7.3 John Seddon - Saving the NHS through system change

The Aural Apothecary

Freedom from Command and Control was the very first book choice on the Aural Apothecary and its themes of failure demand, systems thinking and value have featured heavily on the show ever since. It is a real pleasure therefore this week to welcome its author, John Seddon.
John Seddon is an occupational psychologist and author, specialising in the service industry. He is the managing director of Vanguard the inventor of 'The Vanguard Method', the means by which his organisation helps service leaders transform their organisations from conventional command-and-control designs to systems designs, achieving remarkable results. Seddon’s prominence grew following attacks on conventional management thinking, sometimes referred to as New Public Management, including: the belief in economies of scale, quality standards and much of public sector reform including 'deliverology', the use of targets, inspection and centralised control of local services. The Daily Telegraph described him as a "reluctant management guru".
As expected, our conversation with John was thought provoking and challenging. John does not hold back in his analysis of the current state of healthcare in the UK and the often failed attempts to fix it. How do we fix our broken medicines management systems? How much do our attempts to fix things actually make things worse? What can we do to ‘unlearn’ what we think we know in order to understand the system from the patient's perspective? Can we really save the NHS in 10 weeks…?
In our micro-discussion we discuss Operational failures in general practice: a consensus-building study on the priorities for improvement (https://bjgp.org/content/74/742/e339). The discussion offers Paul and Jamie the opportunity to reflect on their own attempt to apply systems thinking to a GP practice in South Wales. As with all of our guests, John shares with us (albeit reluctantly!) his Memory Evoking Medicine, a career anthem and book that has influenced their career or life.
Can this method reduce costs by 75% ? Here is the video referenced by Gimmo and John that highlights a real-life example of the systems approach in action https://vimeo.com/943283319.
John has recently published a Manifesto on Re-Thinking Regulation https://beyondcommandandcontrol.com/wp-content/uploads/2024/10/Manifesto_bk.pdf which promises to improve public sector productivity and morale.
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