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Vanguard News - February 2009
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In this issue:
Pass the patient
Transactions as 'efficiency'
Standard times: 'should take' vs 'does take'
Failure demand is a systemic phenomenon
Audit Commission gets it wrong
Will CAA be the Achilles heel?
A new Vanguard web site
Vanguard USA
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Pass the patient
The president of the Royal College of Surgeons lamented the fragmentation of the
health service having a detrimental effect on the doctor-patient relationship and,
thus healthcare. For, as people are finding out when they have reason to get help
from the NHS, the doctor is no longer looking after you as you go through the
system; instead your doctor is just one of many transactions you will experience.
No one is concerned with your relationship with the system, it being managed by
computers. So if you want good help from the NHS you'd better be ready to manage
the relationship yourself.
See: http://news.bbc.co.uk/go/em/fr/-/1/hi/health/7839235.stm
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Transactions as 'efficiency'
It is the same with all public services. The 'efficiency' agenda treats all
service work as 'transactions'. Thus they think call centres are good for
'telephone' work (not realising the telephone work should be thought of as a
service or part of a service). They think 'back offices' should be used to
process 'tasks', not realising that many extra 'tasks' get created by thinking
this way. And they turn poor service delivery people into ciphers, 'I process
benefits claims'.
Whereas if the work is designed from the point of view of helping customers (i.e.
designed against demand) the design brings peoples' brains to work, they enjoy
what they do, its far cheaper and citizens appreciate the service and develop
respect for their local authorities, housing organisations and so on. We will
be building lots of evidence of how well this works and guidance on how to
design against demand in our new public-sector web site (see later).
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Standard times: 'should take' vs 'does take'
The obsession with transaction management began in the private sector. Typically
customer demand is split into a series of tasks, each having a standard time. In
some organisations the standard time is called the 'should take' time. But when
you study the work (in 'check') you find a huge difference between what it 'does
take' and the 'should take' times: it 'does take' a long time from the customers'
point of view (the true end-to-end time) and while you may find the 'should take'
times are being met, the fragmentation of the work and the focus on standard
times creates more work (more 'tasks' in this way of thinking). It is a peculiar
form of demand amplification.
Also, when you are working in re-design, you focus on designing against customer
demand(s), learning how to do only the value work (no fragmentation etc). The
result is a massive fall in 'does-take' time and a big improvement in customer
service. 'Does take' is profoundly more useful than 'should take'.
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Failure demand is a systemic phenomenon
On top of the results achieved through designing against demand, you don't get
the failure demand created by the front/back-office standardised designs. Because
the public-sector 'reform' regime fails to appreciate the systemic nature of
failure demand (it is caused by the targets, among other things, they impose
on public services) I wrote a paper explaining all. It is an incredible irony
that the regime should set targets for reducing failure demand.
You can get the paper at: http://www.systemsthinking.co.uk/9-nihorse.asp
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Audit Commission gets it wrong
A reader writes:
'I thought that you would be interested in this area for improvement suggested
by the Audit Commission in their latest report on [my council]: 'The Council
should take steps to increase the availability of information about service
standards so that all members of the public are aware of the standards they can
expect to receive.''
As the reader knows, setting standards makes performance worse; it is in the
nature of an arbitrary measure. Far better to use actual measures, related
to the purpose of the service from the citizen's point of view and ensure
they are in the hands of the workers along with method(s) on how to act for
improvement. But doing the right thing will mean you will get bullied by your
inspector - just doing his job.
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Will CAA be the Achilles heel?
We are now at the dawn of CAA, the new inspection regime. The Audit Commission
behaves like the worst of managers - change things with such frequency that you
never get found out. Best Value, Star Ratings, CPA and all the other associated
regulations have not delivered, but the Audit Commission narrative is each did
its job and was needed for the presenting circumstances; all rationalisation.
The Audit Commission announces CAA with a plethora of meaningless blather.
'Partnership working' 'sharp learning curve' 'flexible' 'not a one-size-fits-all'
and councils should be 'more resourceful, innovative and determined' in a world
where 'less will have to be more'.
When I talk to people at the sharp end, their 'sharp learning curve' has been how
little confidence they have that anyone really knows what they are doing. They
still feel the pain of the overly-bureaucratic CPA regime and as CAA arrives they
doubt that 'light touch' will mean anything, that anyone can be confident about
what 'risk-triggered' inspection means, they worry about being held to account
for services for which they have no responsibility, they worry about the (still
too many) various inspectorates agreeing on what to inspect and what to mandate
them to do, and they fear that CAA will mean more inspection, not less.
Many of these people have been engaged in the 'consultation' process. Imagine the
scene. You are sitting in a room with people from the Audit Commission trying to
work out what CAA will mean in practice. Everyone has ideas/issues/thoughts and
so on, and the Audit Commission people join in, for they too are in the dark.
But as things go along you start to realise that even though the consultation
exercise did not come to sound conclusions, the people from the Audit Commission
will be making their own decisions about how to inspect. Is that the way to do
it? We'll take the ideas we liked best?
And while all this is going on we get a report of the 'trials' of CCA in 10 local
authorities, which concluded it was too early to say if inspection burdens will
be reduced. So, we learn nothing from the trials but we go ahead anyway.
CAA has stumbled big-time into Deming's trap: operational definitions. Will it be
the Audit Commission's Achilles heel? I hope so, for all our sakes.
***
A new Vanguard web site
I am proud to announce 'The Systems Thinking Review' a new web site aimed at systems
thinkers in the public sector. Please take a look at:
http://www.thesystemsthinkingreview.co.uk
Your feedback welcome!
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Vanguard USA
I am delighted to announce that we now have a presence in the USA. For people
on that side of the pond, please go to: http://www.newsystemsthinking.com/ and
say hello. It ought to be the rallying cry for systems thinkers: Yes we can!
In case you missed previous announcements we also have a presence in The
Netherlands, Denmark, South Africa and New Zealand.
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Thanks for reading!
John Seddon
john@vanguardconsult.co.uk
Author: 'Systems Thinking in the Public Sector', available from Triarchy Press:
www.triarchypress.com and 'Freedom from command and control: a better way to make
the work work' available from Vanguard (www.systemsthinking.co.uk).. 'Freedom
from command and control' is also available in the US from:
http://www.productivitypress.com/productdetails.cfm?SKU=3276
Vanguard Consulting: Developers of the Vanguard Method, helping organisations
change from a command and control to a systems design. Beware of imitators, as
Vanguard has developed solutions for sectors others claim to be able to provide
the same service. If providers are not accredited to the Vanguard Method you
should not expect a Vanguard service.
Systems Thinking People - a service helping systems thinkers find suitable work
and helping organisations fund suitable systems thinkers. www.systemsthinkingpeople.com
Vanguard Capchart - simple-to-use tool for creating capability measures.
http://www.vanguardcapchart.com/
***
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