The Journey to Becoming a Systems Thinking Organisation Andy Felton, Assistant Director – Staffordshire County Council 16 October 2008 www. staffordshire. gov. uk
What was our burning platform? Single Status (JE) Adult Social Care www. staffordshire. gov. uk MTFS Settlement Leadership Change VFM/ CPA
Starting Context for Staffordshire • Leadership issues and conflicting Members and Officers views • Change traditionally focused • Finances driving change • Corporate Change Team created • Growing challenge to major change projects www. staffordshire. gov. uk
What’s the strategy? • • • ID something that works Stimulate curiosity Gain senior level commitment Pilot it Grow based on pull Develop internal capacity www. staffordshire. gov. uk
Why Systems thinking There is a better way to make the work… …a way that improves service and customer satisfaction, reduces costs and improves staff morale Convinced by real examples presented by other organisations who’ve done this – levels of improvement were startling www. staffordshire. gov. uk
Getting the Organisation Curious Fundamentals of Systems Thinking What is it? Does it work? Who’s doing it? Change Team – Systems Thinking HR Shared Services www. staffordshire. gov. uk Interventions: • Adult Social Care • Finance • ICT Chief Exec Senior Managers Conference Managers Curious CMT Formal Commitment
Thinking governs performance Thinking What Thinking is driving the system? System “Patients must be seen within 48 hrs” “Performance is rewarded with cash” Performance www. staffordshire. gov. uk Consequences?
Thinking governs performance Thinking by helping organisations to change the way they think…… System ……the system changes…… Performance www. staffordshire. gov. uk ……and performance improves as a consequence
Changing management thinking COMMAND & CONTROL SYSTEMS THINKING top-down perspective outside-in functional specialisation design demand, value and flow separated from work decision-making integrated with work budgets, throughput, targets, service standards measures related to purpose, variation over time extrinsic motivation intrinsic manage budgets, manage people management ethic act on the system contractual attitude to customers what matters? www. staffordshire. gov. uk
Change must be based on knowledge Get Knowledge – Understand as a System Thinking Roll-in, Make Normal & Sustain Change Thinking, Experiment with Redesign www. staffordshire. gov. uk Performance Plan - Do Plan System Change Check Do Analysis Check
Approaches to change • Coercive • Rational • Normative www. staffordshire. gov. uk
Washing Machine Engineer Exercise www. staffordshire. gov. uk
White Goods Maintenance PLC Ron the Engineers Performance Corporate Contact Centre Customer Home Visit Log Jobs in CRM system Target = 10/day Typically 80 -90% of problems relate to the system Monday 12 • What effects the number of and not the people 8 machines Ron can fix per day? Tuesday Common Mistake: Wednesday 5 • What can Ron control and Assuming workers are in control of their work and Thursday 10 what is a consequence of the can be held accountable for the work they do Friday 9 system? www. staffordshire. gov. uk Ron works through allocated Jobs Parts/Stores Work Flow Supervisor allocates the Jobs
The Vanguard model for ‘check’ 1 What is the purpose (in customer terms)? 5 System Conditions Telephone 4 Flow : Value work + Waste Email / Web Post 3 Capability of response In Person 6 Thinking 2 Demand : T&F, V&F What matters? www. staffordshire. gov. uk
The Vanguard model for ‘redesign’ 1 Purpose (Principles for WD/R/M) 6 Act on system conditions 3 What are the value steps? Telephone 5 What are the added value roles Email / Web Post 4 What are the core roles: Design against demand In Person 2 What are the permanent measures? www. staffordshire. gov. uk
HR Shared Services Pilot What did we learn? What did different look like? www. staffordshire. gov. uk
What we learnt in check Customer demands: • Help me fill / advertise this vacancy • I want to appoint……. . • Pay my hours, expenses, etc • Update my personal details e. g. I’ve got married • Advise me how I get……. e. g. child care vouchers www. staffordshire. gov. uk
What matters to customers? “You get it right first time and keep up with any changes in my circumstances” “I can send the information when it’s convenient for me” “I only have to provide information once” “I can easily understand forms you need filled in and any information you send me” “The process is simple and you minimise the number of times we need to speak” “You help me through the process” www. staffordshire. gov. uk
Purpose of HR Shared Services 1. Help me find the right person for the right post at the right time ready to work (Customer = Managers) 2. Help advise, maintain and pay me accurately and on time (Customer = Employees) www. staffordshire. gov. uk
