- Some good vibrations
- Just a reminder
- Last throes
- Do we know why?
- Feeding the probophiles
- Targets alive and well in policing
- IDS: a novel politician
- Tool-heads let loose on baristas
- The difference between lean and systems thinking
- The tool-head collection
Some good vibrations
Many people in the public sector are worried about whether the regime has really changed. I count myself among the doubters (Whitehall watch, newsletters passim). But I have some good news: For everybody who worries about the re-creation of the Audit Commission in another guise (benchmarking unit costs, peer inspections etc), it won’t happen. My sources say there is a clear determination to avoid recreating the wicked regime we have laboured under for the last ten years. We should be pleased.
A Vanguard novice was putting together a system picture for adult social care. She observed that they had all the things that would get you ticks from the Audit Commission but, as ever, the performance was dire. Compliance leads to a de-facto purpose. In her words, the system pictures reveals:
Putting People First = putting people last (record keeping and meeting targets come first)
Carefirst = data entry first, care last
Single Assessment Process = extra assessment process on top of existing assessment processes
Personalisation = help us meet our targets
The Audit Commission (not dead yet) published a report on personalisation of adult care. It said many councils were not meeting their targets to increase the use of personalisation. Jolly good news. ‘Personalisation’ amounts to filling in forms, getting points and pounds; the failure to absorb variety is designed in. Only willing souls who work around the system solve peoples’ problems in ways that also could get ticks for personalisation, many ‘personalisation’ budgets leave people without the help they need.
We have been giving evidence to the Munro review of children’s services. To a systems thinker it exhibits the same problems as adult care; dysfunction and massive waste created by adherence to central regulations. It is important to note that these services have not yet been freed from central control but I am confident the Munro review will address regulation. We are going to put on an event on the Vanguard Method in care services – what they look like when you study them as systems, how to re-design them to drive our costs while service improves and what regulation ought to look like. It will be in the New Year. If you want early warning of when please contact Janice Mack: firstname.lastname@example.org
The minister for local government, Eric Pickles, made it clear in a letter to all Local Authorities that targets were off. There would be no requirement to work to them or report them. More good news. But I worry about whether we know why.
People have an unquestioning belief about targets, Tony Blair said he couldn’t imagine a business being run without them. I have explained at length in my books how and why targets make performance worse. I’m going to see if we can create a short animation to explain the basics to a wider audience. If you know how and why targets do what they do, you’re half-way to a better way. Many need to avoid slipping back, many more still need to know what they don’t know.
In much the same vein: ‘Probophilia’, a doctor writes, ‘is a pathological love of verification over achievement’. Ivan Tyrell, a leader in the Human Givens movement (a profoundly constructive and efficacious approach to mental health), described the same phenomenon as ‘obsessive target disorder’. The point being made is that those who suffer from this disorder are mad but they don’t know it.
The probophiles create their own disconnected world, the doctor writes. It is so true. Some fledgling systems thinkers in the NHS who have tried to get a dialogue going with managers about the need to study the system and then change the measures etc find themselves ostracised and vilified. It is like something out of a Dilbert cartoon. The mind-blocked probophiles cannot even connect, to do so would disturb their psychological edifice, so they attack instead. We should worry, over the last ten years the NHS has created a monstrous management culture. If this continues in the new structures we can only expect more of the same.
You can read the doctor’s paper here:
The doctor says: Patients and their illnesses are mostly continuous, unlike the disjointed care system that tries to treat them as a series of itemised episodes. The more we move towards free flow of patients and information across interfaces of care the better the NHS will work for patients.
Quite so. I was discussing the NHS with some leaders and observed that the purpose of the system ought to be: to achieve fast and accurate diagnosis for all demands and then treatment on time as required for each demand. If we could use those measures we’d be striving for perfect.
A reader writes:
‘A friend of mine works in the clerical/secretarial area for the health service here in Ireland. Their team were called to a meeting recently with their manager who repeatedly emphasised the importance of the team getting their stats completed and sent to management on time as these had to be collated with other stats then sent to the top for review and action by a certain date.
