In December, the board at Hillingdon primary care trust completed its world class commissioning assurance panel day.
At the heart of world class commissioning is having a clear organisational strategy, which the assurance process tests. Can the PCT tell a strong story about its ambitions and support this with evidence? Is the PCT board aligned with this strategy across the three dimensions of outcomes, competencies and governance?
A helpful start to any strategy conversation is whether you could express it in one or two sentences without jargon. In the Harvard Business Review article "Can You Say What Your Strategy Is?" David Collis and Michael Rukstad give some advice:
a simple, clear, succinct strategy statement sets organisational direction, aligns behaviour and enables staff to focus on common goals;
most managers cannot articulate the objective, scope and advantage of their business simply (in 35 words). If they can't, neither can anyone else;
with a strategy statement, staff know what they are trying to achieve and implementation becomes simpler;
when the final strategy statement is circulated in the organisation, it should be accompanied by organisational values and a map of supporting plans.
At Hillingdon, our world class commissioning journey began with strategy development. The board saw setting a medium term strategy for the organisation, and accordingly for the local health economy, as a vital first step. A root cause analysis of our financial failure, joint strategic needs assessment and national policies informed the choice of priorities. We then developed a strategy statement with the following basic elements:
vision: a desired future state of being; the contribution to the local population the PCT aspires to make;
values: what we believe in and how we will behave. The "we" refers to the organisation, not staff;
mission: a specific goal the board wishes to achieve, such as being a "world class commissioner".
It has proven to be helpful to have a strategy statement everyone knows and understands. The strategy sets personal objectives from the executives down, clarifying roles, responsibilities and accountabilities. It informs commissioning plans and validates strategic decisions. The organisational development plan focuses on plugging capability gaps and a balanced scorecard tracks how the strategy is implemented.
The strategy has enabled us to prioritise and stopped the PCT from being distracted and behaving like a candle in the wind. Executives know what we need to do, and a unified board provides support.
We had engaged staff in the strategy process to check alignment with people's values and experience. The final strategy is an evolving product and sets a clear direction of travel for Hillingdon for the next five years.
Our strategy enabled the PCT board to tell a consistent story on the panel day. For obvious reasons, we wanted to do well in the assurance process. We also realised that what we had earlier regarded as yet another bureaucratic hurdle is actually the day job.