“The NHS Commissioning Board will be different from any previous NHS structure,” he said, “with different accountability and different mechanics and culture.”
The board will share responsibility with the Secretary of State for Health, rather than being a subordinate, with appointments to the board made up of individuals with strong values in tune with the NHS but bringing skills honed in different fields. “I want people who will work as a team on the challenges we face, but who aren’t afraid to challenge where necessary,” he told delegates.
Doing things differently
“From the very beginning, we will try to do things differently,” he said. “So that we can engage in a different way, all our meetings will be in public, and web streamed, in different venues around the country.
Top down approach is dead
He recognised that NHS leaders are grappling with familiar problems but unfamiliar structures. “The top down approach is dead,” he said, adding that the board’s job is to enable, facilitate and support. “It’s not out job to tell clinical commissioning groups what to do.”
The board’s draft mandate will be published shortly and he urged everyone to have their say on the draft, but not to overload it with details on every aspect of healthcare. He talked about the need for the mandate and work of the board to be both ‘tight’ and ‘loose’ – tight, he said, on excellence, but loose in terms of a degree or autonomy and allowing those with day to day responsibility to get on and do what they need to.
And he talked about the board’s relationships with other new bodies such as Health Education England, Public Health England, Healthwatch England, and health and wellbeing boards.
“Collectively we have a huge responsibility,” he told delegates, adding:
- the system will only work through partnership, collaboration and cooperation
- it is important to understand that mistakes will be made throughout this “highly complex process of change”. Through the board he wants to deliver a culture where mistakes are an opportunity for learning, not blame
- he wants the NHS Commissioning Board to be obsessed with outcomes over activity, and with pragmatism over ideology.
Concluding, he said: “I want the NHS Commissioning Board to enable the largest and most skilled workforce in the world to improve outcomes for patients.”
Watch Sir Malcolm Grant's speech again