… otherwise someone else will

  10. Deliver incremental benefits and make sure the benefits deliver the cost savings,

  11. Market the service or change continually, get the nay sayers off your bus

  12. Make sure it remains within the business plan/5 year forward view/whatever the new name will be.. keep up the momentum.

That’s it, eight lessons from 30 months in NHS England, would I do it again, I think I will take the Redgrave oath on that one. So you can now do one of two things; pick apart my lessons, easy to do, I have kept this short, and things are never quite as bad or as good as I have suggested, and tell yourself that all of this is irrelevant, do remember that they are my lessons not yours, or, think deeply about what you are doing and see if we share any common ground. If we do then you know where to find me and perhaps we could add to the “what next” for the NHS in England.

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