News and Comment

Getting your new house in order: structural changes in the public sector

Tuesday 3 September 2013

With public bodies under intense pressure to find ever more efficient and effective ways to deliver services, major redevelopments of organisational and sector structures are becoming increasingly common.  The latest of these large scale structural re-designs recently occurred in the NHS, with the establishment of a number of new commissioning entities, namely: Clinical Commissioning Groups, Commissioning Support Units and Local Area Teams.

This process is typically both complex and confusing, with organisations first setting up in ‘shadow’ form whilst a ‘handover period’ is completed, before assuming full statutory responsibility for their given area. Having successfully negotiated this right of passage, there may be a temptation for NHS institutions to feel the hard work is behind them, this however, would be folly.

Because to use a domestic analogy, redevelopments of this kind are a bit like moving house. It may feel like the move is complete once the legal paperwork is done, the finances have been settled and the keys have been handed over, but, as anyone who has ever undergone this ordeal knows, the move itself, is only the first step in establishing yourself in your new home.

So here are some points to bear in mind for NHS leaders and managers currently busy putting their new houses in order:

Notifying everyone of your move

Firstly, your friends and family need to know where you are- have you redirected all your mail? Does your mother approve of your new surroundings or is she going to re-arrange the furniture on her first visit?

The marketing/communication/information management aspect of establishing your new organisation can mean the difference between establishing yourself quickly as a new player, or sitting waiting on the sidelines to get a game.

Arranging the furniture

It’s funny how often without thought cherished pieces of furniture which contain all the family photos get plonked down in the spare room, never to be looked at again. All the family memories, mistakes and successes get hidden away under a layer of dust.

There will be a history to your new organisation which means less energy need be exerted on a range a activities if it can be tapped, analysed and put to appropriate use. Organisational memory can be an asset, even if it only teaches you what not to do again.

Making the house your own

Is the internal layout of the house suitable for your purposes? Does there need to be some new decoration or even some reconfiguration of the internal structure or perhaps an extension?

While form does follow function, don’t be slow to adapt the form of your organisation to most efficiently deliver outcomes.

Living within your budget

Then there are the utilities to consider. The time has gone when we would just notify the national utility companies that we were the new occupiers and take a meter reading. Now we have to find out which company offers the best deal given our consumption. It may not be the same supplier as the previous occupants.

Commissioning strategy and implementation are at the core of the business, whether you are a commissioning or provider organisation.

Good Neighbours?

Of course there are neighbours to get to know and the inevitable discussions about the boundary responsibilities, and more complicated still, shared driveways!

Engage with your partners at an early stage and get agreement of shared principles in place.

The Street Scene

Finally, there is the neighbourhood to get to know. Is there a paper shop which delivers? Does the owner of the corner shop know a good plumber?

Local population and infrastructure knowledge has to be an essential component to delivering good outcomes