Two years ago, Yorkshire Ambulance Service trust was facing the challenge of major organisational restructuring, which involved bringing three ambulance services together to deliver enhanced services across one of the largest and most geographically diverse areas of the country.
It was vital that the strategic decisions we took at this crucial planning stage would enable us to deliver our goals of faster response times, enhanced patient care and value for money. A great deal was at stake and there was, in our view, no margin for error.
Working with David Waller from consultancy Tribal, we adopted a new decision-making process known as benefits management, which has proved so effective that we now use it as the framework for all key business decisions in the trust.
Put simply, benefits management is a method of developing and implementing business decisions that forces you to examine and understand the benefits and impact they deliver to your stakeholders from the very outset, rather than at the end of the process.
The traditional approach, as we knew from our own hit and miss experience in the past, goes something like this: identify the problem, examine options for fixing it, implement the preferred solution, evaluate the impact of the solution and then, often as not, move on to a different problem.
The flaw in this method is that the evaluation happens too late in the process. In fact, this failure to consider the impact and benefits to your stakeholders early enough is all too often at the root of the next problem.
Benefits management breaks this cycle by providing a clear framework for engaging at the outset with all of the internal and external stakeholder groups that may be affected, not only by the problem you are trying to fix, but by the solution you want to implement.
So instead of replacing one problem with another, you learn to identify and listen to the stakeholders you most depend on for success. You learn to understand and communicate the benefits to them and predict what the ripple effect of business change will be before, rather than after, the change is brought in.
Mr Waller started by helping us to clarify our definition of a benefit as ‘a result that a stakeholder perceives to be of value’ – perceptions being vital to achieve buy-in. We then learned to identify and show in the form of a network diagram the ‘cause and effect’ relationships of business processes and, in a stakeholder table, to map out the different needs, attitudes and perceptions of each stakeholder group affected by them.
The stakeholder table has proved an essential tool in enabling us to understand which of the groups we need on board for a particular solution to work and to what extent we need to move them from where they are now to where we need them to be.
An example of this was when we considered the introduction of electronic patient report forms. These enable our clinical staff to quickly gather and convey to the waiting hospital team information about a patient’s identity, suspected condition and the treatment administered so far.
The stakeholder table identified, for example, the importance of securing the co-operation of the acute trust in enabling the forms to be introduced. It summarised the key benefits to the trust itself (timely, appropriate and legible information) and the messages we needed to focus on to get them on board (improves information, compatible with existing systems, better transfer and less duplication of information).
And the benefits to the trust of this new approach? We feel we are still at the start of our journey and the learning is fast and furious at this stage. What is becoming clear, however, is that we have found a robust, rational framework for setting objectives, managing projects, shaping communications and defining success that works for us. Furthermore it is an approach which, once mastered, can be applied to almost any key business decision, giving us the benefit of foresight rather than hindsight.
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