Starmer must adopt ‘radical’ approach to NHS reform

Sir Keir Starmer needs a ‘more radical and disruptive approach to NHS reform’ rather than thinking that throwing money at it will solve all its problems, according to a veteran advisor to the NHS.

Instead, the Labour leader should focus on unlocking billions of pounds of value currently trapped within the health service, Naeem Younis said.

The founder of analytics and innovation agency Strasys has worked with more than 20 NHS trusts over the past 20 years.

Speaking after Labour won an 174 seat majority, Mr Younis believes there is “nothing new” in Labour’s manifesto beyond soundbites about cutting waiting lists and modest increases to its budget.

This will not be enough to tackle its issues, he said, many of which are created by an “outdated” business model.

“Recruiting more doctors and nurses is great, but it’s management that needs to change. In some instances, resources are being frittered away, resulting in ‘trapped value’. Much more could be done with what the NHS already has if resources aren’t misdirected,” he explained.

“It’s about looking at things differently – focusing on patient rather than bureaucratic needs first.

“At the moment that often doesn’t happen because we are working with a 75-year-old business model. And some trusts are still presenting the same plans from 2008!

“To improve things, we can take cues from brilliant innovation happening across the world where organisations are using fewer resources to deliver greater impact.

“Everyone knows that waiting lists take time to resolve. But, as well as reducing them, we should be asking not only about their size but why people are on the list, what their challenges are, and could we do things differently?

“Currently, Labour aren’t clear about what their long-term game is. Their manifesto is very short-term and full of political soundbites.

“Kier Starmer needs to recognise what is required if Labour hope to transform the NHS and deliver a health service fit for the future. Because it would be naive to think this can be solved with money alone”

Mr Younis – whose work has seen Strasys team up with sector-innovators Alder Hey Children’s Hospital in helping to reshape the future of paediatric care – blamed much of the inefficiencies on “trapped value”.

This sees resources deployed inefficiently meaning much of the NHS’s budget is spent on running the organisation rather than treating patients.

He claims that it accounts for up to 25-40% of the budget in some trusts, meaning only 60-75% goes on patient care.

“It is a consequence of regulation and that’s the consequence of centralised command and control,” he explained calling for decision-making to be decentralised to individual boards and trusts.

“There’s a lot of empirical evidence that centralised command and control structures seldom work. Particularly when you have such a dynamic, high-risk environment as the NHS.

“Fundamentally, we need to go back to the principles of the organisation. It needs to be organised locally around responsibility for managing its assets, skills and capabilities in a way that delivers the needs of the population in the local area.

“To do this, we need to devolve power to the frontline. We need to create more transparency and accountability and use data much more intelligently than we do right now.

“This will only be achieved if we recalibrate the role of the boards so they have much more autonomy to react to the situation on the ground.”

If this was adopted, the amount spent on running the organisation could fall to as low as 20% – allowing billions of extra pounds to be spent on patients without increasing the overall budget a penny.

As well as devolving power, he called for the appointment of more “mavericks” who are willing to make difficult decisions which many current NHS leaders are unwilling to.

“People are unwilling to make difficult decisions because it’s going to put their head above the parapet,” he said.

“So, I think one of the things which the NHS does need is more mavericks. People who are less bureaucratic and more champions of their communities.”