Change Management category winner
Derek Felton/Tribal Group

If you have seen the Change4Life adverts with oddly coloured blobby people telling you not to eat rubbish, you will have some idea of what Derek Felton is trying to achieve: a change in how the NHS relates to patients and allocates resources.

Felton is managing director, health commissioning at Tribal Group, and is at the forefront of what is hoped to be a revolution within the health services. He is responsible for major transformational teams under the Government’s Framework for procuring External Support for Commissioners programme. This involves working with clinicians and managers to deliver radical service improvement, system redesign and a complete rethink on the NHS’s relationship with patients and the community.

Felton’s team is responsible for working on long-term programmes. He is in the middle of a three-year project in Wigan, for example, which, he says, represents some severe health challenges. “It is a place where life expectancy is significantly worse than the national average and we are trying to change the way that the NHS relates to that population.”

This means creating a culture within which the NHS cultivates relationships with individuals, rather than seeing the population as statistics, knowing people so well that it can maintain a kind of constant conversation about a person’s health and how he or she can improve it. In what is arguably an overworked NHS this may sound an unlikely scenario but Felton is already getting results.

He says: “We are introducing tools that will allow the NHS to make predictions about health in the future and, therefore, allocate resources differently at an individual level.”

This means that, be it anything from teenage pregnancy to obesity to lung disease, if that relationship exists then resources can be put towards prevention or early intervention, rather than more expensive treatment after the fact.

“The clamour in the media is always for the NHS to keep proving that it has more beds each year but the reality is that the NHS is going to need to exist on fewer beds because it will not be able to manage these diseases. It has only finite resources.

“This is a huge change to initiate at local level. You have this flow of patients going into hospitals and, in one sense, you are trying to turn off that tap safely while introducing new ways of doing things. You are trying to do that within an organisation that does not have a good track record of change.”

Felton says that in many organisations there is a sense of inevitability, so in some areas in the North, for example, people die younger. He is trying to convince local health services that nothing is inevitable and it actually can make a difference.

“If it changes the way that it invests money then it can actually target particular things and succeed,” he adds. “What we are doing is demonstrating ways of shifting resources. Through our work in Wigan we have saved significant sums of money that can be reinvested in the health service. If we can save money from spending in hospitals and improve the practice within the health system, then that money can be reinvested in health improvement.”

Felton is trying to initiate radical change but convincing the NHS of the viability of this is not always easy. “We are taking completely new ideas from all parts of the world and trying to introduce them into a culture which some people would argue is still similar to what it was in 1948.

“I believe in the NHS. I believe the NHS is a really fantastic organisation. But we can help it to be better.”

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