After 8 years in office, Sir David Nicholson has just 26 days left as Chief Executive of NHS England before Simon Stevens, former health adviser to Tony Blair, steps into his shoes. Nicholson stood down in May following the report publication of the Mid Staffordshire NHS Foundation Trust Public Inquiry which highlighted major failings. Yesterday The Guardian published an interview in which Nicholson outlined his vision for the future of the National Health Service.
Nicholson’s future for the NHS sees hospital services centralised to improve quality of care; to between 40 and 70 major emergency centres across the country, with other centres feeding into them as a network; and the number of places providing specialised NHS services, such as cardiac, cancer care or organ transplantation to shrink from 300 to just 15 and 30.
In Nicholson’s eyes, the NHS in its current form is “unsustainable” and these changes are essential to ensure its survival. He stressed that this was change that could be achieved and called for a “change fund” to facilitate this. The extra money would enable the NHS to run existing services while new services in the community were built. Without this overhaul and financial backing, the health service faces a “managed decline” in the quality of care with longer waiting times, drug rationing and fewer nurses onwards.
Even though no over-arching structural changes are needed for Nicholson’s suggestions, they appear highly unlikely to occur, considering that a major reorganisation of the health service has just taken place, and we are fourteen months out from the next general election. Additionally, with the Health Secretary Jeremy Hunt declaring that NHS workers’ pay should be linked to performance, not time in the job, as he announced that more than half the workforce will be denied a widely anticipated one per cent pay rise last week, it is clear that budgets remain squeezed.
It seems more likely that Nicholson’s final days as NHS England’s Chief Executive, after 36 years in the health service, is to engage in a serious, urgent and difficult conversation about the future of the NHS – an organisation that has a unique place in British life, and one that he is clearly still devoted to.
By PI Health team