Targets aren’t everything

In Performance targets, UK productivity on March 7, 2010 by Tim Aikens

A headline in today’s SUnday Times (UK).  “Labour hid ugly truth about NHS”.  In summary, a series of reports have been unearthed highlighting the drive for performance – meeting political and management targets at the expense of patients – customers.  The numbers may be debatable, but this has cost a lot of lives.  So despite lots of new money ‘rigorous targets’ and loads of new ‘managers’ the NHS has declined in productivity AND killed a lot of people seemingly unnecessarily!! As anyone will tell you, running any operation to a tight budget is tough and the NHS is probably tougher than most. However, there is a lot of variation. Some hospitals seem to do really well, whilst others are abysmal.

Where am I going with all this?  Not a rant against the NHS per se. It’s a great institution, I have recently been making great use of its services for my kids who insist on breaking bones. But there are several key messages that emerge.

Chasing productivity in a single dimension may lead to unwanted results! Packing too many kids into classes may get more per teacher, but worse GCSE results.  Faster production may lead to poorer quality etc.  The lesson here is that every effort to improve performance MUST consider the ultimate objectives on the organisation.  In the NHS it is to make people better.

Investment alone is not enough. Throwing money at an issue or problem is often necessary, but usually insufficient. A lot of businesses invest heavily in IT and then wonder why the desired productivity increases don’t happen.  A hospital buys new equipment, but has no budget to hire the professional staff to run it!

Targets can be counter productive. Simply setting targets is rarely enough. Are they the right targets, set at the right level, aimed at the right people?  How do the targets interact. Targets can often be in conflict.  A call centre target fo enquiries per person per day.  The more you try to cram in the more likely you will be to meet quality or satisfaction targets. Where is the balance.  Businesses and organisations are systemic.  So are targets and productivity. A change in one may well have an impact on others.  Targets for performance and productivity need to be considered in their entirety before being let loose on the business.

So how should we go about starting to consider productivity as an organisation. Firstly it has to be part of the job of senior management – not just an edict.  More on this tomorrow.


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