Monday, July 20, 2015

Evaluation of AQuA’s Leading Integrated System Level Change Programme

The Advancing Quality Alliance (AQuA) is a membership quality improvement organisation supporting NHS and social care commissioners, providers and their partners.

In April 2014, AQuA began delivery of a new support programme ‘Leading Integrated System Level Change 2014/15’. The programme was designed to meet member requests for support to collaboratively lead system integration, as they moved towards and progressed with the implementation of integrated care.

OPM was commissioned to undertake an independent evaluation of the programme that commenced in May 2014 and ran until May 2015. The aims of the evaluation were to provide an understanding of how the model and elements of the programme supported large scale system change, and to explore the transferability of the model to other system level reforms.

OPM evaluation leads worked with AQuA Faculty leads to co-produce the detailed evaluation themes, evaluation framework and methodology. The evaluation drew on economy applications to the programme, the workshop evaluations completed after each master class, and AQuA’s System Integration Framework Assessment Tool data. OPM also undertook two waves of fieldwork with participating economies.



Friday, July 10, 2015

Child Sexual Exploitation: A study of international comparisons

Funded by the Department of Education and commissioned by the Virtual Staff College, OPM undertook an evidence collection and desk review of international comparisons of Child Sexual Exploitation (CSE).

CSE has increasingly become the focus of intense discussion, debate and intervention in the UK. At a summit in March 2015, the Prime Minister described CSE as a ‘national threat’, and announced that it will be given the same priority by the police as serious and organised crime.

The report aims to explore:

Wednesday, June 17, 2015

Raising the public voice in infrastructure decision making

New policy paper proposes how best to engage concerning major infrastructure

Current decision-making and consultation processes have led to a widespread and deep-rooted lack of trust, eroding belief in the shared nature of infrastructure. The persistent absence of public acceptance is producing a planning system unable to respond coherently to the future needs of society.

‘Infrastructure and the Citizen’, a collection of four short essays by Consultation and Engagement specialists Dialogue by Design and UCL Transport Institute reveal whether depoliticising infrastructure, viewing it as a social contract, considering it as a special case for dialogue, or accepting it as shared with society would enhance or diminish the public voice in decision making.

Advancing the debate around public engagement practice that took place between participants and speakers at the ‘We Need to Talk About Infrastructure’ seminar co-hosted by the two organisations, the paper proposes:



Diane Beddoes, Chief Executive, Dialogue by Design said:

“Many of the new infrastructure projects we run consultations for are contested by individuals, communities and sometimes stakeholders. Infrastructure projects of national significance have impacts – both positive and negative – on local people and communities that need to be heard and understood.  We believe that good engagement on new infrastructure projects can help to improve the quality of decision-making, reduce risk and ensure that the views of those affected are taken into consideration. If we are serious about infrastructure investment, then we must be equally serious about effective dialogue and consultation with opponents and proponents. We hope the key recommendations in this report are taken seriously”



Note to Editors

The ‘We Need to Talk About Infrastructure’ seminar was held on Monday 23rd March 2015 at NCVO, Society House, 8 All Saints Street, London N1 9RL. The debate was chaired by Jim Steer (Founder, Steer Davies Gleave), with speakers Professor Brian Collins (Professor of Engineering Policy and Director, International Centre for Infrastructure Futures (ICIF), UCL), Dr Jack Stilgoe (Lecturer in Social Studies of Science, UCL), Diane Beddoes (Chief Executive, Dialogue by Design) and Will Bridges (Lead Consents Officer, North West Coast Connections, National Grid).


About Dialogue by Design

Dialogue by Design designs and delivers bespoke public and stakeholder engagement and consultation services. Dialogue by Design specialises in handling consultations on contentious or technically complex issues and are experts at running consultations for nationally significant infrastructure projects.

Dialogue by Design with sister company OPM comprises the OPM Group: an independent, employee-owned research organisation and consultancy.         



About UCL Transport Institute

The UCL Transport Institute has been set up to foster cross-disciplinary transport research and to increase the policy impact of that research.        



For further information please contact:

Lawrence Finkle


t: 0207 239 7800

Wednesday, June 17, 2015

Infrastructure and the Citizen

A simple question was posed at the We Need to Talk about Infrastructure seminar co-hosted by Dialogue by Design and the UCL Transport Institute: when Government plans to invest £375 billion in infrastructure projects up to 2020, how can this be done with local communities, rather than against them?

