created with mindgenius business 2005® john seddon’s thoughts on systems thinking and the public...

Created with MindGenius Business 2005Created with MindGenius Business 2005®®

John Seddon’s Thoughts on John Seddon’s Thoughts on Systems Thinking and the Systems Thinking and the

Public Sector Public Sector Jim Mather MSPJim Mather MSP


John Seddon ‘Systems Thinking John Seddon ‘Systems Thinking and the Public Sector’ and the Public Sector’

Systems Thinking Systems Thinking Current problems & the need for Current problems & the need for

Systems Thinking Systems Thinking Public Sector Specifics Public Sector Specifics How Systems Thinking can work for usHow Systems Thinking can work for us Conclusions, Costs and Choice Conclusions, Costs and Choice


Systems Thinking Systems Thinking

Systems Thinking is the Systems Thinking is the Central Idea the Central Idea the relationship that links: relationship that links: Purpose Purpose Measure Measure

When you derive measures from purpose you liberate When you derive measures from purpose you liberate method method

Method Method

By deriving measures from purpose (defined from By deriving measures from purpose (defined from the customers' viewpoint), you liberate method: the customers' viewpoint), you liberate method: Innovation and Improvement in the execution of work Innovation and Improvement in the execution of work

followfollow


To start at the startTo start at the start The first question the systems thinker asks is The first question the systems thinker asks is

"What is the purpose of this service from the customers point of view?”"What is the purpose of this service from the customers point of view?” The purpose of Service Organisations is to absorb the variety of The purpose of Service Organisations is to absorb the variety of

demand ( the starting point of the systems approach) demand ( the starting point of the systems approach) It is essential to know what the demands are It is essential to know what the demands are If you want customers to "pull value" from your system, you need to If you want customers to "pull value" from your system, you need to

know the nature of the demands that customers place on the system know the nature of the demands that customers place on the system in customer terms in customer terms

A customer typology of demand is essential to the design of the A customer typology of demand is essential to the design of the system system

Systems designs put people at the heart of the enterprise enabling Systems designs put people at the heart of the enterprise enabling them to contribute. them to contribute.

People are key to absorbing variety People are key to absorbing variety Whenever you hear the word "Best" think "Better" for everything can Whenever you hear the word "Best" think "Better" for everything can

be improved. be improved. Everything you need to know in order to improve something will Everything you need to know in order to improve something will

be found in your own system, if you go looking elsewhere you are be found in your own system, if you go looking elsewhere you are looking in the wrong place looking in the wrong place


Customer Demand & WasteCustomer Demand & Waste

Think of the system as one that brings (largely) intangible Think of the system as one that brings (largely) intangible expertise together in response to the variety of customer expertise together in response to the variety of customer demands demands Ohno*Ohno* taught that focusing on demand and flow optimises the taught that focusing on demand and flow optimises the

use of resources because it exposes waste and the causes of use of resources because it exposes waste and the causes of waste. waste.

Paradox Paradox Focus on the flow and costs fall Focus on the flow and costs fall Focus on costs and costs rise Focus on costs and costs rise

Remedies and Solutions Remedies and Solutions Turning off the causes of failure demand is one of the greatest Turning off the causes of failure demand is one of the greatest

economic levers available to managers: economic levers available to managers: It has an immediate impact on capacity It has an immediate impact on capacity The fast way to improve the capacity of a system is to The fast way to improve the capacity of a system is to

remove the WASTE. remove the WASTE. You cannot remove the waste without removing the causes of You cannot remove the waste without removing the causes of

waste. waste. * Taiichi Ohno* Taiichi Ohno is considered to be the father of the is considered to be the father of the Toyota Production System


Demand Predictability and Demand Predictability and System DesignSystem Design

Before managers act on demand it is essential to know Before managers act on demand it is essential to know whether demand is predictable or unpredictable whether demand is predictable or unpredictable

Systems Thinking DesignsSystems Thinking Designs challenge the current norms challenge the current norms of "dumbing down" service - e.g hire cheap people, give of "dumbing down" service - e.g hire cheap people, give them scripts, and computer based diagnostics. them scripts, and computer based diagnostics. Alternative smartening up - more salary costs but overall lower Alternative smartening up - more salary costs but overall lower

costs and more business. costs and more business. Most Managers have little idea how current systems inhibit Most Managers have little idea how current systems inhibit

contribution from staff contribution from staff Principles for Systems Designs Principles for Systems Designs

