THE 5 MAIN PUBLIC SERVICES CHALLENGES WHICH WILL STILL BE RELEVANT IN 2020?

How many of these will still be around in 2020?

This short video from Sir Bob Kerslake the head of the civil service describes the main challenges UK Public services will still be facing in 2020.

Do we agree these challenges are correct?The 5 main challenges still facing public services by 2020.

 

CONFLICT IN AN ORGANISATION IS IT ALL BAD?

 

 

We must get productive results from stand offs like this?

 

They used to say that a wedding in Liverpool was never the quite same without  a good punch up and so it is with conflict which expresses itself in many ways. Though I wouldn't recommend that your next works team meeting finishes in a mass brawl - though that could make it a bit more interesting than normal -- perhaps the plenary session of your brainstorm does need a bit of livening up. 

 

Conflict (fight,struggle,disagreement) is not necessarily all bad - one needs clashes about ideas,beliefs and ways forward to ensure that all possibilities are aired and discussed. Conflicts should be out in the open if they are to be addressed and ultimately resolved. There is nothing worse than bland agreements which are designed to keep the peace at all costs. That just leads to more frustration and problems in the long run as nothing is really resolved and situations fester. Some organisations shy away from any form of conflict at all costs - challenges against people and groups are deflected and it becomes the challenge itself that is the problem and not the problem that the challenge was trying to address in the first place.

Conflict can be productive and helpful but it needs to be managed to provide results that will challenge the way an organisation acts and thinks. Conflict can be between individuals and between groups. In an organisational sense - group conflict can be about:

1. Differing views of what the objectives of the organisation should be.

2.Differing views about how the objectives of an organisation should be achieved.

3.Differing interpretations about what is and is not appropriate behaviour within an organisation.

4. Differing interpretations about how a group's opinions are expressed, formulated and indeed what the particular group does or does not stand for in an organisational context.

The focus in this blog is about inter group conflict - usually easier to resolve than individual conflicts where individual personalities and how they interact with each other are usually the key factors.

How can we try and resolve group conflict within an organisation?

 

The first way is for groups to co-exist in a calm way with each other - groups learn to live with each other and to communicate much better with each other than before. Toleration of each others views is encouraged. The second way is to compromise in some way which will give everyone the impression that there is no right or wrong answer and that everyone is right to a degree - no-one is at fault at all and no-one is to blame. These first two approaches can work but rarely if ever do they address the long term problems of an organisation if there are radical issues which do need to be addressed and resolved. Indeed these approaches can give a sense of false security that everything is fine and that nothing really needs doing because on the surface at least - there is an appearance of respect and mutual understanding. Perhaps these approaches are just short term expedients designed to keep the peace for a while and in that sense they are often successful within this context.

 

If there are radical changes which objectively have to be delivered within the organisation - then these first two approaches can cause dangerous inertia in the light of significant external and internal change pressures. If an objective resolution to the conflict is required, then the application of problem identification and solving techniques is necessary to ensure that the respective groups identify and discuss a whole raft of issues which will address their inter group conflicts - not only must this discussion take place but an agreed alternative conflict resolution path must be taken for the good of the organisation as a whole. This is not an easy approach and requires professional facilitation and management to ensure that conflicts can be resolved and an organisation moves forward -

 

No-one said it would be easy - but avoiding the problem solving route, although at first appearing as an attractive option ( because no-one loses any face?) can in the long run mean a much more grave position for your organisation. The temptation to refrain from solving inter group conflicts should be resisted if you wish your organisation to have a longer term future.

 

.

POINTERS TO MANAGING OUR STRESS

 

Stress - How we might be able to cope?

