Smart Transformation Seminar

               Chair: Graham Walker
Seminar Theme:
 “I know we have to transform services – how has it
   been done and what are the secrets to success?”

 K...
Our session today
  Introduction and Chair’s Address
      Graham Walker
  The Birmingham City Council Transformation J...
Our session today
  Introduction and Chair’s Address
     Graham Walker
  The Birmingham City Council Transformation Jo...
Chair’s Address – Graham Walker
  About me
      Director of Digital Delivery at the Cabinet Office
        Focus on di...
Our session today
  Introduction and Chair’s Address
    Graham Walker

  The Birmingham City Council Transformation
  ...
Birmingham Transformation
Beyond 2010
Karen Bridges
Head of Business Change Development
Birmingham City Council
Birmingham City Council
The City
 – The largest UK local authority
 – 1 million citizens, culturally diverse, relatively y...
What are we doing?

                       Housing                       Environment


               Children, Young Peop...
Key Factors for Success

        Governance

        Resourcing

        Methodology
Governance
                                   Cabinet
Each programme board has                           Programme boards ...
Resourcing
Methodology
  Change Management in the Public Sector – CHAMPS2
  •   Focus on defining and delivery of outcomes
  •   Serv...
Creating a consistent
approach for transformation
              • 8 Phases Transforming Public Services
              • 50...
Journey progress
            Environment                                  Children’s                      Adults          ...
Demonstrating clear results
    28% reduction in back office staff
    £156m savings to date
    BT in the ‘black’
   ...
Beyond 2010….

  • Move away from ‘Great Leader’ model of change

  • Change can be treated as a process; and managed as s...
What made change
successful for Birmingham
   • CHAMPS2, a method that delivered
   • Having clarity about what we wanted ...
Our session today
  Introduction and Chair’s Address
      Graham Walker
  The Birmingham City Council Transformation J...
Managing for Delivery

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


...
Core theme: -
“I know we have to transform services – how has
this been done in the Welsh Assembly Government
and what are...
A family of Dashboards have been developed to
             cover all aspects of Assembly Government Business


           ...
Managing for Delivery (MfD) Overview
                                   Strategic Statement                    Strategic F...
System Overview




                  24
MfD long-term desired benefits
                           Adding strategic insight                          Moving out of ...
SF14 - Wales is an energy efficient, low carbon and low waste society
Benefits achieved to date
 Provides a visual structure which clearly shows the work that people do,
    and its relations...
What I have learnt…
 Keep it simple, zealously reduce complexity wherever
    possible
   Starting simple allows people ...
What I think the organisation has learnt…
   ‘Business Performance Management’ is a contested concept.
   Invest a lot o...
Our session today
  Introduction and Chair’s Address
      Graham Walker
  The Birmingham City Council Transformation J...
Making Transformation a
             Reality…



Andrew Fearn
Director of ICT Services – Nottingham University Hospitals
… or are we just dreaming?
REAL
         TECHIES        WORLD




                           What we should do is
                           redesign...
I will share with you today,
how we are starting to
change perceptions in
Nottingham…
… and so a little about us…
                    1,600 Beds
                    12,800

                  We are one of the...
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
Emergency
Department
Deliver the technology, test it… then replace it!
The Emergency Department Results


                Time saving across ED
                doctors of nearly seven
        ...
The Emergency Department Results

 Response times for
 access to Emergency
 Department Assistants
 improved from only
 30...
The Emergency Department Results



                 Waiting time decreased
                  by 21 minutes (28%)
       ...
The Emergency Department Results


                The average value
                 added time (time spent
            ...
The Emergency Department Results


 Significant reduction in
 noise levels in the
 department, making
 the environment mo...
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
              ...
The Gynaecology Theatre Results


                 The average time
                  between the patient
               ...
The Gynaecology Theatre Results


               There were zero
                communication delays,
                wa...
The Gynaecology Theatre Results

 The were zero delays in
 patient transfer from
 recovery once medically
 fit for discha...
Introduction of
mobile IPT
Come together, and you‟ll be amazed
at the world you can create…
Our session today
  Introduction and Chair’s Address
      Graham Walker
  The Birmingham City Council Transformation J...
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
Graham Walker- SMART Transformation Compilation
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Graham Walker- SMART Transformation Compilation

