Patrick Keady

Realising Lord Darzi’s vision


Lord Darzi, Parliamentary Under Secretary of State at the Department of Health (England).

The NHS is 60 on Tuesday. Happy birthday to a British treasure that is respected at home and around the world.

And tomorrow, Lord Darzi publishes his views on how the NHS can enhance that respect by delivering even better healthcare over the next 10 years. Further changes in NHS strategy are quaranteed. And as we know, implementing strategies can be challenging. Which reminds me of a research paper that I read recently. Based on the views of 35,000 people, the paper highlights just four areas that make (or break) the effective implementation of strategies.


My view is that by focusing on these four areas, professional groups, SHAs, PCTs and Trusts will be well placed to respond to Lord Darzi’s challenges. The four areas are information, decisions, motivators and structure. Here’s my initial thoughts on how NHS organisations and people working with NHS patients, can be better placed to deliver even better healthcare over the next 10 years.


Information – that important ‘competitive’ information gets to Boards, PCTs, SHAs and the Department of Health, more quickly – from patients, staff, independent healthcare providers, charities. That information flows freely across professional and organisational boundaries. NHS employees and other people employed to work with NHS patients, understand the real impact of their day-to-day choices on patients. Middle managers and clinicians have access to the information that they need to measure the key drivers of their service. That sources of conflict are acknowledged and responded to appropriately.


Decisions – reducing uncertainty will ensure that all people working with NHS Patients, understand the decisions and actions that they are responsible for. People will be clear about the impact of their decisions. They will be happy to be held accountable. Senior clinicians and managers will continue get involved in decisions at speciality/Departmental levels. The culture moves further towards ‘persuade and cajole’ and away from ‘command and control’. Human Resources, Finance and other corporate roles further change their behaviour to support Specialities and Departments.


Motivation is the third driver. Performance will focus more on outcomes – differentiating between high, adequate and low performers. Career advancement and salaries will be strongly influenced by the individual’s ability to deliver on their performance commitments. Even when an NHS organisation has a bad year, and one of its Specialities or Departments has a good year, the Speciality/Departmental gets a bonus – the team earns greater autonomy and financial support to further develop their Speciality/Department.


Structure. Increasingly, promotions will be from one position to another on the same level in the hierarchy. Fast-track employees can expect to be promoted upwards, at least every three years. Middle managers have a minimum of five direct reports.


So there you have it – my thoughts on four drivers that will help translate Dr Darzi’s thoughts into reality. Having worked with the NHS for 17 years, I know that we have the ability to achieve this. My gut-feel is that we will exceed! Here’s to even better NHS outcomes over the next 10 years.



Related Posts Plugin for WordPress, Blogger...

Related Posts:

Leave a Reply

Your email address will not be published. Required fields are marked *

Skip to toolbar