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Case Studies

Case Study: Walsall PCT; ICT Directorate Change Management Programme

The NHS had embarked on Europe’s largest and most ambitious Information network (Connecting for Health) which built a fully integrated information network and software systems which was proving extremely challenging. They introduced contestability (introducing market forces to the previously closed internal market) and set clear expectations that all providers would need to meet fitness for purpose checks making them demonstrate value for money, service quality, customer focus and sustainability.

Our Directorate needed to develop a change programme that encompassed all this and developed business awareness and leadership capability of our staff. We also needed a shared and compelling vision for the directorate that senior managers and practitioners had ownership of to guide their problem solving and decision making.

When we started the programme our strategic objectives were:

• The delivery of the NHS National IT Programme “Connecting for Health”
• Ensuring the service was “Fit for Purpose” and to meet the changing requirements of NHS support services
• To enable the directorate to operate in a market environment and compete with similar services for commissioned contracts for IT Development and support
• To manage this major change programme effectively without disrupting business continuity

We needed to empower staff to work on their own initiative and lead their teams to perform to a high standard. We also needed them to be customer focused and raise the profile of what we did to improve our reputation as a proactive support service that responded to customer need. In short we needed leaders at all levels that could deliver operationally and tactically, not just manage day to day tasks (our previous culture).

We commissioned 4 Health Ltd to work with us to identify the challenges and needs of the change programme and design a multi faceted programme that delivered learning and development for the directorate workforce.

• In depth analysis was undertaken (a PESTLE and SWOT analysis) to map the changing environment, policy framework and strategic objectives we had to deliver
• One to one interviews with the senior management team (1 Director & 3 Associate Directors)
• Focus groups with staff to capture their views on gaps and needs

Key findings included:

• Morale across the general workforce was low (at that time) and there was poor awareness of the change and consequences
• Team leaders/service leads were struggling with day to day management and lacked some essential skills and knowledge to deal with the changes
• The customer focus approach needed was present in isolated pockets and needed wider adoption

For the customer relationship programme the learning objectives were to:

• Improve communication of information to customers, exercising professional judgement, decision making related to their area of expertise and working on own initiative (improve the rating of patient experience and reduce complaints)
• Offer technical/specialist advice and support to those delivering healthcare services (reduce number of low level calls to helpdesk)
• Foster positive customer relations and promote the brand image of the informatics directorate (Raise awareness of directorate across all customers)

For management development programme:

• Engage others in Directorate vision, empowering others to embrace change (increase staff involvement and acceptance of change)
• Increase political and strategic awareness ( improve decision making and influencing skills)

For Senior management development:

• To improve whole systems thinking, develop more effective management mechanisms and team working of Director team (cohesive leadership that ensured directorate achieved its strategic objectives)
• Raising the standards of relationship management and customer service with the engineering and technical staff by connecting their behaviours and actions directly with customer satisfaction surveys and reducing complaints
• Sharing learning and celebrating successes across the directorate, thereby balancing the negative feedback with positive and the subsequent impact that had on improving morale
• The running of directorate wide away days for the whole team to understand the challenges of change and the progress made
• The creation of 5 task and finish groups that lead on key work streams needed to deliver the changes. Significant progress has been made through this work and some objectives already met.

One to one coaching for Associate Directors to improve their influencing and strategic influencing skills that has resulted in a much improved culture, leadership and greater recognition of the achievements of the directorate

Regular progress meetings were held with 4 Health to ensure progress was on track and where we needed to amend the plan (e.g. the development of the task and finish groups) we were able to factor that in to the original timescales and budget to ensure control was maintained.

Regular progress reports were made at team meetings so that the whole team knew what progress had been made and they felt part of the change process at all times. Successes were communicated in the same way so that team members could see the impact of their changed behaviours and ways of working to reinforce the need for the changes.

The learning objectives were met 100% and the outcomes the programme achieved far exceeded our original expectations. The Director noted in his address to the team (awayday Dec 09) “ I can hardly recognise you as the same workforce that set out on this path 18 months ago. Your ability to understand the political challenges and the strategic objectives we share has increased beyond recognition and I am very proud of what you have achieved”.

When we set out to deliver this programme, none of us realised how challenging or how rewarding it would be. It has achieved all the business objectives and outcomes we identified. It has solved the problem, in that we are now a leaner and more intelligent directorate able to meet the next set of challenges (This is the NHS after all!)

I don’t think any of us realised what a rewarding process this would be or how much personal learning and development participants would gain from it. So many of us are fundamentally different leaders and managers now we have completed the programme.

It is a rarity in the NHS for a change programme to be planned, implemented and evaluated as consistently as this one was. It needed to change the ethos of habitual public sector workers with a “job for life” mindset to one of service excellence; delivering viable, capable and contestable services. Staff needed to accept personal responsible for their contribution and the quality of their work and take the consequences if it didn’t go to plan and the programme enabled them to do that.

We still have issues and problems and not everyone works perfectly but the difference is that we can identify issues more quickly; we can always find a practical solution and can control our resources whilst responding to crisis. For a workforce wide initiative it has been tremendously successful.

Change management programmes are not just management-speak but can deliver real results and improvements whilst harnessing the co-operation and commitment of the workforce.

Getting the right consultant (4 Health Ltd) to work with you can be extremely good value for money, ours worked with us to implement the programme but developed our change management knowledge and skills at the same time. This has skilled us to deal with change in the future so that we will not need to look for that expertise again.

Last Updated on Wednesday, 01 June 2011 09:23