 

Stress is the bete noire of many of our lives, it can cause us to lose our health and our sanity if we let it do so. So what is stress? In our world of cuts and pressures we are all exposed  to such a variety of work demands- some short and some long - our e-mail in boxes overflow with information and demands and we must try and cope. Some form of pressure is desirable for everyone -- we do need to be challenged with new and interesting work -- doing the same groundhog day job all the time also becomes stressful as people become bored and lose hope in their futures - stress is a reaction to the pressures and challenges we face. When there is a gap between our ability to handle a situation and the tools we possess to handle it, then that results in physical and mental stress. Our perceptions of people and events are also very crucial to the stress process and need to be managed.

 

The categories of our stressful existence can be characterised as follows;

 

1. Time stress -- Getting yourself worked up about time deadlines for specific job

 

2.Anticipation stress -- Worrying about the outcome of an event which has not yet happened

 

3. Situational\Encounter stress - Being in a situation where you feel pressurised by the situation itself or by an individual or group of people's behaviour towards you.

 

The causes of stress include the following but I don't want to go into them too much as guess what -- it will become too stressful:

 

• Working conditions and workload
• Role conflict and ambiguity
• Coping with change
• Relationships with subordinates and colleagues
• Work and family life balance
• Job accountability,status and security
• The culture of the organisation in which you work.

What can we try and do to cope

 

1.Build good relations with your boss and your work colleagues as much as you are able

2. Read e-mails three times a day; morning, lunch and evening time-- E mail is not an instant messaging system -- people will ring you if they need you.

3. Use the phone more.

4. Clarify your job role and objectives with your boss -- iron out ambiguities.

5. Make time for yourself and your partner and family.

6. Exercise more and find a hobby you enjoy doing.

7. Do not agree to loads of new tasks and extra work - focus on priorities and offer to help later when your time is freer. "I'm really glad you asked me but at the moment I have a designated project I must finish, perhaps we can discuss this later."

8. Plan your working day using time management

9.Be realistic about your job goals and abilities - work on your weaknesses

10. Prioritise your work and delegate tasks to others (but not your strategic decision making role)

11. Accept that you will be unable to change everything -- just change the things you can change -- often very difficult to accept.

12 Build alliances and friendships that will help you through any issues.

13. Try to be optimistic and take time out to relax and reflect

 

This may need you,me and everyone to adapt their behaviour to achieve this  and we do need to plan that adaptive change.

Something that is stuck on my wall from Paul McGee the Sumo Guy - is always important to me, regarding any stress issue\challenge you might face and the points are as follows;

1. How important is this issue on a scale of 1 to 10?
2. How important will it be in 6 months time?
3. Is my current response appropriate and effective?
4. How can I influence or improve the situation?
5. What can I learn from the situation?
6. What positives can I draw form the situation?
7. What will I do differently next time?

One other thing, please ensure that the way you try to cope with stress does not become as stressful as the initial stress itself. That would only be self defeating and of course very stressful.


 

HOW CAN WE BE MORE EFFECTIVE?

 

Increasing Effectiveness: The secret of success?

 

Everyone always wants to be effective in their work and personal lives. How can this be achieved? What does being effective really mean in the workplace as we know it? Being effective means doing the right things at the right time to obtain the best outcomes for your organisation and yourself.,usually in that order. Surprisingly it has little correlation with intelligence or even creativity. There are many people who are very intelligent and indeed very creative but they do not register as being effective because they cannot transform their talents into concrete actions which are effective and can deliver optimal results. There are many viewpoints on this. There are those managers who make things happen, there are those who watch things happen and there are those who just don't know what is happening. Where do we fit in? -- probably in some situations we area mixture of all three of these elements -- hopefully we can make things happen but sometimes we hold back because of either personal or organisational constraints.

