Latest news with #SirJimMackey
The Independent
8 hours ago
- Health
- The Independent
This 10-year plan may be the last chance to save the NHS
The 10-year plan for the National Health Service that Sir Keir Starmer is expected to publish in the next few days is likely to be a somewhat incoherent document. From the advance publicity, it would seem to have a lot of disconnected ideas in it, some good, some not so good and some irrelevant. The government hopes that weight-loss drugs will offer the hope of a big advance against obesity-related illnesses – but this comes after new figures raised concerns about their safety. If large language models can speed up the development of new pharmaceuticals, so much the better. But we remain sceptical about whether supermarkets ought to be recruited into policing their customers' calorie intakes. What will decide the success or failure of the NHS over the next decade, however, will be the design of the structural reforms to the service. Wes Streeting, the health and social care secretary, has made a good start in two respects. He has welcomed private-sector providers to help deliver NHS services free at the point of need, and he has taken an axe to the central bureaucracy of NHS England. The test for the 10-year plan will be the extent to which it brings in further changes to incentives throughout the NHS so that it becomes responsive to patients. Sir Jim Mackey, the new chief executive of the NHS, says many of the right things. 'It feels like we've built mechanisms to keep the public away because it's an inconvenience,' he says in his first interview since taking up the post three months ago. He says of the current NHS: 'It takes forever. It costs a fortune. We need to 'de-layer it' because it's expensive, it slows decision-making down, it de-powers people who need to make decisions.' The sentiment is right, but again, some of his ideas seem better than others. We are not convinced that using patient satisfaction surveys to decide how much money NHS trusts receive is going to work. The evidence of reform under the last Labour government was that the mere existence of competition from private-sector providers had a dramatic effect on the performance of NHS units. Already, there are the very early signs that the extra resources put into the NHS are bearing fruit, less than 12 months after the change of government. Luke Tryl, the opinion pollster for More in Common, reported on BBC's Newsnight on Friday that people in focus groups are starting to report positive experiences of the NHS for the first time since the pandemic. 'If there is a bright spot for the government, it's the NHS,' he said. One of the biggest challenges for Sir Jim and Mr Streeting, however, is more political than structural. They have to send the starkest message to doctors: please do not go on strike; take responsibility; show leadership; it is up to you to make the NHS work, because if it cannot be turned round this time, then it probably is the end of this model of healthcare. Sir Jim appears to understand this. He says that his 'big worry' is that if the NHS cannot deliver a service that is better at listening to patients – the particular example he gave was maternity care – 'we'll lose the population; if we lose the population, we've lost the NHS; for me, it's straightforward: the two things are completely dependent on each other.' He is absolutely right. Universal healthcare free at the point of need is a noble idea, but it desperately needs Labour's reforms to work if it is to survive.
Yahoo
14 hours ago
- Health
- Yahoo
Patients are kept away and seen as an 'inconvenience', says NHS boss
The NHS has built "mechanisms to keep the public away" as patients are seen as an "inconvenience", according to the new NHS boss. The incoming head of NHS England, Sir Jim Mackey, has given his first interview since taking up the role as chief executive. Sir Jim told The Telegraph that the health service is clinging on to many "fossilised" practices, some of which have barely changed since its inception in 1948. READ MORE: Friends left stunned at Manchester Airport after landing £24,000 in terminal READ MORE: Workers at trendy new neighbourhood development make amazing discovery His statement comes as he prepares to implement a 10-year health plan to be published by the government next week. Knighted in 2019 for his contributions to healthcare, Sir Jim expressed to The Telegraph: "We've made it really hard, and we've probably all been on the end of it." "You've got a relative in hospital, so you're ringing a number on a ward that no-one ever answers. "The ward clerk only works nine to five or they're busy doing other stuff; the GP practice scramble every morning. "It feels like we've built mechanisms to keep the public away because it's an inconvenience." Sir Jim issued a stark warning about the consequences of this growing divide between NHS services and the public, suggesting it could lead to the demise of the public health service altogether. "The big worry is, if we don't grab that, and we don't deal with it with pace, we'll lose the population," he cautioned in his interview. "If we lose the population, we've lost the NHS. "For me, it's straightforward. The two things are completely dependent on each other." The government's 10-year health plan will aim at improving NHS services through relocating patient care from hospitals to community-based health centres, a greater use of digital tools, and preventive care. Health Secretary Wes Streeting said on Wednesday the plan will also aim to "address one of the starkest health inequalities", which he claims is the unequal access to information and choice when it comes to healthcare. Sir Jim told the Telegraph: "We've got to somehow re-orientate