While we spend most of our time working with systems, organisations and teams tackling major change we consistently find that the scarcest resource is not money - it is time. So we not only share our learning from our projects, research and personal experience but also our thoughts on how you can make the time and space to think differently in overcrowded schedules.
Over the next few weeks 44 Strategic Transformation Plans (STPs) will be pored over and 'marked' by NHS England and NHS Improvement.
So what needs to be different this time? What will give us any more confidence that we have this time solved the mystery of implementation - making the linkages between 'Why', 'What' and 'How'. I suggest both STPs and their assessors will need to discard some well entrenched orthodoxies.
If we accept that, as individuals, we are the culture then our mental model shifts to see organisational culture as an accumulation of individual habits that become aligned and ingrained over time. In this mental model the first and biggest shift for any effort to change culture is the acceptance by each individual within the organisation that 'I am the culture'...
Lets be clear - your data is not about me. Its about the things you do to parts of me. It is the stuff that matters to you because it is your everyday business - I give you that, but it is not about the real me. It might be a ‘patient record’ but it sure as hell is not a ‘me’ record.
I have been working in quieter moments to begin to translate those original Agile concepts and methodologies to the world of service improvement within the NHS. As part of this I assembled a number of bits of a jigsaw to help me 'triangulate' and then sketched out the bones of the idea on a whiteboard.
Transformation is one of those words that is beginning to mean less the more it is used. Increasingly desperate and/or strident calls to ‘transform’ services are shorthand for ‘we are in a fix, have failed to redesign services so far but that is not going to stop us using the word as it makes us sound as though we are on the case’.
Here are what I think are the other core principles of AGILE as it relates to service improvement or redesign....
I have been having fun. We are allowed to do so you know. In this case I had put together a PowerPoint presentation which I was using as a catalyst for a discussion with clients and colleagues about the mindsets we bring to change. I was thinking of recording it with a voiceover and posting it on here.
I am increasingly interested in how we can translate lessons from the Agile approaches to software development to organisational change and improvement and redesign projects
In complex times leaders need to be able to keep themselves and their organisations focused on what matters. In the NHS, in a blizzard of regulation, targets, policy initiatives, planning guidance and organisational upheaval it is too easy to lose sight of what really matters.
The more I work with senior teams and wider systems the more it becomes apparent that the quality of behaviours and relationships are linked not just to the highest things of shared purpose but just as much to some of the basics of self-organisation and personal disciplines.
As we pick up the thread of work after the Christmas and New Year break most of us will have opened our electronic calendars and looked at the crowded months ahead. I am constantly hearing clients struggling to find space in their diaries months ahead and a consistent refrain of 'I will work on that during the weekend'
The way we design physical working space has an enormous impact on the way we engage, behave and think. Imagination, creativity and energy can be enhanced by well designed, simple space. And yet rarely a day goes by when I do not walk into a meeting room or potential workshop space that is the antithesis of all these things - all I see is a 'Black Hole' for creativity and energy.
So a couple of days ago we found out that patients at a NHS HIV clinic in Dean Street London had details of their attendance widely broadcast because someone used cc rather than bcc in an email to patients. So here is my office digital maturity check list...
Oh how I felt superior and laughed when, as an early email adopter (compuserve - remember that?), I was told that a colleague was getting his emails printed out and brought to him in a file twice a day. What a dinosaur! How wrong I was…bloody email!
So the NHS has hired Martha Lane-Fox 'to boost the use of digital technologies by patients'
Might I humbly suggest that she also think about boosting NHS staff's use of digital technologies as well!
Here is a question for you to consider. What is the key feature that has made the Dyson vacuum so successful and has been the one that virtually every other upright vacuum maker has adopted?
As we begin the journey of becoming our own personal improvement project it is worth considering what we stand to gain once we regain control of our time and priorities.