Published 15 December 2008, doi:10.1136/bmj.a2321
Cite this as: BMJ 2008;337:a2321

Analysis

New design rules for driving innovation in access to secondary care in the NHS

Hugh Rogers, senior associate, service transformation1, Lynne Maher, head of innovation practice1, Paul E Plsek, consultant on innovation and complex systems2

1 NHS Institute for Innovation and Improvement, Coventry CV4 7AL, 2 Paul E Plsek and Associates, 1005 Allenbrook Lane, Roswell, GA 30075, USA

Correspondence to: H Rogers hugh.rogers@institute.nhs.uk

Although access to secondary care in the UK has improved, more still needs to be done. Hugh Rogers, Lynne Maher, and Paul Plsek describe how understanding the unwritten rules could help us move towards more radical redesigns

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

Delays in access to health service have been one of the public’s top concerns and the focus of major political reform in the United Kingdom for many years.1 2 Waiting can have an important clinical impact; for example, delays in access to diagnosis and treatment can increase the likelihood of preventable complications, creating unnecessary risks for patients.3

Progress towards meeting national targets has been substantial but has been achieved largely through incremental change and expanding capacity. The most recent review of the NHS notes the need to accelerate change, in view of factors such as the rising expectations of the public and the development of our information society, to provide what patients want—personalised care.4

The US Institute of Medicine’s Committee On Quality And Safety In Healthcare recommended the use of frameworks based on simple rules to guide the complex changes that are needed to transform health systems.5 Simple rules have also . . . [Full text of this article]


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