NHS Leaders need new ‘mindset’ on IT

Mike Farrar, the head of the NHS Confederation has said that NHS leaders need “a new mindset” if they are to successfully deliver on the new information revolution.

Speaking last week at a joint Intellect DH event, on the new NHS information strategy, he said the future success or failure of NHS organisations would hinge on the extent to which their top leaders saw the challenges of information as critical to the business of their organisation.

“We need leadership at all levels, from chief executives and board members to chief clinical information officers and medical directors. It applies to leadership across the board.”

The essential change in mindset, he argued, was to get leaders to see the information challenges in front of them, as critical to the future delivery of healthcare. “They’ve got to understand this is business critical, not peripheral.”

Farrar, who was chief executive at NHS North West immediately before taking on the NHS Confederation job, posed the question “what does it [the information strategy] take in leadership terms?”

One mindset needed, said Farrar, is “a better understanding of what a good B2B deal with a supplier looks like."

“The NHS is good at the point of care but dreadful at contracting by specifying what outcomes it wants to achieve or for getting systematic uptake of proven technology.”

He said this had to change so that suppliers with a really good product or service who get to proof of concept have a better mechanism for getting their innovation taken up, and not have to sell to over 600 NHS organisations.

“And if we think that this has nothing to do with us, we’re mistaken, as suppliers have to pass on their costs of sale in the price paid by NHS customers,” he said.

He said that the slow speed of technology adoption in the health service was not only counterproductive but dangerous, “it does cost lives”.

Rather than NHS leaders acting as passive customers they needed to “be pulling down technology” and demanding it. “We’ve got to get in the mindset of pulling technology as a strategic resource rather than waiting to have it pushed on us.”

Another necessary mindset for NHS leaders was to demand they have all the information they need to take critical decisions, particularly about what patients want. Far too often they are making life or death decisions with only the most partial information or knowledge.

“Information is critical to all the decisions we make, but we are all too happy to make decisions with only poor information,” said the NHS Confed boss.

Farrar pointed out that when patients have the ability to commission their own services based on good information they make very different decisions to current NHS commisisoners. “It’s not good enough to believe we know what patients want.”

“How are we going to get leaders to do the right thing?” asked Farrar. He suggested that Monitor is beginning to drive providers “in the right way”.

Farrar said that the ‘deep mindset’ needed was for the NHS to move away from “the benign dictatorship of the past 60 years”. Instead the strategy and Health and Social Care Bill aim to achieve a decisive shift in power to patients.

“The information strategy implementation is empowering, it will mean that some of the way we do things will have to become empowering to patients.”

Understandably such a big set of changes comes with a fear factor said Farrar. “But if we are frightened of change it will take longer to happen, we must see this as an empowering strategy.”

Farrar said that it was “the absence of such mindsets” in NHS leaders that had helped to doom Connecting for Health and the National Programme for IT. “The model of leadership was not right,” he said.

The success of the 2012 strategy will hinge on partnerships with industry and patients, but NHS leaders must “own these issues” he stressed. “They must understand that It is mission critical to them and their organisations”.