Read the first in this series of blogs about designing and planning population based systems of care here. Step 1: Defining the scope The focus of a system may be: A symptom such as breathlessness. A condition such as inflammatory arthritis or multiple sclerosis. A sub group of the population such as frail elderly people, […]
Category: Muir Gray
Muir Gray: How to design and plan population based systems
I will present the approach we use in designing and planning population based systems of care in ten short blogs. Here are the ten steps: Define the scope of the system. Define the population to be served. Reach agreement on the aim and objectives of the service. For each objective find one or […]
Muir Gray: Meeting the Trish Greenhalgh challenge
In the debate about the NHS reforms that occupied so much Twitter space before the Health and Social Care Bill was passed, Trish Greenhalgh quite properly challenged me to use the five whys approach that Taiichi Ohno used within Toyota and that I had been advocating be used for other issues, to drill down to […]
Muir Gray: Ten essential questions that only systems can answer
I have met clinicians and patients in many parts of England in the last five years and here is a list of the type of questions that cannot be answered. 1. Is the service for people with seizures and epilepsy in Manchester better than the service in Liverpool? 2. Who is responsible for the headache […]
Muir Gray: Bye bye A&E, hello SFS
Reality is created by the language we use. Language creates reality rather than describing it; that is the consistent message from Ludwig Wittgenstein, Benjamin Lee Whorf, and John R Searle. If we want to change reality one way is to change the language used, and for this reason we ban, or try to ban, the […]
Muir Gray: How doctors working in systems could rescue healthcare
“We have nothing as bad as America’s worst, and nothing as good as America’s best,” wise words said to me by someone many years ago, and this principle has stood the test of time. There are certainly many dreadful things in American healthcare, but there are also wonderful services and excellent innovation with a rigorous […]
Muir Gray: The need for systems
“All of a sudden a big mealie pudden came flying through the air.” This is the opening line of a Glaswegian song, which only gets worse, about an assault by a mealie pudden, a sort of second class black pudding with the blood removed. On the 24 November at 11 o’clock, I experienced severe central […]
Muir Gray: Competition between systems for pride 2.0
I was born in the Borough of Partick and a couple of weeks ago watched Partick Thistle, or “Partick Thistle Nil” as they are affectionately called, for the first time for fifty years. Little had changed, with the exception of the availability of a “skinny” mutton pie on the half time menu. The competition, versus […]
Muir Gray: Competition between systems for pride is effective and essential
Is care for people with rheumatoid disease better in Liverpool or Manchester? Is care for frail elderly people better in Somerset or Devon? Which big city has the best service for people with bipolar disorder? […]
Muir Gray:”The most effective screening programme ever”
“The most effective screening programme ever,” this was Richard Doll’s gentle jest when I was director of national screening programmes. Aware of my efforts to ensure that screening did much more good than harm, using every improvement technique I could learn from IHI, Toyota, and wherever, he would point out that the auscultation of the […]