A Disrup3ve Solu3on for the NHS
NHS. The joint vehicle could be created between the GP consortia and private companies which specialise in long-term condition management. The purpose of creating this new business model would be to create and maintain wellness instead of rewarding sickness; the joint venture would span the current chasm between GP practices and hospitals. The incentive would be to maintain health and avoid unnecessary hospital admissions because The purpose of crea3ng a joint business admissions to hospital would be charged to the joint venture at the full model would be to create and maintain wellness NHS Tariff rate. Furthermore, much instead of rewarding sickness; the joint venture higher levels of adherence to NICE care processes could be introduced as would span the current chasm between GP part of the contractual processes. prac3ces and hospitals A joint venture implies some form of gainsharing mechanism between the GP consortia and the private companies which specialise in long-term condition management and crucial to this implementation is understanding baseline costs and resource allocation.
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Acquisition Organisations that are unable to execute the desired technology strategy – either on their own or with partners – can acquire separate organisational structures. These separate organisations will have already begun to exploit the new technologies. When it makes such an acquisition, the originating organisation gains access both to new technologies themselves and to the new routines and practices developed to exploit the new technologies. However, the risk with acquisitions, as with internal ventures, is that the existing routines and practices in the NHS (i.e. the culture) will come to dominate the acquired or newly created organisation.236 Outsourcing In general, outsourcing refers to the reliance on external sources for the performance of value-adding activities. In the context of reforming the delivery of long-term condition management, outsourcing does merit consideration, although complete outsourcing for all long-term conditions is unlikely to be the panacea. This is because outsourcing can erode the originating organisation’s potential for learning and development, particularly those skills necessary for the development of core capabilities.237 While careful outsourcing of supporting activities can certainly help organisations concentrate resources to build core skills, the exact balance in this context would be down to individual GP consortia to decide. Although diabetes is largely a preventable disease, prevalence rates and hospital admissions are increasing. Despite the frequent use of performance management and national target setting by the previous government to drive improvement in the NHS long-term conditions has had only one time limited target which was met early. The objective was to reduce emergency bed days by 5% by 2008 (from the expected 2003/04 baseline), through improved care in primary care and community settings for people with long-term conditions.238
236 Mullins L. Management & Organisational Behaviour. 4th Edition
237 Mahnke V. The Process of Vertical Dis-Integration: An Evolutionary Perspective on Outsourcing. Journal of Management and Governance Volume 5, 2001, Numbers 3-4, 353-379, DOI: 10.1023/A:1014003229386
238 Department of Health. National Standards, Local Action Health and Social Care Standards and Planning Framework 2005/06–2007/08. 2004.
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