Mark Cannon
Brighton
An experienced NHS manager I now work with Prof John Seddon applying the Vanguard Method and systems thinking approaches to the health system. You can see what I am up to on http://vanguardinhealth.blogspot.com/
Recent activity
Comments (24)
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Comment on: Size vs quality? Examining hospital mergers
"The theory that large hopsital mergers will increase efficiency and care quality has as many critics as supporters." Firstly, you are right to use the word theory - and one which the rest of your article apparently demolishes with evidence. Secondly, I see no evidence that mergers, or more accurately scale thinking, has as many critics as supporters. Scale thinking (the logic behind mergers) is the most ubiquitous of the plausible but wrong headed ways leaders view the design and management of work. You end the article saying that mergers are likely to occupy Monitor. Regrettably this is probably true, despite the fact that what should occupy Monitor is how it can remove the system conditions that get in the way of solving peoples problems. Ironically that includes Monitor itself. As its lizard name implies it will eat the flesh of the NHS with this kind of thinking.
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Comment on: Licensing regime could tilt playing field against NHS providers, Confed warns
Interesting, but what if the whole licensing process is itself a "barrier to change" as Mike Farrar says. They should have read this first http://systemsthinkingforgirls.com/2012/12/12/40-bloggers-needed-to-apply-for-the-first-blog-kitemark-blogmarq/. It seems that the NHS management factory has too much time on its hands and is spending increasing amounts of it dreaming up ways to waste taxpayers money and stop people from getting the help they need.
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Comment on: Is bigger better for the NHS?
This is not the first report to destroy the myth of economy of scale. Nigel Edwards analysed evidence for mergers in "The Triumph of Hope over Experience". He found only 30% of them delivered "shareholder value" (a measure of success). KPMG found the same in their recent analysis. Frontier Economics couldn't find any evidence either in their analysis for Monitor http://vanguardinhealth.blogspot.co.uk/2012/09/monitor-your-thinking-scares-me.html. There may be a benefit to be had from the "less of a common good" perspective but that is not what scale thinkers really believe. For them scale = lower transaction costs = efficiency. Yet this is wrong. Economy is in flow, not scale. End-to-end and over time. Scale thinking bedevils attempts to design responses that solve peoples problems. Scale thinking drives costs up and worsens service. Take a look here to see why https://www.vanguard-method.com/content/366/economy_of_scale_is_a_myth/. Or here for research into diseconomies of scale http://locality.org.uk/wp-content/uploads/Public-Services-Civil-Society-and-Diseconomies-of-Scale.pdf
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Comment on: Turning the NHS into a lean, mean, healthcare machine
Does going lean = going wrong in healthcare? http://vanguardinhealth.blogspot.co.uk/2012/05/does-going-lean-going-wrong.html.
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Comment on: Stephen Eames: is it time you turned around?
Cash is king alright. Would a hard nosed, street savvy plan put developing and tending to relationships end-to-end over time at the heart of its design? Or would that, despite the evidence that it works for staff, patients and the Finance Director, not be seen as hard nosed enough? http://vanguardinhealth.blogspot.co.uk/2011/07/what-turnsaround-around-comes-around.html
