Graham Walker- SMART Transformation Compilation

Chair: Graham Walker

Smart Transformation Seminar

Seminar Theme:“I know we have to transform services –

how has it been done and what are the secrets to success?”

Key points to discuss todayDoes transformation really work?Where is it happening successfully? What are the secrets?

Our session todayIntroduction and Chair’s Address

Graham WalkerThe Birmingham City Council Transformation

Journey Karen Bridges

“Managing for Delivery” at Welsh Assembly Government Matt Jenkins

Making Transformation a Reality in the NHS Andrew Fearn

Q&A Plenary

Our session todayIntroduction and Chair’s Address

Graham WalkerThe Birmingham City Council Transformation

Journey Karen Bridges

“Managing for Delivery” at Welsh Assembly Government Matt Jenkins

Making Transformation a Reality in the NHS Andrew Fearn

Q&A Plenary

Chair’s Address – Graham WalkerAbout me

Director of Digital Delivery at the Cabinet Office Focus on digital delivery in the public sector Using digital to deliver efficient and transparent

services.  Director at Race Online 2010

Supporting Office of UK Digital Inclusion Champion Working to deliver a 100% networked nation.

Before this: Former Managing Partner at Gov3 Former Director of Strategy for the Office of e-

Envoy at the Cabinet Office.

Our session todayIntroduction and Chair’s Address

Graham WalkerThe Birmingham City Council

Transformation Journey Karen Bridges

“Managing for Delivery” at Welsh Assembly Government Matt Jenkins

Making Transformation a Reality in the NHS Andrew Fearn

Q&A Plenary

Birmingham Transformation Beyond 2010

Karen BridgesHead of Business Change DevelopmentBirmingham City Council

Birmingham City CouncilThe City

– The largest UK local authority– 1 million citizens, culturally diverse, relatively young– c.400,000 households, 30% social housing – Cradle of industrial revolution but suffered from decline in

manufacturing– Reinventing itself around knowledge and service economies– Excellent recent record of attracting private investment

The Council– Inventor of modern municipal Government– 120 councillors– 40,000 non-teaching employees– An annual budget of £3.5 billion– 5000 customer facing staff– Over 1000 locations - £1.4bn property portfolio

What are we doing?

Housing Environment

Children, Young People & Families Adults

Corporate Services Transformation Customer First

Excellence in Information Management Working for the Future Excellence in People

Management

Realising more than £2 billion of benefits (£1.553 billion cashable) over ten years for an investment of £670 million

Key Factors for Success

Governance

Resourcing

Methodology

Governance

Cabinet

Programme Board

Project

Project

Programme Board

Programme Board

Project

Project

Project

Project

Project

Each programme board has - Cabinet member sponsor - CMT member sponsorNot quorate unless at least one is present

Programme boards established by CabinetProgramme plans approved by CabinetIndividual business cases approved by Cabinet

Resourcing

Change Management in the Public Sector – CHAMPS2• Focus on defining and delivery of outcomes• Service redesign not service improvement

– start from a blank sheet and ask how should this service be delivered in the 21st century

• ‘Golden thread’ from business case through to benefits realisation– measurable outcomes mandatory in business case– these outcomes translated into one or more benefit cards– each benefit card has an owner responsible and accountable for delivery

• Aligns with best practice in programme and project management– MSP and Prince2 deliver the products (e.g. a redesigned service) on time and to

budget– CHAMPS2 ensures that the full value of the product is realised

• Strong emphasis on governance– programme boards– Benefits Realisation Board – independent senior officer body that assesses the

realisability of proposed programme benefits– Star Chamber – partisan senior officer body that monitors the realisation of

benefits and, if necessary, ensures recovery plans are prepared and pursued

Methodology

Creating a consistent approach for transformation

StrategicNeed

Visioning

Phase 3 Phase 4 Phase 5 Phase 6 Phase 7

Identifying & Planning Transformation

Transforming Services Realising Benefits

Programme & Project Management

Transformation

Shaping &

Planning

Common Design

Service Creation

& Realisation

Proving &

Transition Consolidation Continuous

Improvement Strategic Outcome

Transformation Initiation

Initiating Change

Phase 2Phase 1Phase 0

Transforming Public Services• 8 Phases• 50 Stages• 500 Activities

– each activity has associated deliverable(s)• Supporting information

– examples, templates, “How to”– tools, techniques– e-learning, website

• Fully supported by Centre of Excellence– Independent quality assurance– Integrated programme and project management

• Placed in the public domain

Journey progress

StrategicNeed

Visioning

Phase 3 Phase 4 Phase 7

Identifying & Planning Transformation

Transforming Services Realising Benefits

Programme & Project Management

Transformation

Shaping &

Planning

Common Design

Service Creation

& Realisation

Proving &

Transition Consolidation Continuous

Improvement Strategic Outcome

Transformation Initiation

Initiating Change

Phase 2Phase 1Phase 0

Transforming Public Services

Excellence inInformation

Mgt

Excellence inPeople Mgt

Phase 5 Phase 6

CustomerFirst

CorporateServices

Environment Children’s Adults Housing

Working forthe Future

Demonstrating clear results28% reduction in back office staff£156m savings to dateBT in the ‘black’Performance Improvements e.g.

