Improving healthcare through changing practice

The Portsmouth Medical Management (PiMM’s) project is an innovative project that is already helping to change performance management systems as a result of its findings. Dr Tim Trebble, currently the clinical director for PiMMs, presented a webinar to FMLM members about the project and its findings and impact.

The webinar started with Dr Trebble giving some background to the project and clarifying what he sees as the difference between evaluation (“how are we doing?”) and management (“how can we change what we are doing?”) – an important distinction if one is to focus on improving medical management. Quoting management consultant and author, Peter Drucker, Dr Trebble focused on what can be done to improve performance with limited resources, such as in the NHS. He noted that most valuable asset that the NHS has is clinician time and expertise and that this should be managed as the “value resource” it is. He noted the difference between the often advocated “sweat the assets” approach – i.e. make doctors work harder and “work smarter, not harder”, which Dr Trebble advocates. The key to this being to understand people’s motivations to improve performance and facilitating their time to get the most out of it. He went on to talk about a conflict in culture between managers and doctors, showing some evidence from his Trust of a difference in attitude towards change management between the two.