1. What would you do if your NHS trust didn’t have
enough money, and you were in charge?
Use this activity to explore the problem and
evaluate your options.
Actions
Actions are in green boxes.
They tell you what to do.
Timer
When you see this, set a stopwatch/timer and
allow that amount of time.
Read through each slide.

2. You are the Chief Executive in charge of an
NHS trust, which means you are responsible
for hospitals, doctors’ surgeries and other
health care services in your local area.
Your trust is under a lot of pressure and is at
risk of closing down, which would leave
thousands of people without care.

3. You are the Chief Executive in charge of an
NHS trust, which means you are responsible
for hospitals, doctors’ surgeries and other
health care services in your local area.
Your trust is under a lot of pressure and is at
risk of closing down, which would leave
thousands of people without care.

4. PROBLEM
ONE
The system is at
breaking point.
There aren’t
enough staff and
there isn’t enough
money coming
from the
government.
There are three main problems…

5. PROBLEM
TWO
The strain is made
worse by poor IT
systems which are
slow and badly
connected.
PROBLEM
ONE
The system is at
breaking point.
There aren’t
enough staff and
there isn’t enough
money coming
from the
government.
There are three main problems…

6. PROBLEM
THREE
More and more
treatments are for
illnesses caused
by unhealthy
lifestyles, which is
increasing the
demand on
services.
PROBLEM
TWO
The strain is made
worse by poor IT
systems which are
slow and badly
connected.
PROBLEM
ONE
The system is at
breaking point.
There aren’t
enough staff and
there isn’t enough
money coming
from the
government.
There are three main problems…

7. PROMOTE
HEALTHY
CHOICES
Spend money
and use staff to
educate people
about how to
make healthier
choices.
MODERNISE
Spend money to
fix the systems
and upgrade the
IT so that it
improves
efficiency.
PRIVATISE
Private
companies (such
as Bupa) carry out
some services for
the trust. They are
businesses and
make money from
patients. Patients
pay for their own
health care.
The good news is that you have options
Can you guess what these mean?
OPTION 1
Privatise
OPTION 2
Modernise
OPTION 3
Promote
healthy
choices

8. PROMOTE
HEALTHY
CHOICES
Spend money
and use staff to
educate people
about how to
make healthier
choices.
MODERNISE
Spend money to
fix the systems
and upgrade the
IT so that it
improves
efficiency.
PRIVATISE
Private
companies (such
as Bupa) carry out
some services for
the trust. They are
businesses and
make money from
patients. Patients
pay for their own
health care.
The good news is that you have options
Can you guess what these mean?
OPTION 2
Modernise
OPTION 3
Promote
healthy
choices

9. PROMOTE
HEALTHY
CHOICES
Spend money
and use staff to
educate people
about how to
make healthier
choices.
MODERNISE
Spend money to
fix the systems
and upgrade the
IT so that it
improves
efficiency.
PRIVATISE
Private
companies (such
as Bupa) carry out
some services for
the trust. They are
businesses and
make money from
patients. Patients
pay for their own
health care.
The good news is that you have options
Can you guess what these mean?
OPTION 3
Promote
healthy
choices

10. PROMOTE
HEALTHY
CHOICES
Spend money
and use staff to
educate people
about how to
make healthier
choices.
MODERNISE
Spend money to
fix the systems
and upgrade the
IT so that it
improves
efficiency.
PRIVATISE
Private
companies (such
as Bupa) carry out
some services for
the trust. They are
businesses and
make money from
patients. Patients
pay for their own
health care.
The good news is that you have options
Can you guess what these mean?

11. The Chief Executive in the neighbouring
town telephones you. They face the
same problems in their NHS Trust.
You have three minutes to have a conversation with
them (find someone in your household!) and discuss
which option is the best.
3 MINS

12. You’ve heard from senior colleagues, but
what about the staff who work in your trust?
It’s important to see what they think too.
Your first visit is to the school next door, where you
want to catch up with the school nurse, Tom.

13. If you ask me, it’s all about
promoting healthy choices.
That means we should spend money
on keeping people healthy, so they
don’t become unwell. For example:
we should teach people what food is
healthy and how to exercise.

