Preview A Guide to Medical Leadership & the NHS 2020-21 [PREVIEW] A Guide to Medical Leadership & the NHS | Page 10

1.02 About this book
In this book we explore the history, structures and finances of the NHS, along with its
many challenges. Although we update it on annual basis, ensuring the most up-to-date
content is problematic – if not impossible. An announcement by a senior politician, a
report published by any one of a multitude of interested parties or any other breaking
news story means that, in some respects, the book is always, in many ways, out-of-date
before you have even turned a page.
This time around is an even greater challenge than we usually have. This edition is
being created in November 2019 in the run up to a general election being held amidst a
great deal of political confusion. Any attempt to freeze data, describe the shape of the
health services and related issues can only ever be correct for a fixed point in time.
However, the vast majority of the challenges, dilemmas and concepts covered remain
the same. So, although we endeavour to keep the detail and data as fresh as we can,
this book is intended to be much more than a factual document. It is intended to
encourage you to think and to equip you to participate in the system in whatever way you
see fit.
You might find this nautical analogy useful. When we equate the NHS to the biggest
ocean cargo ship imaginable then any forward and even the tiniest of changes in
direction are slow, requiring massive effort. Any momentum gained can easily become
uncontrollable and all but impossible to stop. Alternatively, we can equate the NHS to an
armada where each team is a small vessel under its own control. Progress, changes in
direction and response to hazards or opportunities are fast and realistic. A common
overall direction in this case is the responsibility a multiple engaged leaders and teams.
The solutions to problems at national, regional or local level are likely to be found
through such engagement and participation, through leadership and teamwork, through
identifying issues, defining clear aims, creating realistic plans and seeing them through.
So, we will consider the key drivers of organisational change, the conflicting challenges
facing the NHS and the different approaches being taken by each of the four home
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