it; think about how do we find people who need us, how do we stop thinking 'it's going to be a pain in the arse if you turn up because I'm quite busy' and instead think about how do we find out what you need and get it sorted." Sir Jim added his concerns are driven by his own traumatic experience of NHS services, when his father died in a hospital locally known for its poor standards of care. He told the paper: "My dad died in a hospital where the local folklore was terrible about the hospital, but the hospital was deaf to it and didn't know what was actually being said. "I wasn't long into the NHS, it was a long time ago now, and I felt really powerless. "I found out too late that the clinical community knew the guy who looked after him wasn't as good as I would have wanted him to be. "I'll carry that for the rest of my life. "In an effort to take pressure off hospitals and cut down waiting lists, the government previously announced that 85 new mental health emergency departments will be built across England. The 85 units will be funded by £120 million secured in the Spending Review, the Department of Health and Social Care said. Open24 hours a day, seven days a week, they will be staffed by specialist nurses and doctors. Patients who need help will be able to walk in, or will be able to be referred by their GP. Under the new plans, mental health patients will also be able to self-refer for talking therapies using the NHS App. The new measures could also pave the way for AI-driven virtual support, according to the Department of Health and Social Care. Mr Streeting also unveiled plans to divert more than £2 billion in NHS spending to working class communities.
Daily Mail
18 hours ago
- Health
- Daily Mail
NHS keeps public away and patients are seen as 'inconvenience', health service's new boss says
The NHS has built 'mechanisms to keep the public away' as patients are seen as an 'inconvenience', its new boss has said. Sir Jim Mackey, who was made chief executive of NHS England on March 31, has publicly criticised the health service for often being 'deaf' to criticism and retaining 'fossilised' methods of working that are outdated. Ahead of the implementation of a 10-year health plan set to be published by the UK Government next week, Sir Jim told The Daily Telegraph that in recent years, the NHS has often 'made it really hard' for people to receive care. He added: 'You've got a relative in hospital, so you're ringing a number on a ward that no one ever answers. 'The ward clerk only works nine to five or they're busy doing other stuff; the GP practice scramble every morning. 'It feels like we've built mechanisms to keep the public away because it's an inconvenience.' Sir Jim also warned that if the growing disconnect between NHS services and the public is not rectified at 'pace', it could result in the loss of the public health service altogether. He said: 'If we lose the population, we've lost the NHS. For me, it's straightforward. The two things are completely dependent on each other'. It comes ahead of the Government's 10-year plan for the NHS, set to be unveiled next week. Aimed at improving services, Prime Minister Sir Keir Starmer is reportedly set to link doctors' and nurses' pay to their success in bringing down waiting lists. Under the proposed plans, NHS patients could also be contacted several weeks after receiving treatment and asked if it was good enough for the hospital to get paid in full. If the patient says no, roughly 10 per cent of 'standard payment rates' are set to be diverted to a local 'improvement fund', the Times previously reported. The major revamp is also set to relocate patient care from hospitals to community-based health centers. Health Secretary Wes Streeting said on Wednesday that the plan will aim to 'address one of the starkest health inequalities', which he claims is the unequal access to information and choice when it comes to healthcare. For Sir Jim, the health service, first created in 1948, is in urgent need of a 're-orientation', with a shift in mindset from "it's going to be a pain if you turn up because I'm quite busy" to 'how do we find out what you need and get it sorted.' Having started his career in the NHS in 1990, Sir Jim also revealed that his concerns about the health service are predominantly driven by his own childhood experience, after his father died in a hospital 'known for its poor standards of care'. Adding that he will carry the trauma of his father's death 'for the rest of my life', the NHS England boss previously vowed to MPs that he would 'pick up the pace of reform' and tackle the widespread 'inefficiency'. In April, MailOnline revealed how Sir Jim is 'running the NHS from a train carriage' as he was caught watching Netflix in the middle of the afternoon before snoozing off. Sir Jim, who commutes 1,200 miles a week between the office in London and his Northumberland home, was also found by a Mail exclusive investigation to have left his laptop unlocked while using a train toilet. He openly displayed documents including one revealing details of an 'NHS leadership' meeting. And the health service chief slept half an hour - through an alert on his device reminding him of an online meeting. In response, former Conservative leader Sir Iain Duncan Smith said: 'You couldn't make it up. 