Most reorganisations fail, says NHS boss

Speaking at the NHS Reform conference in London on 3 November 2010, David Flory said that most changes, similar to those outlined by health secretary Andrew Lansley, have been overwhelmingly unsuccessful due to a lack of vision. "And the reasons that it doesn't work are in part, although not predominantly, are that the vision wasn't clear and compelling enough," he told health professionals at the event. He warned that the transition period up to the new changes being implemented could prove to be a dangerous time if not handled properly by the government, and said this period is where a number of other countries and sectors have failed in the past. "Where this goes wrong in other places is that we know where we're heading to; we know where we are now; but we fail to find that right path that gets us from here to there without losing performance, without losing financial control, without being able to support our staff through this huge change process in a way that retains them, motivates them and keeps them focused on both the delivery for today and the design of the future," Flory said. It would be a mistake to concentrate only on the changes outlined in the government's white paper Equity and Excellence: Liberating the NHS "and pick up the pieces in 2012", he stressed, adding that driving on with improvements while designing "the new world" was the way forward. Flory went on to say that he believes that the government's white paper has clear aims and the potential for success. "I think that the white paper is absolutely clear and I think the vision it articulates for the future, the opportunities it opens up for us to do better for the public and our patients are immense. It's a fantastic opportunity that we have to take and make work," added Flory. On the subject of GP commissioning consortia, he said he understood why it is a subject that interests people, but added that the running cost allowances for setting them up would not be revealed until the operating framework for the NHS is published by the Department of Health in the middle of December. He also described the NHS as being in relatively good financial shape after the comprehensive spending review compared to other services, but explained that this came with its own pitfalls: "There's a long queue of people up and down Whitehall waiting to point out that we didn't need to be given this money, that we've wasted it now that we've got it," Flory said.