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