The implementation of total quality management in the NHS: How to avoid failure

This paper suggests that the high failure rate of total quality management (TQM), particularly in the public sector, has resulted from the lack of a context-specific model for its implementation. The 'gurus' have only left a legacy of prescriptions which fall miserably short of providing the practising manager with the essential requirements of an action plan. While their legacy can be construed to represent the what-to-do of TQM, the how-to-do of TQM is left to the interpretation of quality managers. Hence, it is not surprising that our industrial landscape is littered with many failed or mediocre attempts at TQM. The paper shows two empirical cases of failure in the implementation of TQM in the NHS. It delineates the reasons for failure, and suggests the first empirically discerned implementation model to effect and facilitate an effective and efficient TQM process.