HSCBN’s Executive Committee and a number of our members welcomed Sir Harry Burns to a meeting on 11th January 2017 in Glasgow to hear about progress of his review of the targets and indicators, and also give our perspective on the work he is leading.

Sir Harry opened by talking about changing complex systems, with a profound quote from Robert M Pirsig’s Zen and the Art of Motorcycle Maintenance:

“If a factory is torn down but the rationality which produced it is left standing, then that rationality will simply produce another factory. If a revolution destroys a government, but the systematic patterns of thought that produced that government are left intact, then those patterns will repeat themselves… There’s so much talk about the system….and so little understanding.”

He talked about a radically different approach with collaboration across the whole system, with an improvement focus rather than a judgemental one that avoids driving detrimental behaviour. A normative ‘go see for yourself’ approach offers the richest potential and Sir Harry understands the importance of actively involving citizens. He also noted that some definitional issues do need tightened up to give us a common language.

In terms of data, aspects of leading and lagging indicators were discussed, to help think about both the cause and impact of situations. Different potential approaches to the review workstreams were covered, highlighting that the following 3 themes govern what we’re trying to achieve – population health, quality of service and use of resource.

To close, Sir Harry spoke of being bold and creative in this review, aiming for transformational thinking.

We then shared the outputs of the preparation work a number of our members contributed to at our Annual Event “It’s all about Outcomes” in November last year, where we looked at the following questions:

  • Who needs to be involved and how do you think ownership of any outcome could be achieved?
  • What’s important to you regarding the Review?
  • What would be the characteristics of a good performance framework

We also had an opportunity to engage Sir Harry with further questions and comments around the review. We covered subjects such as:

  • How we get a consistent approach for the collection of data for benchmarking, in particular qualitative data
  • Having more scope for better collaboration between academia and practice – with research moving towards a more qualitative way of recording
  • How a new approach could help us understand and learn from targets data – Sir Harry talked about potentially having process measures to help us have an improvement approach underneath
  • In terms of any new approach, it is likely that a testing period will be recommended

Sir Harry noted that our Network is a counterbalance to the medical / NHS groups and our views are very important to him. He’s interested to hear about things we could be measuring and evidence of things that influence outcomes. We’ve followed up with Sir Harry by sharing our slides that outlined our answers to the questions above, and also offered our support in terms of communicating progress of the review to our members, implementing projects on focus areas and getting our members involved in any tests of change. We’ll keep you updated via our regular newsletters.