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In our experience only 1 in 50 RFPs (Requests for Pricing) in the network and applications technology space calls specifically for performance testing to be part of the package. The rest focuses attention in detailing the product requirements, which will only answers the questions -What does your device do? and -What is its functionality?, not -Will it work with my network requirements?
Some RFP’s call for a Performance matrix and on occasions this extends to asking -how much traffic can the device or application handle? However, without independent real world verification (performance testing) in the context of a network’s/application particular traffic types and mix, how can a direct comparison be made? How are your technical people expected to differentiate between new technologies’s of which they have little or no practical experience? What is the difference between the latest technology switch priced at £12k and a switch available at £2k, with similar functionality? More importantly how will you understand the comparative performance in the live network/application environment?
Often purchasing professionals shy away from what they consider the additional expense of performance testing, perhaps they rely on traditional negotiation skills and trust engineers to make the appropriate selection of technology and location. Contrast this with decisions based around real test results where the risk of failure is reduced. Your ability to negotiate is increased through a thorough understanding of the requirements, and it’s not uncommon for post test prices to fall 20%! Add your ability to select the right technology for the right place in your network and the direct savings could outstrip the investment 50 fold.
Why don’t more buyers include test as part of the selection programs? Is it because they don’t realise the huge potential for savings? Or perhaps they don’t know where to start?
We know from our work with West Country Universities, a very large Services Information provider, and many others who do independently test what they want to put into practice, that the outcome of adding -Independent Testing to an RFP is worth a reduction in overall bid prices of up to 20%, that equates to £1m on a £5m project! By testing and selecting the right switch for the right application the Service Information provider for example, stands to save £8m a year! Year on Year! As well as avoiding embarrassing in-service failures.
As buyers becomes better educated and informed through understanding the impact of the test results, essential RFP inclusions like ‘ensure solutions are tested pre deployment’, can be included and contractual negotiations can then be based on facts and evidence of performance .
Where to start, is simple to us, but not perhaps to the commercial buyers. Spirent provide testing methodologies appropriate to switches, routers, server load balancers, firewalls, web applications, database services, application servers, WAN acceleration and applications so that at the very least their suppliers will have to carry out contextual testing as part of their submission rather than guessing best performance. If the contract is of a significant value they might want to complete this testing independently. The cost of testing is around 1 to 2% of the value of most midsize projects, the cost of not testing is a great deal bigger than that.
For More Information Contact:
Kate Innes ZonicGroup
kinnes@zonicgroup.com
A storm is brewing.
As we head into 2010 the healthcare sector is facing many challenges. Not only are budgets being cut but many institutions are faced with growing customer numbers. This means more customer data to manage. Sophisticated technology is also adding to the problem.
Doctors are seeing an increase in super-high resolution imaging technology for diagnosing and treating patients, which in turn is leading to ever more data to manage, secure and store. Every one of these issues is causing huge headaches for the IT managers. While UK hospitals need to grow their storage capacity, many lack the budget, physical space or even sufficient energy supplies to do this. It’s the perfect storage storm.
For the budget-challenged IT manager in the healthcare sector the need to do more with less has become a sudden and harsh reality.
In the past, radiology and cardiology departments were the primary users of medical imaging systems, picture archiving and communication systems (PACs), including CT scans, MRI, cardiac catheterizations and echocardiograms. But recently medical digital imaging has exploded into many more specialties in the medical sphere. Pathologists and dermatologists are among the new users. Images of tissue samples and skin lesions improve diagnosis and track the progress of patients’ treatments.
Also, new cancer diagnostic exams involving the latest medical imaging equipment, such as digital mammography, produce thousands of high-resolution images per study. But the practical ability for most hospitals to host more equipment to store and manage more data is being severely impacted by the expectation that many UK hospital datacenters are rapidly running out of space and power.
About five years ago, the average 500-bed hospital needed less than two terabytes of storage for its medical imaging. Today, it needs 50TB to 100TB for the average 150,000 to 200,000 imaging-related procedures done annually in these facilities.
Storage efficiency is, therefore, being cited as one of the biggest drivers for hospitals determining their storage spend this year and beyond. This was confirmed in a study by analyst research firm Enterprise Strategy Group. Its survey of 504 global storage professionals found that budget-conscious storage decisions in 2009 will be driven by efficiency. The survey also identified that specific efficiency-friendly technologies enabling data reduction, intelligent tiered storage and storage reservation were among the top priorities for the next 24 months.
Intelligent tiered storage is particularly important to the healthcare industry, as it can provide hospitals with a cost-effective way of centralising their image database and other storage resources. On top of the images, hospitals also store thousands of other files that must keep on file regardless of how big they get.
However, only a fraction of this data needs to be accessed frequently; the majority of files, once they pass their useful life, are never opened again. Tiered storage automatically moves the least accessed files to the lowest-cost tier of storage. Similarly, if an infrequently accessed file later becomes more popular, this will be moved back up to the faster, more expensive storage so that it could be accessed and downloaded more quickly.
Interest in fluid storage technologies like these clearly indicates a growing trend, indeed a flight, towards greater storage efficiency. By boosting the efficiency of their storage infrastructure hospitals can accommodate data growth within strictly limited budgets. And they can do all this using a smaller hardware footprint that in turn consumes less physical space and draws down less energy. When these technologies are combined, the compounded efficiencies can be dramatic and immediate.
It’s not uncommon to see 90 percent utilisation improvements over legacy storage capacities resulting in further significant reductions in energy needs.
It sounds simple enough but a major hurdle remains. Hospitals often find it very hard to break free from the traditional and large storage brands, now pilloried for their excessive inefficiencies, to which they’ve grown accustomed to using.
They are also reluctant to move when they look back at the high investment in training and other costs they’ve incurred. However, with the economy at the fore-front of all major spending decision there is now much greater pressure on IT managers to explore new options that deliver greater efficiency. The historical reluctance to transition from the big brands is starting to erode as value and efficiency move to the top of the priority list.
Annual storage requirements for many providers are increasing at a rate of 20% to 100%. Ballooning storage requirements have resulted in a number of challenges, from cost to disaster recovery to security and access issues. IT managers need to ramp up their knowledge of intelligent tiered storage as quickly as possible and ensure that it’s a central platform for their future storage strategy. Not only will this help solve their immediate problems of data growth, budget limits, space and energy, but it can just as directly benefit their hospital’s bottom line. In this period of economic uncertainty, a healthy obsession with efficiency will be the key to weathering the storm.
Additional Case Study – Compellent drives 90% energy saving at University College Hospital Galway
One of Ireland’s major academic teaching hospitals, Galway’s HSE University College Hospital, was experiencing vast IT requirements spread across the various departments and hospital sections.
By June of 2008 storage levels were at a critical level for UCHG and they were on the verge of running out of storage, and were close to capacity on the model of SAN they currently had. These problems were compounded further by the fact that their existing SAN was also past the end of its product life and could not be upgraded. The only option was to buy a new one. Their existing SAN vendor was happy to sell them a new SAN but there was no way of avoiding the same problems again over the next 3 years.
Through working with Origina’s Innovation & Development team UCHG devised a pioneering new storage framework for the entire organisation. Origina storage architects designed a solution built on Compellent Storage technologies that delivered a vast variety of benefits that solved the organisation’s storage problems and, moreover, facilitated their requirements into the future. Based on Compellent’s energy-efficient storage area network (SAN) the solution is saving the hospital 90% on power and cooling costs, and with no model range, the same SAN can be used until a 900TB capacity is reached.
The news that council chiefs are set to quit amid budget and pension plan changes (Financial Times, Council Chiefs Set to Quit as Cuts Bite, 11 November issue) brings into the spotlight once more the issue of attracting the best and most qualified staff to senior roles when remuneration alone will not cut it.
With all parties looking to local government to take additional social and political responsibilities while simultaneously saving money it is quite clear that the political and business landscapes have changed. If public sector organisations are to attract and retain the best talent to cope with these changes they must realise that the manner in which they attract and retain their employees must change with them. The good news is technology can bridge this gap.
Public sector organisations today are increasingly under pressure to deliver top quality service with fewer and fewer resources. A key way to achieve this it to increase employee knowledge and maximise efficiency, so service to customers can be delivered quickly and effectively each and every time. Yet, attracting and retaining talented staff with the necessary aptitude and experience can be very challenging, particularly when budgets are tight and there is pressure to reduce costs. Top quality employees are a hot commodity and in the current economic climate, alternative incentives should be considered when a hefty pay hike or an attractive pension isn’t an option.
For instance, due to the ready availability of flexible working technologies such as videoconferencing or remote access to office functionalities, staff can better balance work and home life, so it can shift from being a -nice to have” to a -must have”. Especially when budgets are tight, organisations need to show they care about work/life balance, or that talent could go elsewhere. And without the right staff, or the right technology to retain them, everyone loses.
