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Nottingham County Council (NCC) has made the decision to substantially increase its investment in online learning from SkillSoft, a leading provider of on demand e-learning and performance support solutions, in order to deliver more training to a wider range of employees, but at less cost than traditional classroom training.
In all, Nottinghamshire County Council has purchased up to 30 courses from SkillSoft with the potential for up to 1,000 users to access each one. Brian Fairchild, NCC service manager learning and development, says that old-style teaching on such an extensive scale would, -not be an option given the current economic climate. Yet he believes that providing SkillSoft e-learning courses will more than maintain the quality of training while extending its reach across the organisation.
Kevin Young, SkillSoft general manager EMEA, reports increased interest from public sector bodies as they investigate ways to maintain training momentum despite the threat of government budget cuts. -This situation is becoming a catalyst for change; giving councils the opportunity to re-assess the way they deliver training and discover that e-learning has matured and is now a viable alternative.
Fairchild explains that previously, only Nottinghamshire County Council’s IT department used SkillSoft e-learning to deliver training for ECDL (European Computer Driving Licence) accreditation. The council had also developed its own online course in-house and the new service from SkillSoft enables the council to build on this success.
-We wanted a programme that covered three different areas, he says. -First, we needed a wide range of general business and personal development courses that we didn’t have to design and build ourselves. Then, we wanted software with an authoring tool so that we could create our own tailored courses. And, finally, we needed to deliver higher level training combined with our own management resources such as HR guides, currently held on a dedicated intranet site.
-We put this all in one tender, but hadn’t imagined that one company would be able to do it all and had envisaged dividing it up among several suppliers. However, we were delighted when SkillSoft demonstrated that they could, in fact, cover our entire brief themselves.
SkillSoft is currently implementing the software with the aim of going live next month. Fairchild is looking forward to a streamlined system with all e-learning courses across the council delivered via a centralised SkillPort interface. -This alone will make delivery of courses far more efficient and manageable, he says.
He says that e-learning will also help the council’s risk plan. -For example, we are at the moment planning strategy in case of a flu pandemic. Recently we had to cancel training sessions because tutors were ill. What with having to re-schedule everyone’s diaries it turned out to be a time-consuming and, therefore costly exercise. Of course, with e-learning this isn’t a problem – and even if an employee is ill, they can easily go back and catch up without involving anyone else.
Background
Newham University Hospital NHS Trust is an Acute Hospital Trust based at Newham General Hospital (Plaistow), with some outpatient services located at the Shrewsbury Health (Forest Gate) and the Appleby (Canning Town) Centres.
The hospital primarily serves Newham’s 240,000+ population but also provides services to the residents of Redbridge, Waltham Forest, Barking & Havering, City & Hackney and Tower Hamlets. Its mission is to ensure a secure future for the local provision of high quality, value-for-money health services to the people of Newham and surrounding areas.
The challenge
In early 2008, the Trust found itself struggling to cope with the volume of patient records requiring processing. In some cases the total turnaround time for drafting approved patient notes was weeks – sometimes even months. The result was that medical secretaries were being distracted from important patient work by hours spent transcribing reports.
Newham’s goal was to become a leading Trust with improved services for patients, and it was therefore seen as essential to implement an electronic storage system for patient records. This was particularly relevant after substantial investment in the Trust led to more patients and a corresponding increase in volumes of paperwork.
Medical secretaries were using tape-based or direct dictation from consultants to record patient notes, and were accustomed to these methods. When the Trust deployed a digital dictation system, the adjustment to the new way of receiving electronic notes proved challenging, and the Trust therefore decided to outsource transcription to free up secretaries’ time for important patient work.
A UK-based supplier was selected initially, but the Trust was disappointed with the service and therefore sought a more efficient and cost effective solution.
The solution
The procurement department selected Dictate IT, the specialist provider of digital dictation, speech recognition and outsourced transcription services.
