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With the government implementing a two year pay-freeze to support its “austerity programme” and planning changes to public sector pensions, concerns arise that health-care organisations might be effected by widespread industrial action for the first time since the 1980s.

Unions reluctantly accepted the necessity of the two year pay freeze though are now campaigning for a significant increase for staff when that deal expires in April 2013. Unions are strongly resisting other changes to employment terms, especially the reduction n the value of pensions.

NHS budgets are under more pressure than they have experienced for a decade and employers are contemplating ways to change the Agenda for Change pay systems which were established nationally in 2004.

By the end of 2010, the organisation NHS Employers had proposed a national enabling framework for local pay negotiations which would have allowed local agreement for freezing pay increments in return for a commitment on preventing compulsory redundancies. At that time, with strong indications from the unions that they would reject local pay negotiations, the initiative seemed to stall.

NHS Employers Chief Executive Dean Royles said recently “It is essential that local employers have meaningful discussions with local trade unions and staff about the workforce implications of the financial challenges for their organisations.”

Through 2011, planning conversations have continued on the management side and NHS Employers has recently reflected employers concerns, suggesting current national pay structures place unsustainable pressures on the NHS pay bill and proposing greater flexibility and local pay deals as potential solutions. Foundation Trusts, with their freedom to negotiate local employment terms with their staff, may follow Southend University Hospitals NHS Trust in starting to change the way pay works. The Nursing Times recently highlighted a number of cases where organisations were describing these tentative steps towards devolution -

• Mid Cheshire Hospitals has been quoted as  “working alongside other providers at a regional level to consider options to negotiate alternative terms and conditions” on areas including incremental progression and sick pay,
• University Hospital of South Manchester is said to be considering “proposals for changes to terms and conditions outside of the national framework”,
• Central Manchester University Hospitals’ attempt to withhold pay increments from employees with poor attendance is being challenged by unions,
• Birmingham and Solihull Mental Health was completing an options appraisal “regarding a move away from Agenda for Change” by 2014,
• Royal Surrey County Hospital polled staff to see if they would accept changes to employment terms in exchange for fewer job losses.

Employers understand the NHS employment market is a complex one and history has taught them that competitive behaviour between neighbouring Trusts has been damaging in the past. At present it seems NHS bodies will share thoughts, ideas and opportunities for change, seeking to move “in concert” on a menu of options and proposals to be discussed with local staff.

An even more dynamic strategy seems to be emerging with Calderstones Partnership NHS Foundation Trust working to set up a spin-out social enterprise subsidiary which will employ staff on non-NHS terms and conditions. With new services being established through this vehicle, services might be run at lower cost, though transferring existing services will pose more challenges with both TUPE and equal pay requirements to be met.

So what change could and should be made in NHS organisation’s pay strategy?

Read the rest of this entry →

Photo: Darrren Hester, Flickr

An article in Consulting Magazine recently suggested benchmarking was a practice which was destructive because it distracts attention from the need to build upon core competences.

Paul Leinwand and Cesare Mainardi, co-authors of the recent Harvard Business Review article “The Coherence Premium,” suggest companies should be paying attention to their own distinct capabilities.

Organisation become profitable through maximising the benefit they derive from those competences them by matching them to market opportunities.

The authors produce an interesting analysis of the coherence with which organisations decide how to bring together the capabilities they need to “face the market” with the needs of their customers. They say -

“The engine of value creation is a system of three to six capabilities that together allow a company to compete in a differentiated way.”

Booz & Company have, apparently obtained further thoughts from the authors (who don’t refer at all to benchmarking in the report) and summarised their views that benchmarking is often evidence of the absence of strategy, distorts the true nature of competitive advantage, discourages differentiation and ties up valuable resources. That’s pretty damning!

So is benchmarking “destructive”? Read the rest of this entry →

Photo:Wolfpix, Flickr

Attractor’s work with a number of NHS organisations has helped to support and deliver improvement activity and realise benefits.

Attractor is often invited to facilitate strategic thinking, present options, identify opportunities, validate some ideas and challenge others.

This was the case with Aintree University Hospitals NHS Foundation Trust. A case study published by the Department of Health provides a good example of work delivered with an NHS team with strategic plans supported by decisive action.

Attractor had worked with Aintree earlier, supporting diagnosis and problem-solving actions with the Trust, and helping refine plans for deploying the ESR training administration toolkit.

