Delivering Service Improvement through LEAN healthcare Mike Farrar

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Delivering Service Improvement through LEAN
healthcareMike Farrar
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So where are we at

• NHS is 60 years
• NHS NW is 2 years
• What achievements?

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The NHS in 3 mins

• 1948-1959
• 1960
• 1970
• 1980
• 1990
• 2000

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3 mins of the NHS

• Was established on 5th July 1948
• 14 regional hospital boards
• Annual budget 437 million
• We shall never have all we need. Expectations
  will always exceed demand. The NHS must always be
  changing, growing and improving.
• Nye Bevan

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NHS in 3 Mins

• Sylvia Diggory the first ever patient of the NHS
  cared for at Trafford now Trafford Gen. Hospital
• By 1953 3.5 million in-patients
• 1956 first kidney dialysis
• 1959 Platt report on the welfare of children

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NHS in 3 mins

• 1960 first kidney transplant
• 1962 First total hip replacement
• 1968 Britains first heart transplant
• 1968 First liver transplant.

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NHS in 3 mins

• 1970 Rubella immunisation
• 1972 CT Scan
• 1974 Ambulance service part of NHS
• 1978 RAWP

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NHS in 3 mins

• 1980 MRI Scan
• 1983 UKs first combined heart/lung transplant
• 1988 NHS Breast cervical screening

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NHS in 3 mins

• 1990 PET Scan
• 1992 Worlds first laser surgery
• 1997 Funding 57 billion
• 1998 NHS Direct launched

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NHS in 3 mins

• 2000 First NHS walk-in Centres
• 2002 PCGs PCTs launched
• 2004 First Foundation Trust
• 2006 NHS NW established
• 2006 Patient choice introduced
• 2008 Funding 110 billion

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NHS NW in 3 mins

• Strategic and organisational capabilty
• Leadership development
• Service Improvement

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Service Improvement

• Smart Practice
• LEAN
• Lisas mini Lean
• From BICS to the Blackpool Way
• Leadership of Service Improvement

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Last year there were more than 2,000 books on
leadership published
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• BEWARE
• Leadership the panacea

BEWARE System incentives replace leadership
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7 messages from me, my experience and my
mentoring (last 3 years)

• Think more do less
• Be more aware of the emotional . be less
  pre-occupied with the rational
• Be more aware of power as opposed to position
• Be more honest less fearful of the truth
• Understand and develop better relationships with
  clinicians
• Its not what you say, its what people hear that
  counts
• Deliver the reality but manage the perception

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Why should anyone be led by you? (Goffee and
Jones HBR 2000)

• Everyone agrees that leaders need vision,
  energy, authority and strategic direction but
  weve discovered that inspirational leaders share
  4 unexpected qualities

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What they found

• They selectively show their weaknesses

• They rely heavily on intuition to gauge the
• appropriate timing and course of their actions

• They manage employees with something
• we call tough empathy

• They reveal their differences

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PLACING LADDERS

• Marshall Goldsmith (2007)
• what got you THERE wouldnt get you HERE
• Tony Mayo ( 2007)
• the importance of context
• Linda Hall (2008)
• leading from behind

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An afterthought.or two. or four.!

• Stamina

• Post-hoc rationalisation

• Youre only ever accountable to yourself

• Define what success is for you