Gap between NHS policy makers and doctors is "enormous"
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《英国医生杂志》
Too many senior managers in the NHS are "disengaged" from clinicians and know too little about clinical processes, the leader of the NHS employers?organisation said last week.
In her speech to the NHS Confederation抯 annual conference in Birmingham, the chief executive, Gill Morgan, a former GP, said the gap between policy makers and clinicians was "enormous" and that far more communication and plain speaking were needed.
She criticised "technocratic management speak" from the government that left even chief officers in the NHS confused about the reasons for new policy.
"This makes it even harder to communicate the benefits to staff ?The story should make as much sense to a patient and clinician in the consulting room as to those in Whitehall.
"If managers and boards find it hard to understand the complexities of change, is it any wonder that clinical staff are not engaged in the process?" she asked.
She said there was only one way to solve the problem, and that was by "jaw, jaw, jaw."
"They say you need two ears and one mouth, by which is meant listen twice as much as you talk. We have got to the stage where there are not enough conversations at local or national level. People aren抰 made to feel part of the decision making process."
Dr Morgan warned that the NHS will not win the argument for sustained funding after 2008 unless the organisation is "lean and mean." She added that managers needed to better understand clinical processes to prevent money "being gobbled up."
"The way we spend money is through the clinical process—the decisions that are made by clinicians on a day to day basis. Yet how much senior managerial and board time is spent on these? A new focus is required to prevent money being gobbled up, as thresholds for intervention shift imperceptibly without any additional benefit for patients. If you give more resources to doctors they tend to do more for the patient in front of them, rather than treat more patients."
However, Dr Morgan said that many successful organisations were giving clinicians some control over the purse strings.
"You can抰 make some of these decisions in the boardroom or in Whitehall. You can抰 have two groups of accountants in the room, talking about what doctors are going to do, but nobody talking to the doctors."
The NHS Confederation also released its latest survey of 80 chief executives, outlining their key concerns with the NHS:
Two thirds of chief executives thought surgical patients were more afraid of methicillin resistant Staphylococcus aureus than the operation itself;
Two thirds of chief executives do not believe that all the targets up to 2008 can be met with current funding, and 84% said that cuts would affect the care of patients;
Most (85%) of the chief executives called for an extension of the choice programme such that patients are offered a choice in the type of treatment as well as where they receive it;
The chief executives believe that obesity is the biggest threat to public health in the United Kingdom, ahead of smoking.(Rebecca Coombes)
In her speech to the NHS Confederation抯 annual conference in Birmingham, the chief executive, Gill Morgan, a former GP, said the gap between policy makers and clinicians was "enormous" and that far more communication and plain speaking were needed.
She criticised "technocratic management speak" from the government that left even chief officers in the NHS confused about the reasons for new policy.
"This makes it even harder to communicate the benefits to staff ?The story should make as much sense to a patient and clinician in the consulting room as to those in Whitehall.
"If managers and boards find it hard to understand the complexities of change, is it any wonder that clinical staff are not engaged in the process?" she asked.
She said there was only one way to solve the problem, and that was by "jaw, jaw, jaw."
"They say you need two ears and one mouth, by which is meant listen twice as much as you talk. We have got to the stage where there are not enough conversations at local or national level. People aren抰 made to feel part of the decision making process."
Dr Morgan warned that the NHS will not win the argument for sustained funding after 2008 unless the organisation is "lean and mean." She added that managers needed to better understand clinical processes to prevent money "being gobbled up."
"The way we spend money is through the clinical process—the decisions that are made by clinicians on a day to day basis. Yet how much senior managerial and board time is spent on these? A new focus is required to prevent money being gobbled up, as thresholds for intervention shift imperceptibly without any additional benefit for patients. If you give more resources to doctors they tend to do more for the patient in front of them, rather than treat more patients."
However, Dr Morgan said that many successful organisations were giving clinicians some control over the purse strings.
"You can抰 make some of these decisions in the boardroom or in Whitehall. You can抰 have two groups of accountants in the room, talking about what doctors are going to do, but nobody talking to the doctors."
The NHS Confederation also released its latest survey of 80 chief executives, outlining their key concerns with the NHS:
Two thirds of chief executives thought surgical patients were more afraid of methicillin resistant Staphylococcus aureus than the operation itself;
Two thirds of chief executives do not believe that all the targets up to 2008 can be met with current funding, and 84% said that cuts would affect the care of patients;
Most (85%) of the chief executives called for an extension of the choice programme such that patients are offered a choice in the type of treatment as well as where they receive it;
The chief executives believe that obesity is the biggest threat to public health in the United Kingdom, ahead of smoking.(Rebecca Coombes)