The new chief executive of NHS England has said he wants to “accelerate the redesign of care delivery” and change traditional staffing models to include more senior nurses.
In one of his first speeches since taking up the post in April, Simon Stevens said that while in some cases services needed to be concentrated, he believed in others they could be redesigned to make facilities such as district general hospitals more viable.
Speaking at the NHS Confederation NHS management conference in Liverpool he said he wanted to “accelerate the redesign of care delivery… Rather than constantly debating the reorganisation of our management tiers, let’s now ask the more profound questions about how care is actually being delivered”.
Mr Stevens, who spent 10 years running international health insurance giant UnitedHealth before taking up his current role, said the NHS needed to “tear up” silos between primary, secondary and community services and rethink why things are done in the way they are.
“I’ve been struck by certain features of how we organise care. While we tend to regard them as self-evident, they are in fact just contingent choices whose original rationale is now either forgotten, irrelevant or on balance unhelpful.”
He said existing staffing models should not be allowed to dictate how care is delivered if that is not in the best interests of patients.
“That’s why some would like to see more general physicians or ‘hospitalists’ working alongside consultant specialists. Together with advanced nurse practitioners, sessional GPs, and networked staffing arrangements with neighbouring trusts.”
His comments come as many smaller hospitals struggle to find enough doctors to staff services safely due to the trend for increasing sub-specialisation over recent years. Some organisations have argued this means they need to close services or merge with other organisations.
Mr Stevens added: “I am definitely not suggesting a wholesale reorganisation of medical training and staffing across England.
“What I am arguing is that medical training and staffing should not drive the wholesale reorganisation of district general hospitals across England.”