The rainbow treatment

In the future hospital, blue is good and pink is bad.

Picture the scene. Instead of doctors and nurses spouting all that technical mumbo-jumbo with which we have become familiar through our addictions to such television dramas as Casualty and ER, they say they are off to do some blue work or perhaps carry out some pink tasks. Unlikely? Maybe. But something like it has been happening at Leicester Royal Infirmary under a trial programme organised by Meredith Belbin, a management thinker who has been closely associated with the development of team working.

As Dr Belbin admits, the project, following as it did an extensive re- engineering programme, was initially greeted with scepticism. While managers were enthusiastic about the notion, those actually performing the jobs were hesitant, seeing the initiative "as another demand from what they thought was a growing bureaucracy", as he, along with an associate and the infirmary musculo-skeletal department's "team coach", told People Management magazine recently.

But they say individuals were won over when they saw what the process could do for their career development. The hospital is carrying on with the project with plans for team leaders and managers to share their perceptions and revise their roles.

There is certainly a strong case to be made - as the three associates do - for finding fresh ways of helping hospital trusts make the best use of human resources, since financial pressures are likely to limit the chances of physical expansion for some time. But is this it? Surely, hard- pressed doctors and other medical staff are going to balk at spending a lot of time discussing with the professional managers the make-up of various people's jobs in a way that many would characterise as downright gimmicky.

Dr Belbin insists that such is the power of the concept that participants in the venture were soon talking naturally about the different codes of work. "People accept it," he says. "It's a very clear-cut form of communication." Furthermore, the absence of detailed job descriptions makes the concept highly suitable for export overseas. Dr Belbin has found a receptive market in Sweden.

Indeed, the tendency of hospitals and, to be fair, many other organisations to persevere with complex and wordy job descriptions was a factor behind his decision to go down this road. In the book Changing the Way We Work, which develops the colour coding and his thinking about organisations, he describes how his daughter, a former hospital ward sister, reacted to being given a 2,750-word job description with the words: "It's a funny thing, but after reading all that material, I still don't have a clear picture of the job".

The Workset concept described in the book aims to cut through all that by breaking work down into tasks and responsibilities and codes them according to the following system:

Blue is the category of structured task work; yellow is for decision work; green is reactive, orange is collaborative; grey is peripheral work, while white is for the spontaneously creative work and pink is unproductive. Using a combination of that and the Interplace computer-based human resource management system developed by Belbin Associates might avoid the age-old complaints of "that's not my job" or "that's a waste of time", it is argued.

But the idea that people should actually go to the trouble of categorising their work in such a way sounds more than a little fanciful. After all, is not deciding into which colour a certain task in today's highly pressured, multi-skilled workplace fits only a variation on the writing out of several hundred words of job description to which Dr Belbin so objects.

After all, he himself says there is "no need to pin everything down". Instead, things should be kept flexible.

Such a commitment to flexibility would ideally lead to the sort of empowered action seen in the best commercial organisations, where individuals take it upon themselves to deal with customers largely as they see fit. The only problem is that, while a telephonist agreeing to refund a customer's payment for a product with which they are dissatisfied may result only in a financial loss, if a hospital porter, say, takes it upon himself to deal with the waiting-room queue by dispensing advice or pills, the result could be more serious.

Though there is much to be said for making doctors in both hospitals and GPs' surgeries more efficient by leaving all but the most serious cases to nurses, such a division of labour would be almost bound to fail on the twin hurdles of the medical profession's keen sense of hierarchy and the public's expectation of being dealt with by a medical practitioner.

It may be unedifying, but it could be that a situation where the medics battle with the professional managers could be an essential part of the transition which the NHS has been undergoing for several years. Only a campaign to set out what is expected could be expected to start countering public expectations. And even that would not be the end of the story.

Even in Leicester, where Dr Belbin is pleased with the progress made, it is stressed that the concept is not immediately transforming systems. "There will be quite a time lag," he addsn