THE BIG PITCH 8 | Cutting the Gordian Knot Sometimes the challenges we face in healthcare can feel insurmountable. The second year of the pandemic has laid bare so many issues that have impacted all of us in some way. From health inequalities, equality diversity and inclusion, wellbeing and resilience to sustainability, continuing to deliver high quality care in a time of unprecedented challenge and the largest transformation in the way the NHS operates for a generation. Perhaps this is howAlexander the Great felt when he was faced with the Gordian Knot – one of the supposedly most unsolvable problems of history. If ever there was a Gordian Knot, the challenges faced by the NHS and its workforce at this time are it, and much like Alexander we need to bring new thinking and action if we are going to address these issues. Before the pandemic the NHS Long Term Plan set out the challenges: an ageing population with multiple comorbidities; reducing unwarranted variation, self-care for wellness and long-term conditions; predict/ prevent interventions; enabling home care and carers; reducing reliance on the acute sector; multi-channel service access; addressing challenges of mental health and embracing the technology revolution – especially AI. The pandemic has accentuated many of these issues, but new challenges have emerged – the reboot of services; addressing the backlog and waiting lists. For the workforce exhaustion and overload is a huge issue, needing more support and development than ever. Then the re-organisation of services with the formation of integrated care systems in addition to the merger of NHSX, NHS Digital, NHS Improvement and Health Education England into NHS England. However alongside great challenges come great opportunities. Just imagine if we could create the right culture and empower our most valuable asset, our workforce, we could rise to these challenges. That is why my second picture, the embodiment of the opportunity in front of us, is a photo of the Clinical Entrepreneurs on the steps at the Royal Institution at our last in person Big Pitch event. What an amazing, diverse group who have been empowered to identify the problems, create the solutions and take ownership of delivering the change. This year the CEP has been completely virtual for the first time, but that hasn’t stopped some of the most inspiring and amazing individuals from stepping forward and delivering world leading innovations that are transforming patient care. Tonight, you will hear many examples of frontline NHS staff cutting the Gordian Knot across the system and how our workforce and the patients we serve are benefiting. Through programmes like the CEPwe can build a purpose-led high performance culture, underpinned by the values of trust and challenge that place our workforce, patients and citizens at the heart of the transformation we need to deliver high quality care now and for future generations. Professor Tony Young OBE National Clinical Lead for Innovation NHS England and NHS Improvement Jean-Simon Berthelemy’s 18th century depiction of Alexander the Great cutting the Gordian Knot CEP Big Pitch event 2019 at the Royal Institution
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