News / Nicholson calls for greater rigour (HFMA 2010 latest)

The NHS will need financial and managerial rigour and discipline like never before as it implements the government’s reforms and seeks efficiency savings of up to £20bn, NHS chief executive Sir David Nicholson told the HFMA annual conference in London.

Sir David acknowledged the size of the challenge facing the NHS – quoting one expert who described it as ‘the only change management system you can see from space’. Yet the service had to learn from the past and ensure financial discipline in particular was high.

Sir David said the NHS had to learn the lessons from 2004 and 2005, when the service last got into financial difficulty. He said NHS leadership community had ‘lost its way; lost the whole point of why it was there’.

 ‘It’s not difficult to write a recovery plan, but it’s very difficult to deliver it. We need to ensure we don’t get ourselves into the place we did before, which is “here’s the recovery plan, but I’ve no idea how to deliver it”,’ he said.

‘There was a conspiracy in the system to make sure we didn’t challenge that. We should not be kidding ourselves or buying time in that way. We had high levels of growth in the system last time – we don’t have that now. The rigour in the way we attack these issues needs to be beyond the way most of us have worked in the past.’

David Flory, the Department’s deputy chief executive told the conference that during the transitional period there must be a ‘tight grip’ on the system. Signalling a tighter, short-term grip on primary care trusts, he said the Department would take away some PCT autonomy.

‘We must ensure the financial policies and processes are robust and reliable, and will deliver the changes we need to make,’ he said.

‘I will be working closely with the strategic health authority finance directors to ensure we become more consistent across the country in the way we deal with issues and in the way financial strategies are enacted locally and regionally.’