Intended for healthcare professionals

Rapid response to:

Analysis Essay

Flipping healthcare: an essay by Maureen Bisognano and Dan Schummers

BMJ 2014; 349 doi: (Published 03 October 2014) Cite this as: BMJ 2014;349:g5852

Rapid Response:

Many of us who work in the NHS are I suspect now tired of the exhortations to innovate for the benefit of patients. The process has become political, utterly top down & driven by central initiatives embodied in the corruption of the "Quality Improvement Programmes" or QUIPs which are, we know cuts in resources masquerading as improvements in patient care. The key mechanism operating in the NHS is - Success is Failure - because you are only allowed to change anything to save money - and if you do that effectively resource is immediately removed whilst expectations are maintained or raised.

Being patient focused & flexible was easy in the NHS & it has in the past been a joy to listen to patients & put together local programmes to improve care, but this is now impossible as we are dragooned into implementing management driven saving plans masquerading as quality initiatives. I'd love to return to flipping but in the current NHS it's forbidden - just as it is in the US where the innovative authors battle to introduce an approach that was natural to the NHS until very recently.

Competing interests: No competing interests

01 November 2014
Geoff Searle
Consultant Psychiatrist
Dorset Healthcare NHS Foundation Trust
Hahnemann House, Hahnemann Rd, Bournemouth. BH2 5JW