Northern Rock – a classic Abilene scenario (the paradox has been referenced previously on the blog)
I really didn’t think they’d go there but the longer it went on the more likely the outcome as in the news yesterday/today. This one, I’m afraid, will run and run and run and run (I don’t mean on the bank!).........
Expect (another) new BBC costume drama ‘The Northern Saga’ where people run around making bold statements, gesticulate with dramatic effect, over-reacting with furtive glances whilst the viewer (aka tax payer) looks on in complete amazement..............
One question if there is no suitable market alternative offered – what does that say about the business? By the way remember the sum of £110 billion which is being bounded around is roughly the annual spend on the NHS.............
Patient stacking in ambulances (rather like aeroplanes)
In this case the scenario as highlighted in yesterday’s Observer regarding the practice of ‘patient stacking’, keeping seriously ill patients in ambulances in a stacking pattern to meet government pledges (treatment within 4 hours). The problem also is the tieing up of resources in a domino effect. Once again, you can't just focus on outputs at the expense of inputs and throughputs (and outcomes).
Also, never underestimate human ingenuity or in this case, managers’ abilities to engineer a way of meeting/beating targets. The problem is, it rather conflicts with the values of the NHS itself. However, you can only admire the degree of human ingenuity (in fact not far off innovation) in a classic example ‘gaming targets’.
As much as you may say this is a fault of leadership, the other real culprit is ill-thought through targets (metrics) that end up ‘rewarding A whilst hoping for B’ (we’ve been here before).
One way to stop it is to have properly thought-through measures and subsequent targets that take account of behaviour (both positive and adverse). This is not the first time but industry sectors keep on doing it without the help of professional expertise (i.e. those who understand measurement not just metrics) – another example of amateur status (that’s not even gifted).
When will we learn? Measurement is both art and science. To get it right demands experience and knowledge of the discipline together with contextual understanding.
Governance and the HCMI
Ahead of this week’s HCMI qualification module we have two ‘smoking’ topics, enterprise governance and CSR/ethics on the menu with cracking case studies. One thing to point out is that CSR is rapidly converting to CR (no S) – though Sustainability is making a move for the current in vogue terminology.
To be honest I don’t really give a fig as long as the outcome means that people (our student-professionals) understand the critical components of good governance whilst at the same time appreciating the complex challenge many organisations face in this area when looking at corporate responsibility and the ethical dilemmas that lie within. I trust that everyone has done their preparation...............the news stories including above are quite timely.......