Rather than produce a summary of the event, the authors have reflected on what was heard and learnt, and wrote a few short pieces on how the discussions that took place could advance the conversation about how best to engage concerning major infrastructure. Four themes are addressed:

Morgan Wild, Project Manager at Dialogue by Design, discusses the extent to which taking the politics out of infrastructure decision making
could enhance the public’s voice;

Dr Tom Cohen, Deputy Director of the UCL Transport Institute asks what it means for engagement to be seen as part of a social contract;

Ian Thompson, Analysis Manager at Dialogue by Design, discusses the extent to which infrastructure presents special problems for engagement and dialogue; and

Elena de Besi, Project Coordinator at Dialogue by Design, discusses the opportunities that our ‘sharing’ of infrastructure creates for overcoming the lack of public acceptance and the consequences in terms of engagement and planning.

Because the meeting was held under the Chatham House Rule (Chatham House 2014), quotations are not attributed to individuals.


About Dialogue by Design

Dialogue by Design with sister company OPM comprises the OPM Group: an independent, employee-owned research organisation and consultancy.

Dialogue by Design designs and delivers bespoke public and stakeholder engagement and consultation services. Dialogue by Design specialises in handling consultations on contentious or technically complex issues and are experts at running consultations for nationally significant infrastructure projects.         



Tuesday, March 31, 2015

Systems Leadership: A view from the bridge

Across the public and third sectors, we are beginning to accept a new way of thinking about the leadership required, applying the theory of ‘systems thinking’ to the practical reality of trying to achieve complex change. For both practitioners in OD, leadership development and for leaders themselves, there is an important opportunity now to exchange learning about how to lead well in these difficult times.

This paper is a personal account from OPM’s Sue Goss on how to make systems leadership work in practical terms. It is not simply about toolkits and ‘hot tips’ – there is a need for new theory to help explain what is happening, as well as carefully observed learning from practice. The paper has been shared widely with OD and HR colleagues and we hope it can form the basis of a wider conversation, so that the next five years can build on the discoveries of the last five.

Tuesday, March 31, 2015

A guide to economic assessment in nursing

This guide supports the work of the Royal College of Nursing (RCN) and OPM, who are working together to provide training in how to perform economic assessments and use economic evidence to demonstrate the value of nurse-led innovation. It is a collection of articles that explain some of the principles of economic assessment and describe the most common approaches to it. The series aims to enable readers to critically examine economic assessments and throughout, we offer practical ideas, tools and templates that we hope can help you navigate the challenges of measuring, demonstrating and unlocking value.

Friday, February 6, 2015

Mythical Maze Makers: An impact study of youth volunteering on the Summer Reading Challenge in 2014

Summer Reading Challenge volunteering (SRCv) is a Reading Agency programme targeted at young people aged 12-24 and involves volunteering in libraries over the summer to help with the running of the annual Summer Reading Challenge (SRC).

In 2013, nearly 6000 young people were recruited as Summer Reading Challenge volunteers in 1454 libraries across 137 local authorities. In 2014, The Reading Agency were successful in securing a grant from the Centre for Social Action at the Cabinet Office to expand the number of young people involved in SRCv. Following consultation with the library sector, it was agreed that a 40% increase in volunteers would be possible in 2014.

The expansion of SRCv means that it is increasingly becoming a key volunteering opportunity in the wider context of developing high quality social action for young people.

OPM was commissioned by The Reading Agency in May 2014 to undertake an impact study of SRCv. During the summer of 2014, qualitative research was undertaken with volunteers, SRC participants, library staff and other stakeholders in four case study locations in England – Gloucestershire, Lancashire, Norfolk and Tower Hamlets.

Sue Wilkinson, CEO of The Reading Agency, said:

“What this report shows is something that we have frequently heard from our library colleagues. Young volunteers not only develop their own skills by working in libraries over the summer; they also act as powerful role models for children, inspiring them to read more and encouraging them to join in with the Challenge. It has been wonderful to see the benefits to everyone which have come from young people participating in this amazing programme.”


Friday, February 6, 2015

Youth volunteers can breathe new life into Britain’s public libraries

National Libraries Day on Saturday is the perfect opportunity to recognise the role of young volunteers in shaping the modern library service

The long summer holidays are nearly over and in a seaside town in Lancashire, a small branch library is preparing for an event to celebrate the end of the Summer Reading Challenge. Families are beginning to wander in, keen to escape from the drizzle outside. The library manager visibly breathes a sigh of relief when three young people arrive – with their bright blue ‘Reading Activist’ t-shirts signalling they are ready for their final volunteering shift of the summer. By 2pm, the Children’s Library is full and the next two hours pass in a buzz of reading related games, crafts, stories and celebration, whilst other library users quietly get on with looking for the latest recommended books, or using one of the public computers.