Mark Miller, Managing Director of Dictate IT said: -We analysed Newham’s specific requirements and tailored a solution to suit the Trust’s needs. Our system automatically assigns dictation to speech recognition, depending on the type of text and the turnaround time required, so high priority records are processed first. This was a key feature in this contract win.
Dictate IT outsourced transcription services were fully integrated into the Trust’s existing operating system, which allowed Newham to work with a single contractor rather than having to engage separate outsourcing companies.
Sheila Catt, Manager of Medical Secretaries at the Trust commented: -Dictate IT offers a very straightforward process whereby consultants’ recorded notes are electronically sent to Bangalore, India. We have seen a significant reduction in the turnaround time of dictation tasks – in some cases from weeks to hours.
With the help of Dictate’s unique Dictation system functionality, the Trust is now able to store and access electronic patient records in the form of transcribed documents. By outsourcing dictation, using the latest digital technology and devices, Newham has achieved top quality recordings. Dictate IT’s Outsource Solution (DIOS) has offered the Trust both direct and indirect advantages:
Improved working practices – DIOS has fuelled the drive towards better working practices and improved efficiency among administration teams – the Trust has seen significant savings on secretarial time.
Speed and accuracy – reports are now transcribed, proofed and error checked in 24 hours with 98. 5 percent accuracy guarantee.
Dictation is sent immediately with no threat of delays from staff availability or lost tapes and the documents are readily available for review.
Cost reductions – the procurement department has seen significant cost reductions as DIOS is less expensive to run compared to analogue tape dictation methods. The service has cut reliance on agency staff, paying for overtime, stationery costs and eradicates backlogs.
Integration capabilities have harmonised with hospital patient systems, databases and Cerner Millennium electronic patient record system.
Clinicians’ working practices have stayed the same with minimal training required. Also, Efficient the service has been utilised as a first step to reviewing benefits of other technologies including other digital dictation solutions, workflow management and voice recognition.
Pradip Karanjit, Head of Access and Capacity at Newham commented: -Although we still print and store hard copies of clinic letters in patient records, electronic access of clinic letters through Dictate IT’s has simplified the process of accessing information as and when needed.
The system enables consultants to dictate there and then allowing secretaries to action immediately, which has helped reduce our turn around time. The Trust aims to move away gradually from paper notes and eventually aim towards the electronic records that will help improve access to our services.
Results
Having used the services for over a year now, secretaries at Newham now report that they have more time to focus on other significant tasks. Improvements have led to the Trust receiving the award for Most Improved Hospital in the Caspe Healthcare Knowledge Systems (CHKS) Top Hospitals Awards in 2008. Newham gained the award based on achievements made by reducing waiting times and improving access, reducing mortality and infection rates and the quality of data produced. The Trust was able to reduce its expected deficit by almost half, down from £4.1million to £2.3 million in 2008 – a considerable achievement and one which has been made alongside a number of improvements to the patient experience.
Sheila Catt said: -The initial negative perception surrounding outsourcing was proved wrong as soon as the staff realised the benefits of being able to focus on other important jobs, leading to increased efficiency. We haven’t lost a single employee as a direct consequence of outsourcing and the error rates are minimal.
With pertinent, up-to-date, confidential patient information converted to a written text document, the Trust has been able to achieve high standards of patient satisfaction.
Diabesity – the increase in obesity-led type-2 diabetes- is demanding ever greater resources from health services globally. Whilst the NHS objective is to increase the management of such conditions in the community, the serious complications associated with diabetes result in numerous hospital admissions and out-patient appointments, whilst also reducing patients’ quality of life.
Many clinicians agree that greater patient empowerment is essential to improve weight and glucose management, yet individuals typically have little or no interaction with carers between appointments. While the NHS is reported to have pulled back from the use of patient portals, a forthcoming pilot of a diabetes-specific portal that provides patients with access to clinical records, trusted information and the ability to track weight and glucose measures against targets, looks set to prove the value of improving day to day patient/clinician interaction, argues Mike Paylor, Business Development Manager, Hicom.