In addition to enabling employees to balance their home and work lives, flexible working technology can also ease the pain of the talent drain by providing organisations with the ability to staff important roles with non-traditional employees such as remote or part-time workers and retirees. This can translate to improved competition with the private sector as well as better service, faster issues resolution and more responsiveness overall.
What about costs? Fortunately, many of the technologies that can make flexible working a reality are already in place in most organisations. By combining the existing infrastructure such as VoIP with newer technology like Unified Communications, employees can work as effectively remotely as they do in the office. Unified Communications (UC) technologies such as presence or extensions to mobile applications which enable remote staff to work seamlessly regardless of location, could enable employees to work a rolling set of hours and equip them with the ability to work from anywhere they happen to be, effectively extending business hours as experienced by customers and partners without requiring employees to work a single extra minute.
Furthermore, employees are not the only ones that benefit from flexible working policies. Customers too see the benefits, through increased access to experienced, knowledgeable staff. Flexible working can allow public sector organsations to live the dream of first call resolution, becoming even more efficient with a limited set of resources.
The social and political landscapes are changing, but so is the way we work. Through increased flexibility, the public sector can become more competitive and efficient, so it can better fulfill its function – to serve.
Many agency nurses, who are an essential function of the NHS, are often treated as -second class citizens- something that needs to change to ensure maximum standards of care. That’s the message from the nurses we’ve surveyed at Arrows Group.
One agency nurse, who wishes to remain anonymous, says that there is a lot of hostility towards temporary nursing staff, that they’re given the most difficult patient and offered no support. She says, -We’re not treated like nurses- I’ve often been referred to as ‘agency nurse’ rather than by my name. Some hospitals don’t allow us to administer drugs, which I can often understand, but when that’s the case they should offer us the training to do so. We’re always willing to pay, but many won’t even offer us the option.
-There’s hostility because NHS nurses know we get paid more than them says another. -And if there are tasks we’re not permitted to do, that can mean more work for them. But that’s not our fault, and if they would work with us as a team then there wouldn’t be a problem. Permanent nurses always ask me what I’m earning, and if there’s a piece of equipment I’m not familiar with, I’ve been told ‘you’re paid a lot of money, you should know how to use it’. One nurse refused to show me how to use a new piece of machinery which everyone had been trained on whilst I was on holiday. This meant I couldn’t change a patient’s IV – I had to spend half an hour finding another nurse and take her away from her work so she could show me. Obviously not all wards in all hospitals are like this but it just shows that this treatment has a direct and negative impact on patient care.
The truth is that the NHS couldn’t function without the input of these specialist nurses. These people are highly qualified and deserve to be treated like any other nurse – and common courtesy is something that every employee is entitled to. The focus of healthcare staff should always be on patient care but it seems this is suffering due to these hostile attitudes.
Then there’s the issue of introducing new rules that state NHS nurses must have degrees, which could cause even more staffing problems for the health service. With specialist nurses already in critically short supply, narrowing the criteria for those wishing to enter the profession will lead to a drop in the number of people becoming nurses, making this problem even more acute.
This is a commendable move – the Government says that these new rules aim to improve the standard of patient care, which of course is of utmost importance. But it runs contra to the most pressing issue, which is nursing skills shortages across the NHS. By introducing these stricter requirements, the NHS may in fact find itself with lower standards of patient care, because it will struggle to find the talent it needs.
An increasingly high percentage of nurses working in the NHS are foreign nationals and raising the bar at entry point would have to be communicated clearly and rolled out internationally as the NHS is staffed by an international resource pool. There are critical staffing shortages across the NHS and the most pressing issue is looking at options that solve this rather than complicating it.
James Parsons, Managing Director of healthcare recruiter Arrows Group, which supplies temporary nurses to trusts across the country.
NHS Trusts have come under increasing pressure to improve the management of several £100m of assets, from medical equipment onwards, in order to reduce spiralling litigation claims and deliver far greater accountability. But with information stored not only by Finance within the capital asset register but also duplicated across Medical Equipment and Estates departments, attaining a single view of asset history, including location, maintenance and value is impossible.
Now, as it becomes apparent the NHS will face a significant financial shortfall in the near future, it is becoming ever more critical to impose control over asset management to improve performance, maximise resource utilisation and minimise mistakes.
Karen Conneely, Real Asset Management, outlines the need for a single integrated asset register.
Funding Crisis
As the NHS Confederation report reveals that the health service will face the most severe and sustained financial shortfall in its history after 2011, managers are now facing an -extremely challenging financial outlook.
This radical change in fortune comes at a time when NHS Trusts are already under pressure to improve performance through a range of measures to meet the Darzi-led demands for greater efficiencies throughout the health service. Furthermore, as growing numbers of Trusts attain – or seek – Foundation Status, senior managers are now considering the implications of significant budget cuts within an increasingly commercial business model.
The growing focus on finance comes at a time when Trusts have already come under additional scrutiny from auditors looking for greater substantiation of the balance sheet through the verification of the existence and location of capital assets that are collectively worth several million pounds.
Furthermore, Trusts are also under pressure to mitigate the risk of litigation. With the NHS paying out an estimated £650 million to patients in claims annually, often as a result of poorly-maintained equipment or equipment being used without adequate training, Trusts now recognise the need to impose far greater control over the asset register.
Complex Asset Management
But imposing this control is far from simple. Assets are distributed across each hospital- and GP surgery – and managed by different departments including Medical Equipment, Estates and Sterile Services. Furthermore, medical equipment is highly mobile and often leaves the premises on loan to patients.
Each department has its own asset management system, resulting in data duplication and inaccuracy across the Trust. It is extremely difficult to achieve full, up to date visibility of assets without hugely expensive manual data reconciliation exercises performed monthly so that Finance can have any level of confidence in the fixed asset register.
In addition, the lack of a single view of assets across the Finance, Equipment and Estates departments leads to difficulties in assessing an asset’s longer term value to the business. For those with Foundation Trust status, this inadequate visibility makes it extremely difficult to undertake the required analysis of the cost of service delivery and to determine profitable future strategies.
Integrated Solution
There is a growing awareness across the NHS in England & Wales that the only way to impose control over this key asset base is to replace these disparate systems with a single, integrated asset register that not only holds the capital asset information for the finance team but also addresses the requirements of each department.
And this is key: to meet both compliance and efficiency objectives, an integrated solution must cater for the specific needs of each department, from tracking which patient is using a piece of equipment to managing proactive maintenance for the estates department and delivering the full audit trail of equipment sterilisation through each stage of the washing cycle.
By providing each department with a customised view of the single asset register, a Trust can achieve centralised control whilst still ensuring that all operational asset management demands are met.
Critically, the previously time-consuming manual processes for condemning outdated equipment can be streamlined, with full visibility between the relevant department and the central finance team – whilst delivering an audit trail that is essential for complete accountability.
Trusts can also ensure that key compliance requirements are addressed without incurring an administrative overhead: from tracking and reporting on response times using time and date stamped maintenance logs, to creating a full audit trail of patients’ use of equipment, linked to associated training histories to minimise litigation risk.
Commercial Imperative
While a single integrated asset system will enable Trusts to meet compliance requirements and deliver cost savings, it will also enable those providing maintenance services to other organisations -including GP surgeries- with the ability to proactively monitor performance against the Service Level Agreement (SLA).
By aligning assets with service records and histories, organisations can not only assess their condition and recommend maintenance but can also determine whether they are meeting the required performance levels, costing too much in repairs or failing to contribute to the overall business strategy.
This shift to a single system also provides a platform for future innovation: organisations can look to leverage their investment by adopting wireless hand held devices, even RFID tracking, to further reduce the administrative overhead and improve real-time information access.
Maintenance technicians -both internal and third party contractors- can be provided with a PDA containing electronic versions of job tickets; as each job is completed, the information loaded into the hand-held device will automatically and immediately update the core system, removing the risk of rekeying errors and ensuring that information is consistently up to date. This will be key to improving response times to breakdown requests and to delivering ever more cost-effective services both internally and commercially.
Conclusion
The combination of escalating compliance pressure and predicted demand for annual savings of 6% for the years 2011-2014 is driving growing numbers of Trusts to look far more closely at asset management. Whilst wireless technology may not be part of the initial implementation, the ability to combine this level of automation with a single consolidated asset register offers Trusts a compelling solution. By moving from disparate sources of, often duplicated, asset information to a single, consolidated asset register, Trusts are minimising the risk of litigation, improving service levels both internally and for external customers and, critically, delivering the cost savings required to meet the forthcoming years of stringent financial control.
AS the world of primary medical care advances into the 21st century, few companies have done more to change the face of the industry than Telehealth Solutions Limited. The progressive firm, established in 2006, has made it its mission to provide a remote monitoring service for patients across the UK.
