“Clinical Transformation in London” The CCA Approach to Successful Change Management

1. “Clinical Transformation in London” The CCA Approach to Successful Change Management Rima Kalra and Steve Worrall May 2005 Training Course Title

2. Welcome & Introduction: BT Capital Care Alliance (BT CCA) 7.2+ million citizens 150,000+ NHS staff 300m consultations in primary care 617m prescription items issued 13m outpatient consultations each year 5.3m people admitted to hospital 1,660 GP practices 13 Care Communities 79 NHS organisations:- 31 Primary Care Trusts 10 Mental Health Trusts 32 secondary care (acute) Trusts London Ambulance Service Trust 5 Strategic Health Authorities

3. LSP London Capital Care Alliance LSP South West, South East StHA StHA StHA StHA StHA LSP North West & West Midlands LSP North East, Yorkshire & Humberside LSP East Midlands, East of England Connecting for Health’s National Programme for IT Choose & Book ATOS Origin The National NHS Care Record Service Health Record Electronic transmission of prescriptions (ETP) N3

4. GP / PCT Benefits Some Key Benefits for Staff • Linking up GPs, community nurses, AHPs, health visitors, midwives and Acute partners • Reduction in duplication of effort • Improved flow of information across organisational and geographical divides • Improved appointments, referrals, diagnostic tests Some Key Benefits for Patients • Reduction in repeated questions and form-filling • Reduced waiting times • End-to-end management of patient journey through electronic care plans

5. The NHS is a Highly Complex Environment 74 Trusts Range of functionality to be implemented …. Approximately 140,000 potential users – personal concerns, issues, challenges and objectives Multiple NHS initiatives with multiple complementary and conflicting organisational priorities …. affecting numerous clinical processes 5 Strategic Health Authorities/ 13 Care Communities Long-term Programme – Phased approach Multiple stakeholder groups: Clinicians / Health Care Professionals / NHS Management Different geographies… Differing environmental challenges

6. Why Can Change Initiatives Fail? Environment Reason for failure Time restricted • Inadequate change leadership** • Poor understanding of what’s ahead** • Failure to harness people** • Inadequate change implementation** Budget constrained Complex **“Achieving supply chain alignment through behaviour change,” Gower Handbook of Supply Chain Management, Jamie Bolton and Karen Dwyer, 5th edition, Gower Publishing Company, p. 603.

7. Strategic Planning Location Preparation Product Deployment Deployment Closure Predeployment Workshops Managing the Different Strands of Change Is Key to Our Success Executive sponsorship and governance Communications Process redesign Training Benefits management 310 years of healthcare experience + 270 years of complex change experience = integrated change framework

8. Characteristics of Our Approach 1 Implementation Consultant per Trust Toolkits Encourage Knowledge Sharing Developing Best Practice Delivering Qualitative & Quantitative Benefits

9. Our Experiences in London PCTs are Shaping the Delivery of our Approach Early engagement is important because of the pressure on people’s time and commitments Linking benefits with prioritiesand strategy Clinical Transformation Linking in with other initiatives – modernisation, workforce, new buildings Understanding the local organisation and relationships Setting out clear roles and responsibilities

10. PCT/Trust Feedback Liked having an Implementation Consultant Liked the Toolkits Too much paperwork! Provided impetus to review Trust-wide delivery of care

11. The Decision & The Journey In the boat or not?