'It's not a great lesson in efficiency when you waste so much time travelling and falling asleep. You can't run the NHS from a train carriage. If you want to do the job properly, you've got to be in the office. It's what most businesses would demand.' But Health Secretary Wes Streeting backed his hire to lead the NHS, declaring: 'Jim is proving to be worth his weight in gold.' Sir Jim was initially appointed to oversee a dramatic cut in waste and inefficiency across the NHS, with the Government saying it wants to axe 50 per cent of corporate management jobs and use the savings of hundreds of millions of pounds to improve frontline services. It comes ahead of the Government's 10-year plan for the NHS, set to be unveiled next week. Aiming at improving services, Prime Minister Sir Keir Starmer is reportedly set to link doctors' and nurses' pay to their success in bringing down waiting lists. (File image of an NHS waiting room) The transition' period under the Labour government is expected to take two years, with Sir Jim due to be the helmsman until then. In a bid to take pressure off hospitals and cut down waiting lists, the Government previously announced that 85 new mental health emergency departments will be built across England. The 85 units will be funded by £120million secured in the Spending Review, the Department of Health and Social Care said. Open 24 hours a day, seven days a week, they will be staffed by specialist nurses and doctors. Maternity wards are also expected to be among the first parts of UK hospitals to be placed under the microscope, after Streeting launched a full review into services across the country, saying that women had been 'ignored, gaslit [and] lied to' by the NHS. Previous plans unveiled by Mr Streeting revealed a diversion of more than £2billion in NHS spending to working class communities.
The Independent
a day ago
- Health
- The Independent
NHS keeps patients away because they are an inconvenience, new boss admits ahead of shake-up
Patients are an 'inconvenience' to the NHS, which has 'built mechanisms to keep them away', said the new boss of the health service. Sir Jim Mackey, who was made chief executive of the NHS on 1 April, spoke of the 8am daily phone scramble for a GP appointment as one example of the difficulties patients face in seeking help. 'We've made it really hard, and we've probably all been on the end of it,' he told The Telegraph. 'You've got a relative in hospital, so you're ringing a number on a ward that no one ever answers. The ward clerk only works nine to five or they're busy doing other stuff; the GP practice scramble every morning. 'It feels like we've built mechanisms to keep the public away because it's an inconvenience,' he said. And he warned that failing to listen to public frustrations could mean the end of a national health service. Failings in maternity services, he said, were cultural and 'thinking we know best when mothers know best, listening to them and families and building the service around them'. He said: 'The big worry is, if we don't grab that, and we don't deal with it with pace, we'll lose the population. If we lose the population, we've lost the NHS. For me, it's straightforward. The two things are completely dependent on each other.' Sir Jim, who earlier this month said the NHS should 'tear up' the way it offers hospital outpatient appointments, said cutting back millions of routine follow-ups would be a priority, since the NHS spent more on hospital outpatients than on the whole of the GP system. 'Outpatients is glaringly obvious. Of 130 million outpatients a year, about 85 million or so are follow-ups,' he told the paper, adding that it felt wrong that the NHS diverted so many resources to follow-ups at the expense of patients waiting for diagnosis and treatment. Moving care out of hospitals into local neighbourhood centres was crucial, to tackle waste and make care more convenient, Sir Jim said. Shifting treatment from hospitals to the community will be a key aim of the government's major 10-year health plan, which health secretary Wes Streeting is set to unveil next week. Mr Streeting has also pledged to 'end the postcode lottery' of care, focusing more on working-class communities. Trials will be set up of 'patient power payments', under which hospitals receive the full payment for treatment only if the patient is satisfied, The Telegraph reports. Sir Jim, who from 2003 to 2023 was chief executive of Northumbria Healthcare NHS foundation trust – the most highly rated trust in the health service, said that in that role he tried to read every email and spoke to every family that approached him. He described the 8am race for a GP appointment as 'that heart-sink moment, someone's got to sit by the phone, they've got to ring forever, don't get through and then have to do it all again tomorrow'. He said: 'It feels like we've built mechanisms to keep the public away because it's an inconvenience. 'We've got to somehow reorient it; think about how do we find people who need us, how do we stop thinking 'it's going to be a pain in the arse if you turn up because I'm quite busy' and instead think about how do we find out what you need and get it sorted.' But he said the NHS performs best when money is tight. 'There's got to be some tension in it, otherwise we'll waste money. 'There is a strong argument that we have wasted a lot of money in the last few years, we haven't spent it as wisely as we could have done.' The NHS needed to be 'de-layered' because it was expensive and slowed down decision-making, he insisted, warning that the NHS has too many 'fossilised' ways of working. And he said: 'We've got too many people dying in hospital when they want to die at home.' He told how the system 'failed' his elderly mother, with inconsistent care over seven days, a lack of weekend services and a 'disjoint' between services. He praised the staff involved, but said 'a hell of a lot of learning' was needed. 'My dad died in a hospital where the local folklore was terrible about the hospital, but the hospital was deaf to it and didn't know what was actually being said,' he recalled. 'I wasn't long into the NHS, it was a long time ago now, and I felt really powerless.'