Train against demand Train against demand Make the worker the inspector Make the worker the inspector Measure for Control and Improvement Measure for Control and Improvement Define the manager's job as being to "Act on the system" Define the manager's job as being to "Act on the system"


Cooperation between Cooperation between AgenciesAgencies

When their joint activities are based When their joint activities are based on knowledge and a common on knowledge and a common "super-goal" - example:"super-goal" - example:

Food Standards Agency:Food Standards Agency: Original GoalOriginal Goal – “Minimise Risk to Public – “Minimise Risk to Public

Health”Health” Super GoalSuper Goal – “Work with the food industry to – “Work with the food industry to

progressively increase the volume and value progressively increase the volume and value of safe, healthy, nutritious food to improve of safe, healthy, nutritious food to improve public health and well-being” public health and well-being”


Making a start - Implement Making a start - Implement the Vanguard Model for the Vanguard Model for

"Check""Check"1.1. What is the purposeWhat is the purpose? ? 2.2. What are the types and frequencies of demand? What are the types and frequencies of demand? 3.3. How well does the system respond to demand?How well does the system respond to demand?

1.1. It is this measure that gives managers their first shock. It is this measure that gives managers their first shock. 2.2. For their existing measures will have been telling them something For their existing measures will have been telling them something

quite different quite different 4.4. Studying the flowStudying the flow

1.1. Follow successive "pieces of work" through the system to build and Follow successive "pieces of work" through the system to build and understanding of what is happening understanding of what is happening

5.5. Understanding System conditionsUnderstanding System conditions 1.1. Waste is man-made Waste is man-made 2.2. Remove the causes of wasteRemove the causes of waste

6.6. Management ThinkingManagement Thinking 1.1. See what is wrong in current thinking - targets and proceduresSee what is wrong in current thinking - targets and procedures2.2. Recognise that at the heart of a system is a change to MEASURESRecognise that at the heart of a system is a change to MEASURES


LLegislation & ITegislation & IT

If legislation turns out to be wrong, you have to If legislation turns out to be wrong, you have to change the law - as indeed happened to "Best change the law - as indeed happened to "Best Value" - which was removed from the Statute Value" - which was removed from the Statute Book without fanfare Book without fanfare

However, incapacity to act is often a feature of "The However, incapacity to act is often a feature of "The System". System".

The better way to introduce IT is to... The better way to introduce IT is to... 1. Understand the work as a system 1. Understand the work as a system 2. Improve the way it works without changing the IT (treat it 2. Improve the way it works without changing the IT (treat it

as a constraint or turn it off) as a constraint or turn it off) 3. And when the design is stable "pull" the new IT into the 3. And when the design is stable "pull" the new IT into the

new design. new design.


Reforming the "Regime"Reforming the "Regime"

Managers fear anarchy and the loss Managers fear anarchy and the loss of "control" of "control"

They fail to realise that the regime is They fail to realise that the regime is not exerting control – instead:not exerting control – instead:

It is driving public services out of controlIt is driving public services out of control It is already anarchic It is already anarchic At best the regime is in control of nothing At best the regime is in control of nothing At worst it is damaging service and morale At worst it is damaging service and morale


There are 5 types of waste There are 5 types of waste associated with the current associated with the current

regime:regime:

1.1. The Costs of people writing The Costs of people writing specifications specifications

Guidance, Standards and Reporting Schedules etc. Guidance, Standards and Reporting Schedules etc.

2.2. The Cost of inspection The Cost of inspection

3.3. The Cost of Preparing for InspectionThe Cost of Preparing for Inspection

4.4. The Cost of Specifications being Wrong The Cost of Specifications being Wrong

5.5. The Costs of Demoralisation The Costs of Demoralisation


The Efficiencies released by The Efficiencies released by stopping the regime are stopping the regime are

incalculableincalculable The steps needed are..The steps needed are.. 1.1. Changing the locus of control Changing the locus of control

1.1. Instead of compliance we need innovation, freedom to Instead of compliance we need innovation, freedom to allow people to meet real demand allow people to meet real demand

2.2. Allow people to derive intrinsic motivation from their Allow people to derive intrinsic motivation from their work work

2.2. Delivering "inspection" as ONE question: Delivering "inspection" as ONE question: 1.1. ““What measurers are you using to help you What measurers are you using to help you

understand improve the work?”understand improve the work?” With the With the MeasuresMeasures framed in terms that matter to the customersframed in terms that matter to the customers

