ABHI Guest Blogs with Roy Lilley
It’s Nobody’s Job
A supermarket chain opened a new store. Unusual for a retail food business, the building was an architectural masterpiece and the landscaping exceptional.
Separating the carpark from the entrance was a lozenge shaped lawn, with tasteful shrubs.
It wasn’t long before the green swathe was sporting an ugly brown trail right across the middle. People were too lazy to walk around the grass to get from the carpark to the store. They took the direct route.
Faced with the problem the company could have erected a fence, planted more shrubs? Instead they installed sixteen paving slabs and built a pathway across the grass.
There is an obvious management moral to the story about customer service. It didn’t end there. It wasn’t long before there were a couple of accidents. People tripped.
The slabs looked great, they were installed by landscaping experts and were as flat as a pancake. The problem; the joins between the slabs. Heels got caught, trolleys skewed and oops…
The company tore up the slabs; replaced them with a ribbon of tarmac.
Second management moral; people trip over the joins in a pathway; the interfaces. The places where services join.
The third lesson. If the company had started with the customer and worked backwards, they could have saved themselves a shedload of failure costs.
They’d thought about making the store look like an architect’s dream with gold medal landscaping. If they’d thought about customers with trolleys, high heels, bad weather and being in a rush…
Lessons for device manufacturers and the NHS. Head office knows diddly-squat.
Faced with problems of access to decision makers in the NHS the ABHI commissioned the Nuffield Trust to look at the problem.
One of the major questions they addressed; “A barrier to innovation uptake is the issue around the responsibility of ownership. Until innovation is actively built into job descriptions, it’s unlikely to become business as usual.”
Too right.
The job of a great supermarket customer experience was in the hands of marketing, finance, policy and estates. They all did their job, none of them did the job that was needed.
The adoption of technologies in the NHS is in the hands of Academic Health Science Networks, Innovation Exchanges, Digital Health Technology Catalyst for Innovators, the Early Access to Medicines Scheme, the Pathway Transformation Fund, the Accelerated Access Pathway, NIHR, MHRA, NICE, NHSE, NHSI and the Innovations and Technology Tariff.
They all do their job, but together they’re a disaster. It’s too many people’s job, hence it’s nobody’s job. A system invented by Joe Stalin, out of the flat-cap, clip-board and brown coat generation. This starts with the government and works down. And, worse; it’s costing £89million a year…before anyone buys a plug.
No one starts with the front-line and works back. Has anyone in the industry asked the front line?
Junior doctors are dumping clunky NHS communications and using WhatsApp. Patients are using ‘dial a doc’ access to GPs on the phones and FaceTime. The new Babylon service for patients to FaceTime a GP, attracted 7,000 users in 3 weeks. Trusts are developing their own apps and software. Making their own way without any help. Several have written their own A&E systems. Nottingham have award winning Apps for Mums.
Trusts are very busy at the moment. They are like Custer, surrounded by Indians, too busy to talk to the Bren Gun salesman. No one is in charge of driving the innovations agenda.
There is a job for the ABHI. Cultivate and encourage the community of COIs, lobby for them to be board appointments. Share best practice and open up the possibilities with new ideas. They must create their own front door with a portal of innovations, a directory of ideas, a place where solutions match the problems.
Most of all the job starts in Whitehall. It is obvious the Department of Health is desperate to save money and leverage efficiencies by the use of innovations and technologies. That is why it is inventing more committees than an East Berlin car factory. Trying to pick winners, throwing money at the problem and missing the targets.
The industry should be lobbying for a clean sweep. Starting with the users and working backwards into the future.
Roy Lilley is a health policy analyst, writer, broadcaster and commentator on the National Health Service