Burning questions: HSRN15

At the HSRN Symposium last week (#HSRN15) I got so wrapped up in a dozen different questions boiling inside me, I ended up asking a long rambling and completely unintelligible question to the final panel discussion.  What did I really want to ask, inspired by my time at the symposium last week, about how we can succeed post-election?  Here are some of them…

  • How is the disconnect between Health Services Research and practice still so great?
  • Is there value in keeping ‘traditional’ health services researchers and implementation/improvement science researchers together?  Or should the ‘new breed’ of implementation/improvement scientists go it alone so they don’t waste time sitting through presentations of practically irrelevant findings (however interesting they may be)?
  • What needs to happen for researchers (and funders) to recognise the value (i.e. the necessity) of research about how to achieve practical improvements in services, not just ‘evaluation’ of whether improvements were made?
  • What are the ethics of researchers watching practice (e.g. during ethnography) which they know could be improved, and not highlighting these potential improvements?
  • Why do we still have anybody (but especially researchers) who think that the 4 hour A&E target is the cause of the flow problems, not a symptom of it?
  • What are we doing (what are the discourses) that continues to convince people that managers are evil and doctors are angels?  What practical damage is being done by the continuing denigration of an entire profession?
  • When did we lose the ability (did we ever have it?) to deliver ‘good’ management in the NHS, and accept ‘good enough’ management as not only a gut-wrenching necessity, but as the gold standard?
  • If an operations manager and a business school researcher were locked in a room together would they a) recognise each other as being from the same profession, and b) be able to have a constructive conversation about how to improvement health services management?
  • Are we really training managers (of all professions) to know how to deliver in (and cope with) the reality of the current environment? (I’m not saying we’re not trying, but are we succeeding?)
  • What are managers (from any profession) and management researchers doing to highlight (and campaign for) the need for recognition and release of management resource to do better than ‘good enough’?
  • What damage is done to the service by the (too quick too simplistic?) policy development process?
  • What is the level of resource put into management (and the service) that only delivers information the government needs to know whether its polices are being implemented? i.e. how much management is spent on managing services, vs managing policy delivery. (Yes I know they’re supposed to be the same thing).
  • What can be done to build the political will to embrace and reward managers?

Contentious? Maybe…

Posted in what I'm thinking, who I'm talking to

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Please note: The views on this website are my own and not those of The NIHR CLAHRC for Northwest London, Imperial College or Chelsea & Westminster Hospital NHS Foundation Trust.