Are NHS success regimes doomed to fail?

NHS England chief Simon Stevens’ initiative is not without merit but service improvement is a complicated long-haul task, not a top-down quick fix

Humpty Dumpty’s declaration in Lewis Carroll’s book Through the Looking Glass that “when I use a word it means just what I choose it to mean” must have rung a bell with delegates at the recent NHS Confederation conference in Liverpool as they listened to the proposal by the NHS England chief, Simon Stevens, to introduce “success regimes” in three failing localities – North Cumbria, Essex and parts of Devon. It might not be as daft as it sounds, but will it work?

A briefing paper from NHS England describes the targeted localities as having deep-rooted and long-standing difficulties that are in need of transformation. The health and care economies of these places will find themselves overseen by NHS England, Monitor and the NHS trust development authority plus others when deemed appropriate. Problems will be diagnosed, required changes identified and implementation plans agreed.

In England, there still seems to be a belief that a regulatory agency can somehow impose a linear solution

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