2.2. Removes waste - nothing should be created for the Removes waste - nothing should be created for the regime or its inspectorsregime or its inspectors


The Steps (2 of 2)The Steps (2 of 2)

3. 3. Learning about what works Learning about what works The efforts of the centre should be focused on The efforts of the centre should be focused on

understanding what works and disseminating understanding what works and disseminating information about method information about method

But with no mandatory PUSH But with no mandatory PUSH Leaving downstream managers free to decide what best Leaving downstream managers free to decide what best

suits their circumstancessuits their circumstances

4. 4. Developing a better view of human natureDeveloping a better view of human nature Healthier Assumptions Healthier Assumptions People are more motivated by the desire for self esteem People are more motivated by the desire for self esteem They are vocational and they want to serve They are vocational and they want to serve


There are good reasons to be There are good reasons to be positive about peoplepositive about people

They are more than capable of using their They are more than capable of using their own ingenuity own ingenuity

They want to take the initiative They want to take the initiative Most are open to the idea that Cooperation Most are open to the idea that Cooperation

will serve our purposes better than will serve our purposes better than competition and disunitycompetition and disunity Hence they are keen to accept a unifying goalHence they are keen to accept a unifying goal

Peoples' behaviour is a function of their Peoples' behaviour is a function of their systemsystem Only by changing the regime can we expect to Only by changing the regime can we expect to

change behaviour – Method- Purpose - Measureschange behaviour – Method- Purpose - Measures


"Front Office - Back Office" "Front Office - Back Office" splits introduce waste.splits introduce waste.

One of the most alarming drivers of failure One of the most alarming drivers of failure demand is the government drive for "Back Office" demand is the government drive for "Back Office" functions. functions. Moving work to a central back office: Moving work to a central back office:

Removes Continuity Removes Continuity Creates waste - handovers, rework, duplication Creates waste - handovers, rework, duplication Lengthens the time to deliver a service Lengthens the time to deliver a service Creates yet more failure demand Creates yet more failure demand

And it isn't long before managers deprived of local admin finds And it isn't long before managers deprived of local admin finds way to recreate and duplicate it locally way to recreate and duplicate it locally

When telephone activity becomes disconnected with the When telephone activity becomes disconnected with the rest of the work waster ensues rest of the work waster ensues

Standardisation inhibits the systems ability to absorb Standardisation inhibits the systems ability to absorb variety and meet customers’ needs quickly and efficientlyvariety and meet customers’ needs quickly and efficiently


Specifications & TargetsSpecifications & Targets

There is now an industry - a management factory - There is now an industry - a management factory - concerned with writing specifications. concerned with writing specifications. The specifications are always quite simply wrong The specifications are always quite simply wrong

Because Because codifying methodcodifying method is to is to impedes thinkingimpedes thinking. . They do not constitute the best way to design services They do not constitute the best way to design services Worse, they drive in waste: poor service, high cost and low Worse, they drive in waste: poor service, high cost and low

morale. morale. “ “94% of the problems down to the system” – W. Edwards 94% of the problems down to the system” – W. Edwards

Deming Deming Targets Targets

Targets drive people to use their ingenuity to meet target, Targets drive people to use their ingenuity to meet target, not improve performance. not improve performance.

It is not a matter of having fewer targets we should have It is not a matter of having fewer targets we should have none none

Their encouragement to cheat is "systemic" Their encouragement to cheat is "systemic"


Economies of Scale & Activity Economies of Scale & Activity ManagementManagement

Ideas like "Economies of Scale" and "Activity Ideas like "Economies of Scale" and "Activity Management" are thought of as "no-brainers"Management" are thought of as "no-brainers" But their manifestations: call centres, back office factories, But their manifestations: call centres, back office factories,

targets etc., are forced on the public sector without evaluation targets etc., are forced on the public sector without evaluation Companies committed to "Economies of Scale" inevitably find Companies committed to "Economies of Scale" inevitably find

the approach bankrupt the approach bankrupt Toyota approach is an "Economy of Flow"Toyota approach is an "Economy of Flow"

The cost of service is in flow, not in The cost of service is in flow, not in transactions:transactions: Failure demand is under the organisation's control Failure demand is under the organisation's control

