Exchange it …Roy Lilley’s blog on the NHS Management

I spend most of my working life helping dentists, medics and other small business owners with their businesses. I firmly believe that you must have basic understanding of the way your business is supposed to run profitably else you will get into trouble.

The repeated parachuting of celebrity business leaders into government organisations doesn’t seem to me to be anything other than a gimmick. Roy Lilley makes the case far better than I can. Today’s piece sees him reflecting on the appointment of Sir Stuart Rose to help with “failing hospitals”. Sir Stuart who recently took over as chairman of Oasis Healthcare dental group has, to quote the Financial Times, a “bulging portfolio” of jobs. In addition to Oasis he chairs Fat Face, Blue Inc and Ocado; he is also a non-executive director of Land Securities and the South African firm Woolworth Holdings.

The NHS doesn’t need big name business leaders, it needs fewer politicians.

Roy’s piece starts here:

The latest celebrity wheeze is to invite Stuart Rose, former boss of M&S to sort out the NHS’s 14 ‘failing Trusts’.

I could be very picky.  I could tell you my recent experience of trying to buy a size 16 ½, wide-cut collar, slim fit, double cuff, white shirt at M&S.  I won’t… It would take my entire 700 words, shock M&S management and explain to the City why their non-food results aren’t going so well.

I could be even more of a smarty and ask what happened to Gerry Robinson?  Didn’t he ‘Fix the NHS’?  Philip Green was going to show how clever he was at buying knickers and revolutionise NHS procurement.  Err, who remembers Loyd Grossman, Albert Roux, Heston Thingamabob and James Martin ‘revolutionising’ hospital food.

Sir Stuart should be careful; the NHS employs 1.3m, most of whom are M&S customers!  What will he say?  Here’s my guess:

First, stop calling these 14 hospitals ‘failing’ Trusts.  They are not failing.  They are struggling, finding things difficult and in many cases, turning in heroic results against all odds.  At M&S we motivate people we don’t mow them down.  We help them, not hinder them with pejorative epithets that make enthusiasm and recruitment even more difficult.

Many of the 14 Trusts are located in tricky places making recruitment difficult, (too far from, or too near, major towns and glamorous teaching hospitals), they have a history of problems including a high turnover of management.  They are geographically isolated and lonely places to manage.  They have local health economies unable to support the level of service activity that is necessary for their communities.  At M&S we have to protect our shareholders and would close unprofitable branches.  The NHS has to protect the public and cannot close ‘unprofitable’ hospitals.  Get over it; invent a different finance regime for socially vital services and link them to other Trusts to broaden career opportunities, end their isolation.  If Monitor Off-Sick don’t like it – get rid of Off-Sick.

End the belief that everyone running a hospital has to be Steve Jobs, or Churchill or Gandhi or Mandela.  Being good and reliable administrators, dependable and honest is no bad thing.  What is required is to be seen and have a thorough familiarity and understanding of the ‘businesses’.  Working with clinicians to deliver fabulous outcomes is obvious.  At M&S our senior management work as a team and trust and value the expertise of our food and non-food expert colleagues.  Leaders emerge.  Give them time.  Cherish them.

At M&S we have a relentless focus on the customer.  It is not widely known that we count-in the number of people visiting a store and count the number of people who make purchases.  Our aim is to improve that ratio.  You can only do that by being one step ahead of what customers want and making it easy for them to get it.  We invest in the shop-floor-front-of-house and make it fun to work there.  Nurses are the NHS front-of-house.  Look after them.

At M&S we train and reward performance with industry benchmarked salaries, employee discounts, pensions, bonuses, Sharesave, perks on holidays and leisure attractions, flexible working and discounted healthcare insurance.  In the NHS you only have pay.  To get the best people you’re going to have to pay more.  That’s all there is to it.

Running a big M&S store is complicated but gets nowhere near the complexity of a hospital but some principles are the same.  A clear idea of what you want to achieve, tell everyone and get them all moving in the same direction… works just about everywhere.  The NHS is an undergrowth of targets, mixed messages, conflicting missions, values, strategies and tensions.

The last shop-keeper to have a go at sorting out the NHS was 1983, Sainsbury boss, Roy Griffiths.  He set up the structures that Lansley’s Reforms have just demolished and we forget he saw; “… a central role for doctors in management, both as chief executives and as the critical managers of resources within clinical directorates.”  We haven’t achieved it.  It will be interesting to see if Rose picks that up.  I don’t see too many butchers and shirt-makers on the Board at M&S

Most Celebrity Reports end up on the shelf but this time Rose can provide the shelf and if the Report doesn’t fit the bill, I guess we could take it back and exchange it?

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