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Service improvement in the English National health service: Complexities and tensions

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  • Burgess, Nicola
  • Radnor, Zoe

Abstract

The English National Health Service (NHS) is a public sector organisation with a longstanding objective to deliver high quality healthcare that is free at the point of use. In order to achieve this, the NHS has endured an evocative and controversial theme of reform across many decades. Despite such high levels of reform, the recent Operating Efficiency Framework declared that the NHS is about to enter its toughest ever financial climate. This paper will illustrate the complexities and tensions of implementing service improvement in the NHS in a climate of persistent policy reform, reduced budgets and tough regulation. The paper reports findings of three case studies of hospital trusts in the UK in relation to the implementation of Lean improvement methodologies, highlighting key complexities of a hospital context and the corresponding tension with service improvement activity.

Suggested Citation

  • Burgess, Nicola & Radnor, Zoe, 2012. "Service improvement in the English National health service: Complexities and tensions," Journal of Management & Organization, Cambridge University Press, vol. 18(5), pages 594-607, September.
    • Handle: RePEc:cup:jomorg:v:18:y:2012:i:05:p:594-607_00
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    Cited by:

    1. D’Andreamatteo, Antonio & Ianni, Luca & Lega, Federico & Sargiacomo, Massimo, 2015. "Lean in healthcare: A comprehensive review," Health Policy, Elsevier, vol. 119(9), pages 1197-1209.
    2. Sharon J. Williams & Zoe Radnor, 2018. "Using bandwidths to visualize and improve patient pathways," Public Money & Management, Taylor & Francis Journals, vol. 38(1), pages 21-28, January.
    3. Penno, Erin & Gauld, Robin, 2017. "The role, costs and value for money of external consultancies in the health sector: A study of New Zealand’s District Health Boards," Health Policy, Elsevier, vol. 121(4), pages 458-467.
    4. Lukrafka, Tatiany Oleques & Silva, Diego Souza & Echeveste, Marcia, 2020. "A geographic picture of Lean adoption in the public sector: Cases, approaches, and a refreshed agenda," European Management Journal, Elsevier, vol. 38(3), pages 506-517.

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