Shelford Group Chair Kirsten Major, Chief Executive of Sheffield Teaching Hospitals NHS Foundation Trust, and Shelford Group Vice Chair Professor Clive Kay, Chief Executive of King’s College Hospital NHS Foundation Trust, have this week written to NHSE CEO Sir James Mackey and Health and Social Care Secretary Wes Streeting MP to affirm the Shelford Group’s commitment to support both them and the wider NHS through the current period of organisational change.
Read the full text below.
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Reforms to DHSC and NHS England
Dear Secretary of State and Sir Jim,
The Shelford Group is a collaboration between ten of the largest teaching and research NHS hospital trusts in England. We are writing to affirm our commitment to support you and the wider NHS through this period of radical change. We are ambitious about what a reformed NHS can deliver for patients by improving access to high-quality care. Alongside the 10 Year Health Plan, these reforms can help to overcome post-pandemic challenges and ensure we have a sustainable NHS for future generations.
As NHS Trust leaders, we know that provider organisations are eager to lead local service improvement and deliver accountability for performance and finances. We are committed to the three shifts of illness to prevention, hospital to community, and analogue to digital. We are equally committed to service integration and partnership working at local level. To enable this to happen there is an opportunity to reset the operating model of the NHS so that it works more effectively on behalf of patients. We can retain the best of local collaboration and system working while ensuring that we have a leaner, more streamlined way of operating that enables and supports provider leaders to focus on what matters most to patients.
We would like to work with you to develop the new operating model and support colleagues across the NHS through this period of major change. We have laid out some initial thoughts below and would welcome the opportunity to explore these ideas in greater depth.
- At national level, we agree that the role of a combined DHSC/NHSE should be to set system rules with coherent financial and operational policy to underpin them including clear financial flows and consistent provider oversight. This will help to remove the duplication that exists when national, regional, and system teams all separately and in different ways drive strategy, oversee providers, and hold them to account.
- At regional level, we see a need for an intermediate tier of strategic commissioners that combines the best of the ICB and SHA models. These commissioners should be responsible for contracting nonspecialised services, ensuring patients have a choice of provider, and ensuring adherence to national priorities.
- At local level, our view is that provider trusts are the right building block to lead the improvement of services – including achieving the three shifts of illness to prevention, hospital to community, and analogue to digital. We want and welcome clear accountability for provider leaders – in terms of finance, access and service quality – with earned autonomy as a guiding principle. Providers should be responsible for their own performance but look beyond organizational boundaries where that improves outcomes and services for patients – acting as anchor institutions and driving the integration of care. We do not believe that NHS Trusts alone hold all the answers to the challenges facing the NHS and we want to work with others to improve services for patients.
As Shelford Group Trusts with significant research capability and the scale to drive change, we have a particular responsibility to develop new models of care and share best practice across the NHS – and we will be focusing on how we do this to the benefit of the whole system.
While much focus is rightly on operational and financial performance, there is equally a need to ensure that we fulfil the ambition of government and the NHS to be a hotbed of innovation, including through clinical research and partnerships with the life sciences sector. We want to meet the ambitions of the life sciences sector plan and the O’Shaughnessy review of clinical trials. We will be working together to achieve these goals and ask for continued focus and support at the national level to make this happen. We have a role to support this focus ensuring we maximise the contribution the NHS can make to future economic growth.
There is much work to do to ensure that the changes announced last week deliver the best possible outcomes for patients. We want to help lead the change that the NHS needs to see and look forward to working with you. We are publishing this letter to help inform the conversation about how best to implement these changes.
Kirsten Major, Chief Executive, Sheffield Teaching Hospitals NHS Foundation Trust, Shelford Group Chair
Professor Clive Kay, Chief Executive, King’s College Hospital NHS Foundation Trust, Shelford Group Vice-Chair