26 August 2016
With the recent return of Great Britain’s Olympic team, a lot of attention is being paid to their success and how they achieved it. Many put it down to meticulous and detailed planning, with talk of small changes (marginal gains) being the key. For example there was a discussion at the Olympics about the aerodynamics of the cyclists’ kit. I don’t disagree with this assessment however, for me it is much more than that. There was a four year plan for the Olympians, culminating in performances where the difference between winning a medal or not was often only a few millimetres or fractions of a second. The plan set out in detail what the athlete needed to do over that period to be successful: the training regime, equipment and ability needed to peak at the right time.
The NHS has a plan called the Five Year Forward View. The way that plan will be delivered is through system wide Sustainability and Transformation Plans. For the athletes the plan is all important and they focus on the four year goal. The NHS should therefore focus on its five year goal, and much of the work we are doing now is targeted towards achieving clinical and financial sustainability by 2020/21. We need to have a proper discussion about how we focus on the plan and convince others that by doing this we will deliver the NHS vision. In essence we are currently being asked to peak yearly in our performance as well as delivering long term goals and I am not sure that doing both is achievable. Some will argue that one leads to the other and I would agree if the one year plan was consistent with the five year plan. Some of you may remember that during the Olympics commentators made the point that many British cyclists hadn’t won a medal since 2012 and this is because they prioritised the Olympics as the most important event. What we must do in the NHS is prioritise delivery of the Five Year Forward View, which, for me, me requires significant compromise and holding our nerve each year prior to 2020/21. Remember, after 2012 the cycling team’s performances got worse before they got better.