Let’s Learn the Hinchenbrooke Lessons


Cogs in the Machine

The news that Circle pulled out of the management of Hinchenbrooke Hospital was a disappointment but, if we’re honest, probably not a shock to many.


The private sector is fantastic, with a huge range of skills and expertise that the public sector can learn from. But the NHS is a strange beast and requires careful, sophisticated handling. It is different.


I once heard a well-known SHA Chief Executive say “Most organisations are straightforward: there is one lever and if you pull it a door opens. Some organisations are more complex: there is a range of levers and a range of doors that they open. The NHS is different: there are hundreds of levers and hundreds of doors, and no obvious link. We spend most of our time running around desperately pulling leers in the hope that the one door we want open does!”


But most in the NHS will admit that they need the private sector. So if the Circle model is no longer an option, what do we do? What are the principles that we can take from effective private sector companies?


Let me suggest just three:

Customer Focus – private sector companies know that if the customer (whoever that is) is not happy, then profits will fall. Without a satisfied customer we have no successful business model. The NHS is usually brilliant at patient care, but sadly this is not always the same thing. We have all experienced less than optimum ‘phone conversations, poorly worded letters, embarrassingly bad waiting rooms. Simple stuff, yet it makes a real difference.

Understand the Money. The NHS must not become financially obsessed, but understanding money is essential. How many trusts have got into trouble as they were too focused on the target and not the cash? Cash is king, not just because we like spending it, but because it can often help us see where the value lies and where the focus is. Doing something that loses money is not a bad thing as long as you know why you’re doing it and why the money isn’t following you.

Decision Making. Private companies make quick decisions because they have to. They cannot wait around or someone will beat then to it. The NHS is often a slow, ponderous beast that makes an oil tanker look like its being driven by Lewis Hamilton. The NHS can learn a lot from streamlined, slimmed down hierarchies that understand the business and decide strategy and operations swiftly.

I am sure there are more lessons, and that it works the other way as well.

There are a lot of lessons to be drawn from the Hinchenbrooke experience, but ignoring the private sector in the NHS is not one of them.

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