It is a direct result of poorly designed flowIt is a direct result of poorly designed flow You discover these phenomena only when you learn to study You discover these phenomena only when you learn to study

demand demand i.e. Why Customers Call – the nature and drivers of these callsi.e. Why Customers Call – the nature and drivers of these calls


The Purpose of Service The Purpose of Service OrganisationsOrganisations

To absorb the variety of demandTo absorb the variety of demand The starting point of the systems approachThe starting point of the systems approach

To do that - it is essential to know To do that - it is essential to know what the demands arewhat the demands are


UK Government's Reform RegimeUK Government's Reform Regime "Takes a dim view of people" "Takes a dim view of people"

It is based on negative assumptions about public servants It is based on negative assumptions about public servants Promulgating specifications assumes that they do not know Promulgating specifications assumes that they do not know

what to do what to do Further it assumes that they don't know what to change andFurther it assumes that they don't know what to change and It assumes that they will need to be coerced or incentivised It assumes that they will need to be coerced or incentivised

to act to act

Yet Intrinsic Motivation is what brought the vast Yet Intrinsic Motivation is what brought the vast majority of them into the job. majority of them into the job.

It does not foster knowledge - instead if fosters It does not foster knowledge - instead if fosters copying without knowledge. copying without knowledge.


Barber and the Prime Minister's Barber and the Prime Minister's Improvement UnitImprovement Unit

Barber describes ‘deliverology’ as Barber describes ‘deliverology’ as "world class tools and processes" "world class tools and processes" Seddon says:- Seddon says:- "I think of it as Mickey Mouse command "I think of it as Mickey Mouse command

& control. That is being generous to & control. That is being generous to Barber and unfair to the mouse. Barber and unfair to the mouse.


Barber and the Prime Barber and the Prime Minister's Improvement Unit Minister's Improvement Unit (2 (2

of 2)of 2) The plausible ideas - the questions and issues of The plausible ideas - the questions and issues of

deliverology - were not ideas that would foster deliverology - were not ideas that would foster knowledge; quite the reverse, they would foster more knowledge; quite the reverse, they would foster more inappropriate and wasteful:inappropriate and wasteful:

Planning Planning Project management Project management Reporting Reporting Rationalisation …….and other dysfunctional behaviours Rationalisation …….and other dysfunctional behaviours

Barbers methodology falls short on method and it's Barbers methodology falls short on method and it's only method that can answer the question how can only method that can answer the question how can services be improved. services be improved.

Barber's de facto method is to create bureaucracy for measuring Barber's de facto method is to create bureaucracy for measuring reporting that deludes people into thinking his improvements are reporting that deludes people into thinking his improvements are real – (see the negative impact this has had on the Police Service real – (see the negative impact this has had on the Police Service in Case Studies) in Case Studies)


Impact of ‘Deliverology’ on the Impact of ‘Deliverology’ on the PolicePolice

Barber and the Police Service Barber and the Police Service The "science of delivery" has spawned a bureaucracy that stifles The "science of delivery" has spawned a bureaucracy that stifles

achievement of purpose achievement of purpose While the waste is palpableWhile the waste is palpable

But the waste associated with the police's morale and their reputation But the waste associated with the police's morale and their reputation with the public is incalculable. with the public is incalculable.

An Insidious culture has been createdAn Insidious culture has been created Officers much less able to use discretion and therefore be responsible Officers much less able to use discretion and therefore be responsible Increased risk aversion Increased risk aversion Citizens ‘encouraged’ to be less responsible Citizens ‘encouraged’ to be less responsible The relationship between the police and the policed is distorted, perverted The relationship between the police and the policed is distorted, perverted

and sub-optimisedand sub-optimised

See also - Scottish Criminal Justice System - belowSee also - Scottish Criminal Justice System - below


Police IIPolice II The Experience of Sgt Norman Dixon after Service redesigning The Experience of Sgt Norman Dixon after Service redesigning

2005 2005 Police Force at local level designed in complete ignorance of demandPolice Force at local level designed in complete ignorance of demand In this instance the majority of demand was youth disorder In this instance the majority of demand was youth disorder But the ability of the then current system to respond was shocking But the ability of the then current system to respond was shocking

resulting in:resulting in: Further demand and unhappy citizens who took a dim view of the police Further demand and unhappy citizens who took a dim view of the police

Redesign Criteria was set as being:Redesign Criteria was set as being: The Ability to turn up quickly and deal with youth disorder The Ability to turn up quickly and deal with youth disorder