Attractor was asked to support an organisational design review – taking forward local ambitions to introduce more integrated working arrangements and effective service delivery. Read the rest of this entry →

Strategic Planning

Tackling complex problems and handling the pressures of competing priorities and resource constraints is something you are familiar with, recognising the major impact your strategic decision-making has on the business and its people.

You are well aware that creating a blueprint for the future of any organisation is challenging.

You work in a fast-paced, complex environment, handling the pressures from myriad influences – political and social issues, commercial markets, organisational policies and procedures, IT systems and, above all, people.

Setting the strategy and direction for such an organisation, taking account of potentially uncertain outcomes can be daunting. Making judgements in complex environments is especially difficult, sometimes so demanding that it leads to paralysis.

Attractor can facilitate clear thinking about the organisations priorities, the selection criteria for strategic options, revealing perceptions and supporting open discussion between key stakeholders. These constructive steps will build consensus and help establish a clear direction and support for strategies to deliver change. Attractor can support the creation of a clear business case for change, with specific aims, objectives and benefits targets.

Operational Delivery

With a sense of direction and purpose established, it just remains to navigate through and around the many obstructions, side-tracks, obstacles and barriers that will present themselves along the way

Attractor can also help establish strong yet simple governance and assurance arrangements to monitor project delivery and project risk.

Attractor can support project assurance activities to ensure ensure your project remains in scope, on time and within budget.

Using a robust, but not over-complicated, project plan and benefits tracking tools, Attractor can help monitor delivery of key tasks, delivery deadlines and accountability arrangements – ensuring you deliver project benefits.

Attractor has developed a reputation for building long-term effective working relationships with Directors and Senior Team members, based on strong subject matter expertise and industry experience.

Attractor’s effective consulting work will always support local strategy and direction with well-targeted, light-touch, expertise. Customers always retain control over what support they need and use.

Aiming to minimise dependence, Attractor’s interventions are complete as soon as the client team has matters back under local control and grow effective solutions confidently.

Attractor’s work generally comes through personal recommendations and referral so business relationships are important to us. Conversation often continues for months or years, between assignments this ongoing interaction is welcome.

Consulting work has generally focused on change and efficiency in back office functions – with structural and functional change linked to deploying new business models and workforce management solutions. Attractor has supported clients to –

• Clarify their vision for back-office functions and both front-line and support service workforce management arrangements – shaping and guiding service improvement, productivity, efficiency and organisational effectiveness,
• Convert a “vision” for Service Transformation into a tangible plan with transition activities, benefits delivery and tracking to ensure delivery towards strategic objectives,
• Re-design and reshape departments, teams and roles, optimising added value, making best use of workforce management systems, reducing back-office costs,
• Engage and communicate strategy and actions to key stakeholders, securing support and political influence supporting change and benefits actions, supporting work to embed new ways of working and deliver benefits,
• Create and monitor plans which address corporate and organisation-wide change – resourcing, skills and capability, plus redeployment and exit strategies – technical, risk and assurance issues for organisation-wide change programmes and smaller technical projects,
• Change management and facilitation for complex projects, with workshops and other activities to support business change and improvement.

Consulting work commonly builds on a formal proposal responding to client needs, and often involves basic fact-finding, strategy, options identification and appraisal, recommendations and, where needed, implementation support.

During 2008, the Head of Learning and Development for a Mental Health Trust asked Attractor to help clarify issues relted to enabling the ESR e-KSF interface – the benefits, drawbacks and workload impact for her team. Having also recently launched a new learning administration tool within the organiation, the management team was seeking clarification of the strengths and weaknesses of this solution compared to OLM. Read the rest of this entry →

A London-based mental health trust had identified the need to move to a “self-service environment” for line managers and employees. While the desire was clear, neither the technology that might enable the transition, nor its implications, were well understood. The trust needed someone to facilitate discussion and decision-making by HR, Line Managers, Finance and IT professionals.

The Director of Human Resources invited Attractor to clarify options, benefits, drawbacks and ramifications. A review workshop facilitated by Attractor provided stakeholders an ideal opportunity to –

• identify potential benefits for the organisation
• clarifiy and agree local objectives and priorities
• explore key features and implementation challenges for self service

Analysis of results revealed administrative cost reduction was significantly less important to stakeholders than empowering line decision-making, improving HR services and improving workflow performance. From conclusions drawn, the trust adopted an integrated HR portal as the most suited tool for to its strategic requirements.

A development path having already been identified, work to implement new tools commenced quickly after the workshop. The trust retained Attractor in a programme assurance capacity during the implementation phase and, following development and communication efforts, the first new transactional tools were used by managers within 6 months.