DELIVERING SERVICES IN AN ORGANISATION UNDERGOING CONSTANT CHANGE

DELIVERING SERVICES IN AN ORGANISATION UNDERGOING CONSTANT CHANGE PowerPoint PPT Presentation


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AGENDA. NHS continual organisational changeNHS new initiativesA case studyImpact on staff and on delivering services Lessons learnt. AN ORGANISATION IN CONTINUAL CHANGE - THE NHS. Established 1948Big changes in 1974 and 1982Pace of change increases - 1990, 1994, 1996, 1999, 2002, 2003Same services, but different combinations.

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DELIVERING SERVICES IN AN ORGANISATION UNDERGOING CONSTANT CHANGE

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1. DELIVERING SERVICES IN AN ORGANISATION UNDERGOING CONSTANT CHANGE Hilary Daniels Chief Executive

2. AGENDA NHS continual organisational change NHS new initiatives A case study Impact on staff and on delivering services Lessons learnt

3. AN ORGANISATION IN CONTINUAL CHANGE - THE NHS Established 1948 Big changes in 1974 and 1982 Pace of change increases - 1990, 1994, 1996, 1999, 2002, 2003 Same services, but different combinations

4. MY EXPERIENCE SINCE 1995 1995 Joined a Health Commission 1996 Became a Health Authority 1999 Primary Care Groups established 2000 Created a Primary Care Trust 2002 Health Authorities abolished 2003 Directorates of Health and Social Care abolished

5. NEW INITIATIVES Griffiths reform of 1985 Working for Patients 1989 Development of Internal Market 1991 Patients Charter 1991 Development of Primary Care in 1990’s The NHS - Modern & Dependable 1998 StBOP 2001

6. NEW INITIATIVES - NOW Modernisation Agenda - NHS Plan National Service Frameworks Targets & Performance Management Patients choice Payment by results New Contracts

7. WHAT HAPPENS WITH NHS CHANGES A new organisation is created New Boards & Chief Executive are appointed Majority of staff transfer, some leave Services continue to be delivered Relationships with partners change New accountabilities

8. WHAT ARE PCTs? Groupings around GP Practices Average 150,000 population Local focus to deliver improved services Providers of Community and other services Commissioners of Hospital services

9. WEST NORFOLK PCT Population 143,000 Mainly rural High population of over 65’s Budget £113m, 1,250m Rand 800 staff, including doctors, nurses, therapists and admin staff 21 GP practices

10. SERVICES PROVIDED A range of nursing services Community Dentistry across 4 PCTs Community Hospital All mental health services Therapy services Independent contractors

12. BENEFITS OF PCTS Seen as local, flexible organisations Involvement of staff and patients Acts as a catalyst for change Brings the right people together Has the money! But they are small organisations to change the NHS

13. CREATING THE PRIMARY CARE TRUST Bringing two organisations together - one dividing into four Joint management meetings Involve staff early Make staff feel they have a contribution A vision of local services

14. PCT VISION A local organisation, created to deliver health improvement of the local population by being responsive to local needs as expressed by local people. The delivery of the appropriate services, at the appropriate time and place, to the people of West Norfolk.

15. PCT OBJECTIVES To integrate services between the various agencies, wherever possible linking services around GP practices to provide patient focussed services (Integration) To develop and modernise services across the health economy to improve access for all (Access)

16. PCT OBJECTIVES To develop and implement an effective Intermediate Services Strategy to maintain the independence of individuals and their families (Independence) Support these initiatives by a range of “must dos”.

17. DELIVERING SERVICES Patients still have to be treated Identify the things that aren’t going to change - give certainty where possible Engagement and empowerment of staff and patients Many front line staff now let the changes wash over them

18. LESSONS LEARNT Create a vision Manage the HR aspects well Support the Managers who have to deliver Open & honest communication, sharing the uncertainty Involve staff all the way through Find your champions

19. DIFFERENT SKILLS REQUIRED Enthusiasm Change agents Facilitation skills Relish a challenge Cover a lot of ground Key deliverers

20. VIEWS OF THOSE LEADING CHANGE People assume the worst; the rumour mill/ water cooler chat goes into overdrive Recognise the impact on individuals Provide support for staff going through change

21. The impact of rapid and constant change has had a number of effects on staff - it has been destabilising, has increased sickness through stress and increased uncertainty.

22. Organisational change is seen as the way to improve services, but it gets in the way and often leaves a vacuum Those that want to leave get packages and those that stay get better jobs and higher pay.

23. Provide a national framework, but allow local discretion Staff need to be involved from the beginning and throughout the implementation phases

24. PERSONAL VIEW Change is endemic in the NHS Key structures are now in place Managers and clinicians need to be left to get on with service improvement Initiative overload Cultural change Services continue to be delivered

25. but What else is there to come? Has it improved services?

26. SUMMARY Explained the changes in the NHS Shared the challenges of change Explained how to continue delivering services through change Shared the lessons learnt and the key messages from those involved

27. Questions?

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