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NHS could learn a lot from Tesco

From Dr John Havard, Saxmundham, Suffolk

This week Tesco announced impressive record profits of £2.55bn achieved through continual change and adaptation to the market. The company's chief executive, Sir Terry Leahy, puts this down to listening to its customers as well as its disciplined management structure.

Are there elements of this success that could be applied to the NHS? The Tesco overarching strategy is carefully determined centrally and yet continually refined. The NHS on the other hand suffers from too much politically driven fire-fighting which detracts from strategic implementation. Removing wholesale political interference would therefore be wise and yet still allow minor alterations to the set course. Store managers have very limited capacity (and desire) to adjust strategy to local demands so there is a clear national approach. Contrast this with Suffolk PCT, which is terminating PMS contracts with its GPs that were nationally determined, even promoted by the Prime Minister.If this course of action is indeed correct, then it should be actioned around the country through the Department of Health. This PCT's capacity to be 'off message' is highlighted by its refusal to allow a health and social care centre in Saxmundham that, because of grant and subsidy, would cost it nothing. Reasons offered include 'not wanting to raise public expectations' and 'being too good for Suffolk'. Every Tesco manager wants to run the best store in the country and serve customers as well as possible, which is a refreshing stark contrast. PCTs seem to be autonomous and free to do whatever they can to achieve financial balance, so they cannot be blamed for 'thinking outside the box' – often in desperation. The Tesco manager, however, is judged not just on his store's profitability but on how he achieves it, which ensures that strategy is not ignored.Social marketing is a buzzword nowadays that really seems to mean understanding people (or customers) and making the whole thrust of the operation about serving them better. A stronger focus on consumers would afford some gravitas to the patient-led NHS.

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