This snapshot encapsulates the description in last year’s Independent Library Report, led by William Sieghart of libraries as ‘modern, safe, non-judgmental, flexible spaces, where citizens of all ages can mine the knowledge of the world for free…’

There are no shortage of campaigns and initiatives championing libraries, and this coming Saturday is National Libraries Day, designed to encourage people to ‘use it, love it, join it!’ Last year, BBC 6 Music organised its own library celebration. When a library closure beckons, opposition is quick to mobilise.

Libraries unite a wide range of visitors: information seeking aficionados, hipsters, sound archivists, job seekers, teenagers doing homework, children looking for the latest Jacqueline Wilson book, and even those just wanting somewhere to retreat to with a copy of the paper.  But libraries are operating in a rapidly changing world, competing for limited resources, and need to adapt accordingly.

Sieghart made the case for investment in the modern library service and a key recommendation was a call for volunteers to be a more important part of the library workforce – recognising the 100% increase in people giving their time for free in libraries since 2009.

However, in these recent debates about the future of libraries, there has not been as much emphasis on how young people are a crucial part of this volunteering picture – often overcoming outdated stereotypes of libraries being stuffy and quiet, and not a place for teenagers to spend their time.

OPM spent last summer evaluating the impact of young people volunteering in libraries to support the annual Summer Reading Challenge (where children aged 4 to 11 are encouraged to read six books during the school holidays), run by the charity The Reading Agency. In 2014, 8,126 young people aged 12 to 24 volunteered in 1,740 libraries – helping to run the Challenge, devising reading related activities and talking to children about books.

The report has been published this week with a clear message that volunteering in libraries gives young people the chance to develop communication and team working skills, experience a professional workplace, work with children – and most of all have fun over the summer.  70% of volunteers in 2014 said that they loved the experience of being a volunteer.

The research team visited 20 libraries in total – from Carnegie libraries in Lancashire steeped in the legacy of their founding aspirational vision, to the most visited library in the UK in Norwich. We saw some under-used spaces and buildings in need of investment but we also saw libraries coming to life with a bustle of reading related activity and enthusiasm. Tea and biscuits lured families to stay and talk to their neighbours, and in many cases, there was a genuine sense of there being ‘something for everyone’ in the library.

Volunteers often told us they’d be spending their summer ‘bored at home’ if they hadn’t decided to volunteer, and that they were passionate about the role they could play in inspiring younger children to read.

Other stories gave an indication of how volunteering can be life changing – one 19 year old talked about how shy she had been at school, and had been struggling to engage with sixth form as a result. She volunteered for the Summer Reading Challenge three years in a row in her local library, and is now leading teams of volunteers, mentoring others, getting involved in other local community events, working part time in the library and about to return to college.

This was youth social action at its most powerful – young people making a difference in their local communities, volunteering close to their homes and changing attitudes towards libraries. At the end of the summer, 71% said they would like to continue volunteering, and over half said they would use a library more as a result.

Library staff were equally enthusiastic about young people volunteering as it enabled them to host more activities for the Summer Reading Challenge than would be possible with core staff alone, and improved the public perception of the library as a welcoming and relevant place to be.

Libraries will continue to evolve and they will undoubtedly look very different in 20 years’ time. Our research is a call to recognise the role of young volunteers. They are not a replacement for full time professional library staff, but they are a powerful way to ensure that libraries reflect the communities they serve, provide more that appeals across age ranges, and inspire new library users through their doors.

Tuesday, January 6, 2015

Evaluation of the Leading Integrated System Level Change Programme

The Advancing Quality Alliance (AQuA) is a membership organisation supporting NHS commissioners, providers and their partners. In April 2014, AQuA began delivery of a new support programme ‘Leading Integrated System Level Change 2014/15’.

The programme involves a series of master classes on large-scale change and complex adaptive system theory and distributed leadership. It also includes the Integrated Care Fellowship Programme and International Exchange Programme. Paul Plsek and The King’s Fund are working in partnership with AQuA to deliver the programme. Bespoke coaching support is also available as a draw-down offer.

The programme is aimed at senior leaders from health and social care organisations, who have authority to take decisions and influence change within their organisations and across the local health and social care system. The participating economies are: Central Manchester, Bolton, Wigan, East Cheshire, Trafford, Oldham and Pennine / East Lancashire. Wirral initially joined the programme, but have currently withdrawn from engagement.