This rapidly rising young company has stepped up to the plate to offer medical professionals and patients alike the chance to embrace the future.
The Telehealth Solutions product list proudly proclaims the presence of a group of ‘pods’, which are prefixed in such a way to make them easily identifiable to both professionals and patients.
These are the CardioPod, HomePod, SurgeryPod, Check-in Pod and CarePod. Each one of these cost-effective and highly effective machines has secured its place in the medical world and is turning conventional care on its head.
One of the main benefits is that patients suffering from chronic conditions that need to be monitored regularly can now do so from home.
This has helped free up valuable time for both GPs and frontline medical professionals, who no longer have to make house calls as data is transferred from the patient on a regular basis. The CardioPod, recently launched by shadow health secretary Mary Scanlon MSP at a pharmacy in Edinburgh, is already changing the face of 21st century primary healthcare.
This remarkable machine, usually installed in pharmacies, offers patients the chance to pop in for a professionally supervised heart check that takes no longer than 20 minutes.
A small blood sample is taken, which registers blood glucose and cholesterol levels. The pharmacist then asks a series of questions and the answers given, combined with the blood results, calculates the risk of the patient having developing cardiovascular disease within the next decade.
These results appear on screen in an easy to follow format – with smiling faces representing heart health and frowning faces representing the patient’s risk of having a heart attack. A personal health check report is processed, allowing the patient to set health goals, which can be anything from smoking cessation and cutting alcohol consumption to taking more exercise.
Afterwards, a clinical report is printed out and given to the patient to take to his or her doctor, if necessary. These results can be, when the system is programmed to do so, sent to the patient’s GP for action.
The HomePod is also another groundbreaking machine for patients with a series of chronic conditions, such as diabetes, asthma or heart disease, who find themselves in and out of hospital on a regular basis. Using wireless technology, the HomePod encourages people to take control of their own health by issuing reminders to take medication, weigh themselves or go for a walk as previously discussed with their GP.
The machine also has the facility to take blood oxygen readings and monitors ailments, like coughs, through a series of targeted questions to ensure nothing is getting out of control. Results are fed back to the GP, who can keep track of the patient’s health without leaving the surgery.
Time-saving for hard-pushed GPs is also where the multilingual SurgeryPod comes in. Usually placed in waiting rooms, the machine offers the chance to have health checks before they go to see the doctor. As the information collected on health and lifestyle by the HomePod is then relayed to the GP electronically, it means they have more time to spend working out a way forward with the patient when they come in for a personal consultation.
Telehealth Solution’s executive chairman Jeremy Cummin, the force behind the emergence of the Watford-based firm three years ago, is remarkably frank about the reaction the firm’s technology has sparked among users.
Adding that he was delighted with Self-Care week and the work it does to promote the work firms like Telehealth Solutions do to encourage self-care through remote-monitoring, he said: -In short, patients love our systems as they offer them a sense of freedom and also the peace of mind that they are taking charge of their own health. It also removes the temptation for self-diagnosis, which is all too common given accessibility to the Internet, but which can be very dangerous.
-For today’s NHS professionals, most of who are bound by budget constraints, there is no doubt that offering patients the chance to take charge of their own health where appropriate – and with remote medical guidance – is a fantastic step forward.
Education is being reformed through various initiatives, and the Government’s flagship vocational qualification, the 14 – 19 diploma is playing a key role in the process.
Naturally the delivery model for diplomas must be flexible to allow for learning in a range of settings, however this affects ICT provision and many schools have not yet contemplated the sheer scope of such change. Steve Smith, director of learning at Ramesys, guides us through the key technological issues.
In response to the changing work and educational environment, the 14- 19 agenda is set to significantly transform learning as we know it. As with any change, there are challenges to tackle, and the 14 -19 agenda must be viewed strategically in order for schools and local authorities to determine the wider picture.
Many schools have spent years planning their 14 – 19 provision. Best practice examples of how schools have worked collaboratively to deliver successful outcomes are often proudly revealed, along with how employer engagement is encouraged, and other equally as encouraging reports. However there is one area that may not have received the consideration required; the technological issues within the education and wider children’s services environment.
Moving between learning environments to study is completely alien to many. After all most of us were educated in the same location for a number of years, and only experienced a change of setting when the move was made from primary to secondary school.
For today’s generation it is vastly different; they will not be restricted by location. In contrast they will study in multiple locations. Students enrolled on diploma courses will find their studies take them to more than one institution. For instance they could be required to study at school, a local college, and a work-based learning establishment to create a more holistic learning experience.
14 – 19 learners are ‘peripatetic’ learners, and therefore have a home school; a second education institution base such as another school or an FE college where they study some elements or modules that their home institution cannot provide; and a work place base where professionals support them in a particular area of study.
Flexibility is therefore crucial to ensure that learning can take place in a number of settings, and consequently ICT must be ubiquitous. As one can imagine, there are technological issues to be addressed if it is going to be possible for students and staff to move between learning centres. Registration, access control, and cashless catering plus many other elements must be considered.
It could be argued that if ICT is not thought through, technology could become a barrier, not an enabler. So, what are these issues, do they affect the staff as much as the students, and how can they be addressed?
Students on the move
Focussing on just one area as an example, student mobility requires registration information to be collected at more than one establishment. However currently the majority of MIS systems have data hosted on servers in the ‘home’ school. This raises an issue of how students register in each place of study, and how can the data be made visible to staff in different institutions? To overcome this, MIS systems should be centralised and web-based interfaces provided and views on the data.
Moving onto other systems which may be linked to the staff member or student’s identity, such as access control or cashless catering. As an example, one centre may have a system based on swipe cards, another biometrics. In one, the access control system may be used for student self registration, in another staff may still call the register and enter the data via a keyboard. Even if all centres use the same system based on swipe cards, unless the data can be centralised, identity information would need to be maintained separately at each centre.
Emma Duffield, a Year 11 student at the Piggott School in Reading explains that these are issues that need to be considered: -I currently study in just one location, but if I moved from place to place to study, the contact I need to have with ICT would be an issue. I am always misplacing things, so if I had a swipe card for each place, it would cause problems! I think biometrics is a good idea even though it sounds like something out of Star Trek!
The area that generates perhaps the most concern is the Managed Learning Environment (MLE) and the access to/submission of resources and assignments. If each learning centre has a different system, does this mean that a student will have to log-on to several according to their place of study? Would this require staff to upload materials to different MLEs to cater for students coming from different institutions? How would the work-based tutors update online resources, records and reports?
All of this highlights the need for a joined-up approach, but what about the wider children’s services area?
Collaborative children’s services
The Systems Interoperability Framework or SIF (formerly the Schools Interoperability Framework) can help overcome many of the issues highlighted.
Organisations must work collaboratively to ensure success, and this is a view shared by those within the industry. Robert Fitzgerald, children’s services senior product manager, from OLM Systems, part of OLM Group, the leading supplier of integrated information solutions to the care sector, explains: -The difficulties of interoperability amongst system suppliers within children’s services have risen to prominence this year with the arrival of ContactPoint. This project has provided a renewed rationale for looking again at ICT integration and has challenged authorities to look more closely at how they can execute the Information Sharing Agenda amongst all professionals working within children’s services as a whole. It is still surprisingly difficult to get an education systems supplier and a social care systems supplier to work together so that data about children in care, for example, can be appropriately shared. SIF may well be the answer.
The SIF vision is a relatively simple one, but the complexity of achieving it is significant. Proof of Concept (PoC) work in Birmingham and in Northern Ireland has formed part of Becta’s evaluation of the use of SIF in schools. Both proved a success, but the findings in respect of the Northern Ireland PoC suggest that SIF works and points the way forward, but the range of data and applications covered by SIF is currently far too limited.
So, for the utopia of complete interoperability between the plethora of school applications to be achieved, let alone meet the challenges in the wider children’s services world, the data model needs to be expanded significantly, and the number of organisations being prepared to adopt SIF needs to increase massively.
-It has been proven that the appropriate sharing of key child and family information can inform early intervention programmes, support families experiencing difficulties and improve the life chances of less fortunate children. The sharing of this information must be facilitated by ICT, not hampered by it, concludes Robert.
With the uptake of social media initiatives in the UK public sector lagging behind other European countries, what steps can this sector take to manage the associated risks and step up a gear?
The government sector in general is currently failing to impress on its level of engagement in social media initiatives such as discussion forums and blogs. These so-called ‘e-government services’ can be an effective way for local councils and individual MPs to publicise a more positive and transparent image to their constituents. Public perception of MPs certainly over the last few years has been very mixed. Often they are associated with negative attributes such as dishonesty, distrust or even having a secret ‘hidden agenda’.