Telegraph
a day ago
- Health
- Telegraph
NHS sees patients as an inconvenience, says new boss
The NHS sees patients as an 'inconvenience' and has 'built mechanisms to keep them away', its new boss has said. Sir Jim Mackey said the health service was too often 'deaf' to criticism, 'wasted a lot of money' and deployed far too many 'fossilised' ways of working that had not changed since the foundation of the NHS in 1948. In his first interview since becoming head of the NHS, Sir Jim told The Telegraph the health service had 'made it really hard' for patients to get the care they needed. 'It feels like we've built mechanisms to keep the public away because it's an inconvenience,' he said, warning that too many patients were left 'ringing a number no one ever answers'. Next week, the Government will publish a 10-year health plan that promises three major shifts in the way the NHS operates – from hospital to community; from analogue to digital; and from treating sickness to prevention. There will be far more 'neighbourhood health', with NHS and private companies working for it to offer more care locally, including increasing the use of high street services. A revamped NHS app will provide a new front door to the health service, with AI used to assess symptoms and direct patients to the right care, and users able to use the app to book appointments, contact medical teams and compare hospital outcomes. The plan will also set out reforms to put the focus of the health service on the experience of patients. The Telegraph can reveal that this will include trialling 'patient power payments', with hospitals only getting the full payment for treatment if the patient is satisfied. The reforms are also set to change the way A&E departments are funded, with payment dependent on cutting long waits and shifting more care out of hospital. Sir Jim, who ran the NHS's most successful hospital for 20 years, said he was driven by the poor experiences of his own family at the hands of the health service. He was just starting a career in hospital management when his dying father suffered terrible care at the hands of the NHS. That was in the 1990s; but the new head of the NHS says since then, far too little has changed. 'We've made it really hard, and we've probably all been on the end of it. You've got a relative in hospital, so you're ringing a number on a ward that no one ever answers. The ward clerk only works nine to five or they're busy doing other stuff; the GP practice scramble every morning.' 'It feels like we've built mechanisms to keep the public away because it's an inconvenience.' He goes further, warning that failing to listen to public frustration could mean the end of a publicly funded state health service: 'If we lose the population, we've lost the NHS.' The candour is startling; not least because it's Sir Jim's first interview since being appointed to overhaul an organisation long accused of a culture of denial. It's 8am on the seventh floor of Wellington House, NHS England's headquarters near Waterloo, and the 58-year-old has been up for hours. Sir Jim, who was knighted in 2019 for services to health care, has been appointed to lead the NHS in somewhat unusual circumstances. On the day Labour won the general election, last July, Wes Streeting, incoming Health Secretary, declared the health service 'broken'. It seemed inevitable that NHS England, the world's biggest quango, which had been created under his predecessors, was for the chop. But it wasn't until February that Amanda Pritchard, its beleaguered chief executive, stood down, with Sir Jim, a long-time hospital boss, quickly announced as her interim replacement. Within weeks, at the suggestion of Sir Jim, NHS England, with more than 13,000 staff, had announced cuts of 50 per cent. But just days later, Sir Keir Starmer announced that the organisation would be axed entirely, with functions subsumed into the Department of Health. Sir Jim is leading the process, while preparing to implement the 10-year health plan, due to be launched next week, which is intended to radically reform and save the NHS. It's probably a good thing, then, that the 58-year-old likes getting up at 5am, and describes himself as 'really competitive'. Personal mission But more than that, the softly spoken Geordie, born in Hebburn, South Tyneside, suggests he has been driven by his own personal experiences of the NHS, and has seen too often the failure of the organisation to listen to those it serves. The NHS leader attended the local comprehensive and Durham New College, qualifying as an accountant, before he joined the NHS in 1990. He has stuck with it ever since, including 20 years as chief executive of Northumbria Healthcare NHS foundation trust from 2003 to 2023. The hospital trust became the most successful in the country, with by far the highest ratings, in what watchdogs described as a 'remarkable' first for the NHS. It also embarked on radical reforms, taking over community and GP services, in a model of integrated care that next week's plan will encourage the best foundation trusts to follow. But when asked how the NHS needs to change in order to deliver for patients, Sir Jim's story becomes much more personal; about how his own family's experience at the hands of the NHS, and the failure of the service to listen to its patients has driven him. 