Before I begin, I must thank all the readers who sent kind notes and advice concerning getting depressed. This one was my favourite:
‘When you feel glum because some far-removed-from-the-sharp-end minister gives you the usual spin, just remember that there are good people out there, working hard… to make things better for the people who really matter in spite of, not because of our Whitehall colleagues. We’re here, maybe unsung, maybe not as charismatic as some, but still spreading the word and quietly going about our business. I think like I do because of the Vanguard Method and there are others like me in the public sector across the country – make like the Undercover Boss and when you feel low, head back to the frontline and see how systems thinking changes outcomes for the better.’
It made my day and it is true, when I spend time with people doing great things I get a buzz. I shall get out more.
One of the things I went to visit recently is our work on what we call ‘Locality’. When we first started working in local public services we helped people (massively) improve the services. But we began to realise that the people who turned up in, say, benefits offices had other issues, so they also sought help from other services, often many. We started thinking about service design as dealing with peoples’ contextual issues too, regardless of which service they turn up at. Then it occurred to us that rather than waiting to see which services they turned up at, it would make sense to get out to them; to understand demand from a family/community/place perspective.
So what we are calling ‘Locality’ working is studying demand from communities and developing a service that goes out to those people and families who are making demands on multiple services, and, of course, helping them. The focus of the help is determined by their perspective on what a better life looks like and places emphasis on them taking responsibility.
The results are, quite simply, awesome. Not only do people get their lives back on track but the costs of achieving that are considerably lower than the costs of current service provision (which doesn’t work, see later). The most amazing result is that demand falls – yes fewer people have fewer problems. The local authorities at the centre of this work are predicting their costs will be slashed by many tens of millions and this is to say nothing of consequential falls in demand into other local services.
I regard this work as the most important we have ever done in the public sector. It is, quite simply, brilliant. The local authorities (Stoke and Bromsgrove and Redditch) who are taking the lead will be holding a conference on October 17th to show people what is happening; I can recommend it.
Further information here:
A Finnish friend encouraged me to read a new book on Lean, called ‘This is Lean’ as it is, he told me, a bestseller. It ought to be titled ‘This is Rubbish’ (I know you’re thinking ‘get off the fence John’). The book started out really well; accounts of two women who discover a lump in their breast, one goes through lots of appointments so typical of the NHS today and it takes weeks before she has her diagnosis while the other goes to a one-stop-shop and has her diagnosis in hours. Even though these stories were fictitious I was excited because it’s exactly what we have been doing with a range of services and, as the book points out, the former is based on a resource efficiency view of the world and the latter is based on a flow efficiency view; all excellent so far.
And then the most terrible thing: the authors postulate, with the use of a four-box model, that ‘perfect’ is a combination of the two approaches to efficiency. It is to mix chalk and cheese, oil and water; just plain wrong. Resource efficiency (optimisation of the parts, maximising the use of machines and people) always creates costs which remain hidden because of managements’ normal measures. Having made this fundamental error the authors make the common mistake of applying manufacturing tools to service processes, like Little’s Law, which is all about queuing theory, a problem you dissolve in effective service design and, maybe because the authors based this book on their review of the gurus’ writings on lean, they have the usual misunderstandings of variation and standardisation.
Going back to their four-box model, the authors say getting to ‘perfect’ (maximised efficiency of both flow and resource) is hard; it is actually impossible. From there the book meanders off on the Milky Way, as Deming would have put it.
Like the lean gurus these authors fail to recognise that what happened in Toyota back in the 1950s revealed some uncomfortable counterintuitive truths, major challenges to management thinking. But maybe that’s how you sell books, don’t frighten the horses.
For the ugly we have to return to what happens to people whose lives fall off the rails. In the research for our ‘Locality’ working, we learned that people whose lives fall off the rails get made worse by public services. The services are focused on protecting budgets, filling in forms, keeping people out through thresholds (you have to be chronic to get help) and of course many of these services have been ‘leaned’, which has only served to increase failure demand. In short, we spend billions and only make people worse.
We will be publishing this research in a month or so. As well as showing how the big picture contains major and ubiquitous causes of sub-optimisation, we have included real life examples of what happened to people; when you read the examples you cannot fail to be disturbed.
But to return to the ‘good’: the counterintuitive truths are that demand for public services isn’t rising, it is stable, peoples’ need are not complex but are made complex by current service design and its associated flawed thinking, and we have more than enough money to provide services that work; we do not have a resource problem. It is, as the authors of ‘This is Lean’ describe, flow efficiency that will unlock everything.
I shall be speaking alongside some talented leaders at the next Kittens are Evil conference (30th September in Fareham). Kate Watts, who made a profound difference to food safety in Great Yarmouth, Karen Burton, who has pioneered the Vanguard Method in health and care services in Gloucestershire, Simon Guilfoyle, the world’s leading police inspector and my friends from Perfect Flow, whose approach to logistics management is profound. Any organisations that buys supplies/materials or needs to deliver to customers when customers want would learn lots from them.
Do join us if you can. For information and to book: https://www.01handshake01.com/events/?story=29
I shall be speaking for the Call Centre Managers Association on 2nd October, at Olympia, London. Information and booking here: http://www.ccma.org.uk/news/systems-thinking-seminar