By adopting a more engaging, open stance via social media, the likelihood of gaining trust and respect to a wider community of people is increased. Although it may appear that by indulging in social media MPs are opening themselves up to public scrutiny the potential knock-on effect of appearing more approachable and less guarded could be very rewarding. Social media can also help those in the public sector to reach out to people in the community that might be disillusioned by politics, with the Government anticipating that social media will help to facilitate access to the wider community that government is currently unable to talk to.
With recent research[i] suggesting that only 23 per cent of MPs are actively promoting their presence on social networks and, even though some MPs have taken the leap into social media they are still not using it effectively as a tool to encourage dialogue with their constituents. Rob Marcus, director of the social media moderation company Chat Moderators looks at why the public sector should embrace the benefits social media has to offer and gives advice on the measures should be taken to ensure they are protected.
Marcus explains, -With so few MPs using social media and only 11 per cent having their own blog, this shows that the sector in general still has a long way to go. Although engagement through social media can hold potential risks and be viewed as time consuming, many MPs still feel that they need to be participating in it but are unaware of the technologies available to them. This may be a reason why so few have actually used social networking as a communication tool in their campaigns. Another reason may be that they are less technology savvy than younger social media users that have grown up with it, and there are still misconceptions that need to be dealt with. It may save time in the long run, but people can take a while to feel confident and get to grips with new ways of communicating.
-With most MPs (92 per cent) using email, social media also offers another route for constituents who wish to get in contact with them. Members of the public often feel that their local councillors are unapproachable, but having a presence on Twitter or adding a discussion forum onto their website could help them become more visible and easier to converse with. However, when embarking on social media MPs will have both different but (in many ways) similar issues to brands when it comes to receiving negative content. The higher profile the MP is, the more they become ‘a brand’ in their own right and when people feel passionately about an issue they tend to get personal.
For large blue-chip brands this is less of a problem but when dealing with an individual public figure like an MP the chances of negative submissions are higher. Having said that an MP is less likely to receive large volumes of submissions on a daily basis as a large brand might, but a higher percentage of the submissions will be negative which increases the very real need for moderation. It is vital for a stringent moderation process to be put in place in order to protect all parties involved.
Rob Marcus suggests some ways that the public sector can get started with social media………
Do some research and see what other local councils or MPs are up to. There are resources such as Tweety Hall (tweetyhall.co.uk) that list all local councillors on Twitter and by searching for local councillor’s blogs you can get a good idea of how your peers are taking the social media plunge.
Ensure you update and communicate through your social media initiative regularly so it becomes a success. Some initiatives, such as blogs, are more high maintenance than others such as tweets, so choose wisely. Perhaps you could share the burden with a colleague?
Your existing website can be a great platform for social media. Although there are numerous third party platforms within the social media sphere such as, Facebook, Flickr and Bebo, recent figures from the Internet Advertising Bureau (IAB) have found that just five per cent of people had joined branded groups and communities on social networking sites. So your own website can probably make a great home for social media initiatives too.
Marcus concludes -The main piece of advice I would give to an MP looking to set up a social media initiative is to seek help from a professional agency, expect that there will be negative comments appearing but to go ahead and give it a go anyway with your eyes wide open.
The UK public sector is facing its most serious funding challenge for many years.
Given the state of the public finances, major spending cuts are inevitable or costs will spiral out of control. While this is starting to be recognised at all levels, there is no clear roadmap of how to get there.
To date, the focus for improvement has been placed on large scale efficiency programmes including back office and shared service functions. Deploying information technology through efficiency-based transformation programmes has driven numerous successes and secured significant cash benefits. However, the new reality of reduced resources is of a different magnitude to anything experienced in recent times.
The public sector’s traditional response to funding challenges has been to top-slice budgets. This has shared the pain but has often risked throwing both strategic ambition and delivery of citizen outcomes out of the window. Reports such as the Institute for Government’s ‘State of the Service’ study demonstrate that the biggest issues have been a lack of focus on what those outcomes should actually be and a failure to clearly understand and prioritise the investments that deliver those outcomes most effectively. The result has been that although we have massively increased public investment, this has not produced the expected degree of change.
Significant change is clearly the only way forward but many organisations still struggle to either focus on or understand the potential impacts of their options due to a failure to integrate their strategic, financial and operational processes. The human aspects are as ever the most challenging consideration and to be successful we must integrate work across a wide variety of professional disciplines starting at the corporate centre.
As one example of the potential results, Birmingham City Council, the largest all purpose authority in Europe, has been working with HCL AXON through its joint venture Service Birmingham to support with all aspects of major transformational change, such as business case definition, benefits management, process design and organisational design, implementation and change management. The first part of programme is on target to deliver £518m cashable savings over 10 years, which will enable investment in improvement to front line services for Birmingham residents.
This example and others show that by creating an integrated solution, public bodies can connect political ambitions with the actual delivery of services and programmes. To make this happen, public sector bodies need to consider:
1. Strategy formulation – agreeing what’s critical and what’s not
2. Resource allocation – driving decisions by outcome aims but based on selected impact- assessed priorities
3. Planning process – delivering strategy-focused, options-based business planning, integrating financial/operational elements often for the first time
4. Performance management – evidence based interventions, supported by integrated financial and non-financial performance information, securing real value
It’s clear that as pressure increases on budgets, selecting investments by credibly linking them to outcomes will become ever more vital. Vague statements of aspiration with no evidence of effectiveness have to be things of the past. Critically in the current climate, while top slicing may begin to balance the books, indiscriminate reductions are very likely to impact delivery and ultimately fail to serve the best interests of the UK public.
By agreeing an integrated, strategic approach up front that makes sound investment decisions and maps these to measurable delivery goals, public sector leaders will be able to cut costs while delivering better, more impactful services. They will also be ready to use them in ever more effective ways to improve citizens’ lives when the economy stabilises.
In the wake of a report commissioned by the Government blaming the UK’s business leaders for low levels of staff engagement, employers working within local Government are being warned not to use the recession as an excuse for failing to acknowledge the efforts of their employees over the festive period.
The warning comes as new figures released by the Chartered Management Institute (CMI) show that almost two thirds (64 per cent) of managers in local Government believe that Christmas parties are important in helping to improve employee engagement.
The survey, of 155 managers, found that a similar number (60 per cent) claimed that the office Christmas party is vital to recognise the hard work of staff undertaken throughout the year. A higher proportion of managers in the sector (72 per cent) also believe end of year celebrations should continue in spite of the recession.
Interestingly, the findings also show that managers working in local government recognise the need for responsible reward and celebration. Asked about public perceptions, an alarming three quarters of managers in the sector agreed that an expensive party could damage their organisation’s reputation. The research also discovered that 64 per cent believe that a ‘team lunch is better than an organisation wide party’.
Commenting on the findings, Ruth Spellman, CMI chief executive, says: -There are too many examples showing that the poor quality of management and leadership in the UK lies at the heart of the disengaged workforce. Our research shows that end of year festivities are clearly still of great importance to the local Government workforce but the survey raises an interesting dilemma for UK organisations. How can employers say ‘thank you’ without incurring the wrath of the wider public? The answer is that employee engagement has never been as important as it is now, but it must come hand-in-hand with a tighter grip around the purse strings.
The results show that local government employers are being cautious about the amount being spent on end of year celebrations. Almost three quarters (74 per cent) indicate they are happy for time to be taken for a Christmas party, but will make no financial contribution. This is a massive increase compared to last year when it was only 47 per cent of employers. A mere 19 per cent have agreed to pay up to £40 per head.
With 76 per cent in the sector arguing that a warm approach to Christmas ‘is good for staff morale’ it is clear, from the survey that organisations will be going some way to improve the reported 42 per cent decline in employee engagement caused by the recession – a figure highlighted in CMI’s Economic Outlook Report, published in Autumn 2009.
Ruth Spellman continues: -The benefits to organisations of employee engagement cannot be understated. A truly engaged organisation can expect to experience high levels of staff loyalty, retention, productivity, innovation and profitability as well as low levels of absenteeism. Given the current economic climate these cannot be ignored as they are the stepping stones towards the future, long-term success of the local Government sector.
Responding to the survey, CMI has developed a micro-site providing more information on how employers can better engage with their workforce.
It can be seen at www.managers.org.uk/employeesmatter.
Today, Symantec, the world’s leading software security company, will advise the UK Parliament on the EU’s policy on protecting European governments from large scale cyber attacks against critical infrastructure.
Ilias Chantzos, Symantec’s director of government relations for Europe and Asia Pacific, will appear before a House of Lords committee at 10.30am on Wednesday 9th December to answer peers’ questions on whether European governments are right to fear cyber-attacks and how they can work together to mitigate the risks they pose.
As up to 90 percent of the critical infrastructure on which Europe depends is privately owned and crosses international boundaries, Symantec will counsel that only a co-operative between public and private sectors and Member States can secure the EU from malicious attacks and high impact, low probability -Black Swan events.
