TQM in the British National Health Service: nine reasons for failure

Abstract

Total quality management (TQM) is dead in the NHS. That is what many academics and arm chair pundits suggest, and there is much evidence to support their claims. Many writers say that TQM is time consuming, and NHS managers found that applying TQM too complex and pushing professional quality rather than systemic quality was difficult, thus creating cultural confusion and organisational chaos. There might be some validity to these findings and while many organisations in the manufacturing industry have embraced TQM, fewer particularly in healthcare, have been able to make it really succeed. This is because TQM is largely abandoned, or ignored to a death befitting another ‘flavour of the month’. In light of this background, the paper identified nine factors responsible for the failure of TQM in the NHS. The paper would suggest that if these factors were initially identified and eliminated prior to adoption and implementation, the failure of TQM as the remedy for all ills associated with the poor provision and delivery of quality patient care and caring would have been prevented.