When a fluorescent tube in our office began to flicker irritatingly I was intrigued at how complex the process of change became. In other words, I wanted to find out exactly how many people it takes to change a light bulb in a large inner city teaching hospital. My research led me as follows.
I reported the fault to my personal assistant (two people). She telephoned the estates department helpdesk (three people). The helpdesk passed on the information to the maintenance supervisor (four), who allocated the job to an electrical assistant (five). The electrical assistant approached the general stores clerk (six), who selected the required item from the store stocked by the general stores manager (seven). The fault was then rectified.
Apparently, the process is more complex for non-standard light bulbs, and I have not yet performed an economic analysis on the number of financial staff required to process the purchasing costs.
My conclusion from this brief research is that change within an organisation like the NHS is complex.
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