Frustration could be the key for the NHS to change for the better
How do you feel? This could literally be the ultimate question for the successful turnaround of the NHS.
What’s the biggest issue facing the NHS? Cost! There has been huge pressure on cost reduction across the NHS for years. This pressure has forced a ‘mean’ not Lean approach. Resources have been ripped out, which in the long run have the opposite effect on cost. Patient care suffers; cleanliness and hygiene deteriorates, inpatient length of stay increases, slowing the turnaround and flow, ultimately increasing the cost of care.
Measures drive behaviours! Metrics have been deployed which drive the wrong behavior, straining the system and focusing in completely the wrong area. Recent drives on productivity have burdened doctors, surgeons and nurses with the drive to care, consult and heal more patients in less contact time. Rushing true value adding activity to an extent where patient outcome and wellbeing are impacted. A rushed decision on whether or not to send your child to school if they claim they are feeling sick, could force you to make the wrong decision, causing frustration and a potential flurry of avoidable consequences.
It’s time to rethink how we tackle the issues facing our beloved NHS. This rethinking has to start with a deep respect for people. Starting with the patients in need of care and ensuring they have the optimum support, which in turn delivers the optimum outcome in the optimum time. Working back from that premise we can then ask what’s stopping the NHS from providing exactly that? What’s stopping our amazing people that work within the NHS healing people? Not forgetting to throw in a few why's when asking that question, so that we get to the underlying issues. What can we do to ensure the percentage of working time that these generous people have given to care for people is respected and fulfilled? How does it feel to be in their shoes?
How frustrating must it be to spend years training, so that you can dedicate your life to helping improve the life of others only to find that you spend more time chasing information, filling in paperwork, duplicating efforts and waiting on resources, than you do actually spend on nurturing patient wellbeing and guiding clinical outcomes. On top of that you are then driven to spend less time with your patients once you actually to get free from the burden of things to actually be with them. That to me must feel extremely frustrating. We need to be setting our teams up for success, not burdening them to fail. It's no wonder fewer doctors and nurses are making their way through the ranks of education. How are we inspiring the next generation?
Ripping out recourses and pushing people to do things faster is a demotivating, talentless and very short-term reactive approach to reducing cost. Instead of ripping out resource we need to move our focus towards ripping out frustration as frustration exposes waste, which once removed rips out cost. To do this you have to tap into talent, not remove or constrain it. Why are waiting times getting longer? What impact does this have on the cost of care? If you know your car needs a repair, you can bet the longer you leave it the worse and more costly it would be to repair, same for your house, the same for our bodies.
Capture the voice of the patient; ask them how do they feel with the level of service that’s been provided to them? I can bet the long waiting times are a key frustration. No surprises there, the difference is we need to honour a deep respect for people and exploit their frustration as a driver towards sustainable cost reduction. Displaying respect for our people and being relentless in our approach to takeaway their frustration is a human centric approach to Lean. This has to be the answer for the NHS to truly set the standard of world-class service for National Health. The outcome of which will shape an increased value proposition, making a higher tax threshold a much easier pill to swallow. The government may well be targeting the right things, but is it being done in the right way? It's time to listen, act and change for the better. If happy people make happy customers, then the NHS has the power to continue to make our great nation happy again.
Note! All statements are solely based on intuitive thinking.