Diabesity Epidemic
The rapid increase in the prevalence of obesity, type-2 diabetes and associated complications (diabesity) is a major global health problem. In Europe alone, approximately 33 million adults will be suffering from diabetes by 2010, and obesity, which is a major recognised risk factor for type-2 diabetes, is itself rapidly increasing in prevalence resulting in a diabesity epidemic.
According to the latest figures, about half the adults in England and Wales are overweight. About one quarter is obese. The number of obese people in England and Wales has nearly trebled since 1980.
The current cost of type-2 diabetes in the European Union is 15 billion Euros per year, and medical complications arising from diabetes account for up to 8% of total health costs in Europe.
This fast escalating cost is putting enormous pressure on the NHS at a time when budget cuts and Darzi-led efficiency drives are taking centre stage. Indeed, NHS organisations will be expected to make -very substantial efficiency savings- around £2.3 billion – in 2010-2011, when the health service’s three year settlement comes to an end.
And diabetes services are already struggling. According to an audit commissioned by the NHS Information Centre in 2007/8, 60% of patients with diabetes in England are not receiving the recommended level of care – just 40% of patients said they received all of the nine care processes as recommended by current NICE guidance.
Primary Focus
Yet it is the consistent delivery of these nine care processes that is essential to controlling the escalating costs associated with diabesity by minimising the incidents of complications such as heart disease, eye problems, gum disease, kidney disease, circulatory problems and neuropathy. It is also key to ensure that those obese individuals without diagnosed diabetes (potentially 500,000 according to Diabetes UK) are made aware of the potential signs since early diagnosis can reduce the risk of complications and improve long term quality of life.
Indeed, an estimated half of all diabetics suffer from neuropathy which manifests as numbness or pain in the hands, feet, arms or legs – although neuropathies can also affect the organs resulting in admissions to hospital or regular outpatient appointments.
And while the NHS strategy is to reduce hospital admissions and increase management of chronic conditions such as diabetes within the community, many Primary Care Trusts (PCTs) are still struggling to achieve this objective.
A growing number of clinicians now believe that patients need far more support and engagement in managing their own conditions. Diabetes is a constantly evolving condition that requires day-to-day management to assess the dangers of complications; patients need support in ensuring glucose levels are maintained and weight reduction goals reached and they need trusted information to support understanding of diabetes, its complications and associated treatments.
Patient Engagement
Yet programmes for greater patient interaction, including expansion of the NHS Healthspace Personal Health Record project, is now reported to have been shelved. And the current raft of alternative patient portal solutions are no more than online tools that enable patients to track their own weight and glucose measures; or GP based solutions to help patients manage appointments and view their own health records with no means of uploading clinical content. As such, none of these systems provide timely interaction with clinicians and, hence, leave patients to locate their own online information via search engines – much of which is of dubious clinical value.
Other patient-focused alternatives include private sector monitoring solutions, using contact centres staffed with nurses to triage diabetes patients based on readings delivered via the mobile phone. But these solutions are incredibly expensive – and increasingly unaffordable – and also fail to build upon any relationship with the key care providers within the NHS.
Improvements in proactive management of the growing diabetic population can only be achieved by delivering continuous patient interaction. A truly interactive patient portal would provide the ongoing carer/patient relationship that is essential in managing these chronic conditions.
Combining a sub-set of the information available to consultants and GPs, including history of admission, treatment records, side effects and blood test results, with excellent, trusted information about diabetes, a portal delivers true patient empowerment. At the same time, the patient can upload onto the portal information about weight and glucose levels, mapping results against pre-agreed targets thus enabling ongoing engagement with clinicians.
Add in diary management and appointment reminders, and the ability to provide feedback to clinicians on the quality of service received, the patient has a single source of information that should enable improved management and control of the condition and ability to highlight potential danger signs that could indicate complications.
Conclusion
The global providers of healthcare are still struggling to reverse the diabesity trend, with weight management and pharmaceutical regimes, to date, having minimal impact. And with the NHS taking a step back from patient portal developments, the focus is now on the commercial sector to prove the value of these systems to empower patients and improve both long and short term outcomes.
