Method in their madness

From time to time I notice the methods industry, an industry which got dug into the world of IT during my time there and has since metasasized all over the place. All kinds of professional types do it, even accountants. But I don't knock it. Methods people can get a bit carried away, make too much of a good thing out of it, but method and process do help to bring some order into a messy world.

So a few months ago I was interested to find a 26 page methods booklet sculling around in the wind on one of the housing estates on what used to be a mental hospital near here.

It seems that customers for mental health services are assigned to one of 21 clusters, with, for example, cluster 15 being severe psychotic depression. With this booklet being all about how one steps from one cluster to another. Stepping up seems to be about getting worse, stepping up the intervention, while stepping down, from a higher number to a lower number, seems to be about getting better. The method lies in setting down the rules for stepping. What sort of things indicate a step up and what sort of things indicate a step down. Which all seems fair enough - although I wonder how much of the method, the process, is shared with its customers. A sort of sharing which I would think is quite often difficult or inappropriate.

Thinking here of all the fuss about the Liverpool pathway for dying, which in itself seemed a sensible enough thing, but which had got out of hand, which was being applied and promoted in an insensitive way. And about which google turns up the following quote from the Daily Mail: 'doctors are still following the abolished Liverpool Care Pathway because they think they know best when it comes to caring for dying patients'. With the inference being that the Daily Mail does know best. All we need now is to get Trump on the case.

Then, speculating, one wonders whether the Surrey Borders Partnership Trust (or whatever outfit is charged with our mental health these days) employs people called cluster controllers, one for each of the 21 clusters and charged with policing the paperwork. No movement between clusters without sign-off from both the cluster controllers concerned. Not to mention being a fount of statistical wisdom in these matters. Not to mention the chief cluster controller sitting at the top of the heap, a sufficiently important person to attract an office all to him or her self. Perhaps even a personal assistant sitting outside.

PS: I don't much care for the subtext 'developing currencies for mental health payment by results' visible here, which doesn't have the right sort of caring flavour about it to my mind. Smells of consultants (not the medical sort), contractors and privatisation.