Cutting the Gordian Knot: How Alexander the Great can help us build a stable future for the NHS

In 333 BC a young man, arriving in the city of Gordium in modern day Turkey was faced with a seemingly unbeatable challenge – a challenge that had proved to be the match of all who took it on for over 1000 years. It was one of wit, perseverance and strength, disguised as a knot – whoever could untie this knot would be crowned the rightful King of Asia. This young man’s name was Alexander, soon to be known to history as ‘The Great’, and his solution to the Gordian Knot was an example of his ability to succeed in ways that no one else had imagined. When faced with a task that seemed impossible Alexander changed the rules and in perhaps the classical example of “out of the box thinking,” drew his sword and cut straight through the rope. The Gordian Knot was undone and the rest, as they say, is history.

At this point you could be forgiven for wondering what Alexander’s masterstroke can possibly have to do with helping us decide the future of the NHS? Well, the answer lies not in his rise to stardom, but in how he approached the tangle of the Gordian Knot.

When faced with a seemingly intractable and immensely complex problem the solution can be made simpler than we think, particularly when you approach the problem from a new direction. Alexander knew this, and it’s a lesson we could learn from.

Unpicking the knot…

Lord Carter recently published a report into the possible areas in which the NHS could be streamlined to help it reach it’s target of £22bn of savings by 2020. His proposed savings are drawn from a wide range of sources, the largest sums coming from General Medicine and Obstetrics and Gynecology. This report represents a fantastic start, a thorough examination of the economies that sit behind the NHS has been long overdue, but Carter’s report somewhat ignores a widely reported phenomenon that costs the NHS dearly – the staffing time bomb.

In the last year the National Health Service spent £3.3bn on temporary staff, most of which was spent on staff who are hired through through private agencies – this figure was half as much again as the forecast, and is expected to increase further over the next 12 months. The posts that are being filled are not only those of doctors and nurses, but those are the 2 most common. In fact such is the problem with filling these roles and retaining staff that the NHS has increasingly had to look overseas – last year alone the NHS dispatched staff overseas almost 100 times in order to find people to fill empty positions. To add insult to the financial injury that these trips cost the taxpayer, one in four of these new starters had left the job within 12 months. It’s not a pretty picture and with budgets being pinched, Junior Doctor’s pay being cut in real terms and a projected growth in the need for healthcare support for an ageing (and increasingly sugar addicted) population, staffing is certainly not the only thing the NHS has to worry about.

…and Drawing the sword

But what if there was a solution to this £3bn problem? What if there was a way to ensure we were hiring based on values and motivations, slashing attrition rates and increasing productivity in the work place? Hiring more intelligently could save the NHS billions and proper management of the existing staff would lead to many hundreds of millions of pounds more in efficiency savings. We here at The Chemistry Group are passionate about making working lives great, and we have seen opportunities in the challenges the NHS is facing today. We’ve already had success working in one NHS trust and, while there are no doubt pennies to be pinched across the board in an organisation the size of the NHS, it is not an exaggeration to say that proper people practices could save the tax payer billions by 2020. Not only this but by hiring more suitable candidates with a higher alignment to the organisation’s values we would likely see an improvement in care standards even as costs decrease.

Alexander the Great undid his knot with a novel approach (and the edge of a sword), it is high time the top brains behind the Department of Health took the same approach. People solutions needn’t be just another frayed end, poking out of the Gordian Knot of the NHS, in the right hands they could be the sharp edge of the sword that cuts through this knot once and for all. What do you think?