Government’s announcement on the New Hospital Programme
This week the government announced that the New Hospital Programme, originally launched in 2019 by the then Conservative government, has a revised timetable for delivery.
Where many systems were preparing to lay the groundwork (literally and metaphorically) for construction, this recent announcement is a huge setback to delivery.
?It’s good news that management of the RAAC hospital schemes are approved to continue.
There are pragmatic and reasonable explanations for delaying the delivery of these schemes (including the 18 which are not even set to begin until after 2030). Public finances are stretched, international policy has impacted the cost-effectiveness of construction works, and the original timeline was inspired more by political ambition than by the reality of major construction projects.
As we've seen before when public sector infrastructure projects are cut or delayed, the biggest impact seems to fall on the local people who rely on these facilities.
For nearly six years, patients and the public in these systems have worked with NHS communication and engagement teams, and senior leadership teams, to build a truly collaborative vision of the future of healthcare provision in their communities.
They’ve attended workshops, answered surveys, and had their current hospitals - many of them held up with scaffolding, with the promise of imminent improvement - decorated with information about their soon-to-be new hospital.
The NHS in turn has built strategic plans, made far-reaching financial assessments, and invested significant human time and energy in getting these schemes from political plans to practical reality.
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There is a significant risk to successful programme delivery in NHS change programmes when stakeholders are marched up the steepest of hills, only to be abandoned there - whether by national government, local systems, or unexpected opposition.
There is an intangible cost to the effective delivery of change when patients and the public are promised one thing, only to be promised another the next day. Faith in the NHS as an organisation to deliver effective change can be really impacted by these setbacks.
The work to bring stakeholders together, to coalesce around a shared vision for the future as well as how to get there, is a significant investment of time, energy and faith. We know first hand that so many of the local NHP teams have given all of these investments, and the potential impact of losing all this to delay is significant.
It must also be said how sad it is to hear that many of these programme teams, who have worked diligently to deadlines and met the aspirational targets required of them, now face the possibility of redundancy as a result of this announcement. Their hard work and dedication to delivering real change for the public has been commendable.
Delay is inevitable in some way or another. Multimillion-pound public sector programmes are subject to intense scrutiny and value for money considerations. Delay to ensure that changes are sustainable, economically efficient, and in the best interests of the most people should be welcome.
It is right that the new hospital programme takes a realistic approach to delivery. No one should take public support for granted, though, or assume it's easily transferable to a later point in time. It will be interesting to see if the government offers local systems any support in maintaining public interest and favour in the actual delivery of these schemes.
By Jonny Williams
Integrated Care System (ICS) System Transformation Advice | Self-employed Management Consultant |
1 个月Managing public expectations and fostering strong community-NHS relationships will be crucial to ensuring transparency and trust throughout the delivery!
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1 个月I'm not sure I would be so charitable. Even in the best of circumstances health systems generally start planning their major capital schemes with no certainty that the money will be there at the end of the process. They might expect at least one change of government and multiple changes of Health Minister in the process, which invariably delays the process. Some of the challenges we face now are linked to short termism and cost cutting in the 70s and 80s, and a lack of ongoing consistent investment. The poor quality of our public service estate is a political choice with underinvestment by successive governments. Yet the public does not seem to have the appetite to vote for the investmwnt that is needed. The resulting mess is a failure of engagement at all levels starting with politicians.
Thank you Jonny Williams. As understandable as the reasons for the delays are, communities will definitely be feeling let down. NHP engagement and involvement colleagues have put their heart, soul, blood, sweat and tears into building coalitions of support and putting the community voice right at the heart of these new hospital programmes. They'll be thinking about what legacy their work can leave. And while lots of learning can be harvested from their engagement and involvement work, many of them will be unexpectedly thinking about their next work move.