The triumph of hope over experience – Lessons from the history of reorganisation – NHS confederation – 2010

Posted on August 5, 2010. Filed under: Health Mgmt Policy Planning | Tags: , , |

The triumph of hope over experience – Lessons from the history of reorganisation – NHS confederation – 2010

By Nigel Edwards
ISBN 978-1-85947-183-8

Extract from the introduction:

“Restructuring has been a common occurrence in the NHS over the last 20 years, including mergers and reorganisation, the  abolition and creation of new organisations and renaming and reforming of others.

With the coalition Government now in place and the scale of the financial challenge facing the NHS over the next three to five years, calls for large-scale reorganisation are increasingly likely.

This report is part of a series from the NHS Confederation reflecting on the last decade of NHS reforms to help managers, policy-makers and politicians ensure that some of the errors made in the past are not repeated. It aims to inform these debates and decisions, and is intended to generate discussion rather than present a definitive policy position.

We review the history of restructuring, what is known about its results and the reasons for the pattern of increasingly frequent organisational change to draw out some important lessons that are particularly salient at this time.

The evidence outside healthcare shows that no more than 25 to 30 per cent of mergers and acquisitions in the commercial sector succeed. Given the greater complexity and level of risk in the NHS, this success rate would be optimistic.

While modest savings can be made over time, dysfunctional effects of reorganisation include a loss of focus on services, delays in service improvements and a difficulty in transferring good practice within the merged organisation.”



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