Benefits Part 3 - “The signal pattern is learning, it’s EVOLVING on its own, and you need to move past Fourier transforms and start thinking quantum mechanics’’ Transformers (2007)

And for me what everyone must genuinely embrace for any chance of successful implementation of EPR systems is to stop thinking that digital transformation equals IT or technical change, there is SO much more in terms of cultural change, documentation, clinical practices, processes. So, to Part 3 of my initial blog which I promised to be gentler, and where I’m aiming to provide a little practical advice.

HOW TO START

I am starting at the top with the HM Treasury Green Book (so the ultimate source of reference for all civil service and public sector funding bids) but stay with me please, just a short first stop.

So, here’s the link The Green Book (publishing.service.gov.uk)

And here is the very first sentence from the first section on the remit of The Green Book.

1.1 The Green Book is guidance issued by HM Treasury on how to appraise policies, programmes and projects. It also provides guidance on the design and use of monitoring and evaluation before, during and after implementation.

And here right on the first page at point 1.6 is some of the most sensible advice you can ever follow in respect of benefits realisation (my own emphasis in bold).

1.6 This guidance should be applied proportionately. The resources and effort employed should be related to costs, benefits and risks involved to society and to the public sector as a result of the proposals under consideration.

So that the resources and effort you put into benefits realisation should be proportional and appropriate to the costs, benefits and risks.

And in even simpler terms

• What are the priorities for your organisation from a benefits perspective?

• What is your current change structure?

• What are your benefits reporting requirements both at Trust and NHSE levels?

• What resources do you have available to support and carry out benefits realisation work?

• What leaders do you have with formal change management and/or benefits realisation experience or understanding to champion this work?

• What timescales or restrictions are you working to or within?

Now start your planning and management of expectations on what you can achieve!

WHERE TO START

There is a myriad of advice, guidance, templates and tools ‘out there’ and a lot of great resources and support on NHS Futures including regular engagement sessions and expertise and advice from subject matter experts in the Front-Line Digitisation (national EPR NHSE) Programme (where you need to be signed up to NHS futures to fully access these links).

However, in my own experience to date across both private and public sectors, there is a lot of focus (understandably) on the monitoring and tracking and forecasting and recording and reporting of benefits, but not actually a great deal on where and how to start.

So, let’s start at the very beginning:

In Part 1 of my blog, I referenced the 3 different ways in which most people tend to talk about benefits – (1) in a general sense, (2) in terms of communications and engagement, and (3) in formal benefits realisation and providing a return on investment from business cases and funding.

MAKE A START

Therefore, what you must do initially is discuss benefits with the SRO (Senior Responsible Officer) and/or project manager and ideally at least some, if not all, of the key stakeholders and start to explore and agree what you collectively believe the future benefits to be, and -

• It doesn’t matter if you change your minds – you can revisit this exercise as your project or programme grows and you understand it better 

• It doesn’t matter if you can’t get all the stakeholders together, have a draft outline, a list, some ideas, anything! 

• And WRITE THEM DOWN so you can share and run these outputs by stakeholders and refine them further after the initial session, and so collectively agree upon the benefits

WHAT TO CONSIDER

And to enable you to start capturing the benefits you will need to go into this session being mindful of what you do already know to better identify your benefits:

• So, do you understand the reason for this change? 

• Does it link to national or mandatory or Trust level strategic objectives 

• Or patient safety requirements or NHSE recommendations?

• Or is it even simply a ‘sticking plaster’ to replace an old system due to a supplier issue at short notice?  

This will help you consider the importance and prioritisation of this project in terms of benefits realisation across your organisation or programme of work and also support the project in respect of future governance and further potential funding bids: 

• You will also perhaps have at least an outline of the possible deliverables and the timescale you are hoping to work to, usually most projects have this if little else at the outset

• Consider the project requirements (if technical) even if not yet fully captured and assessed at this stage, and the early thinking on what these will achieve in terms of the desired change – where this helps inform both the areas and people impacted as well as the likely benefits

• You presumably have some idea of the current issues and challenges you want to overcome through this change? Imagine if you solved some of them – what would be the result? This will help you consider the likely benefits at a high level 

• Consider what you’re already reporting on both at Trust and national level relevant to this change – this will help identify potential measures to support the benefits you’ve discussed and considered

All of the above can help, with a little focus on benefits as a subject matter in its own right.

WHAT TO DO

You need to consider the disbenefits alongside the benefits, as this is not some fluffy tick list exercise focused purely on a perceived positive future but an opportunity to consider if there are any genuine negative impacts as a result of this change, and whilst doing so try not to mix these up with existing risks and challenges.

It can be really helpful to discuss these wider aspects of any change as well as the scope of your project, as part of your early or first formal benefits meeting.

So, by encompassing all these elements – scope, risk, issues, challenges, training & development requirements, business readiness for change, communications and engagement – you have an early informed focused discussion to help draw out the benefits and disbenefits.

A face-to-face workshop can be a positive experience but equally this can still be achieved remotely.

I strongly recommend recording all sessions to allow the benefits managers or analysts supporting the benefits work the opportunity to go back over the comments and draw out and pull together that vital collective knowledge and viewpoint – where this is more the creative side of benefits work.

There is obviously a lot more to the full holistic benefits realisation cycle and all of the tools that can be used and developed but I hope that this blog will at least give you a starting point and some ideas to take forward.  Personally, I prefer to develop a bespoke simplified approach whilst ensuring this is in line with current thinking, best practice and local and national reporting requirements.

TOP TIPS

Finally, a small collection of some of the things I’ve found myself saying over and over again (some of which are also mentioned above and within Parts 1 and 2 but still valid to repeat):

• Effort on benefits – proportional and appropriate to the priority of the change

• Agree and share the high-level benefits with stakeholders 

• Revisit if the remit or scope of the change significantly shifts

• Be realistic on how many measures you can track or develop

• Baseline and capture current timings/data/information pre go live

• Agree an early plan and actions for data collection post go live

• Agree ownership – who will carry out the actions

• Who will collate and report the benefits

• Who has overall responsibility to ensure these actions take place

WRAP UP

So, this is the end of my initial 3-part blog, kindly hosted by 2 Stellar Clinical Consultants – thank you again guys! 

I am planning to continue this positive partnership and keep going with the benefits blogging/networking but dig deeper into both long standing and more topical issues, so:

• Is there an aspect of benefits realisation you really struggle with? 

• An area you’ve not seen benefits realisation applied to or discussed in detail? 

If yes – please feel free to reach out to me on LinkedIn Amanda R. MAPM | LinkedIn 

If you’ve come with me this far, I really appreciate you having taken the time to read: 

THANK YOU

And to my immediate network of close colleagues and friends, my sincere thanks again for encouraging me to share my thoughts on benefits with a wider audience!

I love the engagement and networking it brings and to keep this discussion and topic vibrant and alive as part of digital transformational change – and particularly in supporting our NHS.