 

Is personality the key ? Do you have to be bold,ambitious decisive and even loud to be effective? Personality is very important but it is increasingly clear that techniques to make you more effective can be learnt and need to be practised by you in the correct context. These techniques encompass, planning,organising,motivating, delegating and controlling. You will still need the personality to practise them correctly but we all need to look at how we can become more effective. According to David Mclelland of Harvard Business School we need to examine the following;

• Do we set ourselves realistic but stretching goals?
• Do we prefer situations where we can influence the outcomes ourselves?
• Are we more concerned with doing well - doing a good job per se, rather than rewards? We get our rewards from accomplishment rather than cash.
• Are we satisfied with the status quo or do we think we can change things for the better?
• Are we enthusiastic and committed to things?
• Do we take calculated risks?
• Do we constantly monitor our own and our subordinates' performance and act on it?
• Are we decisive in that we can sum up situations quickly, define alternative actions, pick the correct alternative and get everyone to support the way forward?
• Do we communicate well with our work colleagues?
• Do we demand high performance from ourselves and others as well?
• Do we show perseverance in the face of adversity and take setbacks as learning points?
• Do we listen to and take advice but then decide on our own course of action and then follow it through?

If you do all of the above and more then you are very effective. In reality for all of us, being more effective is a work in progress and I do mean work - we have to work at it constantly. We have to ask ourselves questions like; What did I set out to do? What did I achieve? Was it what I wanted to achieve? Where are the achievement gaps? How can I do better?

Observation, analysis and learning will hopefully make us become more effective. Personal appraisals and even external coaching , both delivered by high quality individuals can help. Recent external coaching which I have received has been excellent in assisting me. Other management techniques like; planning,motivation,leadership, control, target setting, communication and delegation can assist you in becoming more effective but your experience of them cannot and must not be just attending a relevant training course. You must have practical experience and support in applying them to real world situations.

Being more effective can be learnt but it also needs to be worked on.



 

MID STAFFORDSHIRE NHS TRUST - WHAT HAPPENED TO VOCATION AND COMPASSION?

Mid Staffordshire NHS Trust - Bring back the compassion?

The shocking revelations about the Mid Staffordshire NHS Trust put us all to shame - the founding fathers of the NHS will be turning in their graves at what has happened. Conditions within the Trust between 2005 and 2009 were dreadful and there was little at the time that seemed to be done about it, apart from the efforts of one pioneering woman this could have been missed and not addressed. This is doubly shocking because health care professionals are always viewed as people who are not just motivated by money but who do care for the health and well being of the patients they are responsible for. Working for the NHS, the public and the not for profit sector should at least be a partial vocation --- no, we will never get the stellar salaries that some bankers get but yes we will be reasonably well paid and yes we can make a difference to our communities and to our fellow citizens. The latter opportunity to make a difference to our fellow men and women should motivate all of us who work in the public and not for profit sectors. Where was this sentiment in Mid Staffordshire between 2005 and 2009 for the patients?

 

The other element that appeared to be missing in this equation was compassion - defined as pity inclining one to be helpful or merciful to the people under one's care.Some of the conditions that were tolerated included the following; food and water were unavailable, patients were left unattended, bead pans were not emptied, patients and their relatives were treated disrespectfully - the catalogue goes on and on.It was also estimated that some 1,200 lives were lost as a result of the hospital's treatment failures.The report on the Trust by the barrister Robert Francis issued 290 recommendations on how this can be avoided in the future. This seems like an awful lot of recommendations to me. Let's hope they are prioritised and turned into a properly resourced action plan to make things better.

 

Let's also not pretend this is an isolated incident. When my  eighty six year old father in law was terminally ill we experienced some indifference to his plight in the NHS hospital where he was initially treated, an over provision of a pain killer could have  had much worse consequences if we had not been as robust in our stance and questioning as we were. It is good to see that there will be greater training for nurses on compassion although a nurse without compassion is the same as a soldier without any courage - so that is very surprising to me. Nursing = compassion - that should be without question. Poorly paid health care assistants can be a problem -- but that needs to be  addressed -- The Marie Curie helpers and nurses who cared for my father in law when he was at home were excellent and I'm sure they were not better paid than their NHS counterparts.