Capability – How well are we meeting the purpose in customer terms? You get a de facto purpose with the wrong measures Stop BACS payments and keep senior leaders happy Purpose Payroll accuracy through % BACS payments Vs all payments Measures Charging system for BACS payments outside normal payroll run Method www. staffordshire. gov. uk Useful measures weren’t being captured
Learning to see HRSSC as a System “Please pay me my hours” = Multiple Sorts 35%V HO Passed 65%F 87%V 13%F Receive Information over-specification on to team HO HO Check & Batch for Punching 42% ‘dirty’ 7% Passed Back Check info with customer From the top 8 flows No of Steps 23 -157 No of handoffs 5 - 27 No of Checks 5 -30 Accuracy of payroll varies between 7095% www. staffordshire. gov. uk Process Information HO Final run HO – 2 to 4 cycles Corrections HO HO Check For Errors HO HO Pay HO Third Party Punches Run Payroll HO Manual Correct
The Systems Solution: design against demand Demand Value Work Expertise/ Flow www. staffordshire. gov. uk “Please pay me my hours” • Obtain clean information • Process info one stop - minimising handoffs • Run payrolls • Pay staff and issue payslips • Experiment with method of how to get clean info • Share expertise to reduce handoffs • Enable staff to pull support on demand • And measure against purpose
The Systems Solution: measure achievement of purpose Purpose Measures Method www. staffordshire. gov. uk “Pay me accurately and on time” • % information clean when received (leading) • % demand handled one-stop (leading) • % HR and payroll corrections made (lagging) • Level of failure demand (temporary) • Understand variation in measures over time • Act on causes of variation through experimentation to improve performance
Is it making a difference? • Early indications suggest 30 -40% capacity can be released • Some processes released up to 75% • % Clean and % One-stop more predictably closer to 100% • Services already impacted say they are ‘happier’ with the new service / approach • 3 FTE already released, £ 120 k savings projected in current year www. staffordshire. gov. uk
What did we learn from the pilot? • • • Set-up clean Leadership key Service resources commitment Manage stakeholders Deal with HR OD issues early It’s about heads not processes www. staffordshire. gov. uk
Measures must come from Purpose “Help me live the life I want to” End to end time, right first time, number of people and touches Find act on the causes of variation Purpose Help me live the life you want me to lead according to government policy Measures C 28 Number of intensive home care hours provided C 32 Older People helped to live at home Method Push 10 hrs whether needed or not. Increase in C 28 impacts reduction in C 32 Otherwise you get a de facto purpose www. staffordshire. gov. uk
Learning to see Adult Social Care as a System “Please help me live the life I want to” 26%V 74%F Customer Care take initial info HO Not eligible Service/Equipment provided www. staffordshire. gov. uk Passed to Access Team via email Prioritisation Waiting lists HO Flow Average Value Steps – 3 – 5% Average Waste Steps – 58 – 95% Right 1 st Time 52% Review/over 7 days hand off to WB HO Not eligible HO Reduce service Approval for service HO Agree service needed Fit into our boxes Access call back to gain further info HO Decision on visit or fast track Fast Track Visit
Check – Adult Social Care E 2 E Time www. staffordshire. gov. uk
Adult Social Care – System Conditions & Thinking System Conditions / Thinking Effect on Service Targets Drives the type of information we gather and services we provide Budgets held at the top, decisions separated from the work, screen people out and tighten eligibility criteria IT designs the work IT expert at the front not practitioner, functional Specialisation www. staffordshire. gov. uk
Case Study - John • • • 61 years old, male, single, lives alone. Diagnosed with epilepsy, but no recent history Type II diabetes is controlled by medication and diet. Eye sight poor with bilateral cataract and can’t read letters. Aspergers syndrome. Is socially isolated, lacks confidence and lives in his own bungalow and has savings which was left to him by his parents who are both deceased. • Takes daily trips to Birmingham where he purchases DVD’s, CD’s, cassettes and newspapers which he hoards. • Daily route of listening to opera late at night and gets up late. • 7 April 2008 - Received request for review from Sister based in Kent. She had underlying concerns. www. staffordshire. gov. uk
Existing Operating Principles • • • • • What would we Screening to keep service users out of the system do with John in Give people as little help as possible We only deal with people in crisis the old system? We go out of our way not to meet people We don’t listen to or believe that the service users know what matters to them Squeeze individuals into our criteria i. e. square box in round hole People are conditioned to have low expectations – staff & service users Check everything to death and cover our backs We think consistence equals equality Lots of management controls - decision making disconnected from service users We have to hit the targets, it’s the be all and end all We say one thing and do another Episodes are treated as units of work (close cases) Challenge is never seen as an opportunity to gain knowledge & understanding about the system in order to improve Information overload takes us away from the value work We don’t trust the system, the staff or the ICT We put the system first not the people www. staffordshire. gov. uk