Result Result Dealt with those responsible Dealt with those responsible Restored the faith of the communityRestored the faith of the community

Also engaged other parties: Education, Community Councils, Councilors, Also engaged other parties: Education, Community Councils, Councilors, Officials, Parents, Young people and faith Leaders toOfficials, Parents, Young people and faith Leaders to::

Channel energy into positive activity andChannel energy into positive activity and Create amenity for young people that was valued by themCreate amenity for young people that was valued by them


Police IIIPolice III Where police work studies demand enormous Where police work studies demand enormous

improvement follows quicklyimprovement follows quickly

Also demand for ‘Police Services’ first occurs in Also demand for ‘Police Services’ first occurs in Schools and Social Services:Schools and Social Services:

Identifying problem families is straightforward Identifying problem families is straightforward But historically - instead of gathering knowledge about causes and But historically - instead of gathering knowledge about causes and

working on them - police forces are paralysed by the reporting working on them - police forces are paralysed by the reporting demands of the current system demands of the current system

The solution that is work in progress is to The solution that is work in progress is to recognise thatrecognise that The thing that binds the system together isThe thing that binds the system together is measurement measurement - -

NOT TARGETS & ACTIVITY - NOT TARGETS & ACTIVITY - but measurement of demand but measurement of demand and capability and capability

e.g. of those we apprehend - how many are convicted? e.g. of those we apprehend - how many are convicted?


Sir David Varney Sir David Varney His gloomy vision - should be avoided at all costsHis gloomy vision - should be avoided at all costs

Varney and the regime are promoting more and Varney and the regime are promoting more and bigger service factories bigger service factories

Public Service Factories - (PSFs) Public Service Factories - (PSFs) It is clear that Varney et al did not study demandIt is clear that Varney et al did not study demand

Which is Which is the only methodthe only method to provide a reliable insight into to provide a reliable insight into what matters to customers of a service what matters to customers of a service

PSFs will be driven by Key Performance Indicators, PSFs will be driven by Key Performance Indicators, Inspectors who will be seeking evidence of Inspectors who will be seeking evidence of compliance will make these into meta-systems for compliance will make these into meta-systems for non-learning non-learning


Varney cites local Varney cites local authorities who have authorities who have

created shared services created shared services centres as ‘Exemplars’centres as ‘Exemplars’

However, when Seddon visited these exemplars he However, when Seddon visited these exemplars he found found No proper evaluation of the change to the quality of No proper evaluation of the change to the quality of

service provided to citizensservice provided to citizens No information on Cost Benefit changesNo information on Cost Benefit changes No evidence that sharing services produces economies No evidence that sharing services produces economies Plenty of evidence that sharing can lock in costs and worsen Plenty of evidence that sharing can lock in costs and worsen

serviceservice

A better way to share services is to conduct "Check“* in situ A better way to share services is to conduct "Check“* in situ for services that might be shared:-for services that might be shared:- Improving them where they are and then, on the basis of Improving them where they are and then, on the basis of

knowledge gained determining whether and how to go about knowledge gained determining whether and how to go about sharing them sharing them

* – Seddon’s “Check – Plan – Do “ cycle of improvement* – Seddon’s “Check – Plan – Do “ cycle of improvement


Seddon Observations on Legal Seddon Observations on Legal ServicesServices

Contracts for the delivery of Legal Services are Contracts for the delivery of Legal Services are only open to those who create PSFs:-only open to those who create PSFs:- Thus small (local) providers will be driven out of the Thus small (local) providers will be driven out of the

market market Costs and failure demand are ‘locked in ‘Costs and failure demand are ‘locked in ‘ Providers use their ingenuity to maximise the benefits to Providers use their ingenuity to maximise the benefits to

themselves "under the rules“themselves "under the rules“ It is not in their interest to improve service and reduce costs It is not in their interest to improve service and reduce costs In legal services this has meant turning cases into multiple In legal services this has meant turning cases into multiple

cases and limiting involvement in complex cases cases and limiting involvement in complex cases Cases are "Closed" to get them into the billing cycle Cases are "Closed" to get them into the billing cycle

When you use standard prices to manage costs you only When you use standard prices to manage costs you only drive costs updrive costs up

It is hard to learn how to improve when you are fighting It is hard to learn how to improve when you are fighting to optimise your OWN position - as both parties will to optimise your OWN position - as both parties will


Public Sector Public Sector Basic Basic ProblemsProblems

Public Services are often the only option for Public Services are often the only option for many people many people