  1. 1. Smart Transformation Seminar Chair: Graham Walker
  2. 2. 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 today  Does transformation really work?  Where is it happening successfully?  What are the secrets?
  3. 3. Our session today  Introduction and Chair’s Address  Graham Walker  The 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
  4. 4. Our session today  Introduction and Chair’s Address  Graham Walker  The 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
  5. 5. Chair’s Address – Graham Walker  About 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.
  6. 6. Our session today  Introduction and Chair’s Address  Graham Walker  The 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
  7. 7. Birmingham Transformation Beyond 2010 Karen Bridges Head of Business Change Development Birmingham City Council
  8. 8. Birmingham City Council The 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
  9. 9. What are we doing? Housing Environment Children, Young People & Adults Families Corporate Services Customer First Transformation Excellence in Information Excellence in People Working for the Future Management Management Realising more than £2 billion of benefits (£1.553 billion cashable) over ten years for an investment of £670 million
  10. 10. Key Factors for Success  Governance  Resourcing  Methodology
  11. 11. Governance Cabinet Each programme board has Programme boards established - Cabinet member sponsor by Cabinet - CMT member sponsor Programme plans approved by Not quorate unless at least one Cabinet is present Individual business cases approved by Cabinet Programme Programme Board Board Programme Project Project Board Project Project Project Project Project
  12. 12. Resourcing
  13. 13. Methodology 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
  14. 14. Creating a consistent approach for transformation • 8 Phases Transforming Public Services • 50 Stages Initiating Identifying & Planning Transforming Services Realising Benefits • Change 500 ActivitiesTransformation – each activity has associatedService deliverable(s) Transformation Proving Strategic Need • Initiation Transformation Supporting Visioning information Shaping & Common Design Creation & & Transition Consolidation Continuous Improvement Strategic Outcome Realisation – examples, templates, “How to” Planning Phase 0 – tools, techniques Phase 3 Phase 1 Phase 2 Phase 4 Phase 5 Phase 6 Phase 7 – e-learning, website & Project Management Programme • Fully supported by Centre of Excellence – Independent quality assurance – Integrated programme and project management • Placed in the public domain
  15. 15. Journey progress Environment Children’s Adults Housing Transforming Public Services Initiating Identifying & Planning Transforming Services Realising Benefits Change Transformation Service Transformation Proving Strategic Transformation Common Creation Continuous Strategic Visioning Shaping & Consolidation Need Initiation Design & Improvement Outcome & Transition Planning Realisation Phase 0 Phase 1 Phase 2 Phase 3 Phase 4 Phase 5 Phase 6 Phase 7 Programme & Project Management Excellence in Excellence in Working for Customer Corporate Information People Mgt the Future First Services Mgt
  16. 16. Demonstrating clear results  28% reduction in back office staff  £156m savings to date  BT in the ‘black’  Performance Improvements e.g.  90% payment of invoices  <1% off-contract spend  On contract spend 30% (Q1 09) to 70% (Q2 10)  Greater transparency in decisions  More real time information available to managers and members
  17. 17. 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
  18. 18. What made change successful 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
  19. 19. Our session today  Introduction and Chair’s Address  Graham Walker  The 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
  20. 20. Managing for Delivery A Strategic Planning and Performance Management solution for the Welsh Assembly Government 20
  21. 21. Core theme: - “I know we have to transform services – how has this been done in the Welsh Assembly Government and what are the secrets?” 21
  22. 22. A family of Dashboards have been developed to cover all aspects of Assembly Government Business Director-General Dashboards Department Dashboards Sub-Department Corporate Dashboards Dashboards 22