What is now required are joint pilots between the NHS and specialist software vendors that can demonstrate the clinical and financial value associated with improved patient empowerment. These pilots would go a long way to reinforcing the growing perception among clinicians that effective, proactive management of diabesity is key to enabling more patients to successfully control their diabetes within the primary care services, reducing the cost and pressure on the NHS Trusts.
ESRI (UK) has just launched the latest version of CrimeAnalyst, a complete Geographic Information System (GIS) analysis software package for policing and crime prevention. Developed with direct feedback from users, CrimeAnalyst 2.0 enables analysts to manage the increasing demands placed upon them by automating routine tasks and providing new powerful tools that allow them to conduct more in-depth analysis.
The latest release builds on the strong track record of CrimeAnalyst which is now used by police, public safety and national security organisations across the UK and in 16 other countries. Studies have shown that CrimeAnalyst saves users an average of up to five hours a week freeing time to conduct more in-depth analysis which informs decision making and resource planning.
Daran Scarlett, Industry marketing manager for ESRI (UK), comments:
-Analysts are being called upon to inform critical decision making in an expanding range of areas such as crime and disorder, contingency planning and counter terrorism. In a climate where additional resourcing is unlikely, meeting these demands on their time and resources is a major challenge. CrimeAnalyst 2.0 has been developed to provide users with more of the time and the tools they need to achieve their goals and targets.”
Saving time and increasing consistency
New for this release, CrimeAnalyst 2.0 now automates routine tasks by allowing analytical models to be easily created, saved and shared with colleagues to save time, reduce workloads and ensure consistency. These models can be scheduled to run at set times, ensuring assessments are delivered as and when required to those who need them, increasing their value operationally.
Understanding when as well as where
CrimeAnalyst already allows police forces to visualise crimes and incidents by time of day and day of week. CrimeAnalyst 2.0 takes this one step further with a new Seasonal Analysis capability, which enables users to visualise how patterns of crime change throughout the year or from one season to another. For example, this can be important for better understanding crime patterns within University towns that experience seasonal fluctuations in population, or to help inform road traffic policing strategies, drawing on seasonal weather data.
More insight into repeat patterns
Also new to CrimeAnalyst 2.0 is a feature which clearly communicates the extent of a particular crime occurring at the same location, for example a building continually being used for drug dealing. By clearly indicating and numbering the extent of repetition, this enables police resources to be concentrated where they will have most effect.
Exploit third party data and software
CrimeAnalyst 2.0 runs on ESRI’s ArcGIS platform which provides users with the ability to consume many commercial datasets which add value to their analysis, such as census information, 3D landscape and aerial imagery, including seamless free access to Microsoft Bing Maps base mapping. Users can also link to and exploit the functionality within other analytical packages, such as i2’s Analyst Notebook and SPSS data mining software.
For decades, the focus in healthcare business intelligence has been on acute hospitals, almost to the exclusion of all other sectors. Even when other areas began to acquire systems, the tendency was to start with primary care, and then commissioners, and leave mental healthcare as something of an afterthought.
What has caused that to change has been the move towards Foundation Trust status. Over half of all Mental Health Trusts have now achieved foundation status, putting them on a par with their counterparts in the acute sector. As Foundation Trusts enjoy increased autonomy they face a requirement for improved management and more robust financial control, which in turn poses a significant and unique challenge to Mental Health Trusts.
So what are the specific obstacles faced, and what role can business intelligence play in helping to not only meet mandatory mental health reporting requirements, but also to transform healthcare delivery?
Bridging the geographical divide
Mental Health Trusts can operate over hundreds of sites across large geographical areas, and across multiple local authorities and PCTs. A large proportion of the work carried out by Mental Health hospitals takes place on neither an inpatient nor an outpatient basis, but through community contacts.
