I don't know about anyone else, but I couldn't even read that poster (even if I downloaded it and zoomed in). Some of few words I could make out looked looked like Greek to me.

   - Andy.

Andy, Sorry about that. I see what you mean. The actual size is A!. I'm not sure how I can post an actual size image that will fit on the page and be readable. I'll have a go. 

The way I can get to see it is:

1. Click on the image to open it.
2. Right click on it and tell your browser to open it in a new tab.
3. Zoom in on it.

But then it's so big, it doesn't fit on my screen, and I have to scroll around it.

Or use this link: /cfs-file/__key/communityserver-discussions-components-files/37/0068.pastedimage1702215961282v1.jpeg

Having done that, it still makes little sense to me, even if I can read the words.

Thanks for the link Simon. Are you ok with the Toyota Production System diagram, top left? What about GIRFT? Get it right first time. Some detail provided in the key. Unfortunately there is very little engineering input or knowledge into NHS operations. Maybe even less than I thought. I'm hoping that this poster, and an IT System poster to follow, will generate some interest. I think, that with the NHS, we will need a big hammer!

From what I see you have produced from a document or PDF at 75dpi which can be ok for screen presentation but with such small detail but really you need to output at 150 or ideally 300dpi.

Thanks Ian, I'll do some experimenting.

Thanks Ian, I'll do some experimenting.

Hello Tom. To state the obvious that reducing costs and delays would please patients and boost staff morale. However, there would always be resistance to change, especially from those who are comfortable with the current ways of working. Lack of resources, support, and incentives to implement the changes.

Thanks AMK. It's difficult for most to be comfortable with the current ways of working in the NHS. Today's news of more problems with mental health services will emphasise this I'm sure. I do agree though that some are comfortable and they will fight any changes. Nevertheless I do think that change is necessary and it will have to come from outside the NHS. Engineering skills (and other skills of course) are required to make this change. The more of us that understand the technical aspects of healthcare the more chance of that change happening. I don't profess to have the answer but I do want to start the discussion. To date the IET seem to be more interested in other areas of healthcare. Thanks for your interest and please continue with the conversation.

Do you have any experience in participating in any of the trusts that have adopted this approach?

No because no Trusts have adopted this system in the UK. A number have, and some still are, working with the VMI consultants in the UK and one at least is working with Toyota consultants in the UK. I'm sure that will be expensive. I have experience in the UK car industry where elements of the Toyota PS where used. I have 8 years experience of trying to understand how the NHS Process Management - Process Management, via Standard Work is key to this approach.

I am working with individuals from various Trusts looking at how this approach could be adopted.

My aim here is to find IET members that are interesting in developing this approach for our NHS.

I have done a little research and the final report from the WBS team that is evaluating the partnership is coming out in early 2024. The interim reports show that the partnership has done some good things for the patients and the staff, like shorter waits, safer care, and happier staff. The NHS and VMI also made some of the Trusts more open to change and improvement, with more staff getting involved, feeling empowered, and learning new things. But the NHS and VMI also faced some problems and challenges, like having too many things to do, not enough resources, staff leaving, and people not liking the change. The NHS and VMI also found out some things that helped them succeed, like having strong leaders, a common vision and values, good communication, and outside help.

Thanks AMK. I've read all the reports and spoken to people first hand. The VM hospitals in the US are very different from our NHS, nevertheless they have some good stuff in their production system. It need a lot of work to make it ok for the NHS. That is what I'm working on. The most important bit is Standard Work and that is the bit they could not interest the NHS in. That is the cornerstone of their PS. I've done and am doing loads of work on that with the NHS. There is, ok course, lots more than just Standard Work. The way things are all their effort will just be wasted on the NHS. Please do not think that your last sentence holds any weight in the wider NHS. It would be nice to keep this conversation going. Did you notice the two question marks in my poster? - Important issues.

One of the features of Production Systems is level production. On Radio 4 this morning there was a piece on NHS surgery backlogs. A Surgeon was talking about how he had increased weekend theatre capacity. Usually the theatre staff have a wait between patients when the theatre is cleaned and set up for the next patient. To speed up throughput they now prepare a spare theatre during the current patient's surgery so that they can move straight into the pre-prepared theatre with the next patient - and so no. This is an example of 'level production' as included in my poster. I should say that this technique is only possible, at the moment, at weekends where they have spare theatres.

Could it be argued that doing this requires more resources, such as staff, equipment, and theatres, to operate two theatres concurrently. It also relies on the availability of spare theatres, which may not be feasible during weekdays or peak times as you said. Furthermore, it may not tackle the underlying causes of the NHS surgery backlogs, such as the shortage of staff, funding, and capacity in the health system.

Process Productivity, effectiveness and efficiency are all underlying causes of NHS backlogs in addition to the issues you list, i.e. staff shortages, funding and capacity. Process Productivity, effectiveness and Effectiveness will all be addressed by an NHSps.

Thanks for your comment AMK