'My dad died in a hospital where the local folklore was terrible about the hospital, but the hospital was deaf to it and didn't know what was actually being said. 'I wasn't long into the NHS, it was a long time ago now, and I felt really powerless. I found out too late that the clinical community knew the guy who looked after him wasn't as good as I would have wanted him to be. I'll carry that for the rest of my life.' His elderly mother's experience and later death also informed him: 'All their friends knew which ward not to go into.' It happened during 'a very complicated point just after Covid' in 2022. He is at pains to praise the staff involved, but clear that there is 'a hell of a lot of learning' from the way that the system failed her – the inconsistency of care over seven days, with a lack of weekend services, and a 'disjoint' between different services. 'It's our job to bring those experiences back and think about, what do I do about that here? How are we going to sort it out? How do we avoid it happening?' The emphasis on the experience of the patient can be seen throughout Sir Jim's career. As chief executive at Northumbria, he created a 'patient experience programme' that aimed to learn from industry in getting a far deeper level of insight into how the population was being served. Some of it was trial and error – he is deeply sceptical about the tendency of the NHS to embark on 'engagement' processes that have a predestined outcome and 'destroy' any public faith. He wants to see more use of big data to shape NHS services, built on patient satisfaction. But sometimes it comes down to 'having a chat with a few old people about what they were really bothered about', he said. He added that as a trust chief executive, he tried to take every opportunity to act on feedback, read every email and spoke to every family that approached him. One of his deepest concerns is that far from responding to the public it should serve, the NHS has instead constructed walls to lock them out; the 8am scramble for a GP appointment, 'that heart-sink moment, someone's got to sit by the phone, they've got to ring forever, don't get through and then have to do it all again tomorrow'. Equally, he is concerned where practices have tried to force patients to make online requests, even if they are unable, warning that efforts to modernise the NHS must not find new ways to lock people out. 'It feels like we've built mechanisms to keep the public away because it's an inconvenience. We've got to somehow reorient it; think about how do we find people who need us, how do we stop thinking 'it's going to be a pain in the arse if you turn up because I'm quite busy' and instead think about how do we find out what you need and get it sorted.' Earlier this month, health was the winner in the spending review, with a record £29 billion annual cash injection. The total NHS budget will be £232 billion by the end of this parliament. But one of Sir Jim's biggest fears is waste; he said the NHS generally performs best when money is tight: 'There's got to be some tension in it, otherwise we'll waste money,' he added, bluntly. 'There is a strong argument that we have wasted a lot of money in the last few years, we haven't spent it as wisely as we could have done.' Critics have argued that the increase – which amounts to a real-terms 3 per cent a year for the NHS – is not enough. But Sir Jim warned: 'I think we have to understand where we are as an economy. There is a reality about what the country can afford.' Noting that NHS turnover is about the same size as the GDP of Portugal, he said: 'It's bloody massive, it's more than £200 billion quid. We all know and experience waste.' Sir Jim seems visibly appalled by the bureaucratic empire the NHS has created. 'Most NHS organisations are massive,' he said: 'It's hard for people outside the NHS to get their head around.' NHS England, which has 13,500 staff, and the Department of Health and Social Care, with more than 4,000 staff, will see numbers halved. So too will 42 integrated care boards, which employ around 25,000 people. 'We definitely got very complicated and very expensive in our operating model, our corporate overhead,' he said, with far too many layers of oversight. 'It takes forever. It costs a fortune. We need to 'delayer it' because it's expensive, it slows decision-making down, it de-powers people who need to make decisions and need the service to move more quickly and more in a more agile fashion.' He described deep frustrations as a hospital trust chief executive at the sharp end of it, recalling thinking: 'I just don't know how to get that decision made any more.' Public confidence in the NHS has slumped to rock bottom since the pandemic, with just 21 per cent of people expressing satisfaction last year. However, Sir Jim said the health service was heading into trouble long before. 