Transformation or blame in the NHS

One of the few growth areas in the public sector is blame: politicians; regulators; media. Everyone has a view on who has got something wrong and why they messed up. So while we all know that there is a huge amount of positive transformation happening in the NHS, this gets lost and is often sacrificed to sensational headlines, political posturing and personal agendas.

As a result, it is easy for senior managers to circle the wagons, hunker down and bury their heads in the sand (if I can mix my metaphors) and try to survive.

Transformation starts with challenge

But it is the really progressive, ambitious and brave managers who can ask the tough questions of themselves. When people are looking to find fault, they are looking for faults first. They want to know where their service is lacking.

There is a story about Richard Branson in the early days of Virgin Airlines. He flew 20 of the most senior executives he knew who used Virgin to one of his tropical islands. They were wined and dined and treated like the millionaires they were. At the end of the weekend he asked what they thought of Virgin. They all gratefully trotted out platitudes about how great it was and how much they enjoyed it. There was a pause and Branson said “Right: no one leaves this island, no one goes home until every one of you tells me something bad about my airline. Tell me where we are getting it wrong. Otherwise, the plane home is cancelled and you better learn how to live on berries…”

Branson knew that you have to constantly challenge yourself and your service if you want to improve.

So although tricky, it is absolutely the right thing to do to ask people to test and challenge what you do.

NHS IT transformation challenges

Information Technology in the NHS is a good example. We can survive on good enough, but we cannot thrive. Without someone taking a good, detailed and critical look at your policies, strategy and operation, then it is unlikely that you will see the benefits you want.

At Sirius we pride ourselves on doing this critical work rather well! We understand the pressures – having worked in the NHS for over 30 years between us – and understand how tough change can be.

We work to a number of key principles that make the whole review and change process more manageable:

Clarity is necessary. An obvious point but you’d be amazed how often it is missed. Who is driving the change? Why is it needed? Where are we going? What will it look like? Without a vision, or at least an understanding of direction of travel, there is little point continuing.
Relationships are key. To be honest, in a review like these if you get the relationships right, then the benefits follow. Staff need to be brought along with the work; executives need to understand what their role is; end users need to be engaged and listened to.
You cannot over communicate. We love it when people get fed up of us talking about the work we do! This means that they have heard what we’ve said and feel they know what is going on! Advertisers know that no one takes any notice until they have seen an ad 12 times – we know that we have to identify the stakeholders and communicate over and over to ensure people know what is happening.
The expertise is already there. Yes we have a lot of experience, knowledge and expertise in our team, but so do you. By mapping your assets and using the experts in your team – including of course the people who use the systems – we can ensure that the outcomes make sense and make a difference.
Resources need to be found. Spend to save is an overused mantra, but it remains true. You can’t properly look at what you’re doing, or start to initiate radical innovation if you are relying on people who have a day job to do.