14. PROMOTING HEALTHY CHOICES
Advantages
Here are the reasons why Tom thinks it’s a
good idea…
• It will reduce the number of illnesses people get
which means there will be less strain on the NHS.
• People will be healthier and happier.
• It’s good for the economy – if people are healthier
they can work harder and make more money.
What do you think about Tom’s argument? You have two
minutes to decide what the problems are with it.
2 MINS

15. PROMOTING HEALTHY CHOICES
Disadvantages
• Some illnesses are caused by the environment and
not people’s choices, like pollution. This would
need the government to act, not individuals.
• People should have free choice to eat and drink
whatever they like. The government and health
professionals can’t tell people what to do.
• It is very hard to change people’s behaviour.
Were you correct? Check your ideas against the
disadvantages below.

16. You’ve had a busy
morning, so you go to
grab a coffee.

17. In the hospital cafe, you bump
into Ishak, the receptionist,
and Kevin, a hospital porter.
They’re chatting about Ishak’s day.
Ishak wants to modernise the system,
as he’s spent all morning try to find
patients’ record. Kevin isn’t so sure.

18. ISHAK – we should modernise
the NHS because…
KEVIN – I disagree
because…
+ It will speed everything up, so we
can focus on patients
+ If the systems are able to share
patient records quickly and
accurately, then everyone can
give the best possible care and
prescribe the right medicines
+ It will make sure that the NHS
can keep up with the latest
innovations without the underlying
system breaking
— It is spending a lot of money that
could go directly on patient care
and treatments
— We tried it before and it didn’t work
— IT systems need constant updating
and costs always go up, so the
problem is ongoing
Here’s a summary of their points
Whose side are you on? Choose the
person you agree with the most.
Can you say why you agree with
them the most?

19. It’s time for your meeting with
a private health care company.
They have offered a solution to your problem. They want to
take over some of the services you offer, which will reduce the
strain on you. However, they are a business, so they will
charge patients for the treatment they receive.

20. PRIVATISE
Advantages
Here’s the company’s pitch to you.
They say that if you privatise part of your
trust, then…
• The quality of care may improve, because companies will be
in competition with each other, so they will have to offer the
best treatments.
• The government could save money. They can spend the NHS
budget other areas like education and transport.
• It’s a quick solution if the trust can’t provide service internally.

21. Gloria, the cardiologist, is here to join you. She’s
wearing a “save our NHS” badge. You already
have an idea about Gloria’s opinion on privatising
the NHS. What do you think she will say?
Predict the reasons why Gloria doesn’t want to privatise
the NHS. You have two minutes to think of these.
2 MINS

22. PRIVATISE
Disadvantages
Check to see if you were correct. Gloria says…
• Private companies are there to make a profit and sometimes
they do this by cutting corners. This reduces the quality of
care.
• Private companies will only want to work in wealthier areas,
where it is cheaper to do so (as there are usually fewer health
problems). This leaves the state to provide health care in
poorer areas, where it is more expensive.
• It puts money, rather than people, at the centre of the system.
Check to see whether your ideas were correct.

23. You return to your office to
think things through…
The decision hasn’t got any easier. You look out of
the window and see that a protest has started. Word
has spread about the possible closure and members
of staff are outside, urging you to put patients first
and save the trust.

24. There are three groups protesting
and they all want you to choose a
different action.
• Privatise
• Modernise
• Promoting healthy choices
Choose one of the options above to protest for
or against. You have five minutes to come up
with a chant that you would sing at the protest.
For example: the system needs updating!
Computers always crash! Modernise the NHS
and give it some more cash!
5 MINS

25. Perform your
chants and explain
what it means.

26. You have five minutes to recap the
pros and cons of each option.
HERE ARE SOME REMINDERS:
• Privatise: quick solution / unfair
• Modernise: more efficient / patients matter more
• Promoting healthy choices: cheaper in the long run / slow
The protestors
are getting
louder and you
don’t know
what to do.
5 MINS

27. WRITE YOUR ANSWERS IN THE
COMMENTS SECTION
• Who are the winners and losers for each option?
• Can you put the options in order from best to worst?
• As the Chief Executive, what is most important?
• Challenge: what should you factor into your decision
making? For example: patient satisfaction, danger.
Decision time.
What’s the best option?
You need to make a final
decision before a
Trust-wide meeting
tomorrow.
10 MINS

28. THE
END!