Postcard from the Edge
Case studies in Mastery
The bigger our organisations, the more they love efficiency, productivity and cost reduction. I think it’s a “marginal pricing” mindset brought on by management training - get as cheap as possible, scale, and capture the market.
That’s all very well until things start to fray at the edges.
A post by Roy Lilley, who observes one of our biggest organisations, the NHS, really resonated as I spent yesterday taking someone to A&E on the last day of the junior doc’s strike. Both Roy’s post and my experience chimed. When things start to fray, we have to put our best and most experienced people at the front. They know more, have more experience, take more calculated risks, and adapt.
When things are “normal”, finance dictates we use the lowest-cost resources where we can - call centres, junior doctors, and algorithms. Focus on process.
When I got to A&E, the beginning of the process was normal - triage and allocation. Then however, it changed. Experienced nursing staff filled the gap left by junior doctors and channelled people to the few senior doctors on duty. Instead of process, we got personal. Complex tests were done by pressured staff who nonetheless exhibited humour and dedication as they improvised.
It was an up close and impressive demonstration of a stark reality. In something as important as healthcare, where trust matters and well-being is at stake, we need the best people at the front. It gives those in training examples to follow and puts technology in its rightful, critical place - as support, not driver.
Back at home, I binge-watched the excellent “Mr Bates and the Post Office” and was both impressed and horrified at the tale it told, as leaders hid behind the process and let that process destroy the lives of those who were required to rely on it.
Times are volatile. We need our best people at the front. Those with experience, mastery and integrity. Modern-day artisans.