The NHS Transformation Unit is experienced in delivering services throughout the transformational change process. The STP team specialise in a broad range of services to support clinical redesign, taking ideas for change from a point of concept through to the stage where a decision is made on implementing the most suitable solution. We can offer services supporting reform of a single clinical pathway in one site or system change for a whole region.
Our team can offer you an established methodology that allows us to work with clinical leaders to develop a compelling case for change which clearly articulates any limitations of the current service configuration and communicates their vision for an improved way of delivering care for patients.
We understand that strong engagement with clinical peers, senior managers and patients alike is crucial in generating momentum for any reconfiguration and have experts within our team to guide this in the most appropriate and meaningful way to achieve results.
From the foundations of a strong evidence base for change and a thorough engagement approach we blend innovation with existing knowledge of best practice and examples of change elsewhere, to develop solutions that best fit your local health system and answer any challenges outlined during the scoping stage. We understand that that any reconfiguration has wider impacts and will ensure that potential solutions detail these as part of any proposals.
Where most consultancies stop, we don’t. Our colleagues in the Programme & Project Management (PPM) team are on hand to support you in implementing any agreed solutions to move strategic change from paper to reality.
Clinical Strategy Development
The NHS is facing a series of challenges that require transformation to create sustainable services. The pressures are wide ranging but are influenced strongly by reduced financial resource, workforce shortages and a rapidly changing population who are living longer but with high prevalence of long-term conditions. The NHS Long Term Plan sets out a new service model to deliver more joined-up and coordinated care and we can support you to develop clinical strategies that respond to the challenges you face. We can work with your clinicians and local stakeholders to harness their expertise on how to future-proof your services and make sure they fit within your strategic vision.
We can develop a clinical strategy for you that will outline the specific challenges and provide an overarching set of principles and objectives to enable you to respond to them. We will describe in detail the steps the approach will take to deliver on the objectives and will include changes required in estates, workforce and supporting services.
Planning Services Following Mergers, Acquisitions and Collaboration
With the NHS Long term plan’s aim that all of England will be covered by integrated care systems (ICSs) by April 2021 we anticipate frequent strategic changes across the system. The clinical implications of mergers, acquisitions or collaborations can be complex to resolve as organisations have to then work together to create single clinical pathways for services – often starting from very different places and with significant organisational memory.
We can work with you during these processes and other changes in organisational form to design your new clinical strategy and models of care – keeping a clear focus on objectivity throughout. Our colleagues in Organisational Strategy and Engagement (OSE) can also support the considerable cultural changes that will be required in bringing together organisations.
Clinical Service Change Approach Development
If you have the resource available to deliver changes in your clinical services but lack an established methodology to use we can help. Building on our existing knowledge of ‘what works’ we can support you to develop and approach that is tailored specifically for your local setting.
We will work with your clinical leaders, senior managers and programme leads to learn all about the areas in which you plan to deliver service change. We will harness their knowledge to understand the current local context; the commonalities between workstreams within a programme and what the obstacles and risks the planned changes are likely to face.
From this we will develop a clinical approach that will describe a suitable methodology for you to apply to any clinical change programme. This will ensure that your workstreams create a standard set of deliverables that are delivered in a consistent and standardised way; roles and responsibilities for different stakeholders are clearly defined; and governance routes are robust and documented.
Case For Change Development and Documenting
We recognise that a successful service redesign process begins with a strong case for change. We will use the expertise of colleagues in our Finance and Analytics to source relevant health and population data to analyse; and engage the appropriate range of stakeholders to understand and build your case for change.
To ensure a cohesive joined up vision for future services a good case for change is owned by those who will be accountable for delivery, links with national drivers for change and local plans. We will support the development of a succinct and compelling case for change to inform decision making and to help you articulate your key messages to the public and your stakeholders.
In collaboration with clinicians, staff, stakeholders and patients, we will outline the issues and supporting evidence of a clinical, operational or financial imperative. Detailed analysis will help you understand the potential impacts of change on other services, the risks and costs.
