‘Jugaad’ attitude and increasing value within the NHS

Dr Subodh Dave in the careers section of BMJ (It is time to accentuate overseas doctors’ postitives, 22/4/2016) shares his experiences and his views on the limited recognition of the contribution of international medical graduates (IMGs) to the NHS. Though he makes many interesting and thought provoking observations, one that caught my attention was the philosophy of Jugaad. Jugaad refers to succeeding over limited resources by improvising and delivering an effective solution using what is available.

As an IMG and having seen the difficult circumstances in which healthcare is practiced in more resource strapped environments, I feel truly blessed to practice medicine in an environment where I do not have to worry about the financial status of the person I am caring for but to try and to offer the best my team has to offer to them.

Focus on improving value not just reducing cost!

However we live in an age of austerity and we are being continuously encouraged to get better value from our NHS services . The attitude of Jugaad is one of frugal innovation where we try and maximise the outcomes and benefits from the limited resources at our disposal. Hugh Alderwick in his blog (‘Is the NHS delivering too much of the wrong things?’) highlights many of the avoidable interventions and expenses that could free up resources to reinvest in other areas of need.

Inclusion is key

Involving the public and health care users is key to the Jugaad attitude. When people understand the constraints facing the system, then they will be part of the solution of finding innovative cost-effective solutions and avoiding wastage. Jugaad does not imply we compromise on quality. We should try to o be flexible in the deployment of resources, be innovative in our approach to problems and be inclusive in our search for solutions. As health care providers we should continually identify and modify parts of the service that do not add value to the patient journey or patient outcomes.

I think teams with a Jugaad attitude will help improve value of the care they provide to the patients.