Innovation in the NHS

How to improve outcomes, how to be more effective?
The Darzi reforms had their first anniversary last week - and they have been very successful over the last year, certainly in terms of brand awareness.
Quality was the theme for the year. It was a good theme - highest quality removes waste which avoids unnecessary costs (more effective), and often quality and effectiveness go hand in hand.
There's only so far you can go with improving quality and improving efficiency. The same pathway but better. 10% cheaper. As the Wanless 2002 report indicated, if we're still doing health care in the same way in 20 years as we are today, every able person will be occupied looking after the less able - we have to change.

Innovation

Making a real difference comes from being prepared to start again, to go back to the drawing board. All the lessons we learnt about process mapping, about redesign with patients and front-line staff, are all appropriate here: perhaps one of the classic examples is the ECP, giving the first professional contact with the patient, the skills, competencies and authority to change the care, to refer to a more appropriate patient pathway. This makes a real difference - community care instead of hospital care, self management instead of institution.

Permission to fail

But how do you know when it's working? That's when a really strong measurement and reporting regime is needed, tied to meaningful measures designed and implemented by front-line staff, permitting staff to recognise where their own project works and where it needs modification, and the tools to make the changes themselves.

Communication

Of course it requires people to talk to each other. In a market place environment, commissioners and providers need to understand the risks and rewards of innovation and work together to achieve the much-needed benefits

All of the above projects were run by Hugo Minney and I'd be delighted to work with you on your project

Reference
'Securing our future health: taking a long-term view' April 2002, HM Treasury an independent review by Derek Wanless
Search for: INNOVATION

Quality is the new buzzword

Quality is the new buzzword (HSJ 25 June 2009).
I return to my original thesis, that all care is delivered by people and therefore innovation, and quality, is predicated on the motivation of staff, volunteers and carers.
Measuring becomes ever more important than ever. "People do what you inspect" is just as relevant to the self (I do what I'm measuring - I take a shower faster if I'm timing myself, I stick to speed limits if I treat that as a priority) and staff that set their own goals and have the tools to understand how they fare compared to the goals they have set are going to achieve more, with more enthusiasm, faster, than a team with an imposed goal, and feedback 6 weeks after each monitoring period.
Give people the tools to make a meaningful difference, and we'll do it!
Hugo can establish - with front-line teams - frameworks for Benefits design, planning, realisation and reporting and help align individual and team goals to the strategic objectives of the organisation or local health (and care) economy)

Stormy Weather

Today at the supermarket we saw rather a lot of very smart convertible cars. Drop-top jaguars and mercedes, roaring porsche and TVR. I'm sure I read somewhere that there's a recession on. Isn't it interesting how the weather can reflect the times? Or do we just notice it when it does?
The weather's unpredictable. The public appears (at least from the newspapers I read) to be completely split on who is best to run the country - do we go for the party that promises everything to everyone (in the same speech promising to "cut mindless burocracy" and "provide administrative support for frontline staff"; then promising to hold down public sector spend with reductions of 10% a year, but of course the [insert audience here] department will have its budgets maintained), or the party that everyone loves to hate but rather a lot of economists and bankers are saying other countries should immitate?
The health service faces its own dichotomies. There are finite resources. There are new technologies, each more expensive than the last, each marginally better. People are definitely sicker - where did MS, ME, Fibromyalgia, CFS come from? Or did we just not diagnose them before? Why the sudden increase in diagnoses of depression, neuroses, autism? Is it really because we can diagnose them, is it really because we keep people alive who would otherwise have died, are there enough kept alive to account for these large increases?
I wonder how many of these problems come back to simple things. Take the situation in the health service: could it be that something has changed about the food we eat? And could it be that unexplained presences or absences in the food are causing all of these problems?
Makes you wonder if the same is the case for politics . . .