Symantec’s evidence will cover: –
How vulnerable the internet is to widespread technical failures and how it will be affected by natural disasters
Whether regulatory intervention is unavoidable to ensure the resilience and stability of the internet, and what this will cost the Internet industry
How concerned we should be about criminally operated -botnets and can the problem be tackled at a European level
Should the military be more involved in ptotecting the internet
Is the European Commission right to encourage public-private partnerships as a means of protecting critical infrastructure
Does ‘market failure’ mean that Europe is inadequately prepared for high impact Black Swan events?
Should Europe be developing its own approach or following the lead of the US?
Is the European Network and Information Security Agency (ENISA) the right body to develop national Computer Emergency Response Teams (CERTs)within EU member states
The National Heritage Debate on 2nd December was hosted by the former Heritage Link- after announcing the new name and introducing a new Chair- Loyd Grossman. The audience represented the wide range of heritage organisations all of whom have benefited from the umbrella of the organisation and its success.
Representatives from the Conservative and Labour parties each claimed the high ground on heritage protection, followed by the Liberal Democrat representative who moved the discussion from museums and monuments to include the heritage environment in its wider sense.
Provocative questions from the floor probed the future of the Heritage Protection Bill- with commitments from both sides to support this; resources for heritage- everything from support for local authorities to VAT issues and how ‘localism’ was going to be supported in the future.
The Rt Hon Margaret Hodge, Minister for Culture and Tourism reminded the audience how much money had been invested by the present administration in policies and projects and the importance of projects targeting the young- such as ‘Find your talent’.
Ed Vaizey, Shadow Minister for Culture, considered the case for (the value of) heritage had already been made but the Treasury was -philistine in its approach and therefore difficult to convince regarding changes to the tax regime. It was up to local authorities, he said to be -smart about resourcing and for heritage organisations to work together.
Richard Younger-Ross, the Lib Dem’s spokesperson on Heritage, wondered how many buildings currently at risk would be lost whilst the new legislation was delayed and that Treasury support for heritage would give a very strong message to the public about its value to daily life. He called for a wider debate at Government level about heritage which might help to resolve the problem of the -fight for funding.
-This event demonstrated the commitment and level of cooperation within the heritage sector itsel said Chris Winter, HTF Director, -but it also illustrated that we have a long way to go to convince policy makers of how much is being achieved on the ground and of the need for demonstrable support from politicians at national and local levels.
-HTF has supported Heritage Link since its creation and we welcomed the new name – ‘The Heritage Alliance’ – and new Chair and look forward to working together in the coming year on the challenges facing the sector.
Matt Howell, Head of Public Services, Technology at Capgemini UK, thinks that many government IT projects are doomed to failure before they even begin, and argues that the problem won’t be solved without a much better approach to procurement.
Another day, another scandal involving a failed government IT project. Yet more blamestorming, recriminations, finger-pointing and hand-wringing. Eye-watering numbers are quoted on the millions of pounds wasted, and on the dire over-runs in timescale and cost. And another batch of ‘told you so’ experts coming out of the woodwork to offer their wise-after-the-event analysis of what went wrong.
That may sound like hyperbole but it is in fact the literal truth as I write this article, having just scanned the morning papers and tuned in to the Today programme. And although such news is, thankfully, not a daily event, it is a story that occurs with depressing frequency.
And in today’s profuse media coverage, one thing is conspicuous by its absence: any well thought-through advice on how such disasters can be avoided. Instead, there is the widespread belief (a) it’s all about over ambition and that we should somehow be less ambitious in government, and (b) somehow it all goes wrong in the design, in the build or in the rollout phase of the project. Both notions are in my view fundamentally wrong. The reality is that many government IT projects are seriously handicapped before the business users and IT providers ever meet.
Why is this so? Simply because the normal template for government procurement is one of rigid compartmentalisation, with the people supplying new IT systems (or hoping to supply them) kept isolated from the people needing and demanding those systems – the business users. In my experience the procurement function too often acts as a barrier between the users – the ones who need new IT and who initiated the procurement exercise – and the providers – the ones seeking to understand and provide what the users really want and need. There have been plenty of examples in recent years when a procurement exercise, lasting months or even years, takes place without anyone from the business and the IT provider getting to speak meaningfully. Instead we often meet one another for the first time on day one of the project. And of course, we find out then that we have different views of what the really important things are.
Of course the motivations of the procurement teams are entirely laudable. It is, after all, their job to ensure fairness, equitability and a level playing field for all the hopefuls seeking to bid for the project (and people like me would be the first to complain if they didn’t!). But the truth is that buying IT needs real dialogue between the business and the provider. As technology becomes richer and its capabilities greater, this is even more the case. The supplier needs to understand what the user really needs, and to explain what is and is not possible, what different options are available, and how they differ in cost, complexity and risk. In return, providers need to understand what is of most value to the business and what the business risks are
Such mutual understanding is an absolute must for the success of any large-scale IT project and should exist on day one of the project. But it doesn’t because in many cases the procurement team – lacking understanding of the users’ real requirements – acts as an imperfect filter and hampers success. Another consequence of this approach is that procurement has become an industry. What should be a simple process becomes multi-stage, lasts years and increasingly involves layers of expensive procurement advisors – who often act as yet another filter between the providers and the business. Everyone wastes time and effort in this process that we should all spend delivering the project.
The upshot is that often, before the project even starts, the business finds that they still own most of the risk and their provider, after months of procurement, still doesn’t fully grasp those risks, and is locked into an inputs-based contract forcing them to focus on the wrong things..
Three simple things would enable us to get more government projects right, and reduce costs:
1. Business Led Procurement
Refocus on what the project is intended to achieve, and what success really looks like. Don’t focus on just the inputs, rather focus on the results the stakeholders (users and customers) really want from the project. Particularly, let the business identify what outcomes they want, and what risks they want to transfer. Also, recognise that the business environment may change, and that some flexibility in scope and price is not a bad thing. Ensure that the business is fully involved in the procurement exercise throughout, and enable and encourage communication between senior business sponsors, users and potential providers. Professional advice from the procurement team will be vital to avoid the pitfalls and provide experience but not at the expense of business and user involvement. Enable the business to procure a delivery partner who will share their risks and focus on their business outcomes. In the private sector, the procurement and business objectives are more closely linked, and this should be the norm in the public sector.
2. Make more time for delivery
Simplify and shorten the procurement process. We need to buy intelligently, but every month spent in procurement could be a month in delivery, helping meet tight deadlines. It should not take as long as it does to procure technology services in government. There have been over 2000 OJEUs and PINs this year, and countless more non OJEU procurements. If we saved 2 months off each, that’s years of delivery time gained. It stands to reason, with immoveable go-live dates, if we save time in procurement, we will miss fewer deadlines! If we can speed up the procurement process, government could buy in smaller packages and create less risk and flexibility – but you can’t do this while it takes 6 months to procure a standard IT service.
3. Share Responsibility
Accept that in any major IT project, success will depend on the efforts of the vendor’s team and of the user community, and their ability to work effectively together. Responsibility for success is shared. Remember this in your procurement approach and you will start on the right footing
Such an approach is almost the norm in the private sector, and has been adopted with good results here and there in the public sector. And if only the collaborative approach could be applied to all government IT procurements, we could see an end to the era of costly and embarrassing scandals.
London Councils has reacted angrily to plans by the Association of Train Operating Companies (ATOC) to increase the cost of transporting Freedom Pass holders by 25 per cent. During negotiations over the cost of the Freedom Pass, ATOC has demanded London boroughs pay 25 per cent more for the train part of the Freedom Pass next year.
This would mean that the amount London’s boroughs pay to the train operating companies would jump from £12 million in 2009/10 to at least £15 million in 2010/11. The Freedom Pass costs the boroughs £270 million a year in total, the vast majority going to Transport for London. The pass allows Londoners aged 60 and over, plus eligible disabled residents to travel free on the capital’s buses, trains, London Underground, trams, and the Docklands Light Railway.
London Overground services are run by Transport for London and separate train operating companies (working through ATOC) provide all other train services. ATOC sent London Councils an initial proposal on 26 November but no supporting evidence was produced until Monday (30 November), little more than a week before a deal on the cost of the Freedom Pass was due to be agreed by London Councils’ Transport and Environment Committee at a meeting on 10 December. ATOC has not given London Councils access to detailed data on which it has based its current, ‘take-it-or-leave-it’ demand.
Councillor Mike Fisher said: -It is totally unacceptable that at this late stage, the Association of Train Operating Companies announces it wants to charge boroughs 25 per cent more than last year to provide the same train services. -This is outrageous considering that the current rate of inflation is 1 per cent and the average increase in train fares for passengers in 2010 will be 1.1 per cent.
-We have serious doubts about whether the evidence the Association of Train Operating Companies has produced to support their claim is valid. We urge them to use a more realistic figure as the basis for negotiations.
