Massive NHS reorganisation, with ‘devolution’ and local government reform — and more to come. It’s like crossing the straits with the ice floes both shifting and melting underfoot. https://www.linkedin.com/posts/antlerboy_hsj-icbmergers-integratedcare-activity-7325429570424233984-C26Y What’s your advice for people trying to get through their working day, make things a little better, and deal with this overwhelming #complexity?
Massive NHS reorganisation, simultaneous to ‘devolution’ and local government reform — which should have been an opportunity to increase coherence between local government and health, albeit in the expectation of likely nationalisation of adult social care, or at the very least massive upheaval, from the Casey Commission.
So, all (or rather the remaining few of) the same people will be starting again from ‘square one’ in new institutional arrangements with the focus pulled ever-more central — when work needs to be happening right now at the neighbourhood level.
Seldom has there been such a good example of ‘rearranging the deckchairs’.
The recent local elections show the impact on public perceptions — ‘damn you all’ is largely the message — people are sick and tired of managed decline and the perception that nothing can really change for the better.
So what can we do about it? I suspect we need to get heads down and play the game and get the structural changes done solidly in the short term; there just isn’t the headspace or capacity to think wider when ‘safe and legal’ (from balance sheets to recruitment, submissions and agreements to IT integration) is such a massive challenge.
But we must also keep a line of sight to what really matters — making a difference in people’s lives — what are we doing to improve services and boost places?
We developed our #complexitymap to try to help people have #sensemaking conversations about ‘it all’ — let me know if you’d like to explore the territory. And we can help with the practicalities — planning, delivering ,capacity, capability — too.
But it’s understandable if people are overwhelmed by it all — please give your #health and #localgovernment colleagues breathing space if so — they need to get through this and hope for better days ahead. It’s like crossing the straits with the ice floes both shifting and melting underfoot.
What’s your advice for people trying to get through their working day, make things a little better, and deal with this overwhelming #complexity?
This was a response to this linkedin post from Don Diamond:
📣Big shifts ahead for Integrated Care Boards
The NHS is moving forward with plans to cut the number of ICBs from 42 down to between 23 and 28, alongside a 50% reduction in running costs.
📍 What’s happening across the regions?
Midlands: 11 ICBs likely consolidating to 5 or 6
South West: 7 expected to shrink to 3
East: 6 reducing to 2 or 3
London and the North: Could be minimal change
Despite concerns, merger plans are advancing fast, with some ICB leaders predicting the new structure could take shape within weeks.
💡 Where do we go from here?
With regulatory roles shifting and strategic commissioning taking priority, the big question remains: Will these changes strengthen the system or introduce new challenges?
❓ What do you think about the changes to ICBs and the abolition of NHSE?
Read the full hashtag
hashtag#HSJ article here: https://lnkd.in/eP49jCy9
chosen path 