The team pointed out that completing the stats meant they were struggling to get appointments made for patients and that surely the appointments must take priority. ‘No chance’ was the reply, ‘the stats come 1st’. They were advised that if anyone tells them to make the appointments before the stats are done they are to be reported to management.
My friend politely made the point that without patients attending the service, there will be no stats to run. Then it dawned on me, that is probably what they want. The stats showing less people attending, therefore in their eyes costs can be taken out (because stats don’t lie). It’s all beginning to make sense.’
Much the same is still going on in the NHS here; feeding the factory of probophiles, taking the system away from its purpose.
As I observed in the last newsletter, the police have banned targets (not). More on this here:
Lots of re-education still required out there, especially amongst the chief constables. We gave evidence to the Berry review of policing. The report was very positive about our work, it is showing immense benefits. In the New Year we are going to put on an event devoted to the Vanguard Method in policing, if you want early warning of when please email Janice Mack: email@example.com
Maybe the chiefs should start by reading this, a sad account of people being killed to meet targets:
Although our police don’t go that far, there is plenty of evidence that targets have criminalised people unnecessarily as well as contributing directly to a lousy service.
I have been mightily impressed listening to Ian Duncan Smith. His proposals for welfare reform have been built on thorough studying and understanding of the whole system. When he is subjected to questioning his depth of knowledge comes through. We need more politicians like him.
More sad-but-true nonsense from the lean tool-heads, this time taking their disease into Starbucks. You can read the reports here:
If you read the articles note how management respond to the criticisms. Managers have been turned into myopic defenders of the indefensible.
I was asked by someone from a local authority: what is the difference between ‘lean’ and ‘systems thinking? Having been on about it for years I was a bit surprised, but then I thought why should I be? Why should everyone know? So here, for others who have not read all the stuff on lean versus systems thinking, is what I wrote, maybe the simplest explanation:
”Lean’ was the word coined by Womack, Roos and Jones (in The Machine that Changed the World, 1990) to describe the Toyota Production System (TPS). The book brought the extraordinary achievements of the TPS to prominence. This led to the general assumption that if we apply the tools created in the TPS we will improve as it did. So the market for ‘lean’ grew.
But are you in the business of making cars at the rate of customer demand? Why should these tools be universal?
The TPS tools were developed to solve the problems they faced in developing a system to produce cars at the rate of demand. Do you have the same problems?
How did Taiichi Ohno (the man who created the TPS) teach people? Did he give them tools to solve problems they thought they had (as the lean tool-heads do?). No, he taught managers to study their work as a system, his favourite work was ‘understanding’. That’s what Systems Thinking does, it starts with studying. It leads to astonishing improvement. My current favourite: Portsmouth and their suppliers deliver repairs on the day and the time tenants want them, and they do so at half the repair cost. Just like the TPS, an economic benchmark.
Now for the tricky bit. ‘Lean as tools and projects’ appeals to managers. Managers think they know what their problems are and they think tools training and projects will be useful. Managers like the idea (promoted by the lean tool-heads) that services should be standardised (big mistake). If they do get improvement it is marginal, often they end up worse but they don’t know because they are still measuring the wrong things (lean tool-heads don’t question targets or activity measures for example, indeed they don’t question management philosophy).
My work has been the development of the Vanguard Method. It is a method that helps managers study service organisations as systems. On the basis of the knowledge gained, the system is re-designed; changing everything, roles, measures, procedures etc. The first step is leaders becoming curious about changing the way they think about the design and management of their services, for applying the method will change their thinking and hence the way everything is done.’
And if you want to see how effective it is, there are still a few seats left at the Leaders Summit. But hurry, it is almost sold out!
I have written a number of articles on the lean tool-head problem. Last month we put them all in one place, so if you want longer explanations you can find them in the articles section of the web site.