Quality is in the eye of the beholding manager – Managers in the UK’s National Health Service lack quality management skills and application and this has led to a lack of emphasis on operations excellence and future planning, according to Uche Nwabueze, now at the School of Business Administration, in Victoria, Texas, USA, who has 21 years of experience management research and consulting. Writing in the International Journal of Business Performance Management, he suggests that managers do little more than encourage their staff to work harder and faster, but instead of this leading to advancement and a questioning, intellectual approach to conventional healthcare wisdom, staff spend the majority of their time “putting out fires” to mix an emergency services metaphor.
It is therefore no surprise, Nwabueze says, that the NHS has no hospital to compare with the likes of Beth Israel, MD Anderson Cancer Centre and the Mayo Hospital in the USA. Moreover, it is, in its present condition unlikely to elicit a Deming-like observation of “a magnificent and dedicated workforce, unsurpassed management commitment, and the best statistical ability in the world”.
Nwabueze lays the blame squarely at the feet of successive governments starting with the 1979 Conservative government that allegedly sought to get the best out of existing resources and reduce costs in terms of maximising medical services through improvements in the re-structuring and management of the service, improved accountability, and better utilisation of manpower. Throughout the 1980s the NHS was the subject of much political debate and controversy, with ward closures, long waiting lists for critical operations and patients attempting to secure their health through the courts. The shift at the end of the 1980s to allowing hospitals to manage their own affairs – as hospital trusts – brought with it its own problems and the notion of Total quality management (TQM) was first mooted in a nascent form.
NHS employees can nevertheless pride themselves on the service they provide despite endless cutbacks and efforts to shuttle an essentially socialist healthcare system into the private commercial sector. It should be pointed out that in the UK socialism is not a dirty word synonymous with communism as perceived by many outsiders, indeed it is more akin to “capitalism with caring” on this side of The Atlantic. However, as TQM was implemented by the increasingly business-oriented hospital trusts, it seems that in the current climate most NHS hospitals have no clear definition of what quality actually represents from the patients perspective, says Nwabueze.
In his research he discovered three different perspectives, suggesting that quality is very much in the eye of the beholder, as with beauty: To the administrative staff, quality is about appearances, he found. To the chief executive, quality represents low cost. And, to the quality manager, quality is about giving each patient the bare essentials and not attempting to meet all of their requirements. Nwabueze cites many reasons, too numerous to list here, for the ultimate failure of TQM but suggests that it might also be the saviour of the NHS allowing its hospitals to aspire to the quality of a Beth Israel or a Mayo without compromising the vision of the Beveridge Report of 1942 that laid the foundations for a “comprehensive health and rehabilitation services for prevention and cure of disease”
Nwabueze, U. (2014) ‘TQM in the British National Health Service: nine reasons for failure’, Int. J. Business Performance Management, Vol. 15, No. 2, pp.127-137
Choices, NHS Total Quality Management is a post from: David Bradley's Science Spot
via Science Spot http://ift.tt/1kerRW2
It is therefore no surprise, Nwabueze says, that the NHS has no hospital to compare with the likes of Beth Israel, MD Anderson Cancer Centre and the Mayo Hospital in the USA. Moreover, it is, in its present condition unlikely to elicit a Deming-like observation of “a magnificent and dedicated workforce, unsurpassed management commitment, and the best statistical ability in the world”.
Nwabueze lays the blame squarely at the feet of successive governments starting with the 1979 Conservative government that allegedly sought to get the best out of existing resources and reduce costs in terms of maximising medical services through improvements in the re-structuring and management of the service, improved accountability, and better utilisation of manpower. Throughout the 1980s the NHS was the subject of much political debate and controversy, with ward closures, long waiting lists for critical operations and patients attempting to secure their health through the courts. The shift at the end of the 1980s to allowing hospitals to manage their own affairs – as hospital trusts – brought with it its own problems and the notion of Total quality management (TQM) was first mooted in a nascent form.
NHS employees can nevertheless pride themselves on the service they provide despite endless cutbacks and efforts to shuttle an essentially socialist healthcare system into the private commercial sector. It should be pointed out that in the UK socialism is not a dirty word synonymous with communism as perceived by many outsiders, indeed it is more akin to “capitalism with caring” on this side of The Atlantic. However, as TQM was implemented by the increasingly business-oriented hospital trusts, it seems that in the current climate most NHS hospitals have no clear definition of what quality actually represents from the patients perspective, says Nwabueze.
In his research he discovered three different perspectives, suggesting that quality is very much in the eye of the beholder, as with beauty: To the administrative staff, quality is about appearances, he found. To the chief executive, quality represents low cost. And, to the quality manager, quality is about giving each patient the bare essentials and not attempting to meet all of their requirements. Nwabueze cites many reasons, too numerous to list here, for the ultimate failure of TQM but suggests that it might also be the saviour of the NHS allowing its hospitals to aspire to the quality of a Beth Israel or a Mayo without compromising the vision of the Beveridge Report of 1942 that laid the foundations for a “comprehensive health and rehabilitation services for prevention and cure of disease”
Nwabueze, U. (2014) ‘TQM in the British National Health Service: nine reasons for failure’, Int. J. Business Performance Management, Vol. 15, No. 2, pp.127-137Choices, NHS Total Quality Management is a post from: David Bradley's Science Spot
via Science Spot http://ift.tt/1kerRW2
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