Thursday, July 27, 2006

Note to healthcare managers - Involve patients more!

The National Health Service (NHS) has numerous management objectives.

We, the public who pay for the service and are its customers, are constantly told that the highest priority of the NHS is greater involvement of patients in the design and delivery of local health services.

In reality far more emphasis is placed by senior NHS managers on finance, waiting lists and complicated planning and contracting processes. Those of course are measurable things and we all know most managers are far more comfortable with measurable stuff than the hearts and minds stuff.

A lot of my work is about greater patient involvement and I get very irritated by how so many senior NHS managers just don’t seem to ‘get it' about patient involvement. One day I guess I will grow up but I hope not.

To me it seems NHS managers are being forced to focus on ‘hitting’ targets yet ‘missing’ the point. As an ex NHS manager of course I recognise the importance of all the ‘process’ things (what I call the ‘hard stuff’)

I personally feel the NHS should be judged more by how patients experience healthcare and not how managers measure it!


David Wike said...

You are absolutely right Trevor, the customer, in this case the patient, really does not care about internal measures and targets. Success for them is only judged by the service that is provided. I am afraid that the usual measures of 'success', be they star ratings, ISO 9000, OFSTED reports or whatever, often seem to miss the point that the real test of quality is what the customer experiences.

I'm not entirely clear who develops government policies. I rather suspect that the responsible minister has the bright idea and then hands it over to the civil servants to develop the detail. Maybe the civil servants consult a few experts. But I wonder if any of them have much practical experience of the ‘real world’. So many government policies sound like a good idea – after all, who could argue with the principle of cutting waiting lists – but somehow the reality is a disappointment. Is this is because the real experts, the front line deliverers and the customers, are never consulted, or at least, not in any meaningful way?

Trevor Gay said...

Thanks David

I am a passionate fan of 'cock-up rather than conspiracy' thinking.

I think policy is formulated by people too far away from customers (patients). I love this quote:

"Strategies are okayed in boardrooms that even a child knows are doomed to fail. The problem is there is never a child in the boardroom"

Anonymous said...

As you know Trevor, I am of the view that company law should be changed to mandate at least one child on every board!

I am reminded of a report from one of our board meetings a few years ago. Apparently a debate had been going for some while with most board members having a 'view'. A new, and youngish board director, frustrated by the meanderings, was moved to comment, "You know, we might actually make more progress if we had someone here who knew the facts"!

Trevor Gay said...

Lovely comment David - thanks for that.

In the NHS I atteneded many meetings like that one :-) - thanks for sharing that story.

I remember one brave person in a meeting once saying - 'We came frighteningly close to making a decision there'