ASSIST Meeting Managing Change to Realise Benefits

1. ASSIST MeetingManaging Change to Realise Benefits Sheffield 11th April 2005 Presented by Barbara Entwistle Informatics Change & Benefits Manager

2. SECURITY ALERT!! HAVE YOU SEEN THIS MAN?????

3. Managing Change to Realise Benefits • Business Change – Programme & Project management • Benefits Management Deliverables • Benefits Realisation Process • Benefits Dependencies • Examples • Modernisation & NPfIT

4. What is programme Management? • Defined as: The co-ordinated organisation, direction, and implementation of a portfolio of projects and activities that together achieve outcomes and realise benefits that are of strategic importance. Source: OCG Managing Successful Programmes

5. Attributes of a Successful Programme • Clear & consistent vision of the ‘changed business’ or other outcome • Focus on benefits and the internal & external threats to their achievement • Co-ordinate a number of projects and their interdependencies in pursuit of these goals • Leadership, influence management & direction of the transition • These attributes should run as continuous ‘strands’ throughout the programme

6. Programme Management Structure Senior Responsible Owner Sponsoring Group Programme Manager Business Change Manager(s) Delivering capability Embedding Change

7. Business Change Manager(s) Role • The role is key to providing the bridge between the programme and the ‘business operations because the individual(s) will be an integral part of the business operations. • They represent the ‘sponsoring groups’ interest in the final outcome of the programme in terms of measurable improvements in business performance

8. Business Change Manager(s) Role • BCM’s should have appropriate responsibility and authority within the business areas within which change will take effect & benefits will be realised • May be responsible for creating new business structures, operations & working practices

9. Responsibilities • Ensure the interests of the sponsoring group are met • Obtaining assurance for the sponsoring group that the delivery of the new capability is compatible with realisation of the benefits • Work with the programme manager to ensure that the work of the prog. covers the necessary products or services that will lead to operational benefits • Identify, define & track the benefits & outcomes required of the programme

10. Responsibilities • Prepare the affected business areas for the transition to new ways of working; potentially implementing new business processes • Taking the lead on transition management, ensuring’ business as usual’ is maintained during the transition and the changes are effectively integrated into the business • Establishing and implementing the mechanisms by which benefits can be realised & measured. • As the programme progresses, the BCMs are responsible for monitoring outcomes against what was predicted

11. NHS PLAN National Programme for IT Modernisation Governance Output based Spec Deliver Functionality Reform, Change & Expand Service Provision Controls Assurance Standards & Accreditation Infrastructure NHS Spine NHS Care Record Service e-Booking Patient Choice Access to services Financial Flows / FT Agenda for Change Information Gov. Corporate Gov. Clinical Gov. Translate into a cohesive and meaningful context for different stakeholders by prioritising improvement objectives and the local changes required

12. Benefit management deliverables • Benefit statement • Forecast benefits & business impact. • Identify key business changes. • Benefits realisation plan • Align business change with technical implementation. • Plan process and organisational change • Monitoring and reporting • Communication plans / channel alignment • Education, communication

13. What is a benefit? “The goals and objectives of the organisation will determine those developments which will be regarded as beneficial. The Benefits Management regime will take the high-level goals and objectives as the starting point for the identification of the benefits to be achieved through programmes of business change.” - OGC A benefit is a result that a stakeholder perceives to be of value. • Improve • Increase • Reduce • Eliminate • Stop

14. Why do we want improvements? What improvements do we want / could we get? Can we quantify them? Can a financial value be put on it Where will they occur ? Who is responsible for their delivery? What changes are needed to obtain them Who will be affected by the changes? How & when can changes be made? Have we achieved the benefits? if not - why not - further actions? What further benefits can we now get? Benefits Management Dimensions Measurement and evaluation How can we measure them? Planning & effecting business changes Benefits realisation plan

15. Benefits Realisation Process • Stakeholder (user) engagement • Benefits ID & prioritisation • Business Change • Communication • Technical capability • Benefits realisation

16. Stakeholder table

17. Benefit Dependency Principles • Chain of connections to realise benefits • NPfIT – Deliverable to Objective • Local IT – Objective to Deliverable

18. The Benefits Dependency Chart

19. Approach to Benefits Management • NPfIT process – impact assessments • ‘As is process’ - To be Process • Focus on deployment of functionality • Benefits identified as a bi-product of the above process

20. Approach to Benefits Management • Local IT Project – Benefits & outcome driven • Organisational change creating demand for IT solution • Clinical engagement !! Executive lead