 

NHS patients will need clearer service standards and the proposed "duty of candour" where medical mistakes on patient treatment will have to be revealed  - both could make a difference but it will be difficult to see how the duty of candour will work in practice - without committing these trusts to huge legal and compensation bills if something does go wrong. Everyone thinks whistle blowing is a good idea in principle, but in practice few people do it because they do not wish to suffer the personal consequences. Whether it will work as a recommendation of the Francis enquiry remains to be seen. I  personally have my doubts.

 

Apparently the tension between local and central control in the NHS played its part in this, as local managers appeared to cut service delivery standards to cut corners to achieve foundation trust status, which ironically would have given them more autonomy  -- but to do what?  Clearly poor performance was tolerated by some managers,supposedly for the greater good to achieve this status. This reminds me of my own experiences where poor performance in parts of organisations i have worked in has been justified as being for the greater good of the organisation in that people had to be kept "on side" and the proverbial "boat could not be rocked." In my experience ignoring current performance problems just stores up much bigger performance problems in the medium to long term for the organisation and they just become more challenging to resolve than if action had been taken straight away - A lesson for us all perhaps?

 

We need an NHS which is effective,efficient and equitable. This is a tall challenge but not an insurmountable one. Privatisation with lower cost targets is not in itself a solution to this. We need an NHS where patient outcomes are improved -- According to the Economist the % of patients experiencing avoidable harms in the NHS varies from 9% per hospital to 20% per hospital. An avoidable harm is something like; bedsores, infections, falls and missed drug doses. We should be aiming at much closer to zero % in these areas.

 

Let's reset things to bring back vocation and compassion and let's focus on how we can improve patient outcomes over time - That is the priority -- not the precise service model by which these improved patient outcomes are delivered by\through.

 

The future of NHS work lies in these value-based structures giving it a chance to align its budgets within the confines of tighter fiscal realities.  It should now be thinking about value-based provision that is patient outcome-centric not a race to the bottom in terms of the costs of health provision.

Please look at the links to the Francis Report here:

http://www.midstaffsinquiry.com/pressrelease.html

 

 

OUTSOURCING -- NEEDS TO INCREASE SOCIAL VALUE



Outsourcing -- We may save costs but can we increase social value?

Last week we talked about off shoring - the practice of taking whole production elements overseas to seek a critical competitive cost advantage. This is now slowly being reversed amid concerns about quality of products, transport costs, remoteness from end markets and problems with linking production and product\service innovation. The handmaiden of off shoring is outsourcing -- but the one does not necessarily always need to go with the other although this has often been the case.

 

Outsourcing a part of your business to a provider seems to be very seductive - especially when the process, is dull, repetitive and high volume and does not really form a core part of your business operations. Things like, invoicing, payroll, IT provision, cloud computing,cash collection, legal advice and HR advice seem to be prime candidates for this. The Government's 2011 Open Public Services White Paper seemed to envisage a diverse public sector service delivery landscape,however the picture in reality appears to be different. Outsourcing straight forward unit based services like invoicing and packaged advice for specific issues is relatively easy. Outsourcing complex multi-dimensional services like for example social care, health management, prisoner welfare and the resolution of issues with troubled families is much more difficult and challenging.

 

Indeed, when such complex services are outsourced, is there now an argument to say that the traditional contract based relationship needs to transform itself into one of a much more partner based delivery where difficult challenges need to be jointly addressed and it does not become just a cost minimisation stand off. In these circumstances both the supplier and the commissioner need to get inside each others heads to share a common approach because if that is not the case then nit picking and sniping could well be the order of the day. There does need to be a coming together - even a common "karma" to make things work properly. If that does not happen, then even the tightest written contracts and the meanest specifications are no real defence against a supplier or commissioner who wants to catch out the other party in a contractual game of poker.

