The Liverpool Care Pathway catastrophe

For students and practitioners of organisational change (as I have been for over 30 years) the NHS’s withdrawal of the palliative care protocol is only too common a story.

As The Times said, “when the system, devised at the Marie Curie Palliative Care Institute in Liverpool, worked properly, it worked well, offering high quality and compassionate care. But as yesterday’s report from an independent review found, in too many cases the LCP was so badly implemented that it became a byword for negligence.”

But what was implemented precisely? 

It was a process, a set of instructions about inputs.  What was not implemented elsewhere were the supporting resources, the feedback systems and the leadership that existed in the Marie Curie Institute. 

It is notoriously difficult to transfer good practice, much to the frustration of politicians and Whitehall- (or Leeds-) based civil servants. 

But it’s their own fault.

So long as organisations are viewed as machines that can be re-programmed at will through the adoption of a new process in isolation, or a new structure or a new management information tool, failure is almost inevitable.  Only by addressing the whole system, in all its exasperating complexity, will change stick.

Sadly the Department of Health, under all recent administrations, has been swallowing organisational change snake oil.  It needs better advice.