Governance reform in the NHS

In all the commentary this week around the Government's plans to radically devolve power in the NHS, there has been little about the governance challenge this represents (honourable mention to the exceptions: the Chartered Management Institute here and Michael Tremblay here).

Are GPs ready to take control of 80% of the NHS's £100bn annual budget? While some run thriving SMEs, the management challenge to take on commissioning their services is a step change from a small rural practice.

In particular, do GPs have the right governance culture for their new role? By this I mean no disrespect to GPs but simply question whether their existing culture - necessarily elitist, authoritative, closed, collegiate - is the right culture to fit the new NHS strategy.

Working with a plethora of private sector providers requires acute attention to contractual detail, considerable strategic vision of the kind of services mix required, entrepreneurialism, innovation, and (dare I say it) some marketing nous as the reforms bed down and GP consortia start competing for business.

According to my insider sources, these are not the cultural values taught in medical schools nor fostered by the Royal Colleges. It seems like the NHS reforms represent a considerable research and practice opportunity for Governance Beyond the Boardroom network. Please drop me a line if you wish to pursue it.