Are “Lean” DFGs a Realistic Approach to Delivering Government Objectives?

1. Are “Lean” DFGs a Realistic Approach to Delivering Government Objectives? Sarah Cambridge MA research project - summary of findings

2. Objectives of research • To establish a clear picture of current DFG process from assessment of need to completion of works (simple) • To identify “value” in the process • To identify “blocks/failure” within process • Develop proposals for change and streamline service delivery

3. Lean Thinking Method • Studying customer demand from the customer perspective • Distinguishing between “value” and “failure” work • Understanding whether demand is predictable or not • Redesign services against customer demand • Change the system Ref: Seddon, J. (2005) Freedom from Command and Control. Buckingham: Vanguard Education Ltd. http://www.lean-service.com

4. Lean Principles • Design systems based on an understanding of customer demand • Making the right decisions first time, early in the process - no waste correcting errors • Doing work fast and once only • Having the “experts” as first point of contact • No “batching and queuing” of work • The person on the spot is responsible for their own work

5. Methodology • Extensive literature search • Process mapping 6 cases - assessment of need to completion of works (3 owner occupier, 3 social housing) Interviews with: • grants officers in three different Districts/Boroughs • with OT staff who completed the assessments Staff identification of value/blocks

6. Methodology cont • Dates converted into numbers of days between events – recorded on process maps • Event timescales collated by case into comparison table • “value” and “blocks” – collated – by District/Borough

7. Timescales Summary Timescales: • OT/As consistently complete recommendations within 30 days of allocation • Grants officer intervention varies from 24 days to 539 days

8. “Value” summary • OT/As and Grants officers within the District/Borough with the fastest completion time identified a long list of “value” tasks • OT/As and Grants officers within the District/Borough with the longest completion time identified a short list of “value” tasks

9. “Value” examples • Excellent relationships/communication between OT/A and Grants officer • Grants officers do not routinely require scale drawings • Use of standard recommendations/design briefs • Grants officers complete applications with customer • Streamlined paper processes/minimal bureaucracy

10. “Blocks” summary • OT/As and Grants officers within the District/Borough with the fastest completion time identified a very short list of “blocks”/”failure” tasks • OT/As and Grants officers within the District/Borough with the longest completion time identified a long list of “blocks”/”failure” tasks

11. “Blocks/failure” examples • Audit requirements - delay process • HIA staffing resources – availability effects speed of service • Lack of customer understanding of what adaptation will look like “for real” • Customer not understanding constraints within process • Process too slow to support rapidly changing needs

12. Key RecommendationsOccupational Therapy Service • Ensure standard recommendations/design briefs used (Ensure all information required is included in recommendation letter to support prioritisation by Grants officers) • Routine use of photographs of completed adaptations in domestic settings • Routine closure of simple DFGs on Functional Assessment papers

13. Key RecommendationsGrants officers • Grants officers complete applications with customers on first visit • Grants officers able to verify financial information – copies not required • Agreed schedule of rates for “simple” adaptations • Increased admin. support to speed up processing – prevent “batching/queuing” of work