Done

If a minister stands up, surrounded by shiny, smiling faces waving a document… you know, they’re serious.

On the other hand, if a document appears quietly, with no fanfare… it means…
… they’re struggling.

Just before Christmas the DH+ (or was it NHSE) ‘dropped’ (to adopt the vernacular of Gen Z), seven, working-group reports supporting Streeting’s 10 Year brochure…
… identifying areas needing change to make HMG’s strategic vision…

• dumping care onto an unprepared community,
• analogue into digital,
• and stop people getting sick in the first place…

…actually work…

…the answer to which is really simple; change the tariff and the rest falls into place, but…

… no, we have seven documents that to be honest, don’t waste yer time… at between 23-38 pages each, find something more useful to read.

There’re flimflam, padding-out policy direction. They are not operational plans and an embarrassment.

Here are the eight things you need to know;

• Replace NHS People Promise with new staff standards, quarterly published progress and clear milestones.
• Focus on flexible working (something the Jim Reaper is trying to stop), inclusive culture, safety and wellbeing, exit interview data, and stronger social partnership arrangements… blah, blah… nothing new.

There’s no clear timetable beyond April 2026 for standards, no quantified staffing projections, nor integration with workforce modelling because the NHS workforce plan is delayed into 2026, so…

… forget it. Next;

• Build technical foundations for interoperability, (too late for that, mutualisation of data is the practical solution) universal access to devices, a single patient record and value-led data use, alongside public engagement to address trust and understanding.

There’re no milestones or sequencing, creating a gap between ‘what’s needed’ and a workable delivery roadmap with times, budgets and responsible people.

Moving on;

• Establish better planning and capital flexibility, improve estates data, align financial flows to long-term needs.
• Break rigid budget cycles.

Meaningless. Finance and infrastructure, both talk about financial flexibility and aligning capital.

No delivery timeline, prioritisation, or metrics for capital or financial reform… what can be done within 18 months, versus 5 years.

Next;

• Enable the NHS to adopt genomics, AI, engineering biology and emerging tech faster; link NHS innovation more tightly with the life sciences sector.

This is better and a solid recognition that innovation uptake in the NHS is poor but little detail on transitional milestones such as pilot scaling or regulatory alignment.

More;

• Review whether current governance structures support long-term outcomes, clarify roles, expectations and behaviours.

This should be crucial but it remains conceptual. ICBs are due for the chop, Trusts will take over health economies and national bodies are being broken up.

Finally;

• Change should be driven by frontline staff, embedded learning culture, relational leadership and aligned with wider health ecosystem efforts.

This is essentially cultural and systemic leadership framing rather than a delivery plan; no sequencing, deadlines, or implementation models, and…

… that is what is wrong with all of these reports. No ‘how’ or ‘who’ or ‘when’.

What happens in year 1, years 2–5, or 6–10. There’s limited indication of early wins versus long-term shifts.

Resource planning? There are few cost estimates or funding envelopes linked to specific enabling actions. No ring-fenced budgets for key enablers at national or local levels.

All the reports lack specificity on which organisational level is accountable for delivery and how progress will be measured.

Some reports acknowledge overlap… people with finance or data, but there’s no integrated cross-group implementation plan, and…

… no common metrics framework beyond quarterly reporting staff standards.

No KPIs for data interoperability adoption, infrastructure delivery milestones, or finance reforms.

Without a dedicated long-term workforce plan the people in the People Group might as well not bothered.

These reports bring us no closer to the starting gun. The B in Bang or the G in go!

Seven groups means 21 unique interfaces working with each other.

Emphasising;

• culture,
• engagement,
• overlapping,
• foundation and resource intersections with innovation and technology,
• no clear boundaries,
• collaboration frameworks,
• coordinated outputs
• strategic duplication,
• no coordinated delivery governance and no obvious leadership.

No wonder HMG keep quiet when they ‘dropped ’em’.

To turn the Ten Year Brochure into delivery requires ruthless clarity about what matters most, who’s accountable and what’ll be delivered by when.

These reports restate problems and describe everything as critical… which means nothing is.

The NHSE board should take this lot and shove them in the shredder, then…

… decide the top three things that must be achieved before the next election. Everything else gets parked.

NHSE Board must ask themselves…

… are they in the business of deliberating or delivery?

… are they marking time until their cards get marked and they’re shown the door?

… are they report-writing, or rolling up their sleeves to get things done?

News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.