A diagnostic tool boosts organisations’ world class commissioning competencies, says Carol Brooks

As primary care trusts prepare for the second round of world class commissioning panels this spring, a new approach to measuring performance has highlighted the importance of the human factor.

A common problem with new NHS initiatives is that individuals cannot easily relate them to their own role

The Commissioning Qualities Tool is a new diagnostic model developed from an initial project with a northern network of teaching PCTs.

The network recognised that new NHS initiatives often fail to connect with individuals and teams. It commissioned Organisation Development Services to help develop a new way of engaging people in change and, specifically, in better commissioning.

The result was the new diagnostic tool, which has as its first step an online questionnaire that allows individuals to match their own roles and skills to the 11 world class competencies.

The result is a comprehensive picture of a trust’s performance against each competency - with detail provided at an individual, team and organisational level.

Using this information, teams then take part in facilitated discussion sessions to consider the key findings and produce ongoing action plans to deliver improvements.

This externally facilitated feedback and discussion is a vital element of the model, as it helps individuals and teams to understand their role in world class commissioning, where they are, where they need to be, and how they will bridge the gap.

Liverpool PCT - ranked in the top 12 PCTs for world class commissioning - was the first organisation to implement the tool (see box).

Organisation development

The project had an unexpected spin-off for Liverpool; 200 employees completed the tool, and undertaking the exercise helped to raise the profile of world class commissioning across the whole organisation.

Director of organisation development and HR Margo Kane says: “As well as providing the most fantastic baseline measurement for us - informing our organisation development and our workforce plan - the tool provided a valuable platform for internal debate.”

We can draw lessons from Liverpool’s experience:

  • Detail matters: PCTs are bombarded with data, but much of this is “big picture” rather than grass roots detail. It is important to have a detailed understanding of what is happening at individual and team level, as influencing this behaviour is the only way to deliver organisational change.
  • Make it relevant: a common problem with new NHS initiatives is that individuals cannot easily relate them to their own role. Helping people to understand what a new system means for them enables them to contribute to change. The tool breaks down each competency into distinct actions or behaviours.
  • Don’t just analyse, talk: hard data matters, but spreadsheets and graphs alone will never deliver change. Externally facilitated discussion is vital to consider the implications of the data and to plan actions.

Making it happen

  • Ownership at a senior level is a vital factor in delivering any change; individuals and teams need to know that management is committed to seeing the process through
  • Spell out the benefits for all involved - if individuals, teams and managers know what is in it for them, you will get a better response
  • Make change manageable - breaking down complex initiatives into bitesized chunks helps people understand how it is relevant to their own role

Liverpool PCT

Around 200 commissioning employees at Liverpool PCT completed the Commissioning Qualities Tool in 2008. Participation was anonymous and voluntary.

Facilitated feedback sessions were conducted at management and team level, identifying key issues for action.

Staff forums followed up some of the issues raised; the PCT’s staff survey confirms these improved the understanding and communication of the trust’s vision and direction.

People are using the results of their own questionnaire to support personal development - one even used it in a job application.

The PCT is using the findings of the exercise to underpin a new organisation development strategy, which is ongoing.