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The Conceptual Confusion of ‘Priorities’

Thousands and perhaps even millions of pounds are wasted through misunderstanding the concept of priorities, despite it being so commonly used and being apparently such a simple idea.  The cost comes from wasted time in meetings and the missed opportunities to be more effective.

It’s a complex topic but an issue came up in a meeting this week which might shed some light on one aspect of it.

One of the complications in working with priorities is deciding what sorts of thing we should be selecting them from but in this we case we were asked whether we needed to prioritise from an existing list, and if so what we should choose.  This was in relation to the Health and Wellbeing Board’s strategy and the list was Marmot’s six policy objectives:

  • Give every child the best start in life
  • Enable all children, young people and adults to maximise their capabilities and have control over their lives
  • Create fair employment and good work for all
  • Ensure a healthy standard of living for all
  • Create and develop healthy and sustainable places and communities
  • Strengthen the role and impact of ill health prevention

If we define ‘priorities’ as a limited list, of maybe 3 or 6 things, on which we will focus, it’s worth considering why you need to do that; why you need an upper limit of that sort.  The usual reason is that there are limited human resources, such as time, attention or memory, to allocate to them.  So, for example, if you want the workforce to really focus on certain things next year, it’s no use giving them a list of 20 or 30 things.  They won’t be able to remember them all and they’ll either just select a few or give up on the whole enterprise.  However if you choose just two, say, ‘‘next year we need to save every penny we can but still treat each customer with a smile’, you might have more chance.

But in the case of those six policy objectives, it’s not yet clear what we are prioritising.  It’s not those objectives in the abstract.  We need to know who is going to do what in relation to them with what result.  What is it that might be creating that upper limit which means we have to have a limited number of priorities?

In this case, if the Health and Wellbeing Board wants to have a session on each – including reading reports, having a long discussion and working out what to do with them – and they only have four 2 hour meetings a year, there’s a limit to how many of them they’re going to be able to deal with.  Equally if they want to commission someone to do some detailed work on them and they have a very limited budget, again, they may have to decide which to work on.

However, if they can delegate the detailed work to others (and there is sufficient capacity elsewhere), it might be quite reasonable to address all the objective simultaneously.  So if this is about what goes into the strategy and how it is implemented, it might be quite reasonable to include all six, if there are enough people to work on them all simultaneously, while also liaising to deal with any overlaps.

You’re probably thinking by now that this is all blindingly obvious.  Which it is.  These are commonplace questions and issues.  But these questions weren’t asked at the meeting last week, and these were very intelligent and experienced people.

I think it just doesn’t come into people’s heads when they start talking about priorities.  They don’t have a framework for thinking about it, and probably don’t realise a framework is necessary.

So perhaps I need to do a bit more to try and capture all this, and other aspects I haven’t mentioned here, so I can present a coherent, succinct and persuasive account.  And maybe that can help avoid some of the waste that comes from confusion over what seems such a simple concept!

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