-We will not allow some of the most vulnerable travellers in the capital to be exploited in this way.
Children as young as seven are learning how to prepare themselves for the world of work, including the value of a CV, under an innovative project run by Hays, the world’s leading recruiting experts in qualified, professional and skilled people.
Hays is currently running its courses in primary and secondary schools across the country. It has already given work guidance to around 9,000 pupils since launching its programme, named Hays Ignition, three years ago.
Hays Ignition, which is run by Hays Education, is available for all ages starting from Year Three (seven) up to Year Thirteen. Over the full course of the programme – which is already used in over 120 schools nationwide – pupils are eased into an understanding of what work means and how to choose and get a job. They are taught the value of work, why it improves quality of life, and how to choose a suitable job. They also learn key practical skills as they get closer to leaving secondary school: from writing a CV, to preparing for interviews and managing income. An enterprise training session also involves a class setting up their own business.
Ed Balls, The Secretary of State for Children, Schools and Families, last month announced a pilot project to bring more careers education into schools, starting at primary level. Martyn Best, managing director for Hays Education, said: -We’re already there doing the job. Hays Ignition brings the world of work into the classroom using people who are actually in the world of work, complementing the message that schools are giving out already.
-We’re not teachers, we’re real employers and we understand the ins and outs of the employment market, that helps to drive the message across in a way children and young people find interesting.”
Hays Ignition has a 97 per cent re-booking rate from secondary schools and a 100 per cent re-booking rate from primary schools. -We have had a dramatic and transformative effect on thousands of pupils, and once schools have used us once they want us back again,” said Jenny Ward, national business manager for Hays Ignition.
-Children learn from us about rules and opportunities, about how to make the best of themselves, and that gives them self-confidence and options that might otherwise be missed” continued Ward. Steve Dainty, head teacher at St Joseph’s Catholic Primary School in Wirral, Merseyside, said Hays Ignition had proved particularly valuable at Year Six as children prepared for secondary school. The programme has encouraged his pupils -to look at their skills, their talents and ready themselves for moving on”.
The Year Six programme focuses on achievements. Pupils learn about their personal skills, qualities and areas for development. The resulting CV is then used to introduce themselves to their new school, often a difficult transition. -Hays Ignition is a tool for the future, and it really is something that schools need to be looking at in primary, not just secondary education,” said Dainty.
-Children are the workers of tomorrow and in order to develop their skills and talents, they really need to understand themselves at an earlier time in their lives. I think Ignition allows that process to begin.”
For schools interested in learning more about the Hays Ignition programme contact Jenny Ward at Hays on 0121 236 7933
The public perception is that out-of-hours healthcare is provided to the same standard as daytime GP services. Out-of-hours care is often delivered by private companies that do not have to adhere to the same standards of training, competence, scrutiny and risk management as NHS organisations. Arif Ahmed, co-founder and Director of ikonami, examines why private providers have become so prevalent and reveals potential strategies to improve standards of care and to bridge the patient care gap.
At the turn of the millennium the Government commissioned three reports on improving out-of-hours healthcare. The Carson report suggested a fully integrated model, involving GPs, A&E departments, ambulance services, Primary Care Trusts (PCTs) and other partner organisations. Then in 2004 the New GP Contract was agreed, enabling General Practitioners to opt out of offering out-of-hours care in return for a 6% pay-cut. Dr Carson and the other experts could never have anticipated this scenario, nor that 9 out of 10 GP practices would have opted out by 2007 . In many parts of the UK, a fundamental component of Carson’s integrated model – the local GP – no longer provided out-of-hours care, so PCTs had to turn to the private sector to bridge the gap.
The involvement of private healthcare providers has sometimes been controversial. Reports that locum doctors were being flown into the UK from other countries, without adequate checks on the practitioner’s fluency in English, generated a public outcry. In addition, many of these doctors are not familiar with the workings of the NHS. Both issues can negatively impact patient care. Yet out-of-hours healthcare now relies upon the contribution of private providers, so how can we ensure standards of care?
Identifying the main issues
Three major issues need to be overcome: commissioning and contracts, communications and culture. When PCTs first brought private providers on board, many worked through the commissioning process without the necessary background information. Relevant data on levels of demand, the medical conditions encountered, morbidity and costs were held by GP’s rather than PCTs (if recorded at all). This made it impossible to scope out contracts from an informed position. In addition, while the money released by GP’s opting out went into PCT funds, PCTs and providers had yet to realise that this did not cover the true costs of staffing and running out-of-hours care. As a result, some private providers were left to meet a level of demand that had not been anticipated at a price that made it difficult to deliver a high-quality, effective service.
Since 2004, other changes in the NHS mean there is more measurement and reporting on activities and outcomes so PCTs are now better informed. In addition, private providers will have generated their own internal data on levels of demand and the real cost of service provision. This management information can be shared to enable the development of more equitable and accurate contracts that meet patient needs and reduce risk.
Communication and shared values are key
Many PCTs also found it hard to establish and maintain good, clear and regular communications with their private providers. This could be problematic if private providers are not forewarned about localised outbreaks of certain viruses or demographic changes in the local community (like a growing elderly population or local baby boom) that require staff to have particular skills. PCTs gather this type of information and work closely with regional and national healthcare bodies to plan ahead. If they keep private providers informed and are clear about their expectations in terms of levels and quality of service, the private provider is more likely to maintain a better standard of care.
Finally, the culture of the NHS now emphasises risk management, compliance and staff competence, partly because NHS organisations are subject to scrutiny under schemes like the Clinical Negligence Scheme for Trusts and the Care Quality Commission (CQC). This has forced skills and training up the organisational agenda, but that culture is not necessarily shared by private sector care providers, on whom the cost considerations of training provision will weigh more heavily. Yet PCTs should insist their service providers adopt NHS best practice regarding employment, training and development, risk management and reporting. A tool like the Knowledge and Skills Framework (KSF), which details the skills, learning and competences necessary for every job role in NHS organisations, can be used to create a common understanding of what is expected on an individual and organisational basis. Moreover, the CQC regulates all care services in England across public and private sectors, so private companies will have to comply with its standards of care provision and reporting, which will also help to raise standards. The CQC recently warned that it wants to see improved scrutiny of private care providers by PCTs, when it reviewed the case of an elderly patient who was given an overdose by a locum doctor employed by a private out-of-hours care provider.
Working together
GP’s are unlikely to opt back in to providing out-of-hours care, so private companies will remain an important part of healthcare provision. But as noted by the CQC, the onus is on PCTs to ensure that private providers comply with public-sector standards of care. PCTs cannot achieve this through infrequent communication and monitoring the care provider from a distance. Rather, PCTs must learn to view them as colleagues and partners who are an integral part of the PCT’s operations. Where possible, the PCT should enable the private care provider to have secure, remote access to relevant management information systems, so they can provide up-to-date information on activity and outcomes. This data then becomes part of the PCT’s normal risk management analysis and service delivery planning activities.
The PCT should also share with the care provider the training agenda that it feels is necessary to meet patient needs and ensure competence – and ensure that any staff who interact with patients have been trained appropriately. To facilitate this, the PCT may wish to offer the care provider places on its own internal training courses, or have its learning and development team act as consultants to advise on mandatory training and the use of technology, such as learning management systems, the e-KSF, e-learning and social learning tools like wikis and blogs, to improve levels of competence and knowledge.
Working together will involve cultural and organisational change on both sides and it is not a challenge to be taken lightly, but it can be achieved through robust contracts, good communication and sharing the best of the systems and culture of the NHS. If managed properly, this new version of Carson’s integrated model may even deliver higher levels of patient care while reducing costs to healthcare system as a whole, which might become increasingly important as the NHS faces funding cutbacks over the coming years.
Arif Ahmed is the co-founder & Director of ikonami. He has seven years experience in providing bespoke learning solutions for the private and private sector. ikonami is a provider of bespoke learning software systems for government, independent healthcare and other organisations seeking learning and development efficiency. The company was founded in 1999 and originally provided project management consultancy to help organisations exploit the benefits of technology. In response to client demand, ikonami evolved into a full-service technology company that combines its specialised software offerings with a variety of service capabilities, including full Learning Process Outsourcing (LPO).
No one wants to be featured next in the all-too-frequent litany of headlines like -Confidential Data on Stolen Memory Stick or -Lost Laptop Contains Classified Information. Human error does occur, but there are straightforward ways to minimise the likelihood that any such misfortune will cause major problems.
Our on-going experience of working with well prepared organisations, such as the Scottish Government Office of the Chief Researcher, has shown us that robust organisations can put in place some straightforward means of ensuring they minimise the risk of having an IT security breach.
The start point is to ask some essential questions of your organisation.
Key Questions
1. Do you have an up to date security policy which people know they have to comply with and are you confident that everyone knows it exists and has read it?
