It sounds like a tall order, particularly given the level of budget and job cuts anticipated, including the removal of all Primary Care Trusts (PCTs) and Strategic Health Authorities (SHAs) and a tough timescale of completion by April 2013.
Central to the changes will be newly formed GP consortia, which will take on many of the roles previously carried out by the PCTs and SHAs, including responsibility for budgets, developing and co-ordinating the shape of patient services and commissioning external contracts and support.
The Government’s view is that GPs know best when it comes to providing patient care and the changes seek to tap into this knowledge, cutting out layers of management in the process. However, there are concerns over whether GPs have the skills and inclination to drive these changes through, particularly while under continuing pressure to increase efficiency.
Of course, GPs are bright people who have achieved a multitude of academic qualifications and had to take on new information throughout their professional career. So the idea of updating knowledge and skills are unlikely to be a shock to their systems.
There may, however, be a question mark over whether they have the motivation, workplace personality and behaviours to focus on these new responsibilities. Some simply will not find it interesting or engaging, and will prefer to take a specialist role, while others will find the actual transition process harder to cope with. At the same time, there are likely to be others who will relish the opportunity to take a more prominent decision-making role and be excited by the prospect of working in a dynamic and changing workplace.
While it is unclear exactly what the new structure will mean for the role of the GP, this lack of clarity is, in itself, indicative of the skills they will need to succeed in the future environment.
Having the skills and personality associated with managing change will be important, including being comfortable with helping shape the future direction of the organisation and the ability to bring others with you. Having the creativity to come up with new solutions and having the evaluative skills to critique those ideas will also be important.
Given its size – the NHS is the world’s fourth-largest employer and the largest in Europe – this is likely to be one of the most significant transformation projects the UK has seen and the impact on staff and ‘consumers’ of the NHS should not be underestimated.
What we can also be sure about is that it is the intent of the Government to cut bureaucracy, giving doctors a more direct role in making financial decisions about the best course of treatment. We can infer that this means GPs will take on responsibility for a broader set of decisions that impact on a wider group of individuals. Those who can present a convincing case, take action in line with the vision, inspire people and overcome barriers will be better able to succeed in this changing environment.
We shouldn’t assume that every GP, because they have previously focused on mainly technical roles, will have problems succeeding in the new environment. Talent management processes and psychometric assessments can be easily deployed to define the leadership requirements and then identify leadership potential in current employees – not only will this help identify those most likely to succeed but it will also show how and where training and development should be focused.
It seems unlikely that every GP will need to take on significant managerial or leadership responsibilities or that everyone will want to. A useful perspective would be to recognise the starting point of the medical professionals, for example, specialists, and define the desired future state, for example, corporate leaders. With this model the NHS could start to deploy talent assessments to identify those most suited to the new roles and responsibilities required.
It seems clear that many people will lose their jobs and while we naturally want to ensure the psychological wellbeing of those made redundant, those who remain and continue to work for the NHS will also experience significant stress and uncertainty, surrounded by fear of the future and guilt of survival, evidenced by an inability to focus on getting one’s job done.
The NHS must ensure the survivors are nurtured, reassured and supported through the impending change. If this need is ignored, not only will the success of the change programme be impossibly compromised, but it will in all likelihood damage the health of those it employs as well.
Ray Glennon is business solutions manager at SHL
