Hugh Alderwick Harkness fellow, Stephen M Shortell professor of health policy and management, Adam D M Briggs Harkness fellow, Elliott S Fisher professor
Alderwick H, Shortell S M, Briggs A D M, Fisher E S.
Can accountable care organisations really improve the English NHS? Lessons from the United States
BMJ 2018; 360 :k921
doi:10.1136/bmj.k921
Insanity is....
Most people working in the NHS recognise that there will be reorganisations every few years. This costs money, and, as Francis pointed out in his report on the Mid Staffordshire hospitals, can contribute to deaths. In the past 30 years, I do not believe that any reorganisation has truly benefitted the NHS. They are, however, great for politicians and managers to improve their CVs and distract attention from the core problems of the NHS, increased patient demand and expectation, and the rise of defensive medicine.
As Einstein almost certainly did not say, "Insanity is doing the same thing over and over again and expecting different results."
Competing interests: No competing interests