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Let’s present data in a meaningful way to NHS managers

Let’s get managers to explain the way they see the world, so we can present data in a meaningful way to them

Guest blog by Neil Pettinger

It doesn’t take much digging to find people in the NHS who are still sceptical about the benefits of using data. They would prefer to rely on their organisational memory and expertise to make decisions. The majority of NHS managers are intelligent and numerate, but the problem is that they just don’t see the point of data. They don’t need numbers and graphs to see what they are perfectly capable of seeing every day through their own eyes, without data.

Here’s another twist to the plot. Those NHS managers who’ve tried to meet us halfway by trying to engage with data have too often been disappointed. Either because they don’t understand the way the data is presented, or they are concerned about its perceived lack of accuracy. But let’s be clear: it’s not their fault. In fact, if it’s anyone’s fault, it’s our fault.

We should be taking a lead from Andrew Ehrenberg and a paper he wrote over 30 years ago called The Problem of Numeracy. In the paper he said that it’s up to the producers of data to raise their game as opposed to it being up to the consumers of data to raise theirs.

By telling us this, Ehrenberg pointed the way. But where he went wrong – and where a lot of people subsequently still get it wrong – is in thinking that it is just by make our graphs better and our tables better (nicer to look at, easier to understand) that we will make everything fine. It is as if the problem can be sorted by making everything look more polished.

Yes, we do have to find better, more engaging ways of analysing and presenting data. There is no doubt about that. But we also have to address a deeper problem. We have to find out how NHS managers see the world. We have to find out what their mental models look like. We have to get an idea of what the view through their mind’s eye looks like.

I’m not talking here about the third of managers who see the world in the same way as we do (in other words, they are comfortable with describing and summarising clinical reality using counts, totals, averages and percentages). No, I’m talking about the two-thirds of NHS managers who see the world differently from us, the ones who think primarily in terms of individual patients as opposed to the processes and systems that enable patients to be treated quickly, effectively and safely.

As I’ve thought about how to address this deeper problem, I’ve come to the conclusion that it is the data analysts who need to take the initiative here. We need to engage in fieldwork, we need to talk to managers to find out how they see things. It has become increasingly clear to me over the years that most NHS analysts haven’t got the first clue about how NHS managers see their world. Not a clue.

But the problem with this approach is that NHS information analysts too often conform to the reclusive stereotype. The last thing they’re going to do is anything that even resembles fieldwork.

So – faced with this “analyst reticence” problem – I then started wondering whether instead of trying to teach analysts how to talk to managers we can teach managers how to engage with analysts. The conversation would start out in the following way: “This is how I see the world and here’s a drawing of it with a verbal description, but at the moment, it is full of anecdote, and hearsay, and gut feel. People tell me that actual data (evidence) might be more useful. The trouble is that unless the data/evidence fits with how I see the world, I’ll just ignore it along with most of my colleagues. So now we are explaining how we see our world so you can do a better job of describing it in a way that helps us make sense of it.”

By turning our approach on its head and encouraging managers to engage with analysts, rather than the other way around, we will give our data the power to become an irresistible call to action.

Neil Pettinger
Training Consultant, Kurtosis