What I mean by business model - products, productivity, profits, 
machinery, equipment, manufacturing, that sort of thing.




On 2013-08-05 09:57, COMBES Helen wrote:
> Can I just clarify. What do we mean by a business model?
>
> Helen
>
> Helen Combes, DClinPsy, CPsychol
>
> Principal Clinical Lecturer, Staffordshire and Keele University
> Doctorate in Clinical Psychology
>
> Registered Clinical Psychologist
>
> (01782) 295803.
>
> FROM: The UK Community Psychology Discussion List
> [mailto:[log in to unmask]] ON BEHALF OF Penny Priest
>  SENT: 02 August 2013 17:19
>  TO: [log in to unmask]
>  SUBJECT: Re: Lean in mental health care
>
> Yes, I think the business model has trumped the medical model in
> healthcare for years now, although some models, like the medical
> model, fit more naturally with business models.
>
>> ----- Original Message -----
>>
>> FROM: Jane Mitchell [15]
>>
>> TO: [log in to unmask] [16]
>>
>> SENT: Friday, August 02, 2013 5:12 PM
>>
>> SUBJECT: Re: [COMMUNITYPSYCHUK] Lean in mental health care
>>
>> The medical director of the trust said it to service leads when the
>> model was being introduced to the trust to which you referred. I
>> agree with the lack of critical writing on this issue. I work as an
>> inpatient psychologist and amusingly found myself reflecting with
>> the consultant psychiatrist with whom I work that rather than the
>> usual arguments between psychiatry and psychology about how to view
>> distress, both professions now are struggling more with models of
>> new public management of which lean is one, which tries to
>> standardise and reduce everything to set protocols and procedures.
>> This is coming to dominate the workplace so much now that there is
>> little space left to have the old arguments that used to occur!
>> Whilst critical and community thinkers continue to tackle the usual
>> old problematic psychological and psychiatric discourses, are they
>> ignoring or not addressing the impact of this new discourse which is
>> becoming extremely powerful and which in it's own way may have
>> extremely adverse effects on how those who are distressed and
>> powerless, are viewed, constructed and treated? I wonder if the
>> absence of such a critical and community commentary is significant
>> in itself.
>>
>> Sent from my iPad
>>
>> On 2 Aug 2013, at 10:32, Penny Priest <[log in to unmask]
>> [17]> wrote:
>>
>>> Hi Jane
>>>
>>> I don't know of any critical articles, only the stuff trying to
>>> promote the model - e.g. there was a symposium on lean at the DCP
>>> conference last December, and there have also been BPS events on
>>> lean. Even that slide, of the use of the word lean, from adjective
>>> to noun makes me feel a bit ill.
>>>
>>> I'm aware that Tees, Esk and Wear Valleys NHS Foundation Trust,
>>> which I think was one of the first Trusts to use the model,
>>> recently failed a CQC inspection, regarding 'respecting and
>>> involving people who use services'. They had not met this standard
>>> in August 2012, and then failed again to meet it in June 2013.
>>> So...so much for RPIWs (Rapid Process Improvement Workshops).
>>>
>>> I am staggered to hear that you were told to 'treat patients like
>>> cars'. Were you actually? Was this in private or public? Were
>>> others there? What was the response?
>>>
>>> The attached powerpoint, which I just found on Google, I think
>>> demonstrates that messianic flavour you mention. From my own
>>> experience of a meeting following an RPIW event, to check that
>>> people were on course with the 60, 90 and 120 day actions, it
>>> struck me that I was in a room of highly paid, highly skilled
>>> (presumably?) people, (e.g. including 2 consultant clinical
>>> psychologists), and everyone seemed more focused on model itself
>>> (are we meeting that target, if not, why not, etc) than on the
>>> actual issues they were trying to resolve. There was very little
>>> thinking going on. It was quite surreal. I felt as though I had
>>> arrived in some sort of alternative universe, like being in some
>>> sci-fi movie.
>>>
>>> The following blog is pro-lean:
>>> http://www.leanblog.org/2009/06/more-online-criticism-of-lean/
>>> [11]
>>>
>>> I think it gives the sense of that pervading culture.
>>>
>>> Weird times.
>>>
>>> Penny
>>>
>>>> ----- Original Message -----
>>>>
>>>> FROM: Jane Mitchell [5]
>>>>
>>>> TO: [log in to unmask] [6]
>>>>
>>>> SENT: Friday, August 02, 2013 9:08 AM
>>>>
>>>> SUBJECT: [COMMUNITYPSYCHUK] Lean in mental health care
>>>>
>>>> Hi,
>>>>
>>>> I was wondering whether anyone knew of any critical and
>>>> community psychology articles focusing on the issues of lean
>>>> management systems in mental health care? In the trust where I
>>>> work, we were told to treat "patients like cars" as this
>>>> management theory stems from Toyota production systems.
>>>> Adherents and promotors of this ideology can be rather
>>>> messianic, and it is being rolled out massively in many trusts.
>>>> I would love to read stuff on the impact on staff and their well
>>>> being and the impact on how service users and their problems are
>>>> constructed and responded to. Much has been written about from a
>>>> critical and community perspective on the negative impact of
>>>> psychiatric and individualist psychological perspectives on
>>>> people labelled as having mental health problems, but I am
>>>> struck by what appears to be a lack of commentary from such a
>>>> perspective on such a huge and significant ideology which is
>>>> coming to dominate much of mental health services.
>>>>
>>>> I am really looking forward to people's thoughts, as I feel very
>>>> much on my own with these concerns
>>>>
>>>> Jane Mitchell
>>>>
>>>> Sent from my iPad
>>>>
>>>> On 21 Jun 2013, at 19:51, Paul Moloney <[log in to unmask]
>>>> [7]> wrote:
>>>>
>>>>> Dear All,
>>>>>
>>>>> Some of you might be interested to know that I've written a
>>>>> critical psychology book which has just been published.
>>>>>
>>>>> If you'd like to find out more, then you can get details from
>>>>> the website of the publisher, Pluto Press, by following the
>>>>> link below:
>>>>>
>>>>> http://bit.ly/12SAfGP [1]
>>>>>
>>>>> Best Regards
>>>>>
>>>>> Paul
>>>>>
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>>>>
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>>>
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>>
>>> <Lean Tees NHS Trust.ppt>
>>
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