Top tips on making it second nature

by Loretta Outhwaite


As a former NHS Chief Finance Officer, you won’t be surprised to learn that I’m passionate about value. I’ll even admit to it now being a bit of an obsession! As I get older and bolder, when I’m out and about and spot ways people could improve the value of their services, I just can’t help myself – in the spirit of being helpful, I offer my insights. If my kids are with me, they quietly walk away and disown me!

With fierce operational challenges now the norm, it’s hard to find the time and headspace to focus on improving value, so here are my top tips for bringing it into the centre of our thinking and making it a habit you won’t want to break.

Tip 1: The magic question: ‘What value is this adding?’

The most helpful value related resource I’ve come across is the Value Equation from NHS Future Focused Finance’s ‘Best Possible Value’ Framework, which is based on the work of Michael J Porter: value = outcomes (such as care outcomes, user experience, safety) vs the resources to deliver them. 

Download: Value Equation – Healthcare

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Print out a copy of the equation, stick it to your workstation and for everything you’re doing or plan to do, use it to ask the following:

  • ‘Is this delivering best possible value?’
  • ‘How can the value be improved?’

Tip 2: Think upstream (Prevention)

Recognising that most of what we do is a consequence of something that has or hasn’t happened, there’s a powerful, additional question to add to the ones above:

  • ‘How could this have been avoided in the first place?’

Asking this question requires ‘upstream thinking’, something we’re generally not used to focusing on or investing in, as it’s much easier to see (identify) and measure the downstream consequences. Let’s be the person who breaks the cycle of response. To find out more read ‘Upstream: How to Solve Problems Before They Happen’ by Dan Heath.

Tip 3: Pinch and share with pride

We don’t have to reinvent wheels. People are incredibly generous at sharing the fantastic work they’ve done to improve services and deliver more value. Regularly invest some time in exploring these resources to find out what’s worked, how it’s been done and the best way to do it. A great place to start is The Academy of Fabulous Stuff . It’s also the perfect place to share and celebrate the great stuff we’ve achieved ourselves.

Finally, and most importantly of all, at the end of a really tough day, take a few minutes to identify and reflect on one thing, however small, that’s gone well; where you know you’ve added value and made a positive difference to someone’s day. Pinching (with pride) a quote from The Academy of Fabulous Stuff… ‘the little things are the big things’.

Wavy tech

Tip 4: Contact us…

For further information about how 4OC’s tools, techniques and frameworks help to uncover and embed value within organisations contact us on or contact me directly on