Martin McShane: Walk the talk

Martin McShaneSometimes, it becomes apparent that what we have been talking about for so long is actually beginning to happen.

Over the last few weeks we have been preparing for our Annual Accountability Review with the SHA. We have had our monthly cluster board meeting. We also had a meeting with the acute trust, looking at mortality. Then there was the NHS Confederation conference. Meanwhile the commissioning support services were re-launching a new and improved CCG dashboard to track activity and variation.

Within our board papers was the draft Health and Well Being Strategy which, based on the Joint Strategic Needs Assessment, has been out for consultation. It is aligned with the outcomes framework, is focussed and is all about partnership, collaboration, and integration. It sets up the CCGs with strong foundations for their plans and ambitions and, as they all are members of the Health and Well Being Board, it aligns their purposes. Our Board agenda also focussed on quality, as we did in our meeting with the acute trust. In our meeting with the trust we had a draft report on COPD mortality which looked at the quality of care provided in primary care for those patients who had died in hospital. It showed that compliance with a bundle of 6 QOF indicators ranged between 86-97%, which is to be commended but should not induce complacency—we owe it to patients to strive for excellence. The recent IHI report on care bundles illustrates how difficult, but important, getting high compliance with a care bundle can be. Putting a focus on care bundles rather than individual measures must be a step forward in improving quality, especially with the results from the National Diabetes Audit highlighting the need for such an approach.

That can only happen if clinicians are furnished with compelling information. Our dashboard looks at activity such as referrals and admissions, but also variation between practices and CCGs. This has already stimulated peer review, support, and challenge: clinicians talking to clinicians. That dialogue is a powerful force for quality improvement but it needs frequently updated information to nourish it.

Then there was the Confederation conference. I attended a session where I learnt about the work in the Oxford Renal Unit managing the transition through adolescence into adult services for young people with kidney failure. Their story, which included using Facebook and Starbucks to improve experience, outcomes, and cost, is inspiring. I also listened to those at the top talk about the values and ambition for the NHS, as well as the huge challenge ahead. They talked about clinical leadership, a focus on outcomes and patient experience, all of which is tangible in my every day work and is being driven by people who know their patients and communities, as the CCGs demonstrated in our Annual Accountability Review.

It all gives me hope that we are learning to walk the talk.

Martin McShane qualified in 1981 from University College Hospital Medical School. He trained in surgery until 1990 then switched to general practice where he spent over a decade working in a semi-rural practice on the edge of Sheffield. In a fulfilling job, with a great lifestyle, he decided to give it all up and take on a fresh challenge. He entered NHS management, full time, in 2004 as a PCT chief executive after experience in fund holding and chairmanship of both a primary care group and subsequent professional executive committee. Since 2006 he has been director of strategic planning for NHS Lincolnshire, where there are 5,600 miles of road but less than 50 miles of dual carriageway.

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