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. 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. 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. 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. 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
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. 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
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
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. 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. 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. 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. 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. 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. 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. Managing for Delivery
A Strategic Planning and Performance Management
solution for the Welsh Assembly Government
20
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. 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
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.
27.
28. SF14 - Wales is an energy efficient, low carbon and low waste society
29.
30.
31. 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.
32. 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
33. 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
34. 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
35. Making Transformation a
Reality…
Andrew Fearn
Director of ICT Services – Nottingham University Hospitals
47. 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
48.
49.
50.
51.
52. I will share with you today,
how we are starting to
change perceptions in
Nottingham…
53. … 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
54. Sometimes, you have to do what is right…
no matter what the existing „rules‟ say…
55. There will always be
those who want
things to stay as
they are…but they
rarely survive very
long!!
56. … and there are times when those who
are saying it can‟t be done are interrupted
by those who have just done it!
63. The Emergency Department Results
Time saving across ED
doctors of nearly seven
hours per day -
potential annual cost
saving of approximately
£100,000/year
64. 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
65. The Emergency Department Results
Waiting time decreased
by 21 minutes (28%)
for adults and by 29
minutes (40%) for
children
66. 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%
67. The Emergency Department Results
Significant reduction in
noise levels in the
department, making
the environment more
peaceful and far less
disturbing to patients
68. The Emergency Department Results
The cost of the
technology will be fully
recovered in under 14
months
70. The Gynaecology Theatre Results
The overall pathway
time (from recovery to
ward) was reduced by
33%
71. 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%
72. The Gynaecology Theatre Results
The average time
between the patient
arrival on the ward and
handover reduced by
46%
73. The Gynaecology Theatre Results
There were zero
communication delays,
waiting for phone calls
to be answered
74. The Gynaecology Theatre Results
The were zero delays in
patient transfer from
recovery once medically
fit for discharge
78. 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
