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Lessons we can learn from the Health Secretary | A guide for primary care leaders
This week's blog is for those of you in a primary care leadership position, the new health secretary and the lessons we can learn from the advice being given to her.
Whilst it is understandable that your time and attention will be taken up with day-to-day operational issues, it is worth zooming out to build your understanding of the strategic and political landscape to better understand the context you are working within.
The Primary Care Network DES is not the only show in town. In fact, outside the money, the deliverables of this contract may be at the very bottom of your practices list of priorities.
The key to increased engagement with your PCN practices is to better understand their world and then create a strategy to move forward.
In this blog, we cover:
1. The role of the Health Secretary
2. Primary care guidance you need to be aware of
3. Your role in translating national policy locally
We also have 2 graphics summarising some of the recent primary care guidance and a PESTEL (political, economic, social, technological, environmental and legal) analysis of primary care as a starter for ten and pose five questions to help guide your next steps.
Let's jump in!
Victoria Atkins | The new health secretary
On the 13th of November, we welcomed Victoria Atkins, Secretary of State for Health and Social Care.
An MP since 2015, Atkins was previously the Financial Secretary to the Treasury between the 27th of October 2022 and the 13th of November 2023 and Minister of State at the Ministry of Justice and Minister for Afghan Resettlement between September 2021 and the 6th of July 2022.
Victoria was diagnosed with Type 1 Diabetes at the age of 3, so she will have many experiences with the NHS alongside her political experience, making her a strong contender for this role. However, time will tell, but time may not be on her side with a general election due in December 2024.
Let’s hope she stays until then.
Victoria replaces Steve Barclay and is the 6th person to hold this position in 11 years.
Her predecessors include:
1️⃣ The Rt Hon Steve Barclay MP | 2022 to 2023
2️⃣ The Rt Hon Thérèse Coffey MP | 2022 to 2022
3️⃣ The Rt Hon Steve Barclay MP | 2022 to 2022
4️⃣ The Rt Hon Sajid Javid MP | 2021 to 2022
5️⃣ The Rt Hon Matt Hancock MP | 2018 to 2021
6️⃣ The Rt Hon Jeremy Hunt MP | 2012 to 2018
7️⃣ The Rt Hon Andrew Lansley CBE | 2010 to 2012
And yes, Steve Barclay appears twice in this list, making history as the first person to hold the Health Secretary position twice.
What is the role of the health secretary?
The gov.UK website describes this role as being responsible for the work of the Department of Health and Social Care with accountability for:
- financial control and oversight of NHS delivery and performance
- oversight of social care policy
In 2020, during an interview with the Health Foundation, Jeremy Hunt, the UK’s longest-serving health secretary, stated it’s a job which doesn’t come with a job description.
But after reviewing the powers and duties of the Secretary of State for Health, published by the Landmark Chambers, an interview with Jeremy Hunt and Nicholas Timmins, (the author of The Five Giants: A Biography of the Welfare State, of Glaziers and Window Breakers: the role of the Secretary of State for Health, in their own words), if there were a job description, the start of it would look something like this:
To uphold the values of the NHS Constitution
To inform and influence the Prime Minster
To ensure things are going well enough not to trouble the Prime Minister
To communicate party commitments to the NHS
To find a focus amongst a multitude of priorities
To study and keep abreast of health systems around the world
Hold the NHS to account for its performance
To deal with press attention whilst maintaining an untarnished personal brand
To review, amend and enforce regulations
Produce reports and attend countless meetings
To become au-fait with NHS policy documents and policies
To build positive working relationships with key stakeholders across the health and social care system
Key stakeholders
The Care Quality Commission and its Healthwatch England committee
The National Institute for Health and Care Excellence
The Health and Social Care Information Centre
Health Education England Special Health Authorities
NHS Confederation
The BMA
Etc……..
In short, Jeremy Hunt summed up the role by saying:
The role of the health secretary is to get the Prime Minister to accept your judgement.
For as long as they do, then great; once they stop, they will move you on, or they will sack you!
In many ways, the role of the PCN Leader is to get your practices to accept your judgement.
Once this stops, they won't sack you straight away, but it will be made abundantly clear that you are not wanted.
What would we like the Health Secretary to do in primary care?
The NHS Confederation has set its priorities for the new health and social care secretary, which include:
1. To resolve the industrial action
2. To not add new aims and pressures
3. To support the implementation of existing plans rather than new policy
Professor Nicola Ranger, chief nurse for the Royal College of Nursing (RCN), also said:
Ms Atkins’ first priority “must be” to secure additional funding for the NHS at the upcoming autumn statement.
Professor Ranger added that the NHS Long Term Workforce Plan that Ms Atkins would inherit would also need "sizeable and rapid investment to make it happen".
Responding to the appointment of Victoria Atkins as Secretary of State for Health and Social Care, Professor Philip Banfield, BMA Council Chair, said:
“The new Health Secretary must make solving the NHS’s workforce crisis her top priority.
It's also worth noting that general practices will not receive additional funding to support this increased demand as the system enters winter pressures.
What can we learn from the advice being given?
When looking at the priorities above, at a local level, local leaders can adopt this approach too.
1️⃣ If engagement or morale in your network is low, now is not the time to ask our practices to do more. Let’s focus on delivering what we said we would do.
2️⃣ When it comes to workforce, whilst we can't secure additional funding for salaries, recruitment or retention activities, are we making the most of what we have to attract and retain our workforce?
PCNs are repeatedly told to ensure they maximise their additional roles reimbursement scheme funding (ARRS). Yet, many networks want to avoid giving a pay rise which brings their salary in line with neighbouring networks, running the risk of losing experienced staff who understand the complexities of working in a network.
3️⃣ When it comes to key NHS documents and relationship building, are you aware of existing national guidance, policies and local contracts, and are you building relationships with key stakeholders? Do you know who your key stakeholders are?
Also, have you read the following?
- The NHS Long-Term Plan our
There are other social, economic, technological, environmental and legal factors at play which affect us. A summary has been started for you below.
Our role is to make sense of the national direction and the challenges and communicate this in an engaging way (Repeatedly!).
Our role is also to marry the national strategies with our local context and politics and then inspire, lead, manage, facilitate, and coordinate the way forward in partnership with our practices and key stakeholders, building trust along the way, using policy, contracts, patient stories, data, technology, and concerns raised, with your practices and key stakeholders to help you drive forward change.
It’s a challenging and exciting role!
Making this practical
Now you have read through the blog,
1️⃣ Are you up to date on the latest national guidance?
2️⃣ Are you clear on the requirements of your local contracts?
3️⃣ Can your strategy for the rest of this financial year take into consideration the wider political landscape?
4️⃣ What are you not sure about, and who can you ask?
5️⃣ How can you take the information in the blog and make this meaningful to you?
We hope this helps!
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Find out more about THC Primary Care at: https://www.thcprimarycare.co.uk
And follow Tara on Twitter: @THCPrimarycare
About the Author
I'm Tara; I am the founder of THC Primary Care, an award-winning healthcare consultancy specialising in Primary Care Network Management and the host of the Business of Healthcare Podcast, where we have now published over 270 episodes.
I have over 20 years of project management and business development experience across the private and public sectors, and I have supported over 120 PCNs by providing interim management, training and consultancy.
I have managed teams across multiple sites and countries; I have an MBA in Leadership and Management in Healthcare, I'm published in the London Journal of Primary Care, and I am the author of over 250 blogs.
I have 3 children. My eldest has Asthma, my middle child has a kidney condition called Nephrotic Syndrome, and my youngest daughter has Type 1 Diabetes, so outside of work, healthcare plays a huge role in my life.
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