A Change is Gonna Come

It’s a couple of months now since the NHS Long-Term Plan was published. I am sure that I wasn’t the only one that viewed the content of the Plan with a degree of cynicism. Any document that starts with the following paragraph is opening itself up to scepticism and NHS Management jargon bingo:

“…..to succeed, we must keep all that’s good about our health service and its place in our national life. But we must tackle head-on the pressures our staff face, while making our extra funding go as far as possible. And as we do so, we must accelerate the redesign of patient care to future-proof the NHS for the decade ahead. This Plan sets out how we will do that.”

tackle head-on”, “redesign of patient care” “future-proof” – just a few more for a full house!

But with further reading, further discussion and further reflection I’ve changed my view considerably and I believe the NHS Long-term plan brings with it in an important lesson of leadership – not just for the NHS but also with wider applicability.

As the Kings Fund 1 notes

“In many respects, the plan signals continuity rather than change. The focus on Integrated Care Systems and expanding new models of care builds on the agenda set by the Forward View. Many of the chosen clinical priorities, including mental health and primary and community services, have also been singled out for attention in recent years. This reflects a constancy of purpose that has often been missing in health policy and should allow the NHS to build on recent progress.”

How often do we see leadership as being particularly about transformational change? So how refreshing that the document re-states and refines some aspects of the change agenda already described but also recognises that consistency of direction and focus not a new vision or new initiatives is what is required. Considering a massive change agenda is still in its relatively early stages this seems sound to me.

The Kings Fund again:

“Building an understanding of the long-term possibilities and engaging people in shaping the plans that impact the future health and care of populations takes time – and is the investment which makes the difference.” 2

The wider lesson here is that whilst change may be constant, it’s regular changes of the vision, direction and priorities (often from leaders wanting to make their mark) that contributes to cynicism in the workforce.

Maybe constancy of purpose – a tenet of the American engineer, quality guru and consultant William Edwards Deming – should be the new leadership mantra.


1. The NHS long-term plan explained Kings Fund 2019
2. Leading across the health and care system Lessons from experience Kings Fund 2017