Simon Stevens, the new head of NHS England, kick-started his leadership of a million-plus strong workforce this week by giving them a simple mantra to follow - "think like a patient, act like a taxpayer."
This simple phrase is expected to kick start the biggest change the NHS has ever seen, whereby outdated systems and job roles are redesigned around the most effective ways to deliver care to patients.
However, time is not with Simon Stevens and these changes are being hastened by growing public anger about continuing examples of medical negligence and harm caused by a breakdown in patient care. They are also necessitated by potential threats to NHS budgets (what Stevens calls "the most sustained budget crunch in its 66 year history") and a private health sector that is hungry to get its hands on public money for the promise of better and leaner health services.
So with all these competing voices, who will be put first, the patient or the taxpayer?
I would argue that putting patients first is putting the taxpayer first and here's my six-point plan for Simon Stevens to get his teeth into:
1. Firstly, using public money wisely isn't about cutting corners, it's about getting the best value for money. That doesn't mean denying expensive treatments, it means looking at what treatment will have the maximum and quickest impact.
2. Secondly, it's about investing in staff training and getting patients in front of the most qualified person as quickly as possible. Each month at Fletchers Solicitors, we hear of hundreds of examples where lasting harm has been caused because opportunities to treat conditions quickly and effectively were missed.
3. It's also about being honest and transparent. April 1st saw a duty of candour being implemented alongside a set of reforms designed to tackle the NHS' reputation crisis. Put simply, this means that when things go badly wrong the NHS should admit its mistakes and make amends. Sounds obvious doesn't it? But the public (patients and taxpayers alike) would be appalled if they saw the lengths parts of the NHS have gone to in the past to cover up mistakes and deny responsibility. NHS managers may say that doing so is about avoiding payouts for negligence payouts, but guess who picks up the tab for putting right these mistakes? That's right, the taxpayer, in the form of corrective medical treatment, benefit payments and lost tax revenue when people are unable to work. That's before counting the true cost of ruined lives as a result of medical negligence.
4. The NHS also needs to become better at listening. I've written here before about failures at listening to patients and it's clear that the system for accepting and reacting to the views of patients is badly in need of an overhaul. There's less need to spend millions on consultants and managers when you're set up to listen to the 50 million plus people more than happy to share their views on what you're doing wrong.
5. However, listening is only worthwhile if you then react effectively and quickly. The negligence we see in our firm doesn't just come from an individual's errors, sometimes it can be established practices and procedures that are at fault - a willingness to change would see better practices adopted across the NHS and a reduction in unnecessary harm.
6. The NHS should be structured around patients not its staff. Efficiencies and budget crunching is modern-day policy speak for redundancies, and without doubt the number of people employed by the NHS is going to be reduced. However, where the scalpel is to be wielded is another matter. Basing these decisions on each employee's contribution to patient care would be a good place to start. The NHS needs experienced and highly trained people delivering frontline care. It needs the right number of doctors or consultants, making good early judgment calls to ensure patients are dealt with efficiently. It also needs consultants focused and available for when NHS patients need them - people do not stop needing treatment over weekends, late at night or during the Christmas holidays. It also needs experienced heads to guide student and newly qualified practitioners in their early days in practice. Again, cutting costs alone doesn't mean getting better value.
So can 'thinking like a patient' save the NHS? Not on its own. What is really needed is good leadership from Simon Stevens.
We need him not just to say the right things, but also to stand up for patients when it matters. When it comes to pushing back on the political agenda of whichever minister is in charge. When it comes to negotiating with the unions and senior consultants.
We also need him to gain the trust and support of NHS staff. When we're next sitting in a hospital bed we want staff feeling part of a successful, happy and effective NHS, not angry with their boss.
Ed Fletcher is the chief executive of Fletchers Solicitors. For more information visit fletcherssolicitors.co.uk