This week’s TWb4TW is more politics than business for a change, though as always there are lessons we can learn.
This week sees the start of some of the biggest changes in decades for the NHS. These changes are made even more significant given that the Tories said in their election manifesto that this is one thing they would not do. We are used to politicians not doing what they promised but this may be a first where they do what they promised not to do.
As a precursor to these changes there has been a rewrite of the NHS “constitution” as the framework for the new look NHS. Robert Francis in his report on the Mid-Staffs hospitals scandal recommended that patients’ rights be formally enshrined in this new constitution. He wanted to make it explicit that “patients are put first” and that “everything done by the NHS should be informed by this ethos”. A good idea would be the response from most of us I suspect. However all that Jeremy Hunt the Health Secretary has come up with is that the health service will “aspire to put patients first”.
Yes I kid you not, these are the actual words that have been written in to the new NHS constitution and published last week. Coming hard on the heels of George Osborne’s “aspiration nation” budget speech it seems that “aspire” is the new theme for this government as the alternative to actually delivering a result. After all it has a loftier almost spiritual feel to it when compared to “doing your best” or “trying hard”. In fact as long as you are “aspiring” you don’t even have to bother with either of those.
The other thought that occurred to me was if the patient has not been at the core of the NHS constitution previously than what was? Could it have been?
“The NHS exists to enable doctors’ receptionists to satisfy their need to exercise complete power and control over the rest of the human race”.
“The NHS exists to increase the income and egos of medical consultants in equal proportion for ever and ever”.
“The NHS exists for politicians to mess about with, even when they say they won’t and so they can feel they have done something worthwhile”.
OK I am using 3 stereotypes to make a point (and get a cheap laugh) but to actually put the words “aspire to put patients first” into the NHS constitution is just as big a nonsense. The question is how could this happen? I have a horrible feeling it is because:
Clever people do clever things
A lot of clever people would have worked on the new NHS constitution, politicians, lawyers, civil servants, representatives of medical professional organisations and so on. We know these people are clever because they all have firsts from top universities and say things the rest of us can barely understand. They will have worked far in to the night to produce a set of words about patients that would ensure that it would be difficult or even impossible to be held to account for anything that actually happens to them. The person who came up with the word “aspire” may well feature in the next honours list!
However what has got lost amongst all this cleverness is a clear sense of purpose. Without a clear sense of purpose which everyone involved can understand and relate their own role to then the project is doomed to fail. This has been proven in research and practice time and time again in both private and public sectors but still clever people almost invariably get this wrong. The problem is that for clever people having a clear sense of purpose is just too simple and keeping it simple is not what clever people do.
I don’t like your attitude
The Francis report on the Mid-Staffs scandal is an example. Whilst the recommendation for patients’ rights to be enshrined in the NHS constitution is spot on, Robert Francis and his inquiry team could not resist going further and coming up with no less than 290 recommendations on how to do this. Now if you want to make something actually happen 29 would have been too many and 290 introduces such an enormous drag factor on change that any meaningful change is unlikely to be achieved.
The number of recommendations is a product of getting into too much of the detail of what should be done, rather than focusing on what needs to change and then holding people to account for making that change happen. The Mid-Staffs scandal is being used to demonstrate that the standard of patient care throughout the NHS is sub-standard and that this in turn is down to the “attitude” of nursing staff in particular. One recommendation for fixing this is that nurses should spend a year on the wards caring for patients including feeding and washing before they qualify. I suspect like me many people were surprised to find this did not form part of current nursing training. However the inference here is that this will sort out the “carers” from the rest and fix the “attitude” problem, at least Jeremy Hunt seems to think so.
The very worst place to start trying to change people’s attitude is to tell them it needs to change. What is more the attitude of rank and file staff in any organisation is a direct result of the attitude of the leadership. Consequently attempting to change attitudes amongst staff without first changing the thinking and behaviour at the leadership level is bound to fail, as all the research and practice again demonstrates. For the NHS this leadership “attitude” problem goes right up to the top political level. Perhaps if any politician “aspiring to reform” the NHS was required first to work for a year on the wards, caring for and washing patients, we might get better outcomes for the NHS and all of us who use it.
Arising from the ashes
Back to business now and one good story last week was the news that Jessops photographic shops will be returning to the high street. TV dragon Peter Jones acquired the brand, stock and other assets from the administrator in a joint venture with restructuring specialists Hilco.
The return to the high street was a surprise as Jones was expected to relaunch Jessops as an online retailer only. He is smart enough to know that in spite of the best efforts of previous managements and owners Jessops is still the leading brand in the specialist photographic equipment market. What’s more because, as Jones himself says Jessops sells a “technical product” the click and collect model that a combined high street and online presence enables is best suited to the core Jessops customer’s needs. So absolutely the right business model and Jones expects to have around 40 stores open by the end of April enabling him to cover the UK with click and collect and to offer the technical advice that the Jessops customer values. Half the 500 staff will be previous Jessops employees.
The only slight doubt I have is that Jones is to be both Chairman and Chief Exec. Given his many commitments it will be a challenge for him to give the attention to detail that will be needed to make this all work. He will need to find leaders amongst his management and staff to help him with this.
Congratulations to Nick D’Aloisio the 17 year old who sold his app Summly to Yahoo! for £20m. Apparently this app detects the key points in news stories and automatically rewrites it to fit on to an Iphone screen. Even though this is still bigger than the average Sun reader’s attention span Yahoo! is very excited about it and maybe they are right to be. However as they are also the company who took over the management of the Sky e-mail service last week and promptly emptied over 10,000 old e-mails from my business partner going back years into my two mail boxes, I am not so sure.
So that was some of the week before this week. We hope you found some of the above thought provoking and useful for you and your business. We trust you had a good Easter break and hope you have a great week this week.