5 March 2021 – NHS Non-Executive Directors webinar

This week’s session opened in conversation with special guest Suzanne Shale, non-executive director at Oxleas NHS Foundation Trust.

Suzanne said: “The discussions that we have around resource allocation are fairly coded and, in some ways, have been quite restricted. In the system that we have it’s not been the provider NEDs that have been doing the heavy lifting around difficult decisions on resource allocation and I do think this is going to change and NEDs will have to engage more. This is because money is going to be in short supply after the pandemic during post-Covid recovery so we’re going to have to make some very difficult decisions about how we prioritise patients for care and it will be wrong for NEDs to not support there clinical staff and the decision making around that. We will have to trade off short and long term goals.

“The other reason NEDs will have to engage more is the ICSs. Whilst we’re all seeking a more collaborative world, I think we all sense that there will be competition around resources between the acute secondary providers and providers of chronic health care and mental health care. We have seen during the pandemic an unconscious bias in terms of some groups in particular people with learning disabilities and where I see the ICS as making a difference is that it will become our responsibility as an ICS to prioritise and hold each other as providers to account across the ICS.”

Also overheard at Friday’s webinar:

“How we use our skilled workforce is also part of resource allocation. For example, staff now supporting mass vaccination will not be supporting recovery in other parts of the system. This has impacted on children’s services for example – what services should be ‘protected’ as we balance how to use our workforce over the next six months?”

“A lot of the decisions are made by default based on what we’ve done in the past. There is a need to review and look at where priorities should lie in the new ICS system.”

“The more you try to think about things and apply ethical decisions the more difficult it becomes as quite often you simply end up with a clearer idea of the huge difficult decision that you have to make.”

“It’s not fair to dump these decisions on clinicians. We don’t really hold anyone to account around resource decision making unless it’s so bad and so unreasonable that it wouldn’t pass a judicial review. What we have to acknowledge is that we don’t hold organisations to account, don’t hold commissioning groups to account and we only really hold governments to account for the widening inequalities every four years and that’s not a winning strategy either. So what I’m interested in is that we need to give teeth to accountability processes when we move to ICS. If we’re all committed to reducing health inequalities then I think that part of this accountability within a system is holding that responsibility for this levelling up. This is asking NEDs to be a lot more political than they have been in the past as this is a political choice about acute vs. community, short vs. long term and we will need to find solutions.”

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 website https://www.good-governance.org.uk/events/.

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