Making a difference: A look back at what the NHS Confederation achieved in 2019

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The case for investment

Following the success of our seminal report on NHS funding in 2018 which we commissioned from the Institute for Fiscal Studies and the Health Foundation which made the case for significant investment, we have continued to lobby for a major programme of capital funding together with serious investment in public health, social care, and training. 

Our report Unfinished business: the need to invest in the whole health and care system, based on the views of NHS leaders, revealed the threat to the delivery of the Long-Term Plan without this wider investment. There were signs of movement among the political parties during the election on these issues, and we have used our Fit for the future report, again based on member views, to set out what the service believes should be key priorities for the new government, namely workforce, capital and social care.

Embracing our workforce, empowering our leaders  

This year we launched the BME Leadership Network, to bring together the incredible talent and potential talent that we have not nurtured effectively in the past. The network aims to improve understanding and the benefits of equality, diversity and inclusion, expand the number of BME leaders working in the NHS and support aspiring leaders.

Its first report Chairs and non-executives in the NHS: the need for diverse leadership highlighted the lack of progress in non-executive board appointments. The result has been the setting of a goal for increasing the number and proportion of BME non-executives and senior leaders and the creation of a task force to produce guidance to reverse this trend. 

We are now recruiting the fourth cohort of new CEOs for our self- directed programme to support the next generation of healthcare leaders. This year the report from the first cohort, Best job in the world? shone a penetrating light on their fresh approach to leadership – it tells the story of how leaders are changing to meet new and different challenges.

And the Confederation’s Health and Care Women Leaders Network is continuing its campaign to achieve 50-50 representation on NHS boards. This vibrant network is already a real force as we seek to create an inclusive service which genuinely identifies, nurtures and values the talent we employ. What is possible is demonstrated in the network’s report on 20 senior women’s journey to success in health and care and its campaigns Men as Allies and Wonderful Women Do.

Reflecting the emerging NHS 

The NHS is changing and we are seeking to adapt our support to match the new shape of the service at local level. First, at their request, we have established a support network for the independent chairs of STPs and ICSs. These will be important figures in taking forward the transformation in care that everyone accepts is needed and it will be vital to support them and make sure their collective voice is heard. 

At the same time, we have established a new network for STP and ICS leaders – again every one of these leaders will be critical when it comes to bringing together all the various parts of the health and care system shaping the way services are run at local level. They want and need an independent voice and opportunities to come together as a group. Again we will do what we need to support them.

And last but not least we are establishing a new network for primary care networks – the PCN Network. We will be providing a range of support to PCNs, including creating an independent voice for PCN clinical directors and we are leading a coalition of partners to make sure that PCNs have access to a wide range of expertise, resources and guidance. We will not succeed in reforming the health service unless we bring in primary care and create integrated services which cover primary, community, social and secondary care. We are determined at the Confederation to do what we can to make this happen. 


The NHS Confederation established and leads the Brexit Health Alliance bringing together industry and the NHS, together with research, patient and professional groups. This past year we have worked closely, largely behind the scenes, with officials across government to protect healthcare services as the exit deal was shaped and to make sure that everything that could be done was done to prepare for a ‘no deal’.

We also co-chair the Cavendish Coalition, which brings together health and social care organisations to make sure our current and future workforce is protected and again we are confident we have helped to influence government immigration policy and assurances to current EU staff. There is much more to do here but we are encouraged that we have raised the profile of health in the negotiations and we have seen our key areas of concerns were addressed in the Withdrawal Agreement.

Tackling social care 

We have played a significant role in raising the profile of social care funding this year. We convened a coalition of 15 national health organisations who have joined forces as Health for Care to make the case for a sustainable social care system, backed up by a long-term funding settlement. The impact of bringing together health leadership to argue for social care has been significant and we will continue to press government at the highest levels to make good this national disgrace. 


Our members have told us consistently that ‘it’s the workforce, stupid!’ In the wake of the Long Term Plan, we brought together ICS leaders and other partners to inform our work on the role of systems in workforce planning. The resulting report Defining the role of integrated care systems in workforce planning: a draft manifesto, was widely welcomed and was referenced in the Interim People Plan.

Reaching out 

This year we established our regional team across England, to support our members, convene different parts of the system and crucially transmit messages from the frontline back to the centre. From member reaction, we believe they are making a real impact providing access to learning and good practice, supporting relationships and leadership development and creating opportunities to influence national policy and thinking. In 2019/20 to date, they have met more than 1,500 leaders. 

We continue to help shape opinion nationally both behind the scenes and in the media, as well as through podcasts and other outlets. 

Supporting members in 2020

The year ahead will be tough but there is a real sense that the service knows and understands the direction in which it needs to go. We will continue to support you, our members, in 2020 highlighting the issues you regard as crucial, convening partners locally and nationally to shape policy and drive through change.  

At the Confederation we too are changing to reflect the new NHS that is emerging in England and we will continue to adapt and reform our service to you. We are delighted that our new chair Lord Adebowale will be joining us to lead us during this exciting period.  

For the foreseeable future, we will now be dealing with a majority administration in England which will bring both opportunities and challenges, but through all this it will be vital that we reflect accurately and with coherence and conviction the realities of what the service faces and how you can be supported to deliver this incredibly challenging agenda of managing the here and now while creating services that are fit for the future.

We will do everything we can to support you in achieving that outcome in the year ahead.


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