- NAO – good data, wrong conclusions
- Plan for sharing goes awry
- More on ‘tell us lots’
- Pass the parcel?
- One success under threat
- Scots minister illustrates
- Vanguard Method: manifesto for Policing in Sussex
- Hull seminar
- Vanguard and IT: Iceland and the USA
- Benchmarking: a fast way to mediocrity
It saddens me to say that the NAO’s report on shared services reached the wrong conclusions. Replete with compelling evidence of the cost of failure, the report concludes that shared services ventures have been too soft on customers by ‘customising’ services for them, when standardising the services would have been better; not just because the NAO (wrongly) thinks that standardisation means cheaper, but also, alarmingly, because, they say, the IT platforms require standardisation. Further, the report concludes that the Cabinet Office’s move to make government departments share services, combined with stronger governance and project management, will do it.
The report reads like it was written by the IT industry. I used to have enormous respect for the NAO. Recently it has begun promulgating its opinions about ‘best practice’ as we see with this report; it is becoming like the (dreadful) Audit Commission; a pity.
Read the news report here:
Read the NAO report here:
It illustrates the power of narrative over evidence. Ministers think shared services will work, if only they are ‘done right’; and so they lead the charge on doing the wrong thing righter. We need the NAO to be an independent voice more than ever.
Two councils clearly have been duped by their IT suppliers into believing that the way to save money is to have more people join a shared services venture. This is the less-of-a-common-resource argument (see ‘Why do we believe in economies of scale’ in articles section of web site).
East Lindsey and South Holland have spent £600K on marketing, trying to attract other councils to join their venture, but no one has come forward. Boo-hoo. Who will pick up the tab for that then? And when they are left with their investment not attracting others, who’ll pay for that?
I wrote about the failure of the ‘tell-us-once’ initiative back in February (the idea is that if you have a death in the family you can tell someone once and public-sector departments that need to know will be sorted). In short, I described how this much-vaunted ‘flagship’ example of new government service isn’t actually working.
Thanks to readers, I can tell you that so far ‘tell us once’ has cost £111m, it has been trundling on for six years, the IT promulgators (largely ex IT-industry people now with big jobs in government) continue to talk it up and local authority people keep the whole thing going by doing workarounds.
The workarounds are indicative of the central problem – a perennial problem with IT – the failure of IT systems to be capable of absorbing variety. It is the people in local authorities who are best able to determine how to deal with the variety of needs people have when notifying a death. This conjures a picture in my head: IT promulgators and ministers crowing about the brilliant ‘tell-us-once’ scheme while lowly local authority people run like hamsters on a wheel keeping things going. Hamsters treated like that have a tendency to bite.
The King’s Fund reports that elderly people are being passed around hospitals like parcels, often going without treatment because of ageist attitudes. The report calls for better training of staff, leadership and involvement of patients; three tired and worn out interventions.
It is certainly true that elderly people are being passed around; it is also true that they are being readmitted at alarming rates and, astonishingly, are treated each time as thought they are not known to the service. Aside from the fragmentation of the health service, the underlying problem is that many of the services provided don’t actually solve peoples’ problems, hence readmissions; and all of these things are driven by the system promulgated into elderly health and social care services by the departments of health and local government. Staff and leadership training and ‘involving’ patients, won’t do anything about that.
I am pleased to say an interested member of the House of Lords is hosting a one-day event to illustrate our work in health this July; more information in a later newsletter. Meanwhile you can follow our health blog at: http://vanguardinhealth.blogspot.co.uk/. The scope for improvement is astonishing.
One of our experts in health wrote to me:
‘I spent the past 2 days working with a dementia care home in Bradford. They are incredible! Natural system’s thinkers who have created a place which is genuinely full of joy. It was like a 24 hour party. Guess what? They are at risk of being decommissioned because their unit cost is £575 and other dementia homes are a bit less. Guess what? The unit cost is an unbelievable distortion of the truth. They hardly pull on any other services (including GPs), their placements never break down, they don’t use agency staff ever and social workers say that when they place there they never need to turn up again. Also, their approach is massively topical. Fiona Phillips (the newscaster) was in the news recently (she claimed anti-psychotic drugs killed her dad who had dementia). She met with the minister, Paul Burstow. He’s having to pay attention and is sending his advisor on dementia care to this place next week. They refuse to use anti-psychotic drugs, don’t lock anyone up and manage all dementia through behavioural approaches. When I was there 4 residents were playing air guitar to Status Quo in the hallway!’
But how will the minister behave when he learns that commissioning is at the heart of the problem?
The health Secretary for Scotland, Nicola Sturgeon, illustrates how ministers behave when confronted by the reality of their policies. Sturgeon has been an advocate and driver of targets in NHS Scotland. She reacted to the shocking but entirely predictable news that targets for waiting times led to cooking of the books in NHS Lothian by blaming the local health leaders.
Sturgeon ought to have Deming’s famous description of the three ways anyone can react to targets on her office wall:
‘Will a numerical goal be achieved? Anybody can achieve almost any goal by: Redefinition of terms; distortion and faking; running up costs’ Deming 1994, the New Economics.
It appears NHS Lothian did all three. And all because the minister believes in targets.
See the news story here:
Minsters believe that targets hold people to account, but who should we hold to account?
A councillor has put himself forward as a candidate for Police Crime Commissioner in Sussex and on his ticket: the Vanguard Method! I have not met him but I guess he’s read all of our published work on policing and can see that much can be (and is being) achieved. Well, you never know…
You can read his manifesto here:
You may have read about police forces out-sourcing custody work to private-sector providers. Ministers like it because the promise is to send police back out on the beat instead of them being tied up with custody work. The private-sector providers make claims to have ‘continuous improvement’ cultures and they report making great savings in the time taken to process people taken into custody.
Sounds great doesn’t it? Until, of course, you ask what they know about demand. What you find when you study police custody is that many people go into custody for no practical purpose. Having been ‘processed’ they are released. And, guess what? The contracts are based on activity volumes. So the private sector is being paid to process failure demand.
As one of my duties as a visiting professor, I shall be speaking at Hull University Business School on 25th April (1-30 to 3-00 pm). All welcome. To notify of your attendance please email: Susan.Humphrey@hull.ac.uk
Regular readers may have followed my presentations to IT audiences in Europe. I have been asked to present to an IT audience in Iceland (May 2nd) and Tripp Babbit, our man in the USA, will be delivering a keynote address at the CAST conference during July 16-18th in San Jose.
More information for Iceland here: http://www.lean2012.is/namskeid
And USA here: http://www.associationforsoftwaretesting.org/conference/cast-2012/
I wrote an article on the folly of benchmarking for Management Service magazine. You can access it here: http://bit.ly/wLQciD