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STPs need advanced project management skills to deliver ambitious change


By Carolyn Wickware
30 June 2017

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The emerging world of Sustainability and Transformation Partnerships (STPs) brings with it some of the most challenging decisions yet for health and social care. In adopting new ways of working across organisational and regional footprints, it’s important to recognise and use those transformation skills already at our disposal as we work together to deliver change at pace and scale.

The emerging world of Sustainability and Transformation Partnerships (STPs) brings with it some of the most challenging decisions yet for health and social care. In adopting new ways of working across organisational and regional footprints, it’s important to recognise and use those transformation skills already at our disposal as we work together to deliver change at pace and scale.

In order to meet the stringent financial balance required, STPs have had to consider much more radical solutions to how they shape health and care systems going forward. In many cases, plans include shifting services from acute providers into alternative settings, reconfiguring the estate footprint and driving integration across health and care (not forgetting input from the independent and voluntary sectors). There are likely to be polarised differences in opinion about this process. One of the most significant challenges will be to engage effectively with the public and across organisations to ensure the rationale for these changes is fully understood.

As these plans mature, more radical decisions regarding funding and implementation are being taken. This is where project management teams can, and do, play a critical role in changing systems. Project management in today’s NHS is already about a great deal more than Gantt charts, PIDs and Risks and Issues logs. While these processes remain vital, when it comes to successfully implementing change, project managers are required to wear multiple hats. They must understand how all aspects of health and social care systems work, what the clinical needs are, the public consultation requirements and how to align different parts of the system to achieve the desired outcomes.

More recently, our work with Urgent and Emergency Care Networks has highlighted the unique role project managers have among a group of stakeholders trying to work together to achieve solid outcomes. We are there to facilitate the challenging discussions and ask the difficult questions which need to be addressed. As such, project managers need to be truly multi-skilled. To deliver our core responsibility of keeping programmes on track, we must also be a relationship manager, data analyst, and provide an objective and impartial view of the bigger picture throughout the process of change.

Adapting to new challenges

While each STP footprint has a senior leader, the partnerships essentially represent collaborative thinking on how systems can change, as opposed to being an organisational entity. The resulting proposals are the most ambitious attempt yet at integrated working, based on a system where shared decision making is facilitated by much more flexible ways of working across organisational boundaries.

It is inevitable that tensions will emerge as plans mature. Some proposals will benefit certain parts of the health and care system more than others and some will carry greater reputational risk. A number of STPs are already tackling this by evolving into an Accountable Care System. But when operating on the scale of an STP footprint, challenges can become magnified, particularly against the backdrop of day-to-day operational pressures which continue to command attention. So how, as project managers, can we support STPs in navigating these challenges?

·       Objectivity:We need to maintain a strategic overview and separation from individual organisations. Bringing stakeholders back to the STP objectives when obstacles emerge and maintaining a focus on the strategic outcomes will help the programme move forward.

·       Relationship management:Facilitating discussion among the organisations involved, understanding their individual and common needs and ensuring they are talking the same language. Knowing when to involve all partners in a decision and when to devolve decisions to sub groups to allow those most affected to plan a solution to a specific issue.

·       Knowledge and skills:The more we can understand the environment in which each stakeholder is operating, the more confidence they will have in the team managing the project. For example, at Arden & GEM, our service transformation team is made up of experts from a variety of clinical, public sector and private sector backgrounds. We have found this breadth of knowledge has been key to ensuring projects are managed in a way which meets the needs of the patient population as whole, as well as those of individual stakeholders. In addition, a good understanding of data analysis helps us focus on the priority areas and flag up opportunities for alternative approaches.

·       Governance and procedures:Naturally, when working across organisations, it is essential to ensure partnership working is underpinned with the appropriate governance and project management procedures. This ensures projects progress on time and on budget, with careful consideration of the potential risks, and confidence in the shared responsibility to deliver the best outcomes.

STPs are undoubtedly ambitious. The pressure to deliver change at pace and scale means the depth of support required from project managers will be significant. As new challenges emerge, we must use all the skills and knowledge at our fingertips to accelerate and deliver this increasingly complex agenda.

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