Simon Stevens at the NHS Confederation

Simon Stevens speaks at the NHS Confederation's annual conference in Liverpool

Simon Stevens speaks at the NHS Confederation’s annual conference in Liverpool

Well, he’s not Sir David Nicholson. Simon Stevens, the new chief executive of NHS England, gave his first speech to the NHS Confederation’s annual conference this week.

And it was a very different performance to that of his predecessor, who received a standing ovation at the same event last summer.

Sir David may have been dubbed “Stalin” by some, but he had a good line in how he truly believed in the NHS that he had worked for all his life, and in feeling the pain of those trying to run it.

Stevens does not have the same credentials. He may, as he told the audience, have been a Labour councillor once. He may, as he also told them, have started his career as an NHS manager.

But he went on to work for the Prime Minister and for the past decade he has helped to run United Health, a US healthcare provider. And it shows.

Stevens looks and sounds like a corporate executive. His speech rattled out ideas, quoted famous thinkers, and threw out international examples by the dozen.

However, like so many top execs, Stevens gave the impression of a man who has read a lot of books, worked out how to apply the best bits to the task in hand, and then had to chop the results into too many PowerPoint presentations at international airports.

Fortunately, he set out his main messages in a couple of sentences at the start. And they were very different messages to those delivered by Sir David.

His predecessor outlined the ‘Nicholson challenge’ for the NHS to save billions to meet a gap between flat funding and rising demand and costs five years ago (see below). And then he oversaw national programmes to try and close it.

His last speech featured a plea for a “big conversation” with the public on what a sustainable service might look like (see below) and he wanted a big plan to deliver the “new service models” that would entail.

Stevens swept through what think-tanks are now calling a looming crisis (see below) that could reach £30 billion by 2020, and said that instead of worrying about the problem it is time to act on it.

He also told his audience there will be no “five year plan”. Instead, he contended that more “sophisticated” commissioning and more joined up services will do the job. And that a coming “revolution” in medicine could yet save us all.

Genomics. Big data. IT companies spout about this stuff all the time. It sounds exciting. It is exciting. But you have to wonder how it is going to affect a district general hospital in, say, a run down bit of Liverpool any time soon.

While the boffins and statisticians do their thing, Stevens urged managers to come up with ideas for saving their own local hospitals and delivering better, more integrated care for the old and sick.

Many will welcome his message that there will not be another reorganisation of the NHS or its services – although, in passing, Stevens backed Sir Bruce Keogh’s plans to create just 40-70 emergency and urgent care centres, which will feel a lot like one.

But others may feel they have just been told they are on their own by a clever boss who would have no problems coming up with good ideas themselves. Which won’t be comforting.

Applause for the speech was muted. Words like “technocratic” were heard in the few conversations that were held about it. It is indeed a new era.

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