There have been a number of sobering themes developing for the NHS in recent months around what we might loosely describe as ‘business skills’. Concerns about the PSQ agenda were raised in the publication of the Francis Report , the drive for effectiveness with efficiency, reliable and consistent quality plus the need for Foundation Trusts to be run in a more business-like way to name but a few, all point to the value for both boards and middle managers to acquiring more business-like, quasi private sector business management skills to enable them to navigate a successful way through.
So, the NHS needs to be more business-like!
- Who, at least at a superficial level could argue with this? But it does beg several questions:
- What does being more business-like actually mean?
- Why should we be more business-like and what evidence is there it is of value?
- What is the alternative?
How does one go about being more business-like?
If we start with dictionary definitions we get words like, purposeful, systematic, methodical, efficient and professional. Interestingly there is no reference to making a profit. The distinction being that businesses are intended to be business-like in order to make profits and also that those organisations that are not profit seeking may also benefit from being more business-like. The creation of the foundation trust regime has created quasi profit-orientated organisations, they are not purely for profit, but do have certain profit-orientated requirements. The balance of profit orientation and greater social good is a particular challenge.
In our experience of working with aspiring FT Boards and those that are authorised, we find that many Non-Executives extol the need for the Trusts to operate in a more business-like way. But whilst many NEDs are experienced in being business-like, they are not necessarily always good at explaining what this involves and in providing specific of how to achieve this desired way of operating. This can often inhibit progress and create unnecessary tensions.
Getting beneath the surface
Our experience and beliefs tell us that supporting NHS organisations in developing true business acumen isn’t about learning more about finance per se. Nor is it simply a ‘toolkit’ of techniques to manage. Operating successfully and with true business acumen in 2012 onwards is going to require more of a quasi private-sector approach which requires the development of our thinking, feeling and behaviour in addition to sound public sector management and staying true to NHS values.
In outline the process is as follows:
It’s not a ‘quick fix’ but it’s a journey that prepares us extremely well for the task in-hand.