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Standards in the NHS are very high, unfortunately they are sometimes not all met. Standards are maintained through quality control. Good quality control provides quality assurance to clients. I have a view that a first step in a good quality control system is good process management. A first step in good process management is a clear understanding of your processes. I have another view that is that the best way to gain a clear understanding of your processes is to map them. To this end I have set myself the task of mapping all the processes used in the NHS and to identify best practice in each. The process maps, or visualizations as I call them, could be used, by hospitals, to reduce variation in the NHS.

Whilst working in industry some years ago I was tasked with designing and implementing Quality Management systems to meet the International standard for quality management ISO9000, for four SMEs. One of these SMEs undertook the design of software so the TickIT requirements were included in the certification. Experience to date had shown that many such quality management systems consisted of a vast array and volume of printed documentation, often beyond the reach of the people actually doing the work, thus defeating the initial objective.

My solution to overcome the documentation overload issue was, for every process, to create a simple process map to show what was done that in turn referenced written procedures that showed how it was done. The process maps and supporting procedures implemented all the requirements of the quality standard ISO9001. Lloyd's Register Quality Assurance Ltd. certified all four SMEs as having met the required standard for quality management, and commended the pioneering approach taken.

I then went on to further develop process mapping and procedure writing skills whilst undertaking research at Cranfield University in 2002. The 'process management approach' is gaining popularity in the UK and, in fact, the ISO9000-2015 standard, which must be implemented by September 2018 for certified organisations, has fully adopted this approach. Many organisations, like the NHS, still rely on too many written documents.

Advances in 'digital technologies' have enabled a big step forward in the design, development and promulgation of the 'process management approach'.

In the NHS quality improvers talk like academics, in industry quality improvers get on with it. Tom Rose May 2018

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  • Exploring process management in the NHS

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  • My Improvement Journey: Thomas Rose

    Thomas Rose - Research Fellow, Institute of Applied Health Research, University of Birmingham - shares his improvement journey from electrical engineering to the NHS, and invites new members to join the Process Visualisation SIG. 

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