Simplify Before Adding
As part of our ‘What If’ series on change in the NHS, we spoke to Turnaround and Programme Director, Alex Robertson and asked him: “Putting all politics aside, if you could change one thing about the NHS, what would it be?”
If I could change one thing…
It would be that out-of-hospital services, provided by a combination of acute hospitals, community health & social care organisations and the voluntary sector, are frequently disconnected. They often overlap and aren’t effective as a system. Our patients struggle to know which services to access, and often aren’t aware of which services are available – and it’s confusing for health & social care professionals too. Patients default to what they know – an 8am call with fingers crossed to their GP, or a trip to A&E – rather than making use of other available services.
And in CCGs and Local Authorities, there can be a temptation to commission a “new shiny service” which adds to this complexity, confusion, and cost.
Instead of dashing to a solution, be clear on the problem(s) we are trying to solve – based on hard evidence not just gut feel. Take time to understand the data, patient and front-line staff insight, and the existing service makeup. Spend time with patients and the professionals and volunteers who look after them.
Create a clear milestone picture and write task- level plans. Write down what we’ll do, and when, so everyone can see them. Simple yet effective.
Work out what the future model is – the blend of professionals, volunteers, etc., working together to look after patients out of hospital whenever appropriate, meeting both planned and unplanned needs. Co-design the future model with them. Make every contact count – make sure patients have the same messages about which services they can access, and when.
Lastly and most importantly – implement and embed brilliantly. Deliver projects that actually move the dial. Focus relentlessly on the outcomes. This is the time to go all in. Turn up the effort and see our patients benefit.
Too often projects stop at the completion of the task (launching a new service, for example) rather than when the problem has been solved and we can see what’s better for our patients, their families, and our clinicians. Resist the urge to dash to the next task – the next “new shiny service” – before we deliver the benefits.
Alex has an extensive background in turnaround and change management in both the commercial and public sectors. Over the last five years, he has operated as programme director with a number of CCGs and more recently with integrated health and social care organisations, leading complex change programmes. Alex’s main area of focus is supporting organisations in the design and delivery of effective out-of-hospital models of care.
Practicus provides problem solving and recruitment. To find out more about the company, see here