  23. 23. Managing for Delivery (MfD) Overview Strategic Statement Strategic Framework Outcome-Based Strategic Management Business Plans Prioritising Available Department 1 Option 1 £ 250 M Option 2 £ 267 M Option 3 £ 275 M Theme 1 Outcome 1 KPI 1 30% Planning Process Outcome 1 KPI 2 55% KPI 1 25% 30% 32% KPI 3 2,000 KPI 3 2,000 2,000 2,800 KPI 4 1,010 per pop Budget Outcome 2 KPI 5 67% Mliestone 2 Jan-10 Jan-10 Jan-10 Milestone 1 Feb-11 Investment, Budget Outcome 3 Milestone 2 Mar-11 Mliestone 5 Aug-10 Jan-10 Jan-10 Milestone 3 Aug-10 Output 1 Outcome 2 Outcomes Output 2 KPI 1 0.75 Activity 1 KPI 2 2% Activity 2 Milestone 1 Jan-10 Milestone 3 Not delivered Sep-11 Feb-10 Milestone 2 Jan-10 Outcome 3 Option 1 Option 2 Option 3 KPI 1 1 Allocation and Department 2 £ 1,200 M £ 1,250 M £ 1,305 M KPI 2 0% Outcome 1 Milestone 1 Oct-09 KPI 4 1,000 per pop 1,010 per pop 1,010 per pop Milestone 2 Nov-09 KPI 5 67% 67% 67% Milestone 3 Aug-10 Milestone 3 Feb-11 Feb-11 Aug-10 Milestone 4 Aug-10 Outcome 2 Milestone 5 Jan-10 KPI 1 0.70 0.71 0.75 Output 1 Outcome 3 KPI 1 0.9% KPI 2 2% 0% 0% KPI 2 0 per 1,000 Aug-10 80% Outputs Mliestone 4 Feb-11 Feb-11 KPI 3 Business Planning Output 1 KPI 4 0.77 KPI 3 20% 40% 80% Output 2 Output 2 KPI 1 0.46 KPI 1 0.44 0.46 0.46 Milestone 1 Jan-10 Mliestone 1 Jan-10 Jan-10 Jan-10 Milestone 2 Not delivered Activity 1 Activity 1 KPI 2 1 2 3 KPI 1 £ 210,000.00 KPI 3 2 2 2 KPI 2 3 Activities Activity 2 KPI 3 2 Milestone 2 Not delivered Aug-12 Jan-12 Activity 2 Mliestone 4 Not delivered Mar-10 Mar-10 Milestone 1 Oct-09 Milestone 2 Jan-12 Option 1 Option 2 Milestone 3 Sep-11 Department 3 £ 20 M £ 21 M Milestone 4 Mar-10 Outcome 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 Dashboards Performance Review Performance Performance Management Actions 23
  24. 24. System Overview 24
  25. 25. MfD long-term desired benefits Adding strategic insight Moving out of the back office Benefit themes Investing in the Driving value Efficient right things for money processes Stronger process Supporting outcomes More effective Evidence based management and communication of decisions and actions control strategy Priority driven Combined financial options process and performance Continuous Prioritisation of improvement and deployed – less plans based on bidding resources to activities development of the challenged options aligned to strategy solution Key to outcomes Active intervention – Resources focused on PIAR outcome stopping activities higher performing Reliable forecasting which do not drive activities (both financial and Planning outcome outcomes non-financial) Performance Mgt & dashboard outcome 25
  26. 26. SF14 - Wales is an energy efficient, low carbon and low waste society
  27. 27. Benefits achieved to date  Provides 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.
  28. 28. 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 32
  29. 29. 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
  30. 30. Our session today  Introduction and Chair’s Address  Graham Walker  The 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
  31. 31. Making Transformation a Reality… Andrew Fearn Director of ICT Services – Nottingham University Hospitals
  32. 32. … or are we just dreaming?
  33. 33. REAL TECHIES WORLD What we should do is redesign technology to What we should do is optimise Business and Redesign Business and Clinical Practice Clinical Practice to optimise the Use of Technology
  34. 34. I will share with you today, how we are starting to change perceptions in Nottingham…
  35. 35. … and so a little about us… 1,600 Beds 12,800 We are one of the largest hospitals in the UK 1,800 Beds 12,800 Staff 1,000,000 Patients Treated per year 500 people a day through our ED 10,800 babies born per year £720m turnover Delivering care in our City for over 100 years
  36. 36. Sometimes, you have to do what is right… no matter what the existing „rules‟ say…
  37. 37. There will always be those who want things to stay as they are…but they rarely survive very long!!
  38. 38. … and there are times when those who are saying it can‟t be done are interrupted by those who have just done it!
  39. 39. The Emergency Department
  40. 40. Deliver the technology, test it… then replace it!
  41. 41. The Emergency Department Results  Time saving across ED doctors of nearly seven hours per day - potential annual cost saving of approximately £100,000/year
  42. 42. 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
  43. 43. The Emergency Department Results  Waiting time decreased by 21 minutes (28%) for adults and by 29 minutes (40%) for children
  44. 44. 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%
  45. 45. The Emergency Department Results  Significant reduction in noise levels in the department, making the environment more peaceful and far less disturbing to patients
  46. 46. The Emergency Department Results  The cost of the technology will be fully recovered in under 14 months
  47. 47. The Gynaecology Theatre
  48. 48. The Gynaecology Theatre Results  The overall pathway time (from recovery to ward) was reduced by 33%
  49. 49. 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%
  50. 50. The Gynaecology Theatre Results  The average time between the patient arrival on the ward and handover reduced by 46%
  51. 51. The Gynaecology Theatre Results  There were zero communication delays, waiting for phone calls to be answered
  52. 52. The Gynaecology Theatre Results  The were zero delays in patient transfer from recovery once medically fit for discharge
  53. 53. Introduction of mobile IPT
  54. 54. Come together, and you‟ll be amazed at the world you can create…
  55. 55. Our session today  Introduction and Chair’s Address  Graham Walker  The 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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