The NHS Operating Framework 2009-10 for England (OF) sets out a brief overview of the priorities for the NHS in the next financial year. PCT managers are sweating over the framework as I write, producing their operating plans for the same period to reflect these national “must dos” and their own commissioning strategy objectives. And there will be no relief over the hols for many – in London we have to have our plans to the SHA by mid-January so Christmas reading can’t be avoided.
At its most basic the OF sets out four domains. Each of these can be mined for opportunities to advance involvement and engagement and to further partnerships between statutory and 3rd sector bodies. We shall be banging the drum about these opportunities with out clients in the New Year – and we believe NHS managers will be ready to listen, especially as World Class Commissioning competencies are making the same sort of demands.
1. The health and service priorities for 2009/10: This is about strengthening the focus on subsidiarity – the first use of that useful EU word I’ve seen in the NHS – while still delivering national priorities in the current 3 year comprehensive spending round . How they do it is up to each PCT. The “PPI prize” in this is succinctly put on the DH website: “Patient experience is the final arbiter of success.”
2. A system designed to deliver quality: The Darzi mantra to make quality the organising principle of the NHS gets the emphasis here- and so it should. Each SHA has its “vision” of Darzi – including Healthcare for London – and the OF focuses on the levers and incentives to further build on these. Right at the front is staff engagement for the benefit of patients and the public. Hurrah! Finally the NHS has woken up at the 11th hour to the fact that its staff are the best enggement tool it has. For that tool to do its job, people working in the NHS must be treated fairly and rewarded well in return for consistently excellent performance.
3. The financial regime: The NHS has to go further to ensure it makes the best use of taxpayers’ money. The comprehensive spending round made it clear that the NHS tap would be turned down after two years of plenty even before the world financial system nosedived, so no one should be surprised by the admonition to continue to do better with less in the near future. “Delivering Darzi” is a big part of that of course. But so is learning how to get close to customers (aka patients) and realising that they have choices and voices, especially in primary care. That’s where the biggest changes have to take place. All the solutions to the “problems” of secondary care lie in primary care.
4. The business processes: Planning should be based on locally led decision making – subsidiarity again -and maintaining the emphasis on genuine partnership working at a local level with local government and other partners. For “other” in this part of the OF read not only 3rd sector bodies and social businesses but really any health and social care organisation which wants to get into delivering public services to the right level of quality and price under the NHS brand. The old certainties about whose job it is to do certain things are on the way out.
If you are wading through the OF because you have to, then persevere because it has some really positive things to say about new ways of doing public business. If you’ve given it a miss up to now, then think again and don’t judge the OF by its rather austere cover. Anyone wanting to make connections between NHS “must dos”, opportunities for user involvement and more ways to develop the mixed economy in delivering public services will find plenty they can use in here.
And keep an eye out for the PCTs’ Operating Plans 09-10 appearing from mid January to see how they are tackling all of this. Will they all be up to the challenge? If you find some outstanding examples of local planning, you can always post it here.