Delivering the National Programme for IT
in the SW Sector of Greater Manchester
Delivering IT Enabled
Business Change
Helen Walsh and Sally Chadwick-Rock
Change Management Team
Greater Manchester South West Sector
December 2007
Delivering the National Programme for IT
in the SW Sector of Greater Manchester
Delivering IT Enabled business change
•NHS Operating Framework for 2007/08
–Renewed commitment to the vision set out in Delivering 21st Century IT support
for the NHS
–Sustained focus on information management and technology
–Improvements must be owned and delivered by clinicians, managers and front
line staff
•Local IM&T plans
–Forward looking plans to exploit the NPfIT opportunities
–Alignment across the Local Health Community to enable patient centred service
transformation
–Further guidance is now available
•NAO - Delivering successful IT enabled business change
–Recurring themes in successful programmes and projects
•The level of engagement of senior decision makers
•The organisations’ understanding of how to be an ‘intelligent client’
•The importance of determining at the outset what benefits they are aiming to
achieve and how these could be optimised
Delivering the National Programme for IT
in the SW Sector of Greater Manchester
When planning a change programme, there are some
key principles that need to be kept in mind:
• Different people react differently to change
• Everyone has fundamental needs that have to be met
• Change often involves a loss, and people go through
the “emotional cycle"
• Expectations need to be managed realistically
• Fears have to be dealt with
Delivering the National Programme for IT
in the SW Sector of Greater Manchester
The Emotional Cycle of Change
Rewarding
Completion
Positive
Uninformed
Optimism
Level of
Optimism
Informed
Optimism
Informed
Pessimism
Hopeful
Realism
Negative
TIME
Delivering the National Programme for IT
in the SW Sector of Greater Manchester
The Role of Change Management in NPfIT
•
The National Programme for IT has the potential to deliver major
benefits for both patients and staff, but this will only happen if NHS
organisations undertake service review and redesign in advance of
the new systems being implemented
•
A critical success factor in IT deployments that achieve their
objectives is the engagement of key stakeholders at every stage in
the project.
•
Change Management is crucial in managing this engagement,
looking in particular at five main areas;
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Organisational Strategy
Service redesign
Benefits
Stakeholder management
Communications
Delivering the National Programme for IT
in the SW Sector of Greater Manchester
Organisational Strategy
•
There is evidence to suggest that the measure of success is
proportional to the level of interest from the executive team…therefore
engagement at executive and senior management level is essential to
ensure alignment of IT systems deployment with local business
objectives.
•
Identification of local service transformation programmes and local
service planning priorities for which enabling IM&T is required to reduce
the impact of change upon staff and patients
•
Potential benefits of service redesign across a local heath community,
and the use of IT systems as enablers, is required to allow healthcare,
ensure that these benefits are achieved.
•
There needs to be a shared approach to implementation – the NHS
Operating Framework suggests that improvements must be owned and
delivered by clinicians, managers and front line staff
Delivering the National Programme for IT
in the SW Sector of Greater Manchester
Service Redesign
Work is carried out at an operational level to map out current and future
state work in order to identify areas of benefit and service / system
redesign.
•
Identifying current processes, existing policies and procedures and staff
distribution
•
•
Reviewing opportunities for service improvement and redesign
Developing future state processes
•
Communicating the benefits that can be realised through service
improvement and redesign
•
Conducting gap analysis – current vs future, risks and issues, impact of
changes on staff
•
Working to close the gaps by providing system functionality,
information, work flow, technical and people requirements
Delivering the National Programme for IT
in the SW Sector of Greater Manchester
Benefits Identification and Management
•
The fundamental reason for beginning a project or programme is to
realise benefits through change
•
Identify benefits and their dependencies
•
Develop Benefits Realisation Plan to include:
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•
Benefit description
Benefit owner
Unit of measure
Dependencies
Baseline
Targets
Actions
Timeframe
Ongoing review and monitoring of the benefits plan is necessary post
go-live in order to achieve continuous improvement.
