Ben Dyson: Supporting local health systems to enhance collaborative working

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  • Posted:Thursday 17 November 2016

Ben Dyson, Executive Director of Strategy at NHS Improvement, speaks about supporting local health systems to enhance collaborative working and transform care for the longer term.

This presentation was filmed at our conference, Sustainability and transformation plans: from planning to implementation, on 17 November 2016.


When we first floated the idea of sustainability in transformation plans it was based on the principal that we can’t go on as we are at the moment. We have to bring people together, the way that they work in primary care, in community health services, in the hospital sector, in local government, in commissioning groups.  We actually have at our disposal a massive resource in local community.  It may feel extremely tight financially but actually when we look around it’s not just our financial resources but our workforce information we have, wider community assets, volunteers, the relationships we could build with education, with industry, with other sectors.

When we think about that resource in a holistic sense, surely, surely if we came together we could deploy that resource in more intelligent and effective ways to really improve the quality of care and support we provide for local communities and really improve the health and wellbeing outcomes for those same populations.

So what next? There’s a lot to do, I just want to focus on four things for now.

The first is both public engagement, patient engagement and indeed staff and clinical engagement. It’s vital over the next few weeks and months that between we use the emerging STPs as a basis for much deeper engagement with local communities, really starting to articulate what could this mean for me, what could this mean for me in terms of my access to GP services, my access to mental health services, what could it mean if I’m a frail older person or I’m a carer for somebody with complex needs.  I know that within STPs there’s a lot been done already on involving some groups of clinicians and other staff but I think there’s a lot, lot further to go.

We urgently need to be able to, both describe to staff how will this make my job better. How will this mean that I can work more collaboratively with other health and care professionals and with service users themselves? And am I going to be a champion for this change?

The second thing I wanted to say was about how we make sure that we’re agile and slick in how we start to deliver the promise of STPs. We need to make sure that these are living, breathing plans that they continue to evolve.  We need to plan for different scenarios.  I’ve seen too many occasions, as I’m sure you’ve seen this too, where we write plans that say “there will be a 5% reduction in demand for a non-elective care” and writing in a plan clearly doesn’t make it so.  And we have a slight tendency to then sort of sit rather than stand when it turns out that we don’t reduce demand by 5% or whatever it is and wonder why it’s not conforming to the plan.

So one of the things we’re working on with a number of people is how we develop this rather more agile form that enables us to course correct if things don’t go to plan, what do we do differently and so on and so forth.

The third thing, and for those involved in the contracting round, this is obviously of, very much of the moment because we’ve set ourselves the ambition of completing operational plans and contracts by the 23 December which I know is a really tough deadline, but wouldn’t it be great if we could go into the new year with that behind us?

And I guess my plea to everybody involved in this, is can we try and build on the emerging success of STPs to take the adversaries and the back and forth out of that contracting process. Let’s have a really honest, open book look at the resources available to us, the financial resources available and each community and really try and put ourselves in each other shoes and think rather than how do I fight my corner as a commissioner or provider, between us how can we use that set of resources to best effect and cement it into a set of plans?

And then just finally, just a brief word on capital. Part of the reason why there’s been this difficult debate about you know, when best to launch wider public engagements is that in, certainly a while back, we were faced with a situation where if you added up all the capital asks in the emerging STPs, they would have far exceeded the, well both the amount of cash available and the capital limits that treasury and the department set for us, and there were questions also about whether the revenue consequences in future years were affordable.

That is getting a lot better I have to say, so thank you for everybody who’s been involved in continuing to refine those capital investments plans.

Just to finish though, thank you again for the fantastic work that I know lots of you are doing and let’s really work together to build on that early promise.


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