'We ran into Covid in bad shape. All of the key metrics are telling us we're in trouble, patient and staff experience, performance, statistics, financial position, going into Covid. We had that huge amount of public support in that first period. Then if we're honest, that disconnect with the population has just grown and grown.' He believes the goodwill of the public was squandered, suggesting that the NHS took it for granted. Failing to listen to public frustrations could mean the end of a national health service, he warned. In particular he highlighted maternity failings – where a national investigation is about to start. He said: 'I think it's behavioural, I think it's cultural. I think it's about how we listen to people and not desensitising; not thinking we know best when mothers know best – listening to them and families and building the service around them. 'The big worry is, if we don't grab that, and we don't deal with it with pace, we'll lose the population. If we lose the population, we've lost the NHS. For me, it's straightforward. The two things are completely dependent on each other.' Dwindling confidence in the NHS has been fuelled by worse access to services through the pandemic, and too slow a recovery since, allowing waiting lists to grow, he suggested. Swathes of activity were stopped during the pandemic, with more surgery stopped than in almost any European nation. 'Really difficult game' Sir Jim was on calls with healthcare chief executives across Europe and the United States at the time, and was well aware that other systems had paused far less activity – and sprang back much more quickly. 'We curtailed access much longer than other systems. So we were building up more of a problem than others were. There were a lot of other developed systems that were more agile and opened up more discerningly than we did. 'A lot of us operationally felt that we had people chomping at the bit, we knew we could do it safely but we couldn't in the circumstance… it was well-motivated, but we created more of a problem at that point.' Even in 2021, by now on secondment as NHS England's elective adviser, Sir Jim felt that hospitals were playing 'a really difficult game' with far reduced capacity, thanks to infection control practices brought in during the first lockdown, which were still in place some 18 months later. By 2022 the NHS was heading into strikes, with junior doctors, consultants and nurses all joining industrial action. Perhaps little surprise then, that productivity has tanked, despite record funding, with a sharp fall in the number of patients per medic in clinics and theatre lists. Last autumn, an investigation of the NHS by Lord Ara Darzi found that while hospital staff numbers had risen by 17 per cent since 2019, productivity was at least 11.4 per cent lower. 'There's a straightforward argument on productivity and recovery that says, whatever the reasons are, we're actually not seeing as many patients as we were then.' 'Fossilised' ways of working He goes on to suggest that the latest generation of medics may not be used to the workload that came before the pandemic: 'There's a lot of clinicians now who've only worked in a post-Covid environment... they never experienced the busy consulting in 2017 when we had 30 per cent more people on the list than we do now. That's a harder thing to change, because that's what they've come into… it's hard when you've got a big backlog.' However, Sir Jim suggested it was not just about speeding up; but rather about bringing an end to outdated practices. He warned that the NHS has too many 'fossilised' ways of working, some of which have barely moved on since 1948. Sir Jim said getting care out of hospitals into local neighbourhood centres is crucial, in order to tackle waste, and make care more convenient. 'There's so much to go at. There's so much to change in a short space of time.' Top of his list is reform of hospital appointments, which see millions of people routinely called back for checks that very few need. 'Outpatients is glaringly obvious. Of 130 million outpatients a year, about 85 million or so are follow-ups,' he said, saying it feels 'wrong' that the NHS diverts so much resource to follow-ups, at the expense of those waiting for diagnosis and treatment. The NHS spends more on hospital outpatients than on the whole of the GP primary care system, he said. Revamped NHS app The 10-year plan will pledge an overhaul of such systems, giving patients more direct access to medical teams, so they can seek help when it is needed, instead of being repeatedly summoned. A massively revamped NHS app will be key to 'liberating' the patient, Mr Streeting has said, giving a new front door to the health service, with AI used to direct patients to the right care, and users able to compare hospitals by outcomes, waiting times and patient satisfaction. Under the plans, the app will also be a route to contact medical teams and book appointments. It's a revolution Sir Jim has long been calling for, back in 2021, when appointed elective adviser to NHS England, warning of too many 'pointless' appointments. However, he is well aware that access needs to be just as good for those who cannot rely on digital access, including some of the most elderly and vulnerable. Reforming the system means bringing far more services together, out of hospitals, in settings close to home, with multiple checks offered simultaneously. Too many people are coming in and out of hospital for multiple interactions, often in the same week, forcing people to take a day off work and then do it all over again, just because 'we can't join the dots and do it in one go', he said. 