User Co-Design of Services
It is vital that we empower patients, carers and the public to play a central role in the design of services. Not only do users of any service have a wealth of experience that we can draw upon to suggest improvements, but any resultant changes will impact on them directly.
We will engage patients in a meaningful way to use their insight to substantiate the case for change or to co-design any solutions. Our Transformation Consultants will work with the engagement expertise embedded within the Organisational Strategy and Engagement (OSE) to appropriately structure any engagement approach.
Where we are not directly engaging patients as part of a commission, we can support your change programmes to define and document how you can achieve strong engagement. Where required, our team will produce patient friendly content to communicate proposals.
Development of Clinical and Patient Standards
An essential prerequisite to the creation of a new model of care for clinical redesign is reviewing national standards and guidelines to determine the local clinical standards. This forms a critical enabling stage in defining a viable solution, as it enables us to eliminate options that will not meet the clinical standards for the new model.
Our strong engagement approach with patients adds real value to this process. We will draw on evidence from patients that allows the new model of care to go beyond national standards and deliver a world-class patient experience that, for example, defines what chemotherapy treatment rooms should look and feel like to provide the best atmosphere for patients.
Clinical Co-Dependency Assessment
We will support you to understand the implications of service change on other services within and outside of your organisation. This will include reviewing both what the service under review requires access to – and what other services require from the service that is being reviewed.
Our work will draw on a review of co-dependency literature and Royal College Standards. This will be supplemented with clinical engagement across potentially impacted services to provide a deeper understanding of how services interact. Our proven methodology seeks to understand how often and how quickly services are called upon to determine the access requirements.
Service Redesign/Model of Care
We can help you build a solution/model of care that responds to the challenges or risks to the service(s) that were outlined in the case for change. The proposals will be tailored to meet the clinical and patient standards and the co-dependency requirements set out as part of the redesign approach.
To generate momentum for the recommendations we will ensure that there is appropriate communications and engagement to deliver your message for change. Where necessary, a full strategy for media management will also be put in place to ensure that you are on the front foot with public communication. Our colleagues in the Organisational Strategy and Engagement (OSE) team can offer develop a media management strategy for you.
To enable you to shortlist and evaluate your final preferred options we can support you to develop robust criteria and options for your new services. Once your final option has been assured and agreed with our support, we can take your service transformation plans and make them a reality with our implementation and programme management services on offer from our Programme and Project Management (PPM) team.
Clinical Engagement and Change Management
Introducing any transformational programme requires effective change management and, in turn, effective change management in a complex organisation requires robust planning, leadership, communication and measurement.
We offer a structured visible process focusing on people empowerment, communication and engagement. We will build internal resilience and capability for your organisation through an effective communication and engagement strategy while ensuring performance measurement is aligned to the change process. This will ensure you realise the benefits of effective change management:
- Increased collaboration
- Culture of empowerment and engagement amongst staff, volunteers and stakeholders
- Sustainable and meaningful change
- Staff retention
- Improvement in performance metrics
Independent Clinical Review
We can facilitate an independent clinical review process through convening an expert clinical panel to review proposed changes to service delivery. This may be required where decisions need to be taken over major service change proposals and objective external clinical opinion is required. The panel will examine the recommendations with a view to provide assurance that they answer any problems presented in a case for change; and that the proposals provide a clinically safe and a suitable solution.
Coaching and Leadership Development for Clinical Teams
During transformation it’s vital that effective clinical leaders are in place to manage the impact of the change on clinical and staff teams and to articulate the reasons for change to the public and patients.
Leading clinical change is challenging and requires resilience as well as competency in presenting messages at the right time and in the most appropriate way. Our colleagues in Organisational Strategy and Engagement (OSE) offer clinical leaders and their teams coaching and leadership development to support them in leading change and provide them with the tools to do so effectively. Effective leaders of change can inspire staff affected by the change, patients and the public by clearly articulating the vision and objectives of the service and the benefits of making the change in question.