The Corporate Blind Spot
The utilitarian/egocentric clash of cultures is driving a worrying divide between the corporate and the clinical communities.
With the NHS financially constrained by cost of increasing demand, the corporate community (planners and managers) is focussed on the utilitarian need to live within its budget. The response to this corporate risk is all the governance systems and processes that any large organisation must have. Its not a lot different to running a large hotel, more about the form than it is the function.
The clinical response to this corporate risk is what I have been subjected to throughout my years as a GP and what clinical leaders have been required to lead, ie prescribing budgets, referral processes, incentive schemes etc. These are not clinical objectives, I do not go to see a patient to perform admissions avoidance!
Clinical risk is about quality and not making mistakes, we have a clinical approach to it, Clinical Governance. This works well, but with an egocentric hat on, driving clinicians to risk avoidance and fear based medicine, ie more clinical stuff!
The blind spot: What is the corporate approach to the clinical risk?
If we, both the clinical and corporate community, understood the behaviour of clinical decision making, and we acted together to address the fear of getting things wrong, would we reduce demand? I think so.