The Changing NHS

Last week I facilitated a workshop for Self-Care leads working in PCTs and Trusts throughout a SHA geography. It was an enjoyable event and quite a few interesting insights were generated.

However the big bonus for me was the chance, whilst preparing, to reacquaint myself with the work of Richard Normann. Richard, who sadly died in 2003 aged 60 was, I think, the guy who first articulated termed the phrase co-production of value - where more value is created through changing the relationship between service offerer and service receiver - He suggested that this ought to be a core 'business logic' for succesful service organisations.  If you want to get into Richard's work the most accessible book is his first Service Management: Strategy and Leadership in the Service Business.

My preparation led me to one of his last books; Reframing Business: Where the Map Changes the Landscape. In a section summarising the disctinction between organisations that 'relieve' customers and those that 'enable' them, Richard has a list of useful questions that an organisation could ask itself inorder to improve the efficiency and effectiveness of the customer.

Many of these questions seem appropraiate to healthcare organisations seeking to think through how 'self-care' opportunities might be developed further. Richard's questions include:

1. Can the timing of demand be influenced?
2. Does the customer have spare time while he is waiting?
3. Do clients and contact personnel meet unnecessarily face to face?
4. Are contact personnel doing repetitive work which the customer could do himself, with customer operated machines?
5. Can the customer be given an opportunity to choose between service levels?
6. Can customers so more work for each other, or use the resopurces of third parties?
7. Do the clients sometimes try and 'get past' the contact personnel and do things themselves? Could that interest and knowledge be better utilised?

If the self-care 'movement' is to realize it's potential then it really needs to begin to affect core operational processes of Trusts and PCTs. And if this is the goal then these are exactly the kinds of questions therfore that NHS service designers and strategists need to give serious consideration too. Funnily enough, this kind of 'hard' thinking seems to be largely absent from DH self-care material.

nhs

self care

richard normann