23rd July 2015

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Health Chat

Sir Robert Naylor

One of the longest serving leaders in the NHS, running one of the biggest Trusts.

What's life like at the top? Find out; in conversation with Roy Lilley; King's Fund 16th September 

Tickets here.

Great things
News and Comment from Roy Lilley

Our country is something like one and a half trillion quid in debt. Last month, alone, we borrowed £9bn. Apparently, that's good news as it is on the way down. Right now the Chancellor is looking for £20bn savings across Whitehall. Even though it means 40% cuts to some vital services, it's a spit in the bucket. We are up to our oxters in debt.


Crippling cuts and savings, in the name of efficiency, to services for some of our most vulnerable and exposed citizens. How social care will keep going is beyond me.


Crashing health and social care in with the libraries, holes in the roads and lollipop ladies doesn't inspire me. Neither does Ian Williamson, the bloke trying to do it in Manchester. On a recent Today Programme I thought he was representing the Ramblers Association. Focused, concise, crisp and convincing he is not. Devo doesn't still means No-Doe.


Healthcare? Everyone is moaning about not having enough money. Over ten years about £40bn will have been screwed out of the health budget. In the scheme of things the NHS has been well treated; flat line funding and ring fenced is about as good as it gets.


You make take a Greek view of austerity. You may prefer John Maynard Keynes to Adam Smith but we are where we are; five years from the next election, the opposition parties in disarray.


We have to get on with it and managing through austerity is a new skill. We know; no job is safe, budgets diminished and there is a natural belief that being bigger will be better. Success is hard to come by, short-termism takes over; we must have results, now. There is no time to wait, incubate or nurture.


Muddling through, struggling on, head down and fingers crossed. It won't last forever and better days are coming. Wrong. Just think how many noughts there are in one and a half tri££ion.


Managing through austerity takes creativity, imagination and ingenuity; beyond cutting and pretending that doing the same things differently is enough.


People become much more important. Top talent will jump ship. Top talent will ask; why work under this pressure with no hope for the future. They won't wait to be made redundant or side-lined.


It becomes harder to recruit. That's why nurses are migrating to agencies and doctors walking away from being a GP. It is also why management talent will take their MBAs and transferrable skills into commercial sectors where the mood is high and opportunities open.


A 1% pay rise for the foreseeable? No thanks. Vocation doesn't pay the rent.


If ever it was true that your people are your biggest asset, it is true now. Giving someone a job, keeping them on, is not doing them a favour. They are doing us a favour by staying. Look after them, look out for them and look to the future with them.


Tell them how good they are, find the back that needs patting and above all; listen to them


Mergers, partnerships and working together. Let's be serious: mergers... two turkeys don't make an eagle; Partnerships... only work when they reflect the reality for both sides; Working together... it is much harder when funding cycles and budgets are out of sync.


If you are, clearly, the top performing partner the power will be with you. It's all about trust which takes time to develop into common purpose, passion and equality. Working together is not 'working together' if it's only working together. Together, it has to work.


Investment. Be tough. Pick winners. This is no time for a thousand flowers and a bunch of failures. Pick winners that create the maximum return on investment. Not the quickest. Austerity means we are in for the long run.


Plan for a long journey. Austerity encourages short-termism, panic and chaos. Stop and think. Really think. Think redesign, blank sheet of paper. Start with the patient and work backwards. Be persistent.


Finance; do not assume any kind of growth in budgets. Cuts are easy but you can only do them once. Zero based budgeting is the only serious way forward. Do it and be clear about the results.  Make transparency an ally. 


Austerity steals time, sucks energy and pushes away the best people. Austerity-Managers create the time and space for good people to do great things.


And, now is time for great things.


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Sir Robert Naylor
One of the longest serving CEOs of one of the
 Biggest Trusts
At the heart of strategy and policy for over 25yrs.
What does the future hold for the Vanguards, strategy, regulation, funding.
Come and hear him in conversation with Roy Lilley 
King's Fund
16th September.
Book before you go on holiday, it will be a sell out.
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