21. Benefits & Outcomes • CRS PAS - Minimal benefits perceived by Replacement in one hospital • Limited enthusiasm for wider organisational change – project focussed • A&E Local IT development – minor IT deployment – wide organisational change • Benefits exceeded original expectations

22. A&E Example Benefit Dependency NetworkO:\BDN A&E for case study.doc

23. 4. Sheffield Approach to Benefits – An Example of Service Improvement Aim and Objectives Statement AimTo Investigate, assess and improve performance specifically in relation to efficient management of capacity and demand and improvements to patients’ experience of day surgery services in Sheffield. Objectives We wish to ensure the most efficient use of our limited resources to provide patient focussed services. 1. To improve access to day surgery services 2. Improve the efficiency of Operating lists / sessions 3. Improve patient choice and experience 4. Maintain and improve day case waiting times for treatment

24. Day Surgery Services

25. Day Surgery Services

26. Benefits & ImplementationVision Benefits Framework Benefits Framework DH NPfIT Integrated Planning (inc. Benefits Realisation) Benefits Identification SHA National & Cluster benefits Influence through LDP Benefits Reviews Local Health Community • Refocus implementation • Exploit unexpected benefits Benefits Prioritisation Implementation objectives Benefits Measurement Benefits Planning Benefits Framework

27. Benefits Realisation Planning Deployment 1 Deployment 2 Deployment 3 Benefits Prioritisation Benefits Measurement Benefits Reviews Benefits Identification LHC Deliverable Strategy Supporting LDP LDP Technical Guidance • Using benefits menu Benefits Plan Fully signed-off, financially viable, implementation and benefits plans demonstrate that benefits from the NPfIT will be realised in support of overall targets, whilst providing DH assurance that the NPfIT itself is on track National Programme Implementation Guide Appendix J – Model Implementation Project Plan Implementation Plan • A value proposition for each year, combining process and technology, will be defined Benefit Realisation Framework Identify Priorities LDP Trust Change Plan Implement TRUST Agree Shared Priorities LHC Implementation Plan LHC Benefits Plan LHC Identify Benefits Approve NPfIT Functionality SHA Approve LDP Identify Benefits NPfIT Implementation Schedule NPfIT

28. Mental Health Social Care Ambulance Trust PCT AT PCTs Acute Trusts Changing the Programme’s Centre of Gravity Implementation will be driven at LHC level under SHA performance management Strategic Health Authority Much of the shift of balance and focus will be achieved by building on existing programme governance and management arrangements, and on work already being done locally Business Plans & priorities Performance management Benefits Safety Clinical & cost effectiveness Governance Patient focus Accessible & responsive care Care environment Public health Shared agenda and plan Users: patients, clinicians, nurses… Local Health Community PCTs and trusts within a LHC will develop a shared change agenda, articulating how and when NPfIT solutions and other change initiatives should be implemented and exploited to contribute most effectively to the achievement of benefits targets. Best clinical practice IT Engagement, Training, Support NPfIT Programme and investment

29. Benefit 2 Outcome Reference Outcome Group ETPBEN001 Elimination of illegible prescriptions Description Benefit 1 Reduction in adverse drug incidents through dosage errors Enabler / Functional Component Electronic format for prescriptions Reference Outcome 1 Outcome 2 Stakeholder ETPBEN004 Patients Reference Reference Description ETPOUT001 ETPOUT002 Benefit Category Reduction in clerical and clinical effort dealing with prescription queries Safety Outcome Type Outcome Type Cost Saving Process Change Benefit Sub-Category Stakeholder Description Description Patient Safety Management Reduction in queries due to inability to read handwritten prescriptions Fewer dosage errors resulting from handwritten prescriptions Benefit Category Clinical and Cost Effectiveness Benefit Sub-Category Clinical Efficiency Benefits Register – ETP Example NPfIT REGISTER NPfIT Item 1 NPfIT Item 2 NPfIT Item 3 NPfIT Item 4 NPfIT Item 5 NPfIT Item 6 NPfIT Item 7 ETP

30. Realisation & review Presentations Interviews Business Drivers Context Intent Barriers/risks Analysis Way forward Business Benefits Benefits management Impact of IT related change Coaching Review progress Identify further opportunities Benefits Benefits Management – what we do Pre-implementation Implementation Workshop(s) Confirm business drivers Set the context Identify business opportunities, outcome & enabling changes Business Case Realisation plan