Where Process is King

27th January 2009

It is fascinating to observe the culture with respect to process Vs outcome in the UK public sector. Too often it appears that people engaged in process, or even reponsible for managing those engaged in process driven work focus more on ensuring that adherance to the process is absolute than on the reason the process was developed in the first place. This way of working that laughed at so much in television series’ such as “Yes Minister” is alive and well and difficult for those from more outcomes driven cultures to understand.

I remember helping a healthcare funder/provider organisation in New Zealand, some years ago to develop an information management strategy that opened with the words:

Every person employed by the ___ should ask themself regularly “How has what I have done today helped to improve healthcare in our region”.

This focus on the prime reason why that organisation existed at all seems to be missing in the ethos of many who work in the NHS in England.

Our recent dealing with the Connecting for Health organisation which have resulted in iteration after iteration of question and answer sessions designed, not to help us and the people of our region, but it seems, to ensure ongoing employment for public servants is but one example. This overfocus on process with little regard for cost or the impact on healthcare outcomes woul dnot be justifiable in a world where perfomance is measured by production.

The problem may stem from allowing government bodies to have an over-involvement with operational provision of service, rather than ensuring that such bodies are responsibel for the development of guidelines or even statute that ensure that thoose who produce are able to do so in a sensible and joined-up way. Governments do not do service, public servants dont “get” service in the way that most of us understand the word.

To date probably several hundred man/woman hours expended jumping through hoops to get approval from CfH to test our system on the Spine. A system in use at perhaps a dozen hospitals in the UK already and connected to the Spine.


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