Category Archive: Service delivery

  1. Maximising the marginal gain

    The clamour for transformational changes in the NHS and social care continues to grow. There is also a call for evaluation and research to ‘prove’ what changes are successful and which are not. This all seems to point to big changes that can be shown to have significant impact. Does this risk missing an alternative approach to improvement?

    In 2010 the cycling coach David Brailsford (Performance Director of British Cycling and General Manager of Team Sky) developed a concept known as the aggregation […]

  2. Person centred care in my lifetime? Maybe, just maybe

    It was Lynn who first suggested it. “You see” she said “you can cope with the frustration if you accept that patient centred care will come, just not in our lifetime.”

    Lynn was the hospital’s PALS manager and had an office near to mine. She would pop in to offload after she had spoken with one of […]

  3. “In the best interest of patients” – who decides?

    Everyone claims to be acting or making decisions “in the best interest of patients”. Doctors have been doing it forever despite engaging in some dubious and occasionally dangerous practices over the centuries.

    Acting “in the best interests of patients” defines us. It is written all through Good Medical Practice, our code of conduct from the General Medical […]

  4. What can the NHS learn from the film industry, food retail and event management?

    What do the following have in common?.

      Each one of these is a complex operation requiring co-ordination of staff, equipment, premises. They all have customers and interested parties. They all have […]