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At its conference in June 2010, the NHS Confederation published a report challenging the wisdom of constant NHS reorganisations. In “The Triumph of Hope Over Experience”, the Confederation examines a history of rapid and turbulent creations, mergers and disestablishments over 20 years.

Presenting a very interesting analysis of structural change in the NHS, the Confederation’s stated aim was -

“to review the history of restructuring, what is known about its results and the reasons for the pattern of increasingly frequent organisational change to draw out some important lessons that are particularly salient at this time.”

In some respects the report’s messages are relevant to other areas of the public sector. Attractor would encourage leaders of QIPP, Total Place and Efficiency and Reform programmes to read the report as they set about tackling the current financial crisis.

The report suggests a tendency to enthusiastically advocate reorganisation as a solution to all problems, regardless of their nature. It indicates reorganisation can provide opportunities for politicians to demonstrate action, for managers to advance careers, remove “problem people” and take generous redundancies – none of which have anything to do with the “reason” for making change. But the forces supporting reorganisation seem stronger than those resisting.

The Confederation recommends far closer scrutiny for such proposals, better review of the results of organisational change and holding proponents to account for results. In conclusion the report recognises the need to embrace change but expresses strong doubts over the kind of top-down redesign that has been all too common.

“Organisational change is necessary to allow organisations to adapt to changes in the
environment. Experiment and evolution may be a more effective approach to this than
insufficiently intelligent design.”

The analysis and conclusions are clear and ring true. While changing the shape of an organisation can support other business change, simply “moving the chairs around”, redrawing boundaries or lines of accountability rarely addresses fundamental or underlying systemic problems with the way “real work” is organised, supported and delivered.

Weakness in resource allocation and deployment, business processes and systems, communication and information-flows, skills and competences are best addressed by action “close to the coalface” with the teams who are delivering services – not by fiddling with the tiers of management way over their heads. This might suggest programmes like “Total Place” – close to customers and service delivery – are more likely to succeed than other approaches. Read the rest of this entry →

Organisations display very different reactions to “Web 2.0″ – the emerging technologies which support unstructured, informal interaction across networks and organisational boundaries.

Managers and technicians can see both possibilities and risks ahead. Those responsible for maintaining existing infrastructure may see more negatives than developers and strategists.

The response varies from paranoia to unreasoned fanaticism. In a world where everyone wants to contribute to the conversation, is there any way to tell who’s right and judge how to move forward? Read the rest of this entry →

Public sector organisations want to use self service technologies to streamline activities and deliver efficiencies.

Moving away from paper can provide benefits for speed of service response, process cycle times, accuracy of information, eliminating waste, delays and service failures.

The challenge today is to encourage adoption by the “Generation X” and “Boomers”, the population of older managers and staff used to working in more traditional ways, helping them to adapt to new ways of working.

Your younger “Generation Y” employees – the net generation – have grown up with Facebook, Twitter and a virtual world. They expect to interact with your organisation using online tools … considering it’s bizarre to work with paper in the 21st Century.

But obtaining the benefits promised by self service tools shouldn’t be considered “low-hanging fruit”. It depends on good design, smart implementation and effective change management. Read the rest of this entry →

Even before public sector organisations began to implement shared services, they were adopting the language of the Ulrich model.

Rather than HR Managers, job adverts increasingly referred to “Business Partners”.

But in those organisations will anything have really changed … and if they are now looking to implement HR shared services, have they thought about how this works differently? Read the rest of this entry →

Too many organisations respond to emerging challenges by re-organising departments, teams and jobs – hoping this will improve performance.

It can be hard to recognise when problems relate to deep systemic issues though easier to spot poor employee performance.

Changing structures seems, for some, an easier option than exploring and addressing business process change, which can be complex, or tackling known individual performance issues, which is often personally challenging. Read the rest of this entry →

Photo:Hamed Saber, Flickr

The pattern of career movement for NHS managers has been criticised by a former NHS Trust Chief Executive – suggesting rapid job moves reflects poor commitment.

It is right to challenge the idea that constant turnover and staffing instability, especially in leadership roles, is an acceptable organisational state.

An over-simplistic approach, laying blame on managers’ personal qualities, fails to recognise the influence and impact of the wider NHS culture and systems. Read the rest of this entry →

Work to reorganise HR and Payroll operations within an NHS trust involved collating information to assess transactional work in recruitment, contractual and personal changes, terminations, payroll and expenses work, plus enquiry-handling.

Using a model of the transactional workload, Attractor was able to demonstrate the staffing needs of various working models and provide a fully-costed organisational structures fo consideration. This analysis supported decisions by Trust management on a new structure which would deliver effective outcomes while also delivering future efficiencies for the organisation.

The Director of Finance contacted Attractor for help in reviewing HR and Payroll operations. Support was needed to refine and improve arrangements for managing data between recruitment, workforce, HR, payroll and finance teams.

Attractor was quickly able to highlight areas where responsibilities were unclear or where there was significant potential for delay and error. Key issues were communicated, directly by Attractor,to the trust’s Audit Commitee alongside the management team. A number of adjustments were agreed and implemented.

With the initial review complete, new business process documentation was produced to support future training and audit action. Finally a framework of key performance indicators was proposed and high priority measures were selected for small future performance measurement.