NES
Item 8d
April 2015
NES/15/37
(Enclosure)
NHS Education for Scotland
Board Paper Summary
1.
Title of Paper
Organisational Performance Improvement Programme (OPIP) Team Update
2.
Author(s) of Paper
Suzanne Graham, Performance Improvement Project Lead
3.
Purpose of Paper
The purpose of this paper is to provide the Board with an update of the performance improvement
activities supported by the OPIP team during 2014/15.
4.
Key Issues
Directorates/departments continue to develop and deliver their improvement and impact plans,
supported by the OPIP team. The main areas of work for the OPIP team however have been
focussed on cross-organisational projects, such as the Finance Transformation, Digital
Transformation and roll out of Alfresco.
5.
Financial Implications
Cost efficiencies are captured as part of the Directorate/department Improvement Impact Plans and
linked to operational planning targets.
6.
Which NES Strategic Objective(s) does this align to?
An improved organisation - Performance Improvement & Efficient and Effective Corporate Resources
7.
Key Risks and Proposals to Mitigate the Risks
Several projects are affecting a broad range of NES staff and Directorates/departments. The OPIP
team are working very closely with the Employee Director, HR & OD colleagues and Directorate
Improvement Leads to support teams with improvement and change.
8.
Recommendation(s) for Decision
The Board are asked to note the information contained within the paper.
NES
April 2015
SG
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Organisational Performance Improvement Programme (OPIP) Team Update
1. Background
NES has made a significant investment in performance improvement methodologies and in order to
maximise the potential of these tools and to realise the benefits of our investment, NES established
an Organisational Performance Improvement Programme. The programme provides the means to
enhance organisation performance and supports theme 5 of the NES Strategic Framework.
The programme is supported by a small team of 4.8WTE staff (the OPIP team), which is part of the
Planning & Corporate Governance Team in the Finance and Corporate Resources Directorate. Team
activities include 1) supporting all Directorate/department improvement and impact plans; 2) providing
project management support for cross-organisation change and improvement projects; and 3)
supporting the use of improvement methodologies such as ‘Lean’ and ‘Activity Based Costing’ (ABC).
The purpose of this paper is to provide the Board with an update of the performance improvement
activities supported by the OPIP team during 2014/15.
2. Impact Plans
The OPIP team have supported all Directorates/departments to create a local improvement and
impact plan. The plans are owned and managed by the Directorate/department Improvement Lead
who has a dedicated member of the OPIP team to support them.
The effectiveness of the improvement initiatives is measured by impact in one of the following three
categories: 1) cash releasing; 2) productive gain; or 3) quality improvement. The plans are integrated
with the Performance Management Cycle within the Integrated Planning and Performance (IPPS)
system and Improvement Leads report on their impacts on a quarterly basis. A dashboard and suite
of reports is now available, which allows the OPIP team and OPIP Board (consisting of Improvement
Leads) to monitor progress at an organisational level, as well as at an individual Directorate/
department level. As a change for 2015/16, efficiency savings identified during Operational Planning
will be reporting on within IPPS as cash releasing impacts.
3. Priority Areas
The team has been providing project management support for several change projects that impact the
whole organisation, including:
3.1 Alfresco (ECMS) Implementation Project
Alfresco is a technology platform which provides additional functionality around the way that staff
create, use, manage and dispose of documents and records ('content'). Alfresco focuses on
document management, team collaboration and business process automation and it will help staff
make better, faster, safer use of business information, increasing efficiency and reducing risk.
Alfresco provides a range of collaboration and document management tools to help NES share
knowledge more effectively. For example, Alfresco is used to:
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Share a single set of meeting papers across the organisation
Collaborate and comment on documents in teams
Quickly join up teams and projects, through discussions and blogs
Allow the right person to access the right document at the right time on any device anywhere
Working with the IM&T department, the OPIP team have supported the phased roll out of
Alfresco. This involved an intensive training and support campaign which included face to face
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and WebEx training; and a suite of support and guidance materials. The target to complete the
roll out of Alfresco to all Directorates/departments by the end of September 2014 was achieved
and all areas of the organisation are now using Alfresco. Nevertheless, further work is required to
ensure network drives are no longer being used and that all functionality is being fully utilised.