Delivering the National Programme for IT
in the SW Sector of Greater Manchester
Stakeholder Management
Stakeholder; an individual, group or sub-group who has an interest in the
outcome of a project or programme and the environment in which the
project or programme applies
•
The objective of analysing stakeholders is to achieve an understanding
of their requirements and interests in, and impact on, the project.
•
Stakeholders’ positions, in terms of influence and impact, may be
rational and justifiable or emotional and unfounded, but in either case
must be taken into account as they can affect the change process and
hence the outcomes of the project.
•
Stakeholder groups should be analysed to assess the level of interest
and impact, potential power and influence they have. This will form a
basis for the prioritisation of communications and help concentrate
effort where it will contribute most to a successful outcome.
Delivering the National Programme for IT
in the SW Sector of Greater Manchester
Communications
•
Communication is central to any project and there needs to be clear
communication about the reasons and rationale behind it, benefits
expected and plans for its implementation.
•
Communications are required to keep awareness and commitment
high, maintain consistent messages and ensure expectations are
managed in line with what is delivered.
•
Communication channels should be established to ensure that
stakeholders’ expectations of the project can be managed and
maintained
•
An ongoing two-way interface between the project team and
stakeholders is essential.
Delivering the National Programme for IT
in the SW Sector of Greater Manchester
Change Management and NPfIT
A Case Study
Delivering the National Programme for IT
in the SW Sector of Greater Manchester
Facilitating Change
Scenario 1
• IT Project Lead
• Service ( full buy in)
• Full Change
Management support
• Service redesign
• Use of Sector Training
Team
Scenario 2
• IT Project Lead
• Service (??? engagement)
• Scant Change
Management support
• No Service redesign
• Use of Sector Training
Team
Delivering the National Programme for IT
in the SW Sector of Greater Manchester
Benefits
Current Processes
Future Processes
Service re-design
Communication Plan
Stakeholder Management
Product capabilities
Methodology
•
•
•
•
Work shops
Stakeholder Management
Communication Plan
Benefits Identification
• Systems overview
• Process Mapping
Current state
Future state
1day
1day + 5days
2days + 4wks
Delivering the National Programme for IT
in the SW Sector of Greater Manchester
Outputs
Stakeholder Map
Communication plan
Benefits Realisation
Plan and baseline
measurements
1day
1day
1day
+ 10days
+ 5 days
Service Process Map
Service Process Map
Delivering the National Programme for IT
in the SW Sector of Greater Manchester
Comparison of activities
• Scenario 1
• All of the above
• Scenario 2
• Benefits workshop 2hrs
• Stakeholder identification
& Communication
planning 1day
• Revision of generic
Process maps 1/2day
per service area
Delivering the National Programme for IT
in the SW Sector of Greater Manchester
Outcomes
Scenario 1
• Benefits Base Lining
• Process mapping
• Training plan produced
• Planned changes to
working practice :-
Scenario 2
• No Benefits base lining.
• Generic process maps
• No Training plan
• No planned changes to
working practice
Delivering the National Programme for IT
in the SW Sector of Greater Manchester
Service Re-design?
Scenario 1
Scenario 2
1.
No service redesign
undertaken
? Whether national benefits
achievable.
2.
3.
4.
5.
Roles redesigned – clerical officer
duties.
Reception – area(s) re- positioned
AppointmentsBooking office
- expanded.
“Choose and Book” extended.
All telephone enquires –
redirected.
Patient pathway and flow through
improved
Delivering the National Programme for IT
in the SW Sector of Greater Manchester
Some final thoughts…
We would rather be ruined than changed;
We would rather die in our dread
Than climb the cross of the moment
And let our illusions die.
~W.H. Auden
"There is nothing more difficult to take in hand, more perilous to
conduct, or more uncertain in its success, than to take the lead
in the introduction of a new order of things."
— Niccolo Machiavelli The Prince (1532)
It is not necessary to change. Survival is not mandatory.
~W. Edwards Deming