90% payment of invoices<1% off-contract spendOn contract spend 30% (Q1 09) to 70% (Q2 10)

Greater transparency in decisionsMore real time information available to

managers and members

Beyond 2010….

• Move away from ‘Great Leader’ model of change

• Change can be treated as a process; and managed as such

• Change is constant and will require tools

• ‘Whole systems’ approach to change

What made changesuccessful for Birmingham

• CHAMPS2, a method that delivered

• Having clarity about what we wanted to achieve and measuring achievements/benefits/progress

• Adequate resourcing through internal and external resources

• AckNowledging what went well and what didn’t

• Governance that involved the leadership of the organisation in decision making and in leading the change

• Engaging with stakeholders

Our session todayIntroduction and Chair’s Address

Graham WalkerThe Birmingham City Council Transformation

Journey Karen Bridges

“Managing for Delivery” at Welsh Assembly Government Matt Jenkins

Making Transformation a Reality in the NHS Andrew Fearn

Q&A Plenary

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Managing for Delivery

A Strategic Planning and Performance Management solution for the Welsh Assembly Government

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Core theme: -

“I know we have to transform services – how has this been done in the Welsh Assembly Government and what are the secrets?”

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A family of Dashboards have been developed to cover all aspects of Assembly Government Business

Department Dashboards

Director-General Dashboards

Sub-Department DashboardsCorporate

Dashboards

Managing for Delivery (MfD) Overview

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Prioritising Investment, Budget Allocation and Business Planning

Strategic FrameworkStrategic Statement

Outcome-Based Strategic Management

Planning ProcessAvailable Budget

Business Plans

Performance Management

Performance Review

Performance

Dashboards

Actions

Theme 1Option 1 Option 2 Option 3 Outcome 1

Department 1 £ 250 M £ 267 M £ 275 M KPI 1 30%Outcome 1 KPI 2 55%

KPI 1 25% 30% 32% KPI 3 2,000KPI 3 2,000 2,000 2,800 KPI 4 1,010 per pop

Outcome 2 KPI 5 67%Mliestone 2 Jan-10 Jan-10 Jan-10 Milestone 1 Feb-11

Outcome 3 Milestone 2 Mar-11Mliestone 5 Aug-10 Jan-10 Jan-10 Milestone 3 Aug-10

Output 1 Outcome 2Output 2 KPI 1 0.75Activity 1 KPI 2 2%Activity 2 Milestone 1 Jan-10

Milestone 3 Not delivered Sep-11 Feb-10 Milestone 2 Jan-10Outcome 3

Option 1 Option 2 Option 3 KPI 1 1Department 2 £ 1,200 M £ 1,250 M £ 1,305 M KPI 2 0%

Outcome 1 Milestone 1 Oct-09KPI 4 1,000 per pop 1,010 per pop 1,010 per pop Milestone 2 Nov-09KPI 5 67% 67% 67% Milestone 3 Aug-10Milestone 3 Feb-11 Feb-11 Aug-10 Milestone 4 Aug-10

Outcome 2 Milestone 5 Jan-10KPI 1 0.70 0.71 0.75 Output 1

Outcome 3 KPI 1 0.9%KPI 2 2% 0% 0% KPI 2 0 per 1,000Mliestone 4 Feb-11 Feb-11 Aug-10 KPI 3 80%

Output 1 KPI 4 0.77KPI 3 20% 40% 80% Output 2

Output 2 KPI 1 0.46KPI 1 0.44 0.46 0.46 Milestone 1 Jan-10Mliestone 1 Jan-10 Jan-10 Jan-10 Milestone 2 Not delivered

Activity 1 Activity 1KPI 2 1 2 3 KPI 1 210,000.00£ KPI 3 2 2 2 KPI 2 3

Activity 2 KPI 3 2Milestone 2 Not delivered Aug-12 Jan-12 Activity 2Mliestone 4 Not delivered Mar-10 Mar-10 Milestone 1 Oct-09

Milestone 2 Jan-12Option 1 Option 2 Milestone 3 Sep-11

Department 3 £ 20 M £ 21 M Milestone 4 Mar-10Outcome 1

KPI 1 30% 35% Total Available Budget 2,000,000.00£ Outcome 2 Department 1 267,000.00£ Outcome 3 Department 2 1,305,000.00£ Output 1 Department 3 20,000.00£

KPI 1 0.9% 1.0% Department 4 335,000.00£ Output 2 ---- ---Activity 1 Department 16 5,600.00£ Activity 2 Total Budget 2,000,050.00£

Out

com

esO

utpu

tsA

ctiv

ities

System Overview

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MfD long-term desired benefits

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Efficient processes

More effective communication of

strategy

Prioritisation of resources to activities

aligned to strategy

Priority driven options process deployed – less

bidding

Stronger process management and

control

Active intervention – stopping activities which do not drive

outcomes

Bene

fit th

emes

Supp

ortin

g ou

tcom

es

PIAR outcome

Planning outcome

Performance Mgt & dashboard outcome

Key to outcomes

Investing in the right things

Evidence based decisions and actions

Combined financial and performance

plans based on challenged options

Driving value for money

Resources focused on higher performing

activitiesReliable forecasting (both financial and

non-financial)

Continuous improvement and

development of the solution

Adding strategic insight Moving out of the back office

SF14 - Wales is an energy efficient, low carbon and low waste society

Benefits achieved to dateProvides a visual structure which clearly shows the work

that people do, and its relationship to Ministerial objectives/outcomes.

