Helping the NHS to Succeed

Steve Swayne, Chair, Kingsgate

Whither the NHS?

There have always been questions about its future, but the debate about how to “save the NHS” is louder than ever. Staff shortages, inquiries into standards of care, growing waiting lists, overrun emergency departments, industrial disputes, budgetary pressures – a daunting list.

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In the 20-odd years Kingsgate has been helping NHS organisations to change and improve, we have seen most types of problem. And while the circumstances always vary, we have been able to refine an approach which works.

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I was the one of the first financial recovery specialists from the private sector to be asked by the then Labour Government to support the NHS – starting with the John Radcliffe Hospital in Oxford. Since then, I’ve worked with around 20 different NHS Trusts, and the wider Kingsgate team with many more.

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NHS transformation has historically concentrated on operational changes to improve patient outcomes, such as tackling waiting lists. Today, there’s more of an emphasis on financial challenge too – balancing existing budgets and reducing costs.

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The NHS is full of inconsistencies and variation. Different Trusts and departments do things in different ways – some much better than others. This creates significant potential for improvement.

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Ultimately, it’s about enabling Trusts and local systems to increase their productivity by being more efficient. When done well, this will improve healthcare and patient outcomes too – the definition of higher-value services. To achieve this, we have developed a unique approach to change management.

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Change is often uncomfortable. We help NHS leaders to confront the brutal reality of what they face and make the necessary difficult decisions, while also involving clinical and other teams so that everyone understands the situation.

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Kingsgate provides small teams of seasoned Board-level experts with all the necessary skills to analyse the situation and find solutions, working closely with those on the ground. We’re always listening, evaluating and adapting to the needs of the client. We don’t tell people what to do, but rather help them to recognise and take the necessary (sometimes uncomfortable) actions, so that their organisation or service is the best it can be.

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The challenge is to change clinical practice and behaviours in a positive way, recognising circumstances and improving them by doing things differently.

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We do this at pace and with strong governance, making tomorrow better than yesterday. The solution is all about the here and now, taking small progressive steps which lead to something lasting and significant.

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Sustainability is one of Kingsgate’s watchwords. We enable local NHS leaders and their teams to have true ownership of their issues, to make those tough decisions and shift the culture of their organisation. This is how effective change is maintained when we’re no longer there to provide support.

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No matter how high-performing the Trust, experience has taught us that there is always progress to be made. We’re proud of our track record in delivering positive results – increasing the number of patients being seen, improving efficiency, cutting staffing costs, reducing waiting times.

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Despite the growing emphasis on the need to save money or make budgets go further, our focus remains on operations – how NHS organisations actually do things. Get that right and the savings will follow.

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The value of external consultancy to the NHS is often questioned. Quite rightly, in some cases. We take pride in the fact that Kingsgate consistently provides a return on investment which exceeds our fees ten or twenty-fold – identifying achievable savings running into millions of pounds.

We can do this because of our NHS knowhow and the collaborative way we work with its people. We understand the pressures and the passions of management, clinicians and support staff, offering supportive challenge and taking them with us on the journey.

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It’s not easy, but we’ve proved it can be done.