Roy Lilley asks “Don’t we need to think about buying twenty paving slabs?”

This is the story of Morrison’s car-park. It is well laid out, well lit, lots of disabled bays, open and family friendly. The perimeter is nicely landscaped, screening the store from the adjacent houses. Between the car-park and the store, a strip of lawn, hedges and planting. An architect’s dream. And, that is the problem. Most architects live in a parallel universe of perfect people doing the right thing, living disciplined lives.

Well, they hadn’t thought about me. Coz; when I park my car in Morrison’s car park, instead of walking around the grass bit and the hedge I walk straight across the grass, push though the hedge and straight into the front door. And, may I add, so does everyone. Hence, there is a worn strip of grass and a hole in the hedge.

Morrison’s could have put up a sign. Morrison’s could have put up a fence, increased the planting, brought a bigger hedge and posted a security guard with a dog.

They did none of that. They did this. They put in a pathway. More than that, they dropped the kerb so that disabled people and mums with pushchairs could do what I do. They said; if that’s the way you want to get into our store then that’s the way we’ll make it easy for you to do it; it’s cheaper than repairing the hedge and reseeding the grass.

Morrison’s understand they are there only to serve people. Morrison’s are not going to have an argy-bargy over twenty paving stones.

All this came to mind when I was reading some numbskull from the DH, who also lives in a parallel universe of perfect people doing the right thing, moaning about the number of us who attend A&E when we shouldn’t. “People ought to know they should ring NHS Direct, go to NHS Choices, try ringing out of hours services… ” …yeah and look in Yellow Pages for a witch-doctor or go to church, sprinkle themselves with Holy Water and pray for a cure. Apparently we should “…down load an App, look at the mobile symptom checker or try a textphone service”.

All this paraphernalia is the NHS’s equivalent of Morrison’s putting up a fence, increasing the planting, bringing in a bigger hedge and posting a security guard with a dog.

If you are thinking that Morrison’s is not the NHS and are going to write me an email that will explode with indignation onto my screen, poison my hard-disk and melt my speakers, just think for a moment of a little used management calculation called ‘costs-in-flow’. In simple terms; all the money flowing around an entire issue, end-2-end.

In this case; the money (costs) that flow around NHS Direct, NHS Choices, OOH, Apps and text symptom checkers aimed at keeping people out of the very place they can see, have faith in and can get to. If all of that was taken away, given to a hospital and converted onto local telephone triage, hospitalists (GP-type people), and up-staffing – wouldn’t that be a better service than the fragmented incomprehensible muddle we have now, that patently does not serve the people in the way they obviously prefer?

Roy Lilley,

It’s unlikely that the DH will respond to this excellent advice, so here’s my thoughts on what an internal memo written this morning at the DH might read like:

Dear Sir, whilst I take delight in reviewing all the suggestions from external sources (even if they come from “EX” NHS Managers) in this instance we would conclude:

i) it’s quite obvious from the photo that it’s a long stretch of the imagination to think this was achieved with just “twenty paving slabs”. Even if we could ignore the need for independent external consultants and the necessary R&D for an initiative like this it’s quite obvious from our assessment of the location that the project required at least 28 Conventional Slabs, 7 Tactile Slabs, Aggregate Material for Substrate, 1 dropped kerb, 1 right drop kerb, 1 left drop kerb, etc.

ii) I called Capita today (they are the private company that we pay for the NHS Choices, OOH Apps and text symptom checkers that the article is so enthusiastic about) and they said they had little interest in managing the ongoing costs or risks involved with a path like this as they are currently inundated with the important work they are doing live-streaming video from the Hospital waiting room CCTV onto the internet (who would have thought that would be so popular hey?). They did however say that they could possibly send some consultants over if you wanted to pay for them to create an augmented reality “NHS Hospital Landscaping App” for the new iPhone and iPad (alternatively perhaps one of the developers working ‘during the day‘ at the NHS Information Centre might want to run with this as another little private side project?).

About David Doherty
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