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The drivers for retail outlets are profit. Nothing dirty in that, but the business is set up on a system to satisfy shareholders, and the important bit here is that shareholders are not necessarily customers..

The driver for efficiency and success in retail is based on competition. By that, we mean plurailty of supply of all products. the only way healthcare can be seen as the same is to duplicate all services and have excess capacity to fill. it doesn't happen and the country can't afford to provide the landscape, let alone find the expertise..

If the NHS was based on the retail competition model, a trust would be quite in their rights to prevent consultants on their payroll from working in competition in the NHS wings of private hospitals, making legal challenges to commissioning decisions that did not work in their favour and preventing clinical staff from engaging in clinical networks as this is useful to the competition. Innovation would be per silo. The Francis comments re openness and duty of candour have no place in a competitive environment.

Thinking about the patients and their needs, designing systems that are patient focussed, putting the patient in the driving seat? Try asking people to do this because they care, not because you wish to compare sales statistics with others.