Information and evidence from the system is consistent, and makes collective decision-making easier: facilitates cross-cutting analysis, such as for ‘improving wellbeing’.

Business plans to deliver Ministerial objectives and use of indicators to assess progress are not new. But bringing these together consistently across the Welsh Assembly within an IT system is new.

A space is beginning to open up in the organisation for a better dialogue about delivery and performance.

Benefits can emerge. Different managers will use these systems in different ways.

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What I have learnt… Keep it simple, zealously reduce complexity

wherever possible Starting simple allows people to learn as they go

along and a better product evolves Paradoxically you must recognise that public

policy is inherently complex. So performance management need to be more than ‘KPIs’

The relationship between organisational culture/ climate and your choice of implementation strategy is critical

‘Negotiated change’ consumes time and other resources – this may be a necessary price to pay

Collect case-studies about benefits, they work better in communicating the change needed than theory about performance improvement

What I think the organisation has learnt… ‘Business Performance Management’ is a contested concept. Invest a lot of time up-front to create a very clear specification

for the tool you are building. Technology is necessary but far from sufficient. Make a clear assessment of the technical support needed for the

project and business as usual (I guarantee you will underestimate). This is challenging when we are managing with less!

Stakeholder engagement is everything in a project which is as sensitive as this

Political endorsement Strong senior sponsorship Embedded process owner Joint team Working Group to bridge into the business Dedicated communications resources, literally thousands of

interactions Minimise creation of new data during the project – but don’t

underestimate the difficult of accessing the existing stock of performance data. 33

Our session todayIntroduction and Chair’s Address

Graham WalkerThe Birmingham City Council Transformation

Journey Karen Bridges

“Managing for Delivery” at Welsh Assembly Government Matt Jenkins

Making Transformation a Reality in the NHS Andrew Fearn

Q&A Plenary

Making Transformation a Reality…

Andrew FearnDirector of ICT Services – Nottingham University Hospitals

… or are we just dreaming?

…it depends which

world you live in…

REAL WORLDTECHIES

What we should do is Redesign Business

and Clinical Practice to optimise the Use

of Technology

What we should do is redesign technology to optimise Business and Clinical Practice

I will share with you today, how we are starting to change perceptions in Nottingham…

… and so a little about us…1,600 Beds12,800

We are one of the largest hospitals in the UK

1,800 Beds12,800 Staff1,000,000 Patients Treated per year500 people a day through our ED10,800 babies born per year£720m turnover

Delivering care in our City for over 100 years

Sometimes, you have to do what is right… no matter what the existing ‘rules’ say…

There will always be those who want things to stay as they are…but they rarely survive very long!!

… and there are times when those who are saying it can’t be done are interrupted by those who have just done it!

The EmergencyDepartment

Deliver the technology, test it… then replace it!

The Emergency Department Results

Time saving across ED doctors of nearly seven hours per day - potential annual cost saving of approximately £100,000/year

The Emergency Department Results

Response times for access to Emergency Department Assistants improved from only 30% of total calls being responded to within 4 minutes, to an average response time of just 8 seconds

The Emergency Department Results

Waiting time decreased by 21 minutes (28%) for adults and by 29 minutes (40%) for children

The Emergency Department Results

The average value added time (time spent ‘in process’ with a clinician) for adult patients increased by 4.9% and for children by 7.1%

The Emergency Department Results

Significant reduction in noise levels in the department, making the environment more peaceful and far less disturbing to patients

The Emergency Department Results

The cost of the technology will be fully recovered in under 14 months

The Gynaecology

Theatre

The Gynaecology Theatre Results

The overall pathway time (from recovery to ward) was reduced by 33%

The Gynaecology Theatre Results

The average time between calling the ward to confirm a patient transfer and calling the porter to arrange reduced by 73%

The Gynaecology Theatre Results

The average time between the patient arrival on the ward and handover reduced by 46%

The Gynaecology Theatre Results

There were zero communication delays, waiting for phone calls to be answered

The were zero delays in patient transfer from recovery once medically fit for discharge

The Gynaecology Theatre Results

Introduction of mobile IPT

Come together, and you’ll be amazed at the world you can create…

Our session todayIntroduction and Chair’s Address

Graham WalkerThe Birmingham City Council Transformation

Journey Karen Bridges

“Managing for Delivery” at Welsh Assembly Government Matt Jenkins

Making Transformation a Reality in the NHS Andrew Fearn

Q&A Plenary