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True to form Murray & Nick invite a critical re-examination of the dominant approaches used in a great deal of improvement work in healthcare. Based on their extensive experience of working in the field over the last 25 years, they argue that many of the current approaches fail to take proper account of organisational and patient context; invite reductionism and the atomisation of complex issues, and ultimately create only an illusion of progress.
Of course, no one book could cover the hugely complex issues of healthcare. However, Anderson-Wallace and Downham make a valuable contribution and bring insights into areas where they are much needed. These insights cover both ‘hard’ and ’soft’ aspects. The ‘hard’ aspects include the vital topics of demand and capacity. The ’soft’ aspects include new insights into what the authors call ‘avoiding the specialist, generalist and citizen muddle’. Many healthcare professionals - practitioners and administrators - will gain from reading this book.
Do not be deceived by the modest cover and title, this book is overflowing with original ideas highly relevant to current primary and secondary care. The authors take you on a journey from what has happened so far to develop and improve care, to a compelling vision for the future. I’ve been working as Primary Care network Clinical Director for 5 years now, and have been a GP partner for 19 years. This book absolutely resonates with the direction I think we need to go.
Drawing from diverse sources of evidence, this book offers a comprehensive overview of critical issues in healthcare quality improvement. It covers topics such as quality cultures, demand drivers, and the concept of failure demand. Importantly, the book also explores how the social determinants of health influence individuals' health and healthcare needs. The authors have effectively tackled a complex subject, presenting it in a clear and thorough manner that encourages readers to re-examine their assumptions about healthcare.
As a practising GP, I loved reading this book because it gives a theoretical framework to the problems I see every day at work. Failure demand is a new concept to me, but makes perfect sense and provides a language to approach difficult topics like over medicalisation, risk aversion (e.g. due to medicolegal concerns) and fragmentation of care, whereby patients end up seeing multiple clinicians with nobody taking an overview or responsibility for overall care. The language is accessible and clear.
This book critically examines the underlying beliefs and practices that govern quality improvement and challenges conventional approaches. It is a must-read for clinicians and NHS leaders seeking to improve quality in healthcare.
