The Changing NHS

Writing here last week about recent UK attempts to amplify consumer pressure on healthcare providers reminded me of an international seminar I attended in 2000 whilst working for a health care learning network called ODPN . A group of healthcare provider Chief Executives from the UK, USA, Spain, Germany and Australia spent a few days together in Spain, exploring the implications for them of the rise of the informed healthcare consumer.

Without getting bogged down in detail, the starting point was a simple conceptual framework (above) that depicted three key influences and pressures that all healthcare organisations face, to varying degrees, at any point in time.

The assumption being that the system was increasingly likely to become unstable and this, in turn, presented CEOs, as leaders of healthcare providers with some opportunities. For example they could choose, at certain times, to see themselves as:

i) Leader as Maintainer – helping their local system to remain as stable as possible, by seeking to keep these often competing sets of pressures in balance as much as possible. (Most of the the UK and Spanish CEOs felt this was their natural territory);

ii) Leader as Agent - actively seeking to bring about a new dynamic by encouraging an accumulation of power to points A and/or B and/or C. (Most appealing to the CEOs of Mental Health providers who supported the growth of pressure point B).

iii) Leader as Systems Architect – (represented below) encouraging alliances between various pressure points. For example, by encouraging the formation of an alliance between a national consumer group and local clinicians – where both groups (and the provider organisation itself) wants to see funders agree to pay for a new treatment modality. (The most appealing role for majority of USA CEOs).

Despite being quite simple, this framework served as a very useful reference point to help get conversations started. How might a provider CEO’s role within a system ebb and flow as healthcare consumerism growths in strength and technological possibilities become more available? This is sure to become a much bigger question - sometime soon.

Steve

www.stevepashley.co.uk