Driving for efficiency but looking for the outcomes

Reading the newspaper this morning I was struck by the drive for efficiency in the public sector on both sides of the Atlantic regardless of political ideology. President Elect Donald Trump has appointed Elon Musk and Vivek Ramaswamy to head up a new Department of Government Efficiency in the US at the same time as Wes Streeting has announced that the NHS will be held to account on efficiency and outcomes.

Now efficiency has a number of definitions, some concentrate on machinery efficiency, some are focused on inputs vs outputs. The Merriam-Webster Dictionary defines “efficient” as something that produces the desired outcome with little to no waste of time or resources and it’s the desired outcome piece I’d like to pick up on.

I don’t think anyone would argue that generally speaking doing more with less is a good thing. My note of concern is that sometimes the focus on the outcomes can get blurred in the drive for efficiency. This can be particularly difficult for the public sector, why? In the private sector your customer tells you what the desired outcome is and frankly if you don’t produce it you’ll go out of business unless something strange is going on with the market. In the public sector that’s a little more difficult. Think about it. Who’s the NHS’s customer?

For anyone who’s reply is “Well that’s obvious, it’s patients” I’d say “Well not if you follow the money” If you follow the money the customer for the NHS is the Government. So here’s the thing, whether it’s the NHS or the US government increased efficiency only really works if it produces the right outcomes.

The targets set on both sides of the Atlantic will really matter and I hope when those are being set there’s a disruptor in the room watching for unintended consequences. I’m sure we’ve all experienced targets that have had unintended consequences, or where being able to meet the target has become more important than meeting the intended outcome. Neither make the world a better place.

So let’s hope whether it’s the UK or the US those outcomes and targets are well thought out.

I’d love to hear about some targets that you’ve experienced that have delivered unintended consequences somehow-comment below to let me know.

Dianne

Photo by Alex jiang on Unsplash