Training Course Title

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

Rima Kalra and Steve Worrall

May 2005

Welcome & Introduction: BT Capital Care Alliance (BT CCA)

7.2+ million citizens 150,000+ NHS staff

300m consultations in primary care617m prescription items issued

13m outpatient consultations each year5.3m people admitted to hospital

1,660 GP practices 13 Care Communities 79 NHS organisations:-

31 Primary Care Trusts10 Mental Health Trusts

32 secondary care (acute) TrustsLondon Ambulance Service Trust

5 Strategic Health Authorities

N3

Connecting for Health’s National Programme for IT

The National NHS Care Record ServiceHealth Record

Choose & Book

ATOS Origin

Electronic transmissionof prescriptions

(ETP)

LSPSouth West, South East

LSP

North West & West

Midlands

LSPNorth East, Yorkshire & Humberside

LSPEast

Midlands, East of England

StHA

LSP LondonCapital Care Alliance

StHA

StHA StHA StHA

Some Key Benefits for Staff

• Linking up GPs, community nurses, AHPs, health visitors, midwives and Acute partners

• Reduction in duplication of effort

• Improved flow of information across organisational and geographical divides

• Improved appointments, referrals, diagnostic tests

Some Key Benefits for Patients

• Reduction in repeated questions and form-filling

• Reduced waiting times

• End-to-end management of patient journey through electronic care plans

GP / PCT Benefits

The NHS is a Highly Complex Environment

74 Trusts

5 Strategic Health Authorities/13 Care Communities

Multiple NHS initiatives withmultiple complementary

and conflicting organisational priorities

Multiple stakeholder groups:

Clinicians / Health Care Professionals / NHS

Management

Range of functionality to be implemented ….

…. affecting numerous clinical processes

Different geographies…Differing environmental

challenges

Approximately 140,000 potential users – personal

concerns, issues,challenges and objectives

Long-term Programme – Phased approach

• Inadequate change leadership**

• Poor understanding of what’s ahead**

• Failure to harness people**

• Inadequate change implementation**

Why Can Change Initiatives Fail?

**“Achieving supply chain alignment through behaviour change,” Gower Handbook of Supply Chain Management, Jamie Bolton and Karen Dwyer, 5th edition, Gower Publishing Company, p. 603.

Time restricted

Budget constrained

Environment Reason for failure

Complex

Managing the Different Strands of Change Is Key to Our Success

Strategic Planning

Predeployment Workshops

Location Preparation

Product Deployment

Deployment Closure

Executive sponsorship and governance

Communications

Process redesign

Training

Benefits management

310 years of healthcare experience + 270 years of complex change experience = integrated change framework

Characteristics of Our Approach

1 Implementation Consultant per Trust

Encourage Knowledge Sharing

Delivering Qualitative & Quantitative Benefits

Developing Best Practice

Toolkits

Our Experiences in London PCTs are Shaping the Delivery of our Approach

Clinical Transformation

Early engagement is important because of the pressure on people’s

time and commitments

Understanding the local organisation and relationships

Setting out clear roles and responsibilities

Linking in with other initiatives –

modernisation, workforce, new

buildings

Linking benefits with prioritiesand strategy

PCT/Trust Feedback

Liked having an Implementation

Consultant

Liked the Toolkits

Too much paperwork!

Provided impetus to review Trust-wide delivery of care

The Decision & The Journey

In the boat or not?