5 November - non-executive directors webinar

08 November 2021

This week’s session began in conversation with Professor Martin Elliott, Non-Executive Director, The Royal Marsden NHS Foundation Trust, London and Non-Executive Director, Children’s Health Ireland, Dublin.

Overheard during the discussion:

“The NHS has long supported specialist services and there are currently around 146 individual specialist, directly commissioned services where you can gather together groups of patients with rare diseases or severe problems and bid for national funding to make that service work.”

“What’s interesting at the moment is that there has virtually been no mention in the ICS framework or discussions about specialisms and specialist services or the pursuit of excellence.”

“In the past, the NHS was what we believe in most – it’s not just what we’re connected to but its faith, integral to what you’re doing and what we wanted to do in order, to be a part of it and to improve pathways and to make the NHS better. Now, I think specialist hospitals and services feel a number of threats by the NHS and with the development and changes being implemented because of ICSs. First is independence, how could specialist hospitals survive if other organisations take them over. Second is that the patient populations are often national rather than regional/local which clearly doesn’t fit within the ICS structure as its not place, its nation and international.”

“I don’t think the specialist hospitals need touching and changing at all to be honest. They just need to understand their place in the new system.”

“We definitely want a good ICS relationship at specialist hospitals. But to stop cross-boundary referral is a really dangerous thing as specialist hospitals need volume (of patients) to be good and to complete their research.”

“I'm not suggesting that they should be managed locally, but I wonder if a national provider collaborative for each specialist service might make sure they all know what the others are doing. As it stands, it doesn't sound like an obvious mechanism exists to share knowledge & expertise nationally.”

“I think as NEDs we almost need to start pushing the conversation are specialised services now (asking questions of our systems), to push the right people to get into a room and consider all the layering complexities to propose some models that work well. I don't yet have a flavour that ICSs have reached ‘and what about specialised services?’ in their thinking.”

These meetings are by invitation and are open to all NHS non-executives directors, chairs and associate non-executive directors of NHS providers. Others may attend by special invitation. For further details, visit our events page.

If you have any comments, questions or suggestions about these webinars, please contact: events@good-governance.org.uk