THE OXFORD HEALTHCARE TRANSFORMATION PROGRAMME
Developing systems, consolidating culture and improving decisions
|
|
The third healthcare revolution is upon us. The first revolution was a public health revolution in the 19th century when advances in water, housing and nutrition led to the prevention of the infectious disease epidemics that followed urbanisation. In the 20th century the second healthcare revolution saw the development of the doctor as the charismatic and influential professional, replacing the priest in many societies, and, particularly in the second half of the 20th century, the rise of the healthcare bureaucracy. The development of the medical profession and the growth of bureaucracies were the inevitable consequences of the second healthcare revolution, the scientific revolution which has had an impact on longevity as great as the impact of the first healthcare revolution.
|
This revolution, driven by scientists working with clinicians has led to further dramatic increases in life expectancy and freedom from disability. However, at the end of the 20th century, it was clear that there were still a number of outstanding problems in every health service:
-
SAFETY -Errors and mistakes
-
QUALITY - sub standard clinical practice and poor patient experience
-
FAILURE TO MAXIMISE VALUE
-
INEQUALITIES
-
FAILURE TO PREVENT THE PREVENTABLE
|
However, these problems can be solved neither by further scientific advances nor by reorganising the bureaucracy or the financing of healthcare; whether tax-based or insurance-based, co-payment or no co-payment, run by counties or run by a national board, these problems are ubiquitous. They are too complex for structural solutions. What is required is a third healthcare revolution and this is currently taking place, driven by three inter-related forces – knowledge, information technology, particularly the Internet, and citizens. Some professionals are at the forefront of this revolution but the professions, those organisations, which Paul Starr called the “sovereign professions” are often out of step with, and behind, the Zeitgeist.
The need for urgent action is compounded by the fact that not only do health services face major challenges in tackling the problems listed above but also they have to face new 21st Century problems notably AIDS, obesity, population aging and the effects of culture change. What is needed is transformation and structural reorganisations of the bureaucracy or financing with little effect. They achieve change without transformation. To transform a service requires interventions which change people and organisations. Transforming organisations requires a focus not on structural reorganisation but on the two other components of an organisation its systems and culture.
|
| The Oxford Transformation Programme
There are three interlinked components in the Transformation Programme, focusing on people and organisations:
-
an Organisational Development Programme
-
a Professional Development Programme
-
a patient and public engagement programme
These development programmes are designed to
|
|