Outcome driven process innovation

To be honest I dislike talking about large scale organisations as they tend not to be my customer base and often managers do not consider something to be their responsibility.

However occasionally it is worth talking about such organisations because it is often clearer when the real needs and desires of customers are simply not prioritized.

Take the NHS – arguably the most popular brand in the public sector – but even here there are real problems and my attitude of “Lions led by Donkeys” has yet to be contradicted.  Frontline staff are exceptional because they meet their customers/patients and focus on dealing with their needs, which is ultimately underpinned by the Hippocratic Oath, however the further you get away from the patient the more problematic the system becomes.

My elder son is a great example – he has been diagnosed with ADHD after 2 years, this is to us and other people who come into contact with him, (school, his classmates etc) absolutely irrelevant.

This is because there is something else there more akin to autism that means he responds better to praise and more positive parenting than the disciplinary approach.

However this has not stopped the NHS has put us on a magic 123 course (again) in a town 20 miles away in the middle of the summer holiday with no childcare – the absurdity of this would be apparent to anyone who understands the condition or the fact that child carers are understandably reluctant to look after a child who may be continually climbing up the walls.  For most businesses making it apparent you do not really know what you are talking about would be what is called a hygiene factor – for the NHS it is understandable.

I do not think that the system was originally designed to push parents to the edge of insanity and delay support for the child during a key developmental stage, it is just that key stakeholders benefit from a process that puts the child last and it is in no ones interest to change it.

  • The NHS appears to benefit because the focus is on the medical diagnosis and in our region it is impossible to get school funding without a diagnosis.
  • The council saves money by delaying any sort of decision on funding and benefits further if parents have to home school their kids as they take the most costly children out of the system as incredibly if you home school you not only have to pay for tutors and support but even exams.
  • Even the school would benefit if he was on medication (despite the horrendous potential side effects) as this would improve the opportunity of funding

In fact because the school see him on a daily basis the reverse is true and they are actually paying for additional support, even though their budget is about to be cut by £20,000 because my sons needs are evident and have been for the last two years.  The peditrician sees him infrequently which means that she has to go through all the paperwork before she sees him again and is probably managing too many cases at any one time due to the time to conclude them.  So far we have been given a myriad of coping strategies with apparent disregard for what has gone before – the magic 123 method has been tried by the school, the nursery and a couple of bumbling amateurs (us parents) with no success on several occasions.

In Canada they focus on the child’s needs, investing in the child at the earliest possible stage to help them continue in the mainstream – the diagnosis can come later.  This may well be the case in other areas of the UK as there is a clear postcode lottery over mental health issues particularly when they are related to council support. In Cheshire it is about getting the kid off the system without providing any funding, hence the coping strategies.

Businesses work better by focusing on the customer and are rarely in the position of our local council who have clearly worked out that they benefit from a poor service and driving customers away.  The NHS however could benefit from working on the why the system is so convoluted and long – poor communication, refusal to use email, losing records in the administrative system and a host of little details like having more scanners for documents which otherwise do not appear on the system (the reason why no one knows what is going on).

Systems like the Jobs to be done process can cut through the inertia and focus on innovations in process improvement that are sorely needed if mental health support is to increase in the lack of any additional resources.

The reason that it will not be resolved until there is some big scandal is that no one will take responsibility and many in the council will believe they are doing the right thing by “saving taxpayers money”.

If you want to know more about how your business can benefit from the Jobs to be done (JTBD)  you can find more information on my website and more specifically http://www.plannedmarketresearch.co.uk/jobs-to-be-done.html or read my blog on the subject on JTBD

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