2. Are your leaders totally committed? Good security has as much to do with cultural issues as technological controls and it is important to have an effective security organisation which is actively promoted and supported from the top of the organisation. This should stipulate clearly defined ownership of systems and data and help to ensure that your own good practice is extended to those third parties you may deal with.
3. Do you have a robust risk assessment process and asset management scheme? Ideally security measures are driven by such a scheme, one that allows you to classify the sensitivity of all the data which you hold. Without this in place how do you know what data to secure, particularly in those situations where it is transmitted outside your organisation?
4. Do you use encryption? In the current climate ideally all mobile devices, be they USB devices or the wide range of laptops available, should be encrypted and someone within your organisation should know where they all are.
5. Do you invest in on-going staff training? For all of these measures to work it is important to educate your staff and ensure there is regular training and awareness rising. This should extend to a clear and easy-to-follow incident reporting procedure which ensures all security incidents are identified and notified to the appropriate part of your organisation.
6. Are you checking the obvious? It probably goes without saying that you should have suitable virus and malware protection in place along with firewalls and, most importantly, they should be extended to the weakest points of any network which are remote users and home workers.
7. Are you keeping it under lock and key? You need to be sure be adequate physical and environmental security over your core IT infrastructure exists, along with physical controls over access to office areas.
8. Who goes there? All of the above needs to be supported with good control of user accounts, limiting ‘who can access what’ data, including robust password controls or additional, stronger methods of authentication, as required.
9. Are you disposing of data correctly? Having restricted access to your data, it is also important to ensure you dispose of it securely as well. The Data Protection Act stipulates that data should not be held longer than necessary. You need robust measures in place to ensure that data is removed from your systems, and that the devices which held it are also disposed of securely when they come to the end of their useful life.
Case Study
In late 2008 the Scott-Moncrieff Business Technology and Consulting Team was commissioned by the Scottish Government Office of the Chief Researcher. The objective was to provide the Chief Researchers Office with assurance that the data security standards which they, as a government body, are striving to achieve were also being satisfied by their partners in the wider research community.
The report provided a very positive message to the Scottish Government, confirming that, in the main, research contractors had good procedures and processes in place to ensure compliance with data security principles. This appeared to be embedded within the sector, and the existence of the ISO202052 (Market Research Standard) and guidance from the Market Research Society helped reinforce this continual drive towards compliance with best practice.
We identified a number of themes where there is scope for further work and improvement and the two critical areas where there was, not surprisingly, scope for improvement were a wider use of data encryption on mobile devices which could potentially store data of a personal nature, and the need for greater clarity regarding the retention and deletion of research data.
Both of these themes regularly occur in most of the other sectors in which our Business Technology Consultants are involved.
The report itself can be downloaded at www.scotland.gov.uk/socialresearch.
Robert Mackenzie: robert.mackenzie@scott-moncrieff.com or 0131 473 3500
During these difficult and challenging times, when central Government policy requires local authorities to get more than ever done for customers while simultaneously achieving significant cost cuts, transformational steering groups or boards play a vital role in the crucial re-engineering process.
STEPHEN HEWETT suggests how to make the best use of them
No local authority can hope to comply with central government requirements for improved service to customers and cost cuts without effecting not just change but transformation. Today, in response to this pressing and urgent need, more and more local authorities have set up, or are in the process of setting up, transformational steering groups (TSGs).
Some TSGs will cover the entire range of the local authority’s transformational activities; others will specialise in specific areas. For local authorities keen not only to embrace the potential of transformation but to be front-runners in flexing their transformational muscles, TSGs are simultaneously catalysts, powerhouses, think-tanks and centres of ambitious, blue-sky thinking. The challenge is clear: the way ahead perhaps less certain, but TSGs will play a vital role in uncovering it.
In particular, there are vital opportunities right now for local authorities to re-engineer and even reinvent processes that may often have seemed enshrined in stone. But the twin needs of greater efficiency and reduced costs are unlikely to be met without this re-engineering and reinvention. The processes simply must be made to focus more decisively and less expensively on customers; the processes must be made more customer-centric. A powerful argument could be made that the entire rationale of the new strategies of Common Area Assessment (CAA) and Total Place involve boosting a local authority’s level of Customer Centricity, ideally in a dramatic way.
So the challenge facing TSGs is tough but exciting. TSGs have the opportunity to put into action an entire spectrum of change, including all projects that have the core objective of becoming more customer-centric.
In this scenario, the TSG is the catalyst of change as well as the dynamo, the mould-breaker as well as the artist who creates the new mould. The formation of TSGs is consequently a task of great importance for any local authority, and giving careful thought to their formation is vital if local authorities are going to meet central government requirements and expectations.
Essential decisions, including of course who exactly is going to be on the TSGs, need to be made at the very earliest stage. There is a strong case for introducing diversity of interest into the TSG; such diversity of interest can itself be a powerful way for the group to have inherent checks and balances acting upon it.
Inevitably, there’ll be people on TSGs who will have a vested interest in the projects being considered and implemented, and indeed it’s essential there are such people, as they’ll be especially committed to the projects reaching a successful conclusion. But TSGs also need to have people on them who will be able to bring distance and impartiality to the discussions. Union members will be important TSG members, and of course they will have their own vested interests in relation to the workforce. People from the shop floor may also be considered for TSG membership as they will be in touch with matters that may even have eluded union members.
TSGs will also benefit considerably from having people on board who are experts at cultural change. Indeed, why not consider appointing someone from another local authority who has already proved his or her worth in engineering transformation at local authority level? After all, TSGs should be geared toward running hands-on projects.
There is a particularly strong case for the chairperson of any given TSG to be someone who can bring extensive successful past experience of successful transformation at local authority level, plus a fairly impartial overall viewpoint, to the task.
One of the chairperson’s jobs will be to ensure that the TSG’s purpose remains visionary yet pragmatic, ambitious yet realistic, inspired and also inspiring. Overall, the chairperson must be someone who has a truly clear vision of what transformation means for the council while also being someone with a sufficiently strong and decisive purpose not to be blown off course.
TSGs have to focus on high-level issues such as the need to maximise Customer Centricity while reducing costs, yet TSGs must also maintain constant vigilance to ensure that their initiatives are feasible in a practical way. TSGs must in essence be the guardian of the local authority’s vision of transforming itself into a different kind of entity. The new kind of entity will be one that is meeting central government’s objectives and also being true to its own potential for being all it can be to the people who use its services.
Of course there are pitfalls of running TSGs, just as there are when any group of people work together. There seems to be something in the human psyche that makes it all too easy, when people are gathered together, for the gathering to deteriorate into less visionary matters such as discussions of practical difficulties. These will of course need discussing, but it is all too easy for these nitty-gritty matters to dominate the entire discussions, especially if the people on the TSG are not used to working together and may even be starting out with some suspicion of one another’s motivations.
All the more reason for a TSG to be able to make strong and firm decisions about matters central to its remit and to be able to cultivate a pride in its own capability for making decisive and big decisions and never allow itself to become merely a discussion forum.
TSGs must in particular become quickly adept at addressing key questions such as is this particular project really going to advance our objectives? and is this particular project the best use of the money we have available?
Other vital guidelines for the operation of successful TSGs are:
the TSG should at an early stage formulate a statement of its own purpose and objectives. This should be stated in clear, non-jargonistic language, and as briefly and concisely as feasible
the TSG needs to be run with focus and discipline in order to maintain a spotlight on the projects that will bring the most immediate benefit to customers. It is indeed vital to avoid the danger of becoming bogged down in details and letting key projects lose momentum. There are always likely to be interdependencies between some projects and so an emphasis must be placed on clearing a way for the most customer-benefiting projects to be advanced and pushed forward
there needs to be a constant focus on meetings on ensuring that the local authority’s overall culture remains a customer-focused one
one of the TSG’s first tasks should be to identify and document five or six very clear design principles that can be applied to all the projects with which the TSG concerns itself. These design principles should include all the specific requirements that each project will need to meet. By applying them from the beginning, the danger of wasting time pursuing projects that will not advance the overall directive of the TSG will be considerably reduced, if not avoided altogether. Time requirements are especially important when the design principles are being formulated. Projects need to be bringing benefits within, at most, six months
meetings of the TSG should be arranged when the need for guidance is most acute rather than a slavish time frame being adhered to such as, say, meetings being held on a fixed day every month
a clear record should be kept of the key outcomes and decisions of meetings and these should be referred to in detail when monitoring progress with implementations
the TSG needs to steer projects decisively and without flinching from implementing radical solutions where necessary. If a project isn’t sufficiently on track, measures must be taken without delay to get it back to being so
the TSG must decide early on about how it will assess success. In particular, where Customer Centricity is the goal, and it so often is, the TSG needs a workable methodology to allow it to assess the overall progress of its projects towards the twin goals of greater Customer Centricity and reduced costs.