New Operating Principles • Build relationship with customer by listening, trusting & clarify what they want • Anticipate need • Have access to the right person at the start and the same person throughout. • Treat people as valued individuals • Record & measure only relevant information linked to purpose (proportionately) • Support, empower and trust staff • Pull in expertise • Continuously improve don’t be afraid to get it wrong • Deliver the right service at the right time • Be honest • Confidentiality www. staffordshire. gov. uk
What we learnt redesign • • Referred by Sister, visited to build relationship and identify needs and what mattered to him – “Help me live the life I want to” Cataract and damage to retina causing problems reading letters, labels, bank statements and the cooking instructions. Implications were: – Poor diet making diabetes unstable, cataract operation refused by GP – Finances getting into trouble Fridge, oven door and washing machine broken Signposted to visit Stafford Blind Centre, but unable to gain access Sister signposted to Age Concern for cleaning - visited and declined services due to H&S risks in cluttered lounge and bedroom Had Meals-on-wheels in past, but cancelled as he didn’t like them Previously visited by Rehabilitation Officer who supplied visual impairment equipment (white cane and liquid level indicator) - does not use as in Johns words “they were useless” but case closed, due to not meeting FACS criteria www. staffordshire. gov. uk
What we did in redesign • Assisted with purchase of new washing machine, cooker, fridge and vacuum cleaner • Helped him find his birth certificate to obtain a rail card and order large print bank statements • Took him to Stafford Blind Centre to meet staff and to view and try out various equipment. He purchased hand magnifier at a cost of £ 2. 99 to assist with reading labels when shopping • Also successfully tried and supplied a desk top magnifier for reading letters, papers and bank statements etc at home • Motivated John to clean up the bungalow - met Age Concern who have now agreed to start a cleaning service at a suitable time for John • Arranged with GP to re-refer John to eye surgeon • E 2 E = 29 Days, £ 150 staff time and overheads, £ 1, 200 equipment loaned www. staffordshire. gov. uk
What Customers have said • • • • Social Services are ace You’ve been so kind to me, god bless you I really appreciate what you’ve done and that you’ve taken an interest You can have a gold star, in fact have two I didn’t believe all this would happen it’s amazing I can’t believe it your heaven sent I’m just very grateful you’ve come out This is the first time someone has listen to what I feel I needed and trusted me and that has made such a difference to me now I’m really grateful you’ve responded so quickly a load has been lifted from my mind I’ve rung your office three or four times and nobody ever rang me back, I can see things are really changing now though You are so kind and helpful You were so helpful when I felt so lost in the system, you helped me spend the last few weeks of my husbands life in peace without worrying about everything I’m impressed with Stafford Social Services www. staffordshire. gov. uk
Where are we now? • • CMT/Cabinet formal commitment Managers pulling method support Services leading and doing it to themselves Change Team quickly developing learning Acting on lessons learnt from HRSSC still continuing to improve Second phase well underway Linking strategy with operations through CXO www. staffordshire. gov. uk
There is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success, than to take the lead in the introduction of a new order of things, because the innovator has for enemies all those who have done well under the old conditions, and lukewarm defenders in those who may do well under the new. Machiavelli, The Prince www. staffordshire. gov. uk
This is a Leadership issue…. . Introducing System Thinking to service organisations can be a trying experience. This way of thinking exposes waste mercilessly. People must be prepared to abandon familiar and longstanding practises. Top management must take part directly in clearing away obstacles & in implementing & maintaining the new system. Middle level managers, meanwhile, must provide worksite leadership in putting the concept of System Thinking into practice. With thanks to the Opertaional Management Consulting Division, Toyota Motor Corporation www. staffordshire. gov. uk
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