Dalton review: Response from NHS Partners Network and Care UK

COLCHESTER, U.K. - Dec. 12, 2014 - PRLog -- Published on hsj.com, David Hare and Jim Easton’s analysis considers the demand and financial pressure faced by providers, encourages organisations – regardless of their ownership model – to work together, and explains why the independent sector is well-positioned to support efforts in driving Dalton’s recommendations forward.

The Dalton review

The Dalton review was commissioned by Jeremy Hunt, Secretary of State for Health, and its publication quickly followed the announcement of NHS England’s Five Year Forward View. Dalton explains how his review complements the NHS’s forward view and “provides the organisational ‘delivery vehicles that can help to translate ideas into reality.”

His report, Examining new options and opportunities for providers of NHS care, identifies five themes that are crucial to accelerating the transformational change required to help overcome the challenges facing the NHS:

1) One size does not fit all

2) Quicker transformational and transactional change is required

3) Ambitious organisations with a proven track record should be encouraged to expand their reach and have greater impact

4) Overall sustainability for the provider sector is a priority

5) A dedicated implementation programme is needed to make change happen

Explaining point three – ambitious organisations with a proven track record should be encouraged to expand their reach and have greater impact – Dalton recommends a system where CCGs and providers utilise a credentialing process implemented by Monitor and the Care Quality Commission (CQC) that allows them to identify new partner organisations that can help to efficiently deliver improvements. A new procurement framework, which Dalton recommends should be live by April 2016, would streamline some aspects of the tendering process while, for individuals, an academy should support the development of skills and experience so that leaders are equipped to manage the delivery of new organisational models.

In his conclusion, Dalton states that the effective and quick implementation of the recommendations he makes for the five themes, is crucial to ensure the maximum impact for patients.

Read Dalton’s recommendations in full by downloading his report from the Department of Health website.

David Hare and Jim Easton’s response to the Dalton review

Ever since its inception, the NHS’s founding principles of meeting the needs of everyone, free at the point of delivery based on clinical need and not ability to pay, have ensured that the NHS has been a triumph of post-war Britain. However, as healthcare professionals and the public are becoming ever-more aware, the NHS has reached a critical point in its history, facing rising demand pressures and unprecedented financial strain. A recent National Audit Office report into the financial sustainability of NHS bodies stated that the combined gross deficit for NHS trusts and foundation trusts increased from £297.2 million in 2012-13 to £743.3 million in 2013-14.

With this in mind, Sir David Dalton’s excellent report into new models for providers of NHS care couldn’t have come at a more critical time. As Sir David makes clear, we must now look at innovative new ways of doing things and to be radical in considering new organisational forms for delivering NHS care. To do this successfully it is vital that we draw on the strengths of all providers and, as Sir David’s report states, utilise more widely the potential for partnerships between all providers no matter what their ownership model.

The NHS provider sector has been made up of a rich mix of publicly-owned, independent, voluntary and social enterprise organisations for many years, all of whom share the same commitment to NHS values and to playing their part in serving patients. Partnerships between different types of providers have long-existed; however, it is now more important than ever that all providers work together to drive innovative changes in care provision and to draw on each other’s strengths and experiences.

As with all types of provider, independent sector providers can and do make a valid contribution to new organisational models. The sector has decades of experience in working with public-sector providers, whilst it also has experience in implementing changes swiftly across organisations and a sound knowledge of different corporate and clinical models, all of which it could share with other providers. The independent sector is also a valuable source of capital, able to invest in new services, technology and to update and modernise facilities.

As Sir David points out, there is no ‘one size fits all’ solution and providers need to drive new organisational forms that will provide the most appropriate care for their local populations. This will require regulators to give providers space to consider all of the options which Sir David sets out in his report but also to offer support and guidance where needed to help organisations make the transition and to ensure that patients are receiving the best possible service.

The independent sector has a great deal to offer to partners within the NHS to assist with this. Hospital groups have decades of experience managing multi-site group structures and ensuring high standards of clinical governance and patient experience.

There is evidence that the independent sector can successfully take on management contracts under franchising arrangements and many providers are already partnering with the independent sector to run diagnostics facilities, operate surgical specialties or manage clinical homecare partnerships to enable more care to be carried out in people’s own homes.

Enabling these kinds of changes to happen at pace and scale is going to be one of the defining challenges for the NHS over the coming years.

“There are no right or wrong organisational forms – what matters is what works.” This crucially important statement from Sir David’s foreword must now shape how the NHS responds to his report and guide all providers of NHS care as they consider what will enable them to continue to deliver on the principles of the NHS whilst adapting to the needs of patients in the 21st century.