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Waiting for

Problems…

How many do you want? What kind? There are three basic types;

There’s ‘cause and solution’… that’s a simple-problem.

There are multiple causations and a variety of solutions… that’s a complex-problem… 

… usually difficult to understand with solutions that can bring unintended consequences.

Then, there are multiple causes and hidden causes with a plethora of problems… that’s a wicked-problem. Much more fun…

… a solution is hard to envisage because the problem is hard to define. There may be no right or wrong answers.

Solving the problems?

You could try the Garrette, Philip and Simony, 4S method.

  • State the problem… helps you really understand what the problem is.
  • Structure the problem… breaking it down into components
  • Solve the problem… hypothesis-driven or issue-driven problem solving. Maybe the creative path of design thinking.
  • Sell the solution… you may well come up with an amazing and innovative solution but if you can’t get by-in from others, it’ll never be implemented.

Simples…

… and then there are the problems we just bring on ourselves, that we don’t really recognise and as you will see are doing untold damage.

Enter my new friend Harry…

… he saw his GP who did a test or two and decided a referral to hospital was required. Off it went. 

Harry waited and waited and waited… nothing happened. 

Back to the practice…

… they didn’t know the progress of the referral. 

Harry waited…

Harry knows his way around the system.

He tried the hospital… PALS. They couldn’t help, they just do complaints. 

Harry waited…

He tried the hospital general enquiries. The up-shot of that… they are overwhelmed and have no real idea about anything.

Harry waited…

He tried the ICB after all, they are commissioning the services. Theyhad no idea of the progress of Harry’s referral and didn’t seem that interested.

Harry waited…

He tried the local MP who played a bit of lip-service and a huge game of pass the parcel. They wrote to the CEO of the ICB… who had a polite templated letter all nice and ready… useless. 

Harry waited…

… and has identified a black-hole in the system. 

Back to the practice… a conversation with the practice manager… ex-business-person and very savvy.

To cut a long story short…

… the practice manager measured the amount of time the staff spent on questions about referrals, follow-ups, ‘where am I on the list’, ‘I think I’m getting worse’, ‘is there anybody there‘?

The upshot… are you ready for this… the answer was a whopping 23% of practice activity was taken up, in some way, with chasing referrals.

Yup that’s right 23%.

If there are 8,000 practices and they are all in the same boat, and they are open 6 days a week…

… I make that 12,000 days are lost, each week, in the pursuit of ‘where is Mrs Smith’… or Harry.

Six hundred and twenty four thousand days a year… looking, repeating, covering the same ground. Primary care bloodhounds following up the scent.

This entirely self inflicted problem has a name. Apart from %^&$-bleep, bleep…

… it’s called failure demand. 

Demand created by the failure to get something done properly, in the first place.

Harry, is an ex-business man and a thinker. He suggests PALS, who are inside the hospital’s firewall, could be funded by the ICBs to provide the ‘where-the-hell-am-I’ service…

… they would also be able to create data to figure out where pinch points were.

Another idea would be to link the NHS App, in someway to answering ‘where am I questions’.

Turning failure demand into value demand, the back-bone of total quality improvement.

Get NHS technology delivering something useful, for a change.

People want to know where they are. They don’t necessarily want to jump the queue, they just want to know where they are in-the-queue. Get their lives organised. Worry a bit less. It’s not unreasonable, is it?

Communication… or the lack of it, is creating its own kind of hell for practices. 

If half of them are not plagued with ‘where am I’ questions, the other half probably are.

Maybe you have a solution up and running. Perhaps you have a bright idea? If you do, share it with me, or better still, with the Academy of Fabulous Stuff…

… and I’ll tell Harry.

… what are you waiting for?

Have the best weekend you can. 

News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.

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