Rage Against the Fax Machines

Technology is everywhere, from instant online grocery shopping to GP apps that use AI to triage you to the nearest hospital. It feels that soon we will be living in a technological utopia in which we will all be creatures of leisure, where work is a thing of the past. And yet, waiting for the arrival of driverless cars feels like waiting for a food delivery after your fridge has been ransacked from too many midnight raids. It doesn’t feel like it’s coming anytime soon. So when the chance came up to see how modern technology is used in manufacturing and how lessons can be learned in the NHS, it felt like it was an unmissable opportunity to have a glimpse into the future.

How many NHS improvers can you fit into a MINI?

MINI have around 1000 robots at their plant in Oxford and have produced over 3 million cars since the factory opened in 2001. The plant has an assembly line stretching 1.7 km and every single MINI is manufactured to order. The plant is on the cutting edge of productivity with an efficiency rate close to 95%, making it one of the most productive manufacturers in the UK. To achieve this they apply LEAN methodology to processes and use Kanbans and root cause analysis to analyse their daily activity and see where improvements can be made. Every station has an improvement board and the team regularly reflect and debrief in these areas to monitor their output. The factory is a LEAN consultants dream with every process monitored, counted and analysed to ensure that nothing is wasted within the system.

Increasingly NHS organisations are relying upon LEAN tools and consultancy models to look at inefficiencies within the service. Often we are told that we need to process map systems and reduce wastage from within healthcare. And whilst these tools are effective for looking at the way we run systems and analyse data, there is a real danger that when used in isolation we miss the complexities of the NHS and the unique values that exist in healthcare. MINI is a slick operation employing 500 staff members at their Oxford plant and achieving impressive results. In contrast the NHS in England alone employs 1.5 million people with 168 trusts spread across the country

The ideas of robots and AI feels like a science fiction movie to the majority of frontline staff who continue to face daily battles with fax machines, Windows 95 and reams of paper. Whilst robotics will play an increasing role in the operating theatre and other areas of the NHS, it is far from the sheer scale of technological achievement they have within manufacturing and other industries. Therefore when we talk of applying LEAN methodology principles, we must be careful to base it in the reality of the NHS. Making processes more efficient isn’t just about reducing waste, creating new policies and streamlining processes. The key to successful change is about building improvement capability within staff and working collaboratively to improve patient outcomes. The NHS does not have the luxury of robots to tweak or new machines to change processes. Instead the greatest asset of the NHS is its amazingly talented staff and its patients. Whenever we look to make any real lasting change in an extremely complex system such as the NHS, we must ensure that it is collaborative with all involved.

The question of whether technology will deliver its promise to healthcare is still up for debate. All of humankind may one day be replaced by robots in the future, but plumbers, electricians and nurses are projected to stay in employment the longest due to the nature of their roles. A Chinese factory in Dongguon City replaced 90% of its human workforce with machines and saw a 250% increase in productivity when they brought technology into their company. The reality of the NHS is very different. The size of the workforce and the variety of different treatments and care that the NHS provides is currently far too complex to solve without taking a collaborative approach. Looking at the NHS today, I think my fear of my job being replaced by a toaster is safe for now.

A big thank you to Alan Dodge and Andrew Pentecost at MINI plant Oxford for the visit and providing facts and figures for this article.