The Artisans of the NHS


The NHS has been under, and remains under almost unbearable strain as its slow bureaucracy, politicians and an obsession with “efficiency” encountered Covid 19. It has not only been resilient, it has been inspirational and as this week’s Economist highlights, has seen radical innovation as the artisans just worked round the buskers.

I’ve always found the dominant narrative about the NHS misleading. My own encounters with it have always shown it to be on the ball. Caring and deeply impressive at point of care. The admin side can be slow, but I can deal with that if, when I turn up broken, I get fixed.

When it came to it the artisans delivered. Doctors, Nurses, Porters, Administrators for whom the work they do is the client they are accountable to. Long hours, front line, risk exposure, indifferent pay and busking bureaucrats all came second to artisinal delivery and the relationship with their patients.

As complexity increases the challenges facing the NHS will be mirrored in many organisations as the complicated that delivers efficiency has to move aside for the those who can deal with complex to deliver effectiveness.

Leadership and delivery is changing. The centre which proved so effective at efficiency is much less use when complexity demands effectiveness. Power and accountability moves to the edge, to the point of delivery. Organisations needs people like those in the NHS. Artisans who care about what they do and who they do it for.

Artisans deliver when buskers go home.

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