Special Measures

  |   Thought Leadership

“Insanity: doing the same thing over and over again and expecting different results” Albert Einstein


Current health policy and those loud policy voices within the UK confuse me. One the one hand, they refer to empowering patients and integration. Then with the other hand, they instruct failing organisations to head into “special measures”. They seek to punish rather than support.


The problem for the government and their health advisors is that the organisations giving them advice are born out of the industrial age. They execute the mantra of Frederick Winslow Taylor. “Standardise and Simplify”. When they embark on a course of special measures, their approach is to focus on milestones and process. They want on assurance provided by Centralised Controls.  Their mantra is “You have to be in control of the numbers….”


Yet the Francis report wrote “I said that it should be patients – not numbers – which counted”


This industrial “health factory” mentality doesn’t achieve sustainability. It’s an optical illusion that a hospital is a machine that can be automated by a programme plan.


So Einstein. Welcome to Planet PMO


Where does science fit in?


Over the past 30 years, a new systemic understanding of life has been emerging at the forefront of science. At the core of this new understanding, there is a change of metaphor from seeing the world as a machine to understanding it as a network. The network has been recognised as the basic pattern of organisation in all living systems. Ecosystems are understood in terms of food webs (i.e. networks of organisms); organisms are networks of cells; and cells are networks of molecules. And then there are the social networks in human societies, which are networks of communications.


The paradigm shift from the machine to the network is taking place today not only in science but also in society at large and throughout a newly emerging global culture in which social and technological networks have become all important. Within a few years, the internet became a powerful global network of communications, and many large corporations today are organised as decentralised networks of much smaller units.


What does that lead us to conclude?


Local Health and Social Care provision is more like a small ecosystem than a fitness factory. Health and Social Care systems are not sets of machines that can be counted, unbundled and re-engineered by process.


Sustainability in healthcare will come from leaders embracing Succession.


Nurturing top leaders in world class hospitals, being incentivised to move care out of hospitals to integrated community and primary care teams, modernising and investing in real primary care and not only “retail primary care”, and the most important of all-extending health literacy and navigation.


Write a Succession plan. A Turnaround plan is defunct.