 

Public sector commissioners who write the contract specifications for specific unit based contracts like for example grass cutting or school meals face a more straight forward task than those who need to try and specify how an adult care service might look like or how an NHS health promotion service might be delivered, These 2 latter services will need to be assessed not only on the basis of how much direct costs are saved by going for them but also how subsequent choices by commissioners will impact on society as a whole. The Public Services - Social Value Act 2012 - Now places a duty on on local authorities to consider the wider social and environmental effects of their contracts and also the effects of these on their local economies. The traditional outsourcing model - when applied to complex multi faceted services can prove to be inflexible and a significant long term financial commitment - It is time hungry in terms of officer and member time for consideration and any savings are often overstated at the outset.

 

Some would argue it would be better for the authority to re-engineer its services itself however in may instances,authorities simply do not have the ability and the will to do this properly. There is a trend for certain authorities to go for in-sourcing -- bringing back services which have often been poorly delivered by the external contractor and the risks of continuing with such existing arrangements have proved to be just a step too far for these authorities. Many of these instances of bringing services back have resulted from occurrences where the external contractor underestimated the cost and complexity of delivering the services within the contract period and to the required specification. The commissioner of these services was probably not blameless as well in terms of writing poor ill defined contract specifications and practising very poor contract monitoring and follow up procedures. In-sourcing needs to be handled with extreme care as the returning service will be unable to go back to the way it operated before it was outsourced, whatever the failures of the incumbent contractor may have been.It is highly likely that such an in sourced service will need to change anyway once it is back in-house and that might mean working with new partners and having a focus on increasing social value.

 

Oscar Wilde described a cynic as, " A person who knows the price of everything but the value of nothing," and so it is with contract prices and social value. Outsourcing organisations can increase efficiency and save costs -- but can they increase social value and are they even trying to measure and assess their own social impact in these areas? My direct experience, albeit from a traditional outsourcing exercise, is that the new provider puts in a very keen price for delivering the service, but then later on, looks for loopholes he can exploit and then puts in claims for variation orders etc. Not exactly in the spirit of closer collaborative working and hands across the sea etc. but nevertheless something I have had bitter experience of. This "price driven" contracting model in the words of the Partnership adviser - John Tizard is alive and well and probably in an authority near you. According to Mr Tizard, "Anyone can buy cheap but can they source increased value?"

 

Is the supplier who puts in a keen price but delivers little or no social value - in terms of his impact on the local economy, better than the supplier who puts in a higher price but significantly increases local social value? We must go for the latter and not the former but there are some caveats here.

 

Public service commissioners need to include transparent measures of increased social value in their service specifications whilst potential service suppliers need to include in their contract bids - creative and imaginative ways of ensuring that increased measures of social value are attained and that there is a real social value improvement delivered for the area in question whose impact can be measured in the light of the contract specification. These potential suppliers must be committed to a reasonable return and also ti increasing social value as well. This will involve a change of heart by some potential suppliers.

 

Yes - people might argue that these elements are challenging and difficult to achieve and measure -  but they must be attempted if we are serious about high quality future public services delivered from a diversified supplier base. We need to move away from simple price squeezing on services to a position where the charity and private sectors can increase public value and make service efficiencies as well. I do not believe that these aims are necessarily incompatible and this certainly is not mission impossible.

 

There has to be a dual commitment from the public service commissioners and also the potential public service providers be they  public, private, charity or third sector partners ( or indeed a mixture of all of these); to the aims of;

 

1. Increasing the efficiency of the service in question.

 

2. Ensuring that the social value of the area is maximised by landing on a service supplier who will be most likely to achieve the social value aims.

 

Social value must be transformed from an esoteric concept into a practical measure so we can all be confident of where we are heading. This will take time but the journey will be well worth it.

 

We cannot just focus on cheap services which may turn out to be inappropriate for ourselves and our local areas - in the medium to long term.

 

Cheap and nasty commissioned services - no

 

Efficient and valuable services  -- yes.

 

These measures will need to provide value for both service users and taxpayers - We need to move further down the road in these areas as soon as we can.