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‘Fear of failure’ and gaps in information sharing holding back NHS value

Niall Dickson
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The NHS could be missing out on opportunities to improve patient care and make long term saving by failing to share good practice and innovation. This is one of five key issues to making value-based change to healthcare in a new briefing paper from industry leaders presented at Confed18. Contributor Niall Dickson, Chief Executive – NHS Confederation.

Delivering greater value for every NHS pound is an increasingly important agenda for the NHS and wider system. As pressures and demands grow, so does the need think about how we deliver care in different ways.

‘Value-based healthcare’ – which involves taking a whole system approach and long-term view of where to focus resources – has been a growing concept within NHS in recent years through efforts like NHS Right Care, but relatively little guidance exists on how to put into practice on the ground.

The briefing paper, Kickstarting Value-Based Decisions, aims to fill this gap by identifying five areas where NHS organisations can focus efforts to encourage a stronger focus on value-based healthcare and help drive the innovation which will help transform the NHS and wider system for the future. These cover:

  • Thinking about pathways across the system
  • Learning and adapting through adoption of innovation
  • Managing risk
  • Making best use of data
  • Listening to patients.

It poses a number of challenges – how do we encourage and promote innovation, encourage second and third adopters?  How do we change the way that the NHS thinks about risk and so create the space for genuine innovation?  How do we support the system to make best use of the wealth of data it has at its disposal?  Are we certain that what patients and public truly value is part of planning health services?

The paper is the outcome of a roundtable discussion of senior professionals working across the NHS – commissioners, providers, clinicians and finance leads – to gain their insight on the barriers to the uptake and adoption of value-based decision making and what can be done at a practical level to overcome them. The roundtable was convened by Decisions with Value – an initiative supporting Value-based healthcare guided by an independent steering committee of UK experts and funded by pharmaceutical company AbbVie UK – and the NHS Confederation.

Niall Dickson, chief executive of the NHS Confederation, said: “Every day the NHS faces complex challenges and pressure to make the most of its precious resources while handling relentless demands, so it is vital it makes value based decisions that are driven by providing patients with the best possible care.

“This report, driven by senior leaders, makes recommendations which should make everyone in health and care sit up and take notice.”

Phil Schwab, director of government affairs at AbbVie UK, said: “There’s a wealth of great examples of long-term planning and teams working across NHS organisational boundaries to deliver for patients, the challenge comes in spreading this good practice rapidly further than first adopters. This roundtable found that managing risk and a fear of failure can sometime be a barrier in NHS to trying new things. The goal of the Decisions with Value initiative is to give tried and tested support to help overcome this and spread value-based decision making across the NHS in order to secure the best possible outcomes for patient. We are proud that our initiative is helping to support the aims of the NHS Confederation.”


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