'Too many people dying in hospital' The NHS fails to respect what patients actually want, he suggested; then ends up paying a higher bill for it, with long stays and multiple interventions. The simplest example is perhaps the most stark: 'We've got too many people dying in hospital when they want to die at home,' he said. The plan will put a central focus on the experience of patients, he promised. 'Patient power payments' will be trialled in some areas, with hospitals only getting the full tariff payment for their treatment if the patient was satisfied. When Mr Streeting unveils the final draft of the 10-year plan next week, it will have gone through so many drafts that those involved blush. Sir Jim said he was 'genuinely a bit emotional' on reading the first draft. 'I was thinking, thank God, we are talking about things I really want to talk about.' He praised its long-term ambition, saying the NHS has previously failed to look sufficiently ahead. Labour's election issue While the spending review is for three years, with a four-year plan for capital, it will look much further. 'One of our failures, I think, in the last sort of 10 years or so, has been our inability to think and plan ahead. But it generates some ambition. So you will look at it and think, 'Oh, that looks a bit frisky compared to where we are now'. That's the point. It's not saying this is all going to happen tomorrow.' For Labour, saving the NHS is an election issue. Sir Keir has pledged to restore the maximum wait to 18 weeks (for 92 per cent of cases) by the next election. Does Sir Jim feel like the next election result is resting on him? 'I don't worry about that,' he said, while he insisted the waiting pledge will be delivered. 'I worry about the population. I'm really competitive. I want to deliver on everything, and in all of that, I want to deliver for the population and our staff. I want to see more pride in the NHS; I want to see more joy. I want to see more celebration of the brilliance of it all; but we've got a lot to sort out.' That competitiveness isn't just professional. Sir Jim is a former competitive swimmer, who admitted to being 'a bit obsessive' about health and fitness, and said exercise was his first call if he is getting stressed. Carping from the sidelines One thing that frustrates him is critics carping from the sidelines, even before the plan is out. 'I needed to swim last night because I was wound up,' he said. 'I'm a very motivated person, right? Some would say I'm really driven, but I want to deliver. I feel the responsibility of delivering. And there's one thing about negativity that really winds me up is that kind of tone, that negativity, defeatism and cynicism when the plan isn't even locked down yet.' Another thing that wound him up? An article in the Daily Mail in April, which dubbed him 'Sleepy Jim' after catching him snoozing on the train back up to Newcastle. 'It did irritate us,' he said. 'The day before, I worked 17 or 18 hours, even on the day of that picture. I started at five. I finished it just after seven. I've been in a health select committee for two hours in the middle.' He was inundated with messages, unanimous in stating that the piece was 'a bloody disgrace'. 'Everybody who knows me knows I'm not sleepy, I'm not lazy. It jars, it was upsetting what it did to the family; one thing I'm not is sleepy.' He's up at 5am every day ('I was a swimmer, my kids were swimmers, my body clock has been completely buggered up since then'); when he can, he tries to get home at a decent time to see his family. 'Heart has always been in North East' Even when he took the top job, Sir Jim, a family man with a wife, two grown children and grandchildren, said 'my heart has always been in the North East'. He intends to return to Newcastle upon Tyne Hospitals NHS foundation trust, where he last year became chief executive, once he has 'led the NHS through its transition from the current crisis to getting back on its feet'. Football also keeps him going; he has previously described himself as a 'Newcastle United supporter with all the psychological scars'. Is he the Eddie Howe of the NHS, able to turn around the NHS, as much as 'Steady Eddie' has transformed Newcastle United's fortunes? He pauses – in a notably steady way: 'The Eddie Howe of the NHS?… He's very grounded and very analytical, a decent bloke, with a good way of getting the best out of people… I think there are some commonalities.'
