The National Health Service in the UK, probably the greatest free health service in the world is broken at such a fundamental level that it must undertake significant and serious reform. We have the medical expertise, pharmaceutical expertise, care, knowledge, understanding and finance. The issue is only with how the service is managed, it can only be the management and leadership that is not operating effectively because we have world class leading everything else. This implies that it is how we use the resources which is at issue. Could the issue be the way the service has been organised. Organisation is a critical integral part of management. The NHS is organised by segregation into a myriad of pieces, trusts. Each Trust has a board, executives, senior, middle and operational management, administrative team. There are further layers of services in property, maintenance, cleaning, laundry, security, procurement, resources and other non-clinical patient services. Each layer is cost, each segment is cost, multiple layers and segments are repetition of cost multiplied across the nation. Could a return to origin bring the simplification required. Like any service this service is a business. In business this would either be a franchise or a single business. A single business would enable the consolidation of non-clinical services, resources, procurement, security, laundry, cleaning, maintenance and property. This consolidation may include some outsourcing to enable the NHS to focus of its clinical, medical purpose. Imagine the cost you could avoid and repurpose into the medical treatment or patients. This requires consolidated management, consolidated leadership and behaviour as a cohesive service, a collaborative brand.
