Real QIPP: reflections from our annual conference

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Does the NHS have the necessary skills to continue the drive to improve quality despite the impending budget cuts? Steering the NHS through an era of restrained public sector spending was the dominating theme at The King's Fund's annual conference yesterday.

The opening keynote speeches were inspiring, but most delegates were probably wondering how transferable the ideas were to the NHS. Cleve Killingsworth, CEO from Blue Cross and Blue Shield Health of Massachusetts Inc, focused on controlling annual cost rises of over 10 per cent in health care insurance premiums by incentivising providers to reduce activity and drive quality up. Caroline Waters, director of People and Policy at BT, painted a picture of BT's flexible, split-shift, remote-working, digitally connected, innovative, engaged workforce.

John Appleby, our chief economist, brought a quick dose of reality, reminding everyone of the scale of the financial challenge ahead. This was usefully reframed by NHS North West CEO, Mike Farrar, as being about a care deficit rather than a budget deficit if we fail to respond appropriately – a useful way of getting clinical staff to own and engage in the challenges ahead.

Panellists in the final session were asked to give their prescription for the NHS. Ruth Carnall from NHS London, expressing obvious frustration with the current system of prolonged public consultations, called for them to be swept away but didn't specify what they would be replaced with. David Dalton from the Salford Royal NHS Foundation Trust requested the governance of GPs be aligned with that of hospital doctors. The Health Foundation's Stephen Thornton demanded a pay freeze, saying that the public sector had been 'cocooned' for too long against the impact of the recession. Nick Timmins from the FT compared the NHS' relationship with the recession with that of an American battleship demanding a lighthouse to move out of its way! Bold views indeed…

Voting during the opening and closing sessions showed that most delegates left the conference still holding the belief that improving quality could result in cost reductions. However, by the end of the day, delegates were significantly more pessimistic about whether the NHS would continue to improve quality during the new economic era.

It appears that this senior audience understand the potential for the NHS to thrive during times of resource constraint but, having discussed the realities during the course of the day, are more sceptical about whether the NHS could align all the levers to make it happen.

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