NHS needs to look to past before planning future

Released 23/06/2010

NHS Confederation warns leaders not to repeat mistakes of the past

The NHS Confederation has today warned policymakers and NHS leaders not to repeat the mistakes of the past in the rush to reorganise and restructure the NHS.

In a paper published at the Confederation's annual conference in Liverpool today (Wed 23 June) director of policy and acting chief executive, Nigel Edwards argues that the NHS needs to learn to consider previous attempts at reform and ensure there is a sound evidence base before embarking on major change.

Writing in The Triumph of Hope over Experience, Edwards says, "Reorganisation often seems to be pursued in the absence of good evidence.

"Overall the history of restructuring and merger is not encouraging and yet the enthusiasm for it continues."

He says too many reorganisations in the past have been poorly thought out and that too often the system rewards people who are advocates of change rather than those who counsel caution and consideration: "Too often we resort to universal solutions and big bang reorganisations rather than careful experiment or local design."

But the report, which comes as the NHS prepares itself for another period of change, says reorganisations do not have to fail.

It identifies an eight point plan which can help organisations deal with change and includes making sure there is a decent evidence base for a shake-up, proper evaluation of results and not expecting every problem to be dealt with by a new structure.

Speaking about the publication Edwards said he hoped it would provide a useful guide for future change in the NHS: "At times it looks like the NHS is addicted to change.

"We have seen three once in a generation reviews of the service since 2000 and it can seem as if those engaged in health policy are more focussed on finding the perfect organisational structure than delivering world class patient care.

"The reality, of course, is that any way of doing things will have its pros and its cons and the energy expended in changing a structure is often best spent simply making it work properly."

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