Exploring evidence based management in the National Health Service

Purpose and aims of the study: To contribute to the on-going debate over whether the use of evidence could and should improve organisational effectiveness. This is especially important in the context of the health service that has, since (May 1997) enthusiastically adopted evidence based medicine as its method of health delivery. To develop a practical explanation for policy makers and managers on how and where evidence based management is used appropriately. Justification: Kovner and Rundall (2006 p3) said “the sense of urgency associated with improving the quality of medical care does not exist with respect to improving the quality of management decision making. A more evidence based approach would improve the competence of the decision makers and their motivation to use more scientific methods when making a decision”. The paper reviews the conclusion of Kovner and Rundall (2006) (an American study) within the context of the UK National Health Service. There is a need to develop a theoretical framework of how and why evidence is (or is not) used by managers in the NHS. Motivation: The author holds a senior management position in the National Health Service. The author has performed the role of Director and Chief Executive in NHS organisations since 2000. These organisations have been surplus making, target hitting, award winning, credited by the auditors and successful in the eyes of the regulators. Unfortunately over the last few years the author has been in a quandary about something. Are NHS managers as a group of professionals, using policies that solved the wrong problem or solving the right problem, but still in the wrong way? Following this line of thought, the author wanted to ask "why don’t executives in the NHS make evidence based decisions?