What Tesco can teach the NHS?

NHS reorganisation


Healthcare Audit Consultants

For years Tesco has been held up as a model to be emulated by the NHS.

Sir Gerry Robinson:

“I, for one, would like to see the NHS learn from and copy working practices from Tesco, in particular, which has constantly modernised to better meet the needs of its customers. Our health service could be vastly improved, made more efficient, more innovative and, crucially – in the light of what has happened at Mid Staffs and Barrow-in-Furness hospitals – safer.”

Sir Paul Corrigan:

“…health service should learn from supermarket chains such as Tesco, by mirroring its business model of large superstores and smaller local shops, with a smaller number of large specialist hospitals, supported by small-scale community hospitals”.

Roy Lilley:

“The NHS must do the same thing: out of town super hospitals and the equivalent of Tesco’s corner shops – ‘NHS-Extra’ – locally”.

What are they saying now ?

Tesco have invested too much in hyper markets that people do not want to go to, don’t like and prefer smaller, more efficient generalist stores closer to home.

They have been managed by insular managers used to dictating terms (and Gulfstream planes) , inadequately governed by incompetent and complacent boards, only focussed on meeting financial targets , with little interest in how that was achieved. Evidence of poor quality and complaints from suppliers met with insouciance and denial.

Sounds familiar?

I can hear you say that the Tesco debacle couldn’t happen in healthcare because there is no effective competition ready and able to undercut the NHS. But that is a worse scenario. Just as shoppers do not like long expensive journeys for often small transactions so too do patients. Is it better that shoppers can choose but patients cannot?. It gives the lie to all the talk of empowerment and engagement.

Another response may be “there is no alternative”. That’s not true however. Another model for the disposition of hospitals would be to enforce a more rigid hierarchy amongst clinicians ensuring that only patients requiring the most specialist care were referred to centralised units. The reality is that for most conditions the DGH is adequate without the need for further centralisation. The real problem in the NHS is easy access to rapid diagnosis and proper referral for which more remote hospitals will make matters worse.

The real lesson from Tesco is that the consensus can be wrong. The high and mighty exposed as hollow drums, capable of a big noise and of spending lots of money but also capable of strategic errors and co-pilot syndrome.

Is the NHS Board taking note? Is there an NHS Board?

Healthcare Audit Consultants Ltd