Almost all our emergent consortia have completed their elections. Chairs are being identified and the process of change and transition is accelerating. Someone asked me last week whether the process we were embarking on was irreversible. Psychologically, I think it would be very hard to reverse it but, more importantly, across the country the clustering of PCTs has also made it nigh on impossible. The person who asked the question was worried whether the reforms would derail the likelihood of meeting the financial challenge whilst maintaining the quality of services; a good question.

We have now pretty much reached the end of the annual planning cycle. Sitting at the core of this year’s plan is QIPP (Quality, Innovation, Productivity and Prevention). We have had multiple and frequent requests from the SHA to assure the centre that we have a robust plan. They want regular and frequent reports and assurance which shows no signs of abating. It is understandable. They reflect the sense of concern my questioner had. To address this and to turn ink into action, in parallel with the planning process, we have taken a programme management office approach to our entire portfolio of work. This has been a Herculean task to detail the projects, the benefits, the sustainability and prioritisation scores, the risks, milestones and metrics associated with the plan and get everyone across the organisation to realise that this approach wasn’t optional.  The reason is that this approach will help us implement the plan and also tell us if it is working.

We need this way of working, excellent programme and project management, to be embraced owned and led by Consortia, if we want to ensure delivery of QIPP.  In fact, even if we weren’t going through the reforms, in my opinion, this is what would be needed to truly transform the system to meet the financial challenges. We need to (and will be told to) align all the staff, who have helped work up the plan, to consortia to support consortia development and delivery of the plan. The new consortia leaders will need to accept the responsibility.  They don’t have to accept the accountability, yet, but from April they will inherit any legacy once they do become accountable.  Development of Consortia and delivery of QIPP are inextricably intertwined. Both will need a lot of commitment from GP leaders.

This is why when I heard one of our newly elected GPs wondering if they could do this job with a meeting every two months I suppressed a panic attack.

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.