Paul O’Connor shares our learning from working with a quarter of all sustainability and transformation partnerships

What can the sector learn from our experience of working with a quarter of all sustainability and transformation partnerships to transform and improve health and wellbeing and what does it mean for the NHS?


#Quality improvement and financial rigour are not mutually exclusive:
initiatives that enhance one, if implemented responsibly, can often enhance the other

Clinical cases for change are the most persuasive to stakeholders: these link to the NHS’s values and are critical to winning “hearts and minds” at every level, across all stakeholder groups

Action and engagement are not mutually exclusive: both are essential in any change process, the former sets the direction, the latter takes partners (staff and organisations) on the journey

Underperforming trusts are often a symptom of wider problems: often the causes of underperformance are built up over the course of several years, with system partners holding some culpability. Addressing issues in a single organisation will only address part of the problem.

Interventions to improve quality typically win significant buy in from staff: delivering better and safer services or outcomes for patients is an effective motivator across all staff groups

Transformation is more about “culture change” than meeting in year targets: momentum built during transformation needs to quickly become “business as usual” or the energy will be lost

Mandated change will have more immediate external support and momentum, but locally driven change will have more natural local buy in: leaders need to create comparable urgency in internally led change to enable effective transformation

Special Measures status (organisational or system wide) can be a driver for rapid improvement: despite the obvious stigma, it can provide a burning platform and a clear unambiguous way forward. However, over extending the length of time of Special Measures is detrimental to momentum morale and recruitment.

A new direction is easier to achieve with new leadership: leaders need to be seen to “own” and be accountable for the change to encourage staff to commit to it

Interventions are more persuasive if they are seen to be owned by the whole health economy: for the most part, it is not in the gift of any organisation (in isolation) to transform itself. A wider “health economy” view is critical.

Are you doing everything you can to ensure transformation is successful?

Attain is one of the most respected and effective providers of healthcare advisory and delivery services. To achieve this, we do everything we can to help make the NHS its patients, partners and staff better off. Transforming and improving means we deliver tangible results, doing more than just “getting the job done”, we do the right thing and exceed expectations.

We can do this because we are driven by deeply held values and an ethical commercial model. Health and wellbeing means improving not just the lives of patients and staff across the NHS but in the wider community. At Attain, we have a profound understanding and personal experience of issues within the healthcare sector means we always work with dedication, commitment and professionalism focused on improving outcomes.

#Paul O’Connor​ is a highly experienced NHS leader with 12 years as chief executive in acute, community and mental health services for NHS trusts and foundation trusts. He has held executive director roles in teaching hospitals, DGHs and specialist trusts and strategy at national, SHA, STP, regional and local levels. He has also held board level provider and commissioner roles.​