Paul Allen on business principles for the NHS

Last year, I wrote an article for this column on the role leadership plays in building and sustaining great organisations. It featured the work of Jim Collins, author of Good to Great and Built To Last. 

Essentially, his research pinpointed the leadership and management practices that define enduring organisations that are not merely good, but great.

Not surprisingly, there are relatively few organisations that make it into the latter category. He shortlisted 126 and only 19 made it into the genuinely world class category.

When Collins' work hit the bookshelves in 1994 (yes, it was that long ago!), it took the business world by storm. He was hailed as the next business guru and the book soon became an international bestseller.

Interest from the public sector, including the NHS, soon gained momentum and people were enthusiastically embracing Collins' key concepts: understanding the core purpose and values of the organisation, getting the right people "on the bus", and building organisations that are not dependent on their senior leaders and that could get along nicely if they left.

Business sense 

So far so good. Everyone went off comparing themselves to the corporate sector, implicitly believing they had to act more like a business, and the management consultants had a field day.

To his credit, however, Jim Collins urged a few words of caution. He argues that far from being great, many business practices are mediocre, not something we would want to import into the public sector. The point is well made. Having spent most of my career in business, I can cite examples of good, average and poor practice in even the most admired and successful companies.

Good to Great is not about becoming more like a business, it is about the evidence-based principles and practices that define great organisations - a framework for defining what great can look like.

I am unashamedly a fan of Collins' work and see huge benefits for NHS organisations that are or that want to embrace the principles and set their sights high. After all, why should anyone be satisfied with average performance and services?

Most importantly, the common sense that Collins talks can be readily embraced in all parts of the NHS, in all jobs and at all levels for the benefit of patients and staff. It does not have "for the eyes of the chief executive only" written on the tin.

Keep the ambition and the aspiration high, but do be realistic about where you are starting from, where you want to get to and by when. A journey of a thousand miles begins with a single step.