He talks about asking the question “What is Camden all about?”
We discuss their systems thinking work in Housing.
Mike talks about what “outcomes focus” really means and how measures can enhance or distort.
We hear how Camden is using Yammer to open up innovation and communication. And also about their plan to do away with the classic performance appraisal.
]]>Improvement is done on projects.
Improvement is done during improvement events.
Improvement is done when forced by a disaster.
Improvement is done locally.
Improvement is done wholesale.
Improvement is done with a rigid method.
Improvement is done with no method.
Improvement is done with resistance.
Improvement is done causing confusion.
Improvement is done when the last change and the one before that haven’t finished yet.
Improvement is done then it goes back to the way things were done before.
Improvement is done on paper but never implemented.
Improvement is done with no planning.
Improvement is done to increase efficiency.
Improvement is done to decrease costs.
Improvement is done to increase quality.
Improvement is done to improve service to the public.
Or more likely, improvement isn’t done at all.
Improvement is done as it is currently done.
Improvement needs to be done totally differently.
]]>His career started in welfare rights, then working with homeless people and you’ll hear his story about taking the way disabled people were helped back into work and turning it on its head.
He tells me why he doesn’t like the word transformation and talks about the downside to altruism.
You’ll also hear the inside story of Bristol City Council’s current improvement effort, the Applied Programme, problems its overcome and what it hopes to achieve.
And there’s lots more in an interview that certainly made me think and reflect on many aspects of improvement and transformation.
Max Wide’s potted biography:
Max Wide joined Bristol City Council in February 2014. He is a Strategic Director responsible for business change, ensuring that the Council uses money, technology, staff development, policy, the democratic process and data in pursuit of better outcomes for Bristol. Max is responsible for the delivery of the Council’s single change programme, creating a more efficient and effective organisation.
Max came to Bristol from the local government consulting firm iMPOWER where he led their work on Childrens services partnerships in Sandwell MBC and Doncaster. He has a history of achieving major positive change in organisations and helping Councils break new ground leading organisational development at London Borough of Barnet and Suffolk County Council.
Max’s career began in welfare rights and led, through working with homeless people in the third sector, into local government. Max worked for many years in adult care, in training and development and then in corporate transformation. He led the work of SOLACE Enterprises in leadership and cultural change and whilst there was the author of books on organisational development, cultural change and leadership in political environments. An experienced peer review and peer challenge leader, he has worked with many senior teams delivering transformation programmes across Councils. He is a tutor on the new Chief Executives programme and an experienced mentor of senior officers. Max spent six years at BT Global Services as Director of Local Government Strategy and has been recognised by LGC as one of the top 30 most influential voices in local government.
]]>Get in contact with Benjamin at http://www.redquadrant.com or find him on twitter @antlerboy
]]>Jon can be contacted at CEO (at) havantcab.org.uk and Havant CAB have a twitter account @HavantCAB
]]>What is the Prime Domino that a Chief Executive in the public sector can push over to start changing their whole organisation. In other words, what is the best, first thing to do, to start radical change?
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HT to Mark Gillett
]]>The question is:
Is there a Prime Domino for improving services to the public across a system in the public sector?
I.e. what is the one thing that a Chief Executive can or should do that will cause all the other dominoes of change to fall?
I got the idea for the Prime Domino from Tim Ferriss, the author of The 4-Hour Work Week. His focus is on distilling excellence in people’s performance. He talks a lot about the “lead domino” as being the first thing to do to that will create the most effect for the least effort. Another way of putting the Pareto (or 80/20) Principle. One example from Ferriss is that if you want to lose weight you can follow his Slow-Carb Diet, but the lead domino is eating 30 grams of protein within 30 minutes of waking (with no carbohydrates). If you forget the whole of the rest of the diet system and do just one thing, that will, says Ferriss, give you the biggest weight loss benefit from the minimum of effort and change of habit.
Why this question? First let’s step back a little bit. My ethos is that the only way to cut costs is to improve services to the public. That was the whole thrust of my book ‘Beat the Cuts – How to Improve Public Services and Easily Cut Costs‘. But the two questions that I get most commonly are:
The first question is a variant on the Prime Domino question and the second hints at the fact that without senior managers, and ultimately the Chief Executive (and board), any change is going to founder.
But let’s pick apart the main weakness of the question first. There is no silver bullet in changing whole systems. W. Edwards Deming used to say, “there is no instant pudding” and the Prime Domino question is asking what’s the one thing to do first. But the only way to properly answer the question is to know what the next thing and the next thing after that will be. And then all the other things that everyone has to do. So I’m not trying to find the magic sauce, or really to find the “One Thing” that everyone should do. It is a way into the problem of sustainable change. Because in any change there is always something you have to do first. There is no way around it.
Interestingly, W. Edwards Deming used to refuse to go and speak to an organisation unless he was talking to the top person. If a senior manager asked Deming to come to see him, Deming would politely decline if the CEO wasn’t interested.
The other prompt for the question is that so many consultants, experts and practitioners do have a One Thing. They say you must start by looking at x, or first act on y and I want to uncover if any of those are true, effective and widely applicable. Also I want to feed in the experience of Chief Executives from around the world who have initiated whole systems change to see what worked and what didn’t. I want to ask what they did first, why that, and if they did it again, would they start with the same thing?
That’s the focus for me for the next while, and I really need readers’ help. Your help.
I’d be grateful if you could comment below and tell me if you think there is a Prime Domino, if so, what it is and is it the same in every situation? Also if you think there is an expert or Chief Executive who I should talk to learn about this, and of course everything I find out will be fed back here on the blog.
So what’s your Prime Domino? It’s to leave a comment below, of course!
Thanks,
Rob
]]>If the NHS cannot afford to fund everything then it will need to make tough choices about what it does fund.
Do we think about increasing our tolerance for longer wait (for care), or do we say NHS funding is only for the health aspects of care and treatment, which means patients being asked to cover their hotel costs for bed and board?
But the part about ‘increasing our tolerance for longer waits for care’ is nonsense. If capacity is higher than demand then there should be no wait. If capacity is lower than demand then waiting times should continuously increase. What we usually see is that waiting times are stable which means that, give or take, capacity matches demand, it’s just that for some reason or other the backlog isn’t being worked through.
Because what Webster is saying is that with less money there are fewer resources so we’ll have to accept longer waiting times. But as above, stable, long waiting times mean that capacity matches demand so if we worked off the backlog, then we could have no waiting at all.
Best,
Rob
]]>This week she submitted two repeat prescriptions, one for her, and one for her child. A couple of days later she went to the pharmacy to find that her child’s prescription had been filled and was ready and waiting, while hers was not there. So she had to waste her time by going to the GP surgery to be told that the doctor had not had their smart card on them when reviewing the prescription and so was not able to forward it to the pharmacy. This was also a waste of time for the surgery reception staff who had to deal with this visit. This is not the first time, and not the first time that some prescriptions submitted have been sent over and not others.
The problems are that:
The notifications could be emails or texts to notify that a prescription is:
If the system worked predictably then there would be less need for notifications, but it doesn’t.
My friend was thinking of taking her and her family off the electronic prescription service and going back to schlepping to the GP surgery to collect prescriptions to take them to the pharmacy herself. At least that way she would know what was happening and didn’t spend time going to the chemist, only to have to go back to the surgery to find the prescription.
Sometimes a potentially good system that is badly implemented, is worse than a bad system that is predictable.
Best,
Rob
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