We welcomed over 500 people to the first day of our annual conference and exhibition in Birmingham.

You can catch up with all of the day's events and join the conversation on Twitter using the hashtag #NHSP16, and highlights from the plenary sessions are below.

Chris Hopson

NHS Providers chief executive Chris Hopson opened this year’s annual conference and exhibition. He said the NHS is here to deliver high quality care to patients and despite current challenges. He highlighted how providers are leading the move to new care models, providing better care closer to home. Chris said the system should remain confident of the NHS provider sector's ability to deliver when we are set a reasonable task and are appropriately supported and funded to deliver that task.

Chris said that, with support from the national bodies and the secretary of state, providers are creating a culture of learning from mistakes and listening to families when things go wrong. He said the commitment of frontline staff is what ensures the NHS is able to provide outstanding care to patients all day every day and we as a sector must support them in their roles.

However, the NHS is facing its biggest set of challenges in a generation. There is now a clear gap between what the NHS is being asked to deliver and the funding available, meaning the NHS now can’t deliver what it is formally and constitutionally required to deliver.

Chris outlined three broad solutions to this challenge - more money; change the NHS offer and, therefore, the constitutional standards; or, try and muddle through. NHS Providers believes the government should increase funding. Without this additional funding the NHS will no longer be able to deliver what is being asked of it and the offer will have to change.

Chris also formally launched our new report, The state of the NHS provider sector, which is based on survey data from 172 chairs and chief executives from 136 trusts.

See the full speech and Twitter highlights.

Lynda Thomas, with Q&A panel

In her session, Lynda Thomas, chief executive of Macmillan Cancer Support, highlighted the importance of relationships between the voluntary sector and the NHS. She stressed the need for partnership building between charities working across long term conditions and also with providers, given that they share common beneficiaries. For example, considering whether a cancer nurse could be doing more to support patients with diabetes and vice versa.

Lynda shared practical examples of what the voluntary sector can do in partnership to deliver innovation and improve care, such as Macmillan supporting acute oncology departments to help patients avoid having to go to A&E or delivering speech and language therapy through telemedicine. Macmillan's workforce has grown from one nurse in 1976 to 9,247 professionals in 2016. However, workforce challenges are not only a key risk for the NHS but also having a knock-on effect and adversely affecting the voluntary sector including Macmillan. It is now crucial to be investing in developing new roles, such as cancer support workers or 'care navigators'.

Lynda was joined by panellists Saffron Cordery, director of policy and strategy, and Fiona McKenzie, patient leader and deputy director, UK Improvement Alliance, for a Q&A session. Lynda noted that most providers are receptive to partnerships but also argued that all providers must recognise the business case of working in partnership with the voluntary sector. Saffron pointed to research carried out by NHS Providers which found that third sector involvement in the STP process needs improvement, despite positive examples of this being done well in some areas.

The panel showed optimism that health charities are not only a key part of the overarching health infrastructure but also about the sector's ability to weather the current tough financial climate. Fiona McKenzie, from UK Improvement Alliance, pointed however to a less certain picture for smaller charities providing services for rarer conditions which may be facing greater financial struggles than the larger charities.

See Twitter highlights of the session.

Dr Jonathan B. Perlin

Dr Perlin said the United States and the NHS face many of the same challenges such as increasing demand, high failure rates in some specific services and increasing costs of healthcare. Technology can be a potential solution to meet this challenges.

Dr Perlin noted how meaningful use of electronic health records has been used in the US to build an interstate highway for health information. Within five years nearly all hospitals have adopted electronic health records to some extent. 

However, the challenge is now to move from transacting in health data to learning from collective memory, knowledge and data we now have in electronic patient information.

Dr Perlin cited hospital acquired infections as an example of how care can be significantly improved by harnessing data to support a culture of continuous improvement, such as testing different methods for reducing infections in real time through aggregating information across multiple sites.

Learning opportunities are not rare or esoteric. In fact, opportunities are ubiquitous but the data need to be harnessed effectively and used o inform behaviour of staff and patients on issues such as reducing early childbirth.

Dr Perlin discussed how big data can be used for predictive as well as descriptive means. For example predicting patients at risk of sepsis based on groups of information collected to date. He said this agenda is about far more than moving from apparently to digital records - it is a new way of delivering care.

See Twitter highlights from the session.

Jim Mackey

Closing the first day, NHS Improvement chief executive Jim Mackey acknowledged that providers are currently operating in a context that is centred around politics and money, but he stressed that this can't distract the sector from the day job. He highlighted that providers are already delivering the impossible, but there is little recognition of this in the media. Jim believes the negative narrative may be a result of operational performance challenges, particularly around the four hour A&E waiting time target and referral to treatment targets. However NHSI will be leading some work in partnership with the sector to restore consistency in the recording of A&E attendance data, which should help paint a clearer picture of the challenge.

Jim shared examples of where trusts are making good progress including: Oxford University Hospitals FT, the acute sector collaboration in North West London, Moorfields Eye Hospital NHS FT, The Dudley Group NHS FT; amongst many others.

On the sustainability and transformation plan process Jim commented that while politics and negativity has taken over he is yet to hear anyone in the sector say that it the concept is a bad one. He acknowledged that while there is some work to do around re-confirming the exam question for STPs and getting the engagement and governance processes right, the process of building relationships has been extremely positive and means progress is already being made in many areas. In response to a question from the floor Jim stated that he doesn't believe there is a need for primary legislation to make the STP concept a reality. 

Jim announced the launch of a national leadership strategy, which is expected to be published in the next few days. The key objective of this strategy is to hand control back to providers and move back to a system of earned autonomy.

He stressed that the current priority for providers between now and end of the year is to confirm two-year operational plans and contracts.

See Twitter highlights from the session.

Publications 

We were pleased to launch a number of new publications, as well as our inaugural report looking at the state of the provider sector.

Our report with Hempsons provides practical guidance on governance for STPs, and includes a template memorandum of understanding which can be adapted for use in local areas.

In collaboration with the DataFlow Group, a new whitepaper, Document forgery in healthcare, looks at the benefits of primary source verification. 

Fighting fit

We asked delegates what one thing would get the NHS fighting fit - see what they said: