Monday 2 February 2009

Benefits by Portfolio - WHY?

This series of Benefits by Portfolio is based on the 4Mat system by Bernice McCarthy
I facilitated a group of stakeholders spread right across a health economy a short time ago, 
  • to look at all the services they have and initiatives in progress
  • do a gap analysis
  • and work out what they need to do more of, what stays the same, and what to do less of
I usually start such groups by meeting them - not at the beginning (demographics and public health needs analysis), but where their minds and attention are, on the projects themselves.  I find I get quicker engagement and more willingness to subsequently accept change.
Anyhow, we were working through their list of 110 initiatives.  One initiative was to close down primary care-owned facilities in order to save on the facilities bill and raise capital by selling the plots of land.  In spite of an enthusiastic and able team, every time they tried to empty a building, it mysteriously filled up again.
Another initiative was busily moving services out of hospital and into primary care facilities, and had people actively looking for any underused facilities or resources and pressing them into service.  Finance vs. Commissioning - they talked to each other every day but nobody had noticed this clash of interests.


Running each project, each service, in isolation is like trying to squeeze a balloon - you make an efficiency saving here, only to cause a problem for some other part of the patient pathway, a bulge in the balloon.
At the same time, having each project understand each other project would be unweildy - I well remember an IT department of 750 staff in a large engineering company.  Of these 750 staff, it appeared only 250 did any productive work - the rest were all liaison: desktops division had to have liaison with networks, applications, remote, database, hardware, security.  Applications division had to have liaison - you get the picture!

Mindnumbing demotivation

This gets incredibly expensive.  It also gets mindnumbingly demotivating for staff - health and care are vocational careers, services from the heart, and people want to make a difference.  Put people in a situation where 2/3 of the time nothing is actually achieved and they will get fed up and clock watch.

Benefits across the organisation

Managing benefits across the organisation, so each service and each initiative can see the difference they will make IN CONTEXT is an attempt to change all of this.
I have a workshop on Portfolio of Benefits on March 3 at the Information Centre in Leeds which formalises my consultancy across PCTs and health economies to date.  If you need to know more, please let me know and I'll send on contact details for the Benefits Network for Yorkshire and the Humber who are hosting this.

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