Norms, Habits and Systems … what does the NHS stand for?

Norms, Habits and Systems … what does the NHS stand for?

In my actual day job, I am currently doing some work within a very large community.
It is one of the largest employers in the world alongside the Chinese People’s Liberation Army, the Indian railways and the Walmart supermarket chain.
It is so large that in terms of its employee population it rivals some cities. In fact there are 90 countries in the world that have a smaller population than this organisation.
You could take the entire populations of Glasgow and Edinburgh and only just have enough numbers of people to fill the workforce needs of this organisation.
And the budget is around £120 billion!
The client?
Yes, it’s the National Health Service!
Given the logistics of running entire nations, or the two largest cities in Scotland, it is amazing that the NHS does as well as it does – and according to data from the Kings Fund, not always missing their imposed targets!
A modern aircraft carrier had a crew of 6000 men and woman and is about the size of a modern hospital. The NHS in England and Wales employs around 1.3 million people. This is approximately 1 in 23 of the working population and enough people to operate nearly 217 aircraft carriers.
Communities of this size require not only a fixed set of rules and regulations but a myriad of unspoken and unwritten rules and rituals. These form the real fabric of the community, the stories that people tell about what goes on and the signs and symbols associated with sense of belonging. They form the culture of an organisation. But how do you map out or measure the intangible and unspoken? Who sets the expectations and boundaries that only exist in people’s minds rather than on paper or physically?
When trying to work out how to make a community better, more efficient or effective it is critical to understand the rights, rituals, unwritten rues and culture in addition to the written requirements and systems and structures.
Systems always drive behaviour but it is not always possible to predict what behaviour will result from a given set of rules when applied to so very many people in so many different locations.
Real leadership of communities such as this – effective leadership – is able to both anticipate and predict the combined behaviour of large groups of people living and working together and is what is really required for the on-going and sustainable effective future of a community.
This the kind of leadership required in the NHS.
Best wishes
THE NEIGHBOURHOOD ECONOMIST

No Comments

Post a Reply