Feedback gathered from the Senior Operational Group and a staff survey is being used to inform
future developments of the system.
3.2 Finance Transformation Project
A vision for Finance and Procurement was discussed and agreed by the Executive Team in
December 2011. The Finance Transformation project has looked to realign the different elements
of the finance function throughout NES to best support delivery of strategic outcomes. It
represents a fundamentally different approach and way of working.
Currently in NES there is a central finance team, regional finance teams and individual posts
throughout the organisation with some involvement in finance activity. There is currently no real
cohesion across all these different elements. The Finance Transformation project was
established to develop the finance operating model which would allow NES to address the
disadvantages and limitations with the current model. The aim of the project is to reallocate time
and effort towards the value add activities of analysis, synthesis and evaluation to support
decision making and accountability. The transactional processing and report generation remains
essential, however the way in which these activities are carried out needs to be improved to allow
reallocation of resources to more value-add activities.
Significant progress has been made with the project over the last 12-18 months. The OPIP team
carried out a capacity review exercise to identify the level of resource utilised in finance activities
across NES. This involved gathering information from approximately 180 staff members and the
resulting data has been invaluable for informing future state requirements.
In order to develop business processes fit for purpose for the future state, it was important to first
fully understand the current state to ensure no part of the process is omitted. Therefore in
addition to carrying out the capacity review exercise, workshops were held to map out current
business processes.
The development of the new business processes and design of the future-state organisational
structure were developed simultaneously to ensure a consistent, 'joined-up' view of the new
Finance operating model. Activities included:
I. A workshop (facilitated by Develop Global) for the project and Senior Finance team to work on
creating a shared vision for the transformation and exploring future roles, responsibilities and
accountabilities for the future state.
II. Review of best practice: desktop research on recent papers from all the major accounting
bodies on Finance Transformation; review of operating models in other organisations; and site
visits.
III. Experience: input from the Finance Team and Business on what works well, and areas for
improvement; and analysis of how best practice could most appropriately be achieved in an
organisation like NES. Throughout this work it was recognised that “one size does not fit all”
and elements have been drawn from different research models.
IV. Capacity review results: data on the WTE currently involved in each activity informed likely
volume of activity for each post required.
V. Numerous ‘Future-state' mapping workshops have taken place, involving staff from central
finance and the business areas to flesh out the detail of the new business processes.
The formal consultation exercise was completed in February 2015 and approval to proceed with
implementation was granted by the Change Management Programme Board and Executive
Team. Recruitment has now commenced and it is hoped the new team will be in place by the end
of 2015.
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3.3 Digital Transformation
Following the PA Consulting ‘NES Digital Blueprint and Roadmap’ report, which was
commissioned to position NES as a digital organisation, the OPIP team have supported the
Transformation. Work has been completed to identify: 1) the amount of staff time involved in digital
activities (i.e. current capacity); 2) the processes currently in use to access digital resources across
NES; and 3) the digital products that we have already developed and maintain.
Following the appointment of the Interim Digital Director, the team have worked closely with him
and HR to support the organisational change process required to establish the ‘Digital Group’ and
new ways of working. Internal recruitment is underway to appoint to three new business critical
posts which will complete the Digital Group’s senior team and will improve the management and
running of the group.
4. Continuous Improvement Requests
The team regularly receive requests to support individual Directorate/department improvement
initiatives. Highlights are provided below.
4.1 Lean Events
‘Lean’ is a systemic method for the elimination of waste within a process. A lean organization can
be described as one that understands customer value and focuses its key processes to
continuously increase it. Depending on the process, examples of NES’s customers include trainees
and NHS staff.
Lean events are used to redesign business processes to be more efficient and effective. During
2014/15, the OPIP team have supported 1) three lean events within the Pharmacy Directorate; 2)
one lean event within the Learning and Organisational Development department; and 3) four lean
events within the NMAHP Directorate.
