Originally posted on thinkspeakthink:
When I wrote last time about compassion, and particularly the role of the environment on culture and behaviour, I had planned to pitch the next post at a lighter (and shorter) level. However it seems that what I said chimed with a lot of people, and so my thoughts over the last week have continued on this track. I’d like to reflect on NHS managers this time. Please keep reading.
The Secretary of State spoke recently about an NHS management culture of ‘ticking the box but missing the point’. It’s not difficult to see how he got there. I wonder though how many managers out there get a real buzz from the next target to be met, the next penalty to be imposed, the next efficiency to deliver or the next constraint to be bound by. How many rely on these things to gain their motivation and commitment to a role which is universally demonised. I wonder how many believe that if we have ticked those boxes that we have a great service for patients. I haven’t met any of them, and I’ve been doing this a while.
We have a problem here. Every day the people responsible for NHS delivery (managers and clinicians) face ‘wicked problems’ that are complex, entrenched, long term and unpalatable, for which we seek the ‘least worst’ solutions. More so than ever. These problems simply don’t lend themselves to solutions which can be reduced to a series of boxes on a spreadsheet. We all know that, don’t we? So why do targets become such a feature of daily NHS work?