Therefore High Demand Therefore High Demand

They are historically designed as Command They are historically designed as Command & Control hierarchies & Control hierarchies

They have back-offices and a distinct lack of They have back-offices and a distinct lack of accountability for flow accountability for flow

They often are or seem insensitive to the needs of They often are or seem insensitive to the needs of customerscustomers

They are rarely synonymous with crisp efficient services They are rarely synonymous with crisp efficient services Hence sub optimal and full of waste Hence sub optimal and full of waste


Planning Process Planning Process SpecificsSpecifics The purpose of planning is to say "Yes" to good The purpose of planning is to say "Yes" to good

developmentdevelopment When you study the current Planning Process as a system, you When you study the current Planning Process as a system, you

discover that the 8 week target leads to:-discover that the 8 week target leads to:- More refusals More refusals Withdrawals and/or Withdrawals and/or Planning consents with conditions Planning consents with conditions ……..All ruses enabling the achievement of the target ..All ruses enabling the achievement of the target

Those who have adopted the systems route to redesigning Those who have adopted the systems route to redesigning development control achieve all decisions in less than 30 days - for development control achieve all decisions in less than 30 days - for what are termed delegated decisions that don't go to committee - and what are termed delegated decisions that don't go to committee - and that includes the 21 days notice period - with the notice on lamppoststhat includes the 21 days notice period - with the notice on lampposts

See also Seddon’s Case Studies on:See also Seddon’s Case Studies on: Housing Repairs, Rent Arrears, Void Lets, Housing Allocations, Police, Social Services, Trading Housing Repairs, Rent Arrears, Void Lets, Housing Allocations, Police, Social Services, Trading

Standards etc. Standards etc.


Scottish Criminal Justice Scottish Criminal Justice SystemSystem

Learning about Demand Learning about Demand

The majority of crimes committed by the same small The majority of crimes committed by the same small group of people group of people

Best to focus on the Criminals and not the crimes Best to focus on the Criminals and not the crimes Currently, those who ought to be the focus of police Currently, those who ought to be the focus of police

attention are dealt with by many groups:attention are dealt with by many groups: Hence Duplication of activity by Police, Probation Service, Hence Duplication of activity by Police, Probation Service,

Social Services, Health Service and DWP. Social Services, Health Service and DWP. Crime is highly predictable by Crime is highly predictable by

Type Type Time Time Geography Geography But many Police Forces ignore this and do not study demandBut many Police Forces ignore this and do not study demand


Adult CareAdult Care People deteriorate if their needs are unmet People deteriorate if their needs are unmet

Often simple solutions could have prevented the need for more Often simple solutions could have prevented the need for more expensive care expensive care

But Sub Contracting care organisations are paid per hour of But Sub Contracting care organisations are paid per hour of provision - so there is no incentive to reduce the amount of care provision - so there is no incentive to reduce the amount of care

Also many Local Authority managers work on belief that Also many Local Authority managers work on belief that subcontractors cannot be trusted – as a result:-subcontractors cannot be trusted – as a result:-

Resources are allocated to control and inspect their work Resources are allocated to control and inspect their work Costs increaseCosts increase Contractors are NOT seen as part of the system Contractors are NOT seen as part of the system Contracts and measurements are not focused on the degree of Contracts and measurements are not focused on the degree of

independence or improvement achieved for the clientsindependence or improvement achieved for the clients And in Scotland SWIA audits divert resources that could be focused on And in Scotland SWIA audits divert resources that could be focused on

improving servicesimproving services


Adult Care IIAdult Care II The problem is exacerbated because we fail to harness Volunteering potential The problem is exacerbated because we fail to harness Volunteering potential

because:because: The need to be trained and certified turns many good people awayThe need to be trained and certified turns many good people away

Like the police service, adult social care is designed as bureaucracy to feed Like the police service, adult social care is designed as bureaucracy to feed the regime - not as a service to older peoples' needsthe regime - not as a service to older peoples' needs

There are three major types of Waste in Adult Care:-There are three major types of Waste in Adult Care:-1.1. Waste in AdministrationWaste in Administration

Form filling, duplication of assessments, re-work, errors and delays Form filling, duplication of assessments, re-work, errors and delays Paperwork is intrusive and bureaucratic for both the care worker and the clientPaperwork is intrusive and bureaucratic for both the care worker and the client Plans & reviews never have value to these people doing their work - their only Plans & reviews never have value to these people doing their work - their only

purpose is to feed the regime. purpose is to feed the regime. 2.2. Waste of material resourcesWaste of material resources

