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My evening with Sir Robert Naylor: “The future is about collaboration”

Last week I attended Roy Lilley’s latest health chat with Sir Robert Naylor, the outgoing CEO of University College London Hospitals NHS FT.  If you’ve attended these before, you’ll know that the health chats are always a lively affair with good questioning and humour from Roy as well as coverage of a broad range of strategic issues.  The glass or two of wine before we get started always helps!

In this conversation some of the hot topics raised included

  • Why does PFI have such a wide variation of success/failure?
  • Why clinical management structures matter
  • The role of an NHS CEO – is the job doable? 
  • The parlous state of the NHS Finances – what’s to be done?
  • The UK health spend vs other countries – relative to our size, we deliver strong outcomes
  • What does the future structure of the NHS look like – collaborative in nature

That was a lot of ground to cover in an hour and a half and Sir Robert raised some very interesting thoughts. Two particular areas of interest for me were around the role of the NHS CEO and the future of commissioning.  

Sir Robert stated that the NHS CEO role “is the best job in the NHS.”  There were a few CEOs in the audience, some current and some former, all of whom seemed to be either smiling or nodding.  Is the job actually doable? It has been widely reported that NHS Chief Executive tenure remains low, with a range of figures suggesting between c. 750 and 1000 days on average depending on the dates of the study.  

For Sir Robert, it’s not the qualities of leadership within the NHS that are at fault, rather the challenge for CEOs and the NHS lies in government decisions about resource allocation.  The discussion broadened as to whether there was any incentive to deliver a surplus, if there are too many commissioning organisations and what the future of the NHS tariff may/should look like.  Some of you may have read the recent Health Service Journal enquiry into the future of the NHS Leadership which you can read here.  

What do you think- is the role of an NHS Chief Executive doable?  My colleague Claire Carter recently wrote on NHS CEO tenure and how many CEOs are “feeling the burn.”  

Another key area of interest was the future role of accountable care organisations and the potential impact that this could have on the structure and nature of commissioning within the NHS.  For Sir Robert, commissioning is too fragmented and he envisages a very different future structure along the lines announced by Northumberland  CCG.  He summarised that the “future of the NHS is about collaboration.”  

What do you think - are accountable care organisations the future? Do you want to be a NHS CEO? I always welcome your thoughts either directly or posted within the comments.  

David Rason is the Consultant for Healthcare at Interim Partners.

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