In May 2014 OPM was commissioned to undertake an independent evaluation of the Leading Integrated System Level Change programme. The aims of the evaluation are to provide an understanding of how the programme supports large scale system change, and to explore the transferability of the model to other system level reforms. The evaluation also aims to explore the value added by the International Exchange Programme and the AQuA Fellowship. AQuA will use the external feedback to shape the programme and demonstrate its impact.

This report presents the emerging findings at an interim stage of the evaluation.


Friday, December 12, 2014

Making It Better: Manchester’s reconfiguration of maternity, neonatal and paediatric services holds essential lessons about how to lead successful change

2014 has been another year of attempts to future proof the NHS. Policy proposals within The ‘NHS Five Year Forward Review’ were welcomed by many, and the recently released Dalton Review on the future of hospitals further challenges NHS leaders to think differently about how healthcare services are organised and delivered. Throughout the past year, CCGs too have devoted considerable time to producing two-year and five-year strategic plans for their local areas.

The ultimate goal of all this future thinking is to create financially viable and sustainable local health systems, but this is more easily imagined than achieved. For if there’s one thing the NHS is good at, it’s planning. Implementing complex change is where things get messy and stalled. Few places have managed to transform local health services without hiccoughs and major setbacks.

Particularly after the election,  2015 should be an watershed year for the NHS – especially for its commissioners. What should CCG leaders be doing now to ensure their plans are achievable? Learning from what others did well – and also from their mistakes – would be a good place to start.

OPM recently completed an evaluation study of Greater Manchester’s ‘Making it Better’ reconfiguration of maternity, neonatal and paediatric services.  Through this evaluation, we have identified some important lessons for CCG leaders and their local partners.

The first observation is that transformational change takes time – and patience. The Making it Better process actually took about 12 years from conception to final delivery.  While there were many setbacks along the way, the programme managed to move from planning to public consultation to implementation by 2007. The reconfiguration of hospital services was completed over five years in 2012.

A tremendous number of people were involved in the delivery of the changes.  Local implementation groups were formed, with task-based delivery groups and clinical advisory groups leading most of the work and taking on clinical accountability.

Governance mattered, too; a programme board was set up, and there were regular meetings between providers and project leaders. The project’s governance structures and processes ensured that clinicians, executive directors and managers across the whole of Greater Manchester presented a united front and worked well together. Governance was crucial to maintaining focus and momentum over such a long period of time.

But what mattered most of all was the clinical credibility of the reconfiguration – both in terms of visible and continuous clinical leadership and the clinical merits of the proposed changes.

There was genuine clinical ownership of the need for change across the whole of Greater Manchester and impartial clinical and managerial leadership for paediatrics, obstetrics and neonatology. This promoted a strong recognition that the need for change was underpinned by a robust clinical argument rather than one of efficiency.

With the continuity of clinical leadership, great effort was put into ongoing engagement of clinicians during the implementation process. Strong clinical participation ensured that care options were underpinned by robust data analysis and supported more widely. A networked approach proved vital; the networks acted as clinical reference groups, and helped to build consensus amongst local stakeholders, such as frontline staff in the respective NHS Trusts.

One of our most interesting evaluation findings concerned leadership capacity building.  Making it better offered many clinicians, senior executives and managers the opportunity to develop new skills and experiences. Being responsible for the safe implementation of the reconfiguration led to personal satisfaction and a strong ethos of commitment to change.

Leaders became adept at managing vested interests. Making it better involved the relocation of inpatient care from some Trusts. Where this occurred clinicians had to balance their personal views with the need for safe and sustainable services across all of Greater Manchester.

Making it better spanned twelve years and took place within a context of great change across the NHS. The disbandment of PCTs and introduction of CCGs led to a lack of continuity on commissioning boards at a critical time in the reconfiguration, as well as turnover of managerial staff, and the concomitant loss of organisational memory.

This situation reinforced our conclusion that the key ingredient for success was the continuity, strength and commitment of the Making it Better clinical leadership team.

Such a dynamic environment will undoubtedly exist for CCGs taking forward their newly agreed strategic plans. Maintaining the momentum locally will require long-term commitments of GPs and their consultant partners. The question is: Will local leaders have the stamina, drive, resources and skills to make a difference to their own local health services?

Part 2: How to resource reconfiguration delivery programmes (to follow)

Download the Making it Better interactive PDF

Download the Making it Better full report