Assets rarely properly recycled & reusedAssets rarely properly recycled & reused3.3. Waste associated with the failure to careWaste associated with the failure to care

Unintended consequences Unintended consequences Depression, medication, dietary impact.....and massive deterioration in Depression, medication, dietary impact.....and massive deterioration in

client conditionclient condition


Adult Care III SolutionsAdult Care III Solutions

The key to this system is understanding The key to this system is understanding the expertise required to assess and the expertise required to assess and provide and that means thinking provide and that means thinking "Outside-In". "Outside-In".

Improve System - smarten up the Front End Improve System - smarten up the Front End Deliver what is important to the patient Deliver what is important to the patient

Trigger increased independence - family Trigger increased independence - family and volunteer involvement and volunteer involvement


Public Value Public Value Seddon believes we ought to take a look at what Public Value means Seddon believes we ought to take a look at what Public Value means

by asking the Deming Question: by asking the Deming Question: By what method? By what method? i.e. “Do you understand the work – and are you improving it?”i.e. “Do you understand the work – and are you improving it?”

Citizen Engagement in helping to define and improve “Method”Citizen Engagement in helping to define and improve “Method” The key requirements for method is: The key requirements for method is:

The involvement of right people in both understanding the problems (an The involvement of right people in both understanding the problems (an essential first step that is often ignored or assumed) essential first step that is often ignored or assumed)

Working together to study the problem makes it far easier for the different Working together to study the problem makes it far easier for the different parties to cooperate parties to cooperate

It leads to solutions that would not have been considered from an individual or It leads to solutions that would not have been considered from an individual or narrow perspectivenarrow perspective

Freedom means the freedom to choose method, which will require a Freedom means the freedom to choose method, which will require a fundamental change in Public Sector regimes. fundamental change in Public Sector regimes.

They will need to avoid detailed prescriptions for action They will need to avoid detailed prescriptions for action


Public Centre Call CentresPublic Centre Call Centres

Up to 80% of resource consumed by "Failure Up to 80% of resource consumed by "Failure Demand" Demand" It appears that Ministers and Senior Civil Servants It appears that Ministers and Senior Civil Servants

assumed that ‘access’ was synonymous with ‘service’ assumed that ‘access’ was synonymous with ‘service’ To illustrate the folly: we have seen how private sector To illustrate the folly: we have seen how private sector

organisations "off shore" calls to low cost economies to organisations "off shore" calls to low cost economies to get lower transaction costsget lower transaction costs

However, when they learn that lower transaction costs can However, when they learn that lower transaction costs can actually drive up the number of transactions - the calls the actually drive up the number of transactions - the calls the customers have to make to get service - they change their customers have to make to get service - they change their point of view. point of view.

Indeed it is in the interest of the service provider for Indeed it is in the interest of the service provider for demand to grow demand to grow

They They cancan and and do do benefit from "Failure Demand" benefit from "Failure Demand"


Costs Costs

Focusing on costs drives costs up Focusing on costs drives costs up

Managers need to learn to focus on Managers need to learn to focus on value value


Current compliance effort Current compliance effort excessive - based more on excessive - based more on opinion than knowledge opinion than knowledge

There is now a vast bureaucratic factory dictating There is now a vast bureaucratic factory dictating how services should be designed and managed:-how services should be designed and managed:- Tragically their specifications are based on flawed ideas Tragically their specifications are based on flawed ideas They are pre-ordained to perform badly They are pre-ordained to perform badly In this climate greater diligence on the part of the In this climate greater diligence on the part of the

workers will make no difference - flawed systems have workers will make no difference - flawed systems have design and performance problems. design and performance problems.

Inspection is concerned with compliance and is Inspection is concerned with compliance and is an integral part of dysfunction, poor performance an integral part of dysfunction, poor performance and failure demand and failure demand


Choice Choice

When it comes to Public Services - "I When it comes to Public Services - "I do not see any evidence that people do not see any evidence that people want choice - I see instead plenty want choice - I see instead plenty evidence that people want services evidence that people want services that work that work

Systems Thinking approach can meet Systems Thinking approach can meet that expectation….have a look at:that expectation….have a look at:

http://www.lean-service.com/home.asphttp://www.lean-service.com/home.asp

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