High quality care for all NHS Next Stage Review - Antibiotic Action

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60 5: Freedom to focus on quality5• Partner: Clinicians must be partnersin care delivery with individual andcollective accountability for theperformance of the health serviceand for the appropriate use ofresources in the delivery of care.Partnership requires clinicians totake responsibility for theappropriate stewardship andmanagement of finite healthcareresources. Partners will be expectedto work closely with others in thehealth service and beyond, such associal care colleagues, children’scentres and schools, to manage thebalancing of individual andcollective needs, integrating carearound patients.• Leader: Clinicians are expected tooffer leadership and, where theyhave appropriate skills, take seniorleadership and management postsin research, education and servicedelivery. Formal leadershippositions will be at a variety oflevels from the clinical team, toservice lines, to departments, toorganisations and ultimately thewhole NHS. It requires a newobligation to step up, work withother leaders, both clinical andmanagerial, and change the systemwhere it would benefit patients.5. These three ways in which clinicianscan use their talents are already inevidence in parts of the NHS andinternationally. 96 The best work on96 The formulation “practitioner, partner, leader”builds upon international experience bestexemplified by Kaiser Permanente’s approach toclinical leadership in the United States.professionalism is also acknowledgingclinicians’ wider roles in the NHS. 976. The exact balance betweenpractitioner, partner and leader willbe different, depending on theprofessional role undertaken. Forthose in formal leadership roles, suchas clinical directors, a majority oftheir time is spent as leaders. Formany, clinical practice will continueto dominate – though they will stillneed to work with others as partnersand show the necessary leadershipto keep practice up-to-date anddeliver the best possible care fortheir patients.7. What is clear is that this newprofessionalism, acknowledgingclinicians’ roles as partners andleaders, gives them the opportunityto focus on improving not just thequality of care they provide asindividuals but within theirorganisation and the whole NHS. Weenable clinicians to be partners andleaders alongside manager colleaguesthrough the following principles:• Giving greater freedom to thefrontline. We will continue thejourney of setting frontline staff,both providers and commissioners,free to use their expertise, creativityand skill to find innovative ways toimprove quality of care for patients.97 For examples of where this is already taking place,see Doctors in Society (Royal College of Physicians2005) and Understanding Doctors: HarnessingProfessionalism (King’s Fund and Royal College ofPhysicians 2008).
High Quality Care For All – NHS Next Stage Review Final Report61• Creating a new accountability.Setting NHS staff free from centralcontrol requires a new, strongeraccountability that is rooted in thepeople that the NHS is there toserve. It means the service shouldlook out to patients and thecommunities they serve not upthe line.• Empowering staff . Professionalsneed to be empowered to makethe daily decisions that improvequality of care and we will enablethis to happen.• Fostering leadership for quality.All these steps together create theright environment for high qualitycare to happen, but we need tofurther develop clinical andmanagerial leadership.Giving greater freedom tothe frontlineAcute, mental health, andambulance trusts8. The journey of setting NHSorganisations free from centraldirection began with the creation ofNHS trusts and, subsequently, NHSfoundation trusts. It continues. Ourcommitment to making acute,mental health and ambulance trustsinto NHS foundation trusts remainsstrong. It is our clear ambition that infuture hospital care will be providedby NHS foundation trusts. In order toachieve this, we will aim to acceleratethe rate at which existing NHS trustsachieve NHS foundation trust status.9. We will extend these freedoms tocommunity providers, exploring arange of options including socialenterprises and communityfoundation trusts. However, there aresome providers, for example highsecure units, where NHS foundationtrust status is not appropriate. Herewe will aim to give similar freedomsto organisations, which achieveand maintain similar levels ofgood governance and financialstability to those required of NHSfoundation trusts.10.It is important that providerorganisations enjoy these new andexisting freedoms in the context ofthe national framework. We willtherefore continue to ensure that FTsand other providers meet agreedstandards for quality of care andchoice, and take account of the newNHS Constitution.11.The freedom of NHS foundationtrusts to innovate and invest inimproved care for patients is valuableand essential. We welcome recentinitiatives that have seen some NHSfoundation trusts share the proceedsof their success with all of their staff,from the porter to the seniorclinician, and encourage more todo likewise. 98 These autonomousorganisations are ideally placed torespond to patient expectations ofhigh quality care.98 Gloucestershire Hospitals NHS foundation trustannounced that all staff would benefit from a£100 bonus, BBC Online, 14 December 2007.
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IntroductionTHE NHS NEXT STAGE REVI
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PrefaceBy the Prime MinisterThe Nat
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High Quality Care For All - NHS Nex
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8 Summary letterThe next stage of t
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High quality care for all NHS Next Stage Review - Antibiotic Action

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