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NHS must improve efficiency before asking for more money, claims ICS chief executive

Published on: 6 Jan 2023

An ICS chief has said the NHS workforce crisis is not the result of a ‘funding issue’ but caused by an inefficient use of resources.

Patricia Miller, chief executive of Dorset Integrated Care Board, told a board meeting on Thursday that “constantly talking about the NHS needing more money” was undermining leaders’ case to government.

She said: “We have got a workforce issue in the NHS, there is no doubt about that. I don’t actually believe we have got a funding issue. We just don’t use our resources very efficiently and I don’t think we do our case any positive favour with government when we’re constantly talking about the NHS needing more money when we can’t demonstrate that what we do is efficient.

“So I don’t actually accept we’ve got a funding issue unless we start to work at the optimum and then we can absolutely demonstrate that.

“I think what this comes down to is that our systems are too complicated and that starts at the centre, where every initiative we have is not about redesigning service models end-to-end but about layering on different solutions to different ends of the pathway and it just makes it more complicated.

“I’ve no doubt that we’ve probably got 50-plus entrance and exit points to our urgent emergency care service, it’s ridiculous. I can’t navigate my way around 50 or 60, so there’s no way a patient can do it.”

Ms Miller told board members that one of the tasks of Dorset’s forthcoming transformation programme will be to redesign and simplify service models “because they’re too complicated” at present.

She said the system needed to take a “person-centred approach” rather than the current “process-centred approach, which she said is often driven by “organising services how clinical teams need and like to work as opposed to how people need to receive service”.