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Service improvement in the English National health service: Complexities and tensions

Published online by Cambridge University Press:  02 February 2015

Nicola Burgess  and
Zoe Radnor
Nicola Burgess
Affiliation:
Warwick Business School, University of Warwick, Coventry, England, UK
Zoe Radnor
Affiliation:
Cardiff Business School, Cardiff University, Cardiff, Wales, UK
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Abstract

The English National Health Service (NHS) is a public sector organisation with a longstanding objective to deliver high quality healthcare that is free at the point of use. In order to achieve this, the NHS has endured an evocative and controversial theme of reform across many decades. Despite such high levels of reform, the recent Operating Efficiency Framework declared that the NHS is about to enter its toughest ever financial climate. This paper will illustrate the complexities and tensions of implementing service improvement in the NHS in a climate of persistent policy reform, reduced budgets and tough regulation. The paper reports findings of three case studies of hospital trusts in the UK in relation to the implementation of Lean improvement methodologies, highlighting key complexities of a hospital context and the corresponding tension with service improvement activity.

Keywords

LeanNHSpublic sectorcomplexitytensionservice improvement
Type
Service improvements in healthcare systems
Information
Journal of Management & Organization , Volume 18 , Issue 5: Healthcare management: Progress, problems and solutions , September 2012 , pp. 594 - 607
Copyright
Copyright © Cambridge University Press and Australian and New Zealand Academy of Management 2012

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