All of which poses a challenge in ensuring unified and accessible clinical records – multiple case notes at different sites can make it difficult for health and social care teams, clinicians and managers to share patient data effectively to deliver the best possible care.
The deployment of electronic patient record systems will improve accessibility, but challenges remain, both in developing more flexible systems which can be adapted to the needs of the clinicians who use them, and also in educating clinicians on these new systems and the way in which data needs to be recorded.
The approach we have taken at North East London is to deploy a single data warehouse from Ardentia, to ensure the information silos that can all too easily exist within the distributed geography of mental health are broken down. A web-based approach also means data can be shared more easily. Improving access to data in this way will not only improve care delivery, and meet management reporting requirements, but is also a fundamental building block to transforming healthcare delivery, giving clinicians the ability to lead, in line with the recommendations of the Darzi review.
Business intelligence for business processes
Foundation status requires Trusts to function on a robust and clear business footing. Greater autonomy brings with it the need for more far-reaching management decisions, based on reliable evidence and giving clear understanding of the issues that need to be addressed.
There is also a requirement for far more detailed financial reporting, a mandated requirement from Monitor, which oversees Foundation Trust applications, regulates performance and requires the development of service line reporting to meet these financial requirements.
The challenge for senior clinicians is to understand the financial and management issues related to the care being delivered, in order to ensure more robust management. They need accurate information on resources used, quality of care and financial performance, and to access this, they need powerful business intelligence solutions.
Dealing with complex patient pathways
Many patients with mental health have long-standing and complex needs. Unlike acute physical care – where clear-cut pathways determine the intervention needed – the challenge in mental health is to bring the relevant services together at the right time, according to patient need, ensuring the appropriate care bundles are delivered.
Within the treatment of a single patient for a single condition, there may be moments when the patient moves from one bundle of care to another. This would be the case, for example, when the patient is being treated for a sub-psychotic condition but goes through a psychotic episode in the course of treatment. This all impacts on resource usage and the costs involved.
Mental health trusts therefore require good quality data on multiple patient episodes and need to reason in terms of real pathways of care, in order to develop comprehensive reports and develop the right care package. Business intelligence systems must be able to bring together and link data from many different systems, to build pathways that identify community contacts, therapy sessions, outpatient attendances and so on into coherent pathways, to be analysed as a package.
Bringing it all together
That kind of complex care then needs to be married with financial data drawn from our accounting systems so that we can provide service line reporting and meet the management requirements set out by Monitor.
Looking at the financial implications and management issues associated with the care delivered in this way also does something else that is profoundly important: just as it brings together data about the healthcare activity we carry out, the inpatient stays, outpatient attendances and community contacts we deliver, with data from our accounts, so it brings together clinicians who provide the care with the finance managers who are answerable for the performance of the Trust.
Bringing together clinicians and managers to break down information barriers and meet the unique data challenges within mental health will not happen overnight, but in doing so, will generate unprecedented improvements in patient care.
Creating the clinical leaders of the future
The Department of Health, guided by the recommendations of the Darzi review, is committed to bringing senior clinicians and consultants to the very heart of decision-making. To do so requires clinicians to have an understanding of the wider financial and management issues, and the resulting challenge for Trusts is to provide the necessary data. This is where business intelligence is crucial, bringing together information on care delivered, outcomes and the financial costs attached.
North East London Foundation Trust is working closely with Ardentia to ensure we have good quality service line reporting which provides the data we need on cost, activity and outcome. As a result, for the first time, clinicians will get a more comprehensive understanding of the care delivered, empowering them to make more meaningful decisions, and to work more closely with commissioners to shape future healthcare delivery.
Give senior clinicians the data they need, and you give them the capacity to lead, to function in a business manner as proposed in the Darzi review, and as a result to transform care delivery and meet the needs of those who need it.
www.nelft.nhs.uk
www.ardentia.co.uk
A six-month project to barcode the mechanical and electrical components of every bridge, road underpass, pedestrian subway and tunnel in the City of Westminster has just been launched. Multi-