Stephen Hewett is head of Customer-Centricity Business Change at business and information technology consultancy Charteris plc. Tel: 020 7600 9199. www. charteris.com
You can’t go 10 minutes without a politician banging on about the looming cuts to public sector spending. What you won’t hear is anyone explaining how we are actually meant to find and deliver these savings. The word cuts has quickly switched from banned to election winning, but there is another C-word that politicians and senior civil servants must embrace if we are going to get through the next few years without decimating our services. That word is commissioning.
Commissioning is a new model for change. It is about understanding citizen’s needs in a new light, planning and designing services around the population, and finding innovative ways to deliver outcomes cheaper. More for less. Some local authority chief execs are considering massive 33% cuts – can commissioning continue to improve outcomes and deliver savings targets?
Public services have been making steady progress during the last 10 to 20 years and this has led to a strong social and public expectation of continual improvement. The trouble is that improvements have often been thanks to additional funding rather than the fundamental effectiveness of services. Previous increases in funding have led to a degree of lazy management and government leadership that shies away from tackling the big problems in society or the inefficiencies in our services. Looming spending cuts mean this cannot continue.
We must now make large savings whilst maintaining service quality and outcomes- we can’t just tweak services but have to transform them. Commissioning is the model for doing this – emerging in its current form from children’s services and gaining credence across central and local government. It is about taking a whole system view of the needs of the population and available resources, and then finding much better ways of delivering outcomes by moving away from traditional, outdated service models. The commissioning revolution is driven by transformation through a better understanding of the complex public sector system, new ways of designing services around the population (such as patient choice), innovation and entrepreneurship, and a fresh ethos that embraces partnership working and joint leadership.
The question now is whether this revolution can meet social expectations within spending cuts? Are we developing fast enough to rescue public services?
Positive examples are now emerging across the public sector where commissioners have redesigned services, cut spending and still improved individuals’ outcomes.
Disabled adults can now receive a budget similar to the value of previous services which they spend themselves. This has resulted in better services that are designed around the individual, more community accessed support, and huge improvements in satisfaction. Better outcomes – for a reduced cost.
In some London boroughs childcare was badly designed; it often subsidised well-off families and stopped those in most need from accessing services. Commissioning redesign has identified families that are disadvantaged and changed the system so that their children can access childcare – limited resources now have a much greater impact.
The proposed change to the donor card scheme (from opt-in to opt-out) is a simple tweak to make it much more effective, with no added costs. Understanding the system – and redesigning it to work better.
Commissioning sounds like it’s coming to the rescue – but why is it taking so long? The truth is that government is beset with historic and traditional approaches which are barriers to the new ways of working. Old structures, targets and initiatives are preventing us from moving forwards and enabling commissioners to transform services.
There is now overwhelming evidence that targets deliver just the statistic, and not the improvement to lives or service efficiencies that were first desired. A comparison of disparate management approaches between the private and public sectors is stark. Which FTSE 100 company is run through micro-management and ring-fenced funding attached to the latest untested headline-grabbing idea? Excess funding can no longer cover up mis-management. It’s time for change and we are starting to see visionary public servants who understand what is needed and, given half a chance, have embraced commissioning and are delivering more for less. We now need this good practice to be reflected across the whole system.
Politicians and senior civil servants must use the looming cuts as a burning platform – to change the way we run public services, to move away from initiatives, command and control leadership, micro-management, spurious targets and headlines. Commissioning must be part of our common language, our only hope to avert decimation.
Richard Selwyn, Government and Public Sector, PIPC UK Ltd
www.pipc.com
Richard Selwyn
Richard is an expert in designing commissioning systems in central and local Government. In 2005 Richard led the national change programme which redesigned the joint planning and commissioning of children’s services across all local authorities, health, schools, youth justice, etc – a system that is now in universal use across the sector. Key elements of this approach were adopted by the major central departments including the Department for Work and Pensions, Department of Health, Communities and Local Government and Ministry of Justice.
Richard’s career started in the Ministry of Defence in 1996 working on major naval procurement projects and space engineering. He then progressed through the Department of Health and Department for Education and Skills where he was a policy lead for Children’s Trusts and the consequent national service redesign. Richard is now a consultant, originally working for PriceWaterhouseCoopers before moving to PIPC UK Ltd where he has continued a career managing major government change programmes and heads up PIPC’s Commissioning team.
Richard is currently working on the Commissioning Support Programme for the Department for Children, Schools and Families and Department of Health. He is a member of the cross-Government Commissioning Learning and Development Group and is widely regarded as a leading commissioning expert across central and local Government.
The National Health Service has enjoyed an unprecedented increase in real funding over the last ten years. But the fallout from the banking crisis, recession and subsequent public sector debt suggests a far bleaker outlook.
The debate over NHS resources and funding has been bubbling away for some time, assisted by excellent work by the King’s Fund and Institute for Fiscal Studies. A number of organisations have criticised the NHS’s use of external consultants. The British Medical Association and Royal College of Nursing in particular have both criticised the public money spent on management consultants. Dr Peter Carter of the RCN called it -utterly shocking.
The Commons Health Select Committee recently reported on management consultants and the NHS, and recommended that the government publish a central list of the consultancies contracted by the NHS and the projects that they have worked on.
The Management Consultancies Association supports greater transparency for taxpayers and has endorsed this proposal. We are working with the Department of Health on a concordat setting out the responsibilities of both buyers and suppliers of consulting.
To help understanding of the role of consultancies, the MCA has also recently produced a report into the use of management consultants by the NHS. Improving care, reducing cost looks at what work is done by management consultants, the value it adds and how this fits in with a future NHS which delivers high quality care without stretching public finances beyond breaking point.
The NHS has a budget of over £100bn and our figures show that of this, £300m was spent on management consultants in 2008 – less than 0.3% of the total budget. This equates to £200 per NHS employee – a typical large private sector organisation spends ten times more per employee on consulting.
Commentators frequently misunderstand the role of consultants, arguing that money spent on consultants could be better spent on frontline services. Our data shows that two thirds of consultancy spend is associated with large scale programmes, including project management, process re-engineering, IT consulting and change management. This spending could indeed be redirected, but only if these projects – which are often core to improving patient care – were stopped.
The other third of consultancy spend is used for assistance with day to day operations of the NHS. Consultants provide strategic advice to Trusts and other health organisations and help to deal with and implement changing government policies. As Steve Barnett, chief executive of the NHS Confederation has commented: -A number of major policies have been implemented in recent years to increase the effective running of the health service where it has been necessary for NHS organisations to procure outside expertise. The NHS is a large and complex organisation which requires management and planning like any other. Responding to major national policy changes often requires local planning and external advice and in many cases the use of this kind of expertise can help to drive down costs in the long-term.
Other projects are geared to improving productivity and identifying and managing outsourcing opportunities. For example, MCA member Atos Consulting recently worked with NHS South Central to increase efficiencies in patient services. This project resulted in an average decrease in patient waiting times of 14 weeks, in some cases by 25 weeks.
A key quality that consultants bring to the NHS is specialist knowledge of other organisations and sectors. This wider understanding can often result in innovative ideas and solutions being used by the NHS. Further, consultants’ position as outsiders allows them to take a long term view and offer objective advice, independent of internal politics.
Consultants are also able to bridge the gap between clinicians and administrators/managers – they always need to work together effectively if the NHS is to provide a world class service at an affordable price to the taxpayer.
Of course, the use of consultants by the NHS can be improved. For example, the different roles of interim managers and consultants could be better defined. And, where full time employees can be recruited cost effectively this should be done rather than hiring consultants. Project outcomes could be made clearer by the NHS and consultants rather than the focus lying on the inputs. We are already seeing a trend in the private sector of greater sharing of risk between consultants and clients and we expect more performance related contracts between the NHS and consultancies to emerge.
There is no shortage of good ideas for improving productivity and patient care in the NHS; but it will often take strong partnerships between the NHS and management consultants to ensure that they are delivered. Taxpayers rightly demand high-quality services and value for money. Those who attack the role of management consultants are undermining efforts to increase efficiency and improve patient care.
Case Study – The Berkeley Partnership: Making Polyclinics a Reality'”
Polyclinics are a good example of an initiative the NHS is pursuing to transform its services. By changing the way services are delivered and moving some out of an acute setting, we should end up with higher quality care delivered at a more affordable price. But completing the transition and realising the benefits will require five years of sustained project management because so many interconnected processes have to change and so many people, including the public, have to be won over. The Berkeley Partnership been working with two of the early implementer PCTs in London to establish their first polyclinics and plan the full transition journey.
Alan Leaman is Chief Executive of the Management Consultancies Association (MCA), whose NHS report, Improving Care: Reducing Cost is available at: www.mca.org.uk/reports/insight/improving-care-reducing-cost
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