The NHS is suffering from repetitive change injury | André Spicer

It affects Swedish trains and US business. Now the poor British health system is catching another dose of reform mania

During the past few decades, people working in the NHS have noticed the rise of a puzzling yet dangerous new syndrome. It cannot be found in any medical textbook, but the symptoms are more obvious each year. They include delusional behaviour, stress, memory loss, anxiety. Unlike most syndromes in the NHS, this doesn’t infect individual patients. It contaminates entire organisations. The experts call it: repetitive change syndrome.

It was first noticed by two professors working on different sides of the Atlantic. In Sweden, Nils Brunsson, of Uppsala University, had spent decades trying to understand how public sector organisations worked. He and his team spent years following the fate of reform programmes in city councils and railways and standard-setting bodies. They noticed a puzzling pattern: the media would point out some serious failings in a government service; politicians would cry out that something must be done; civil servants and consultants would come up with a plan, announced with great fanfare; the plan would be passed on to managers; and the politicians and consultants would make hay.

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