BMJ  2005;330:1332 (4 June), doi:10.1136/bmj.330.7503.1332-c

Letter

Consumer advertising and doctors' prescribing

Right patient, right treatment, right time

The first 150 words of the full text of this article appear below.

EDITOR—Braithwaite issues an interesting challenge in his personal view on axioms governing health sytems.¹ Collins shows how companies moving from good to great do so by developing a "hedgehog" principle.² The hedgehog principle is that great companies do repeatedly what they are good at and that they stop doing anything they are not good at, no matter how worth while or interesting these activities could be. Great companies take a complex world and simplify it so that it becomes clear for them, their staff, and their customers what they should be doing.

When these companies have discovered their hedgehog principle they implement it both by a "to do" list and a "to stop doing" list. The NHS at present does not have a hedgehog principle and suffers badly for this lack.^3-5

I want to propose a hedgehog principle for the NHS—namely, that it should aim to get the . . . [Full text of this article]

Shelf Health Centre, Halifax, West Yorkshire HX3 7PQ npgdavies@blueyonder.co.uk

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