Preliminary discussions have taken place with the Property and Facilities Management team to
review the travel booking process and with Medicine to review the endoscopy training booking
process. These events are expected to take place in the first and second quarter of 2015/16.
4.2 Activity Based Costing (ABC) Exercises and Capacity Reviews
Activity Based Costing (ABC) is a costing tool that identifies activities undertaken by an
organisation. It then assigns the cost of each activity to the products and services it delivers. To
help identify where efficiency savings can be made, a clear view of the current costs of activities in
the business is required and NES has chosen ABC as the means to provide this view.
During 2014/15, the OPIP team received requests to conduct ABC reviews with 1) the Dental
Infection Control Team; and 2) the Training and Development Support Unit (TDSU). Both
exercises have been completed and local action plans are being developed to address the
findings.
The ABC methodology is also used for ‘capacity reviews’ to understand how much staff time is
spent on a particular activity. The team recently carried out a ‘Knowledge into Action’ capacity
review exercise. This involved staff who have a core role in the knowledge management,
information management and research activities which make up ‘Knowledge into Action’.
It is anticipated that a Property and Facilities Management capacity review within regional offices
will be conducted in 2015/16 in support of the Facilities Management Strategy approved by the
Finance and Performance Management Committee.
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5. Quality Improvement (QI) Infrastructure
The NHSScotland QI Hub is undertaking a diagnostic review of quality improvement infrastructure at
local and national level and the OPIP team have managed this exercise for NES. A sub-group of the
Executive Team worked through the Quality Improvement Infrastructure self-assessment in October
and the QI Hub visit took place in November 2014.
The following themes, presented in a paper to the Executive Team in February, have been proposed
to address the QI Hub visit discussion and the visiting team’s feedback:
NES should consider how best to develop its role as an ‘Agent for QI’ – e.g. promotion of
multidisciplinary training, influencing professional and regulatory bodies and Higher Education
Institutes to include QI in training for professional groups and in professional curricula , and
coordinating a network of educators to support development of the QI educational approach.
II. Improve the quality of education provision through a detailed review of a health board or part
of a health board to look at the NES contributions to this area and to determine how NES can
meet needs more effectively.
III. Develop constructive linkages between Educational Governance and the Educational
Leadership Group (ELG). The ELG should take responsibility for addressing QI themes or best
practice in areas identified in Educational Governance reports. While it was not specifically
discussed during the visit, the Senior Operational Group could take responsibility for
addressing internal QI themes.
I.
6. Property Strategy Benefits Realisation
The team have been overseeing the benefits realisation plans for the Edinburgh and Glasgow
property projects. The final report for Westport was submitted to the Finance and Performance
Management Committee in August 2014. In summary, of the 42 Westport benefits identified, 22 have
been fully realised. These benefits include financial savings in 1) rent, rates and service charge; 2)
electricity usage; 3) insurance costs per square meter; 4) maintenance costs; 5) Facilities
Management contract costs; 6) waste disposal costs; 7) photocopying and reproduction costs; and 8)
IT hardware and software costs. Other realised benefits include 1) significantly better space
utilisation; 2) improved building condition, functionality, quality and statutory compliance; 3)
environmental performance; and 4) speed of response/fix times for IT related issues.
Two benefits (the avoidance of paper/generation of waste and off-site storage/archiving) were not
realised. Unfortunately it could not be determined whether the remaining 18 benefits had been
realised, due to a lack of data. This has been an important lesson learnt and the benefits realisation
plan for the Glasgow Property project has been developed to ensure data is available for all
anticipated benefits.
With regard to the Glasgow property project, at present 14 of the 38 benefits have been realised. The
remaining benefits are awaiting the Post Occupancy Evaluation and/or financial information following
year end to determine whether they have been realised or not. A final report will be submitted to the
Finance and Performance Management Committee in due course.
7. Summary
The OPIP team continue to support cross-organisational improvement initiatives as well as individual
Directorates with the implementation of their improvement and impact plans. The request for support
is ongoing and the team has witnessed a positive shift towards a culture of continuous improvement
within the organisation.
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