Having identified potential priority programmes, it is necessary to build the evidence of impact and the case for change
The process that delivers reform is the same as the clinical pathway; that is, a series of steps, each one adding value to the next, culminating in the desired outcome.
One part of this reform pathway that is vital is an effective service review process. This is the sub-process that optimises the identification of and building of evidence for the opportunities that need to be taken in order to drive the improvement that the indicators show is possible in a particular service area.
The principles of an effective service review are that a team containing all of the relevant expertise (Informatics, public health, clinical, financial, etc) from the CCG, its Commissioning Support Unit and wider partners and stakeholders as appropriate:
1. Draw a picture of the current system in that service area – that you know is not optimal because the indicators have pointed you towards looking here;
2. Draw a picture of the optimal future system for your demographic in that service area. This will be based on investigative work into what guidelines and toolkits advise, what best practice looks like elsewhere – adapted as necessary for your population’s needs and local innovation regarding pathways and outcome delivery,and;
3. Play ‘spot the difference’ (steps 3 and 4 of the process map).
A robust business process that enables the optimal development and delivery of reform and transformation must first support the generation of ideas for improvement and then take these ideas, support the addition of evidence and impact to the case for the proposed change and drive the implementation of those proposals once they are approved for delivery.
Business Process Engineering is a term used to describe the systems, techniques and tools employed to coordinate and direct the management structure of an organisation to deliver its core purpose. When designed and operated effectively, it ensures:
A focus of management and supporting resources on the objectives of the organisation
Delivery of prioritised outcomes, in an environment of expenditure reductions
Development of proposals in a way that ensures appropriate decision-making;
Decisions at optimal points in the process to drive delivery
Actual and timely implementation of decisions made, and
Minimal use of resource on activities and projects that are not viable or capable of implementation
The approach drives the use of the optimal lever to implement individual changes, for example contract management, clinical leadership, policy development or procurement.