Tips from the top

National Health Executive spoke to world renowned lean expert Professor Peter Hines about how the way in which trusts approach the implementation of lean

To what extent do you believe that people's perception of lean techniques has been effected by the recent negative publicity around Toyota?

I think there was a little flurry of excitement over this but now seems to have pretty much died away.

Why do you think that this is?

Why, it is hard to resist the growth and success of Toyota.

Given that Lean management is about cutting back on processes, is there not the risk, especially in healthcare situations, that essentially too much can be cut away, if practitioners are not careful?

I guess there is always a risk of this if strategy and operational improvement becomes dis-connected. However, to describe lean in terms of just cutting would be to misunderstand it as it is as much about reducing people’s frustrations. If this is the focus it is unlikely that the problem you mention will occur.

In the same way, do organisations run the risk of alienating staff if they are not fully involved in the decision making process?

As I have touched upon in my previous answer, if lean is applied properly (which may or may not be the case) it should give local level people much greater autonomy by allowing them to understand what the organisation needs and why this is important and then making local calls on how to do this. In other words much greater local decision making.

In general how effective do you believe that the application of Lean has been in NHS organisations?

Generally from what I have seen I would give it a low score as I see far too much ‘big bang top down change’ or ‘local tools led change e.g. around 5S or kaizen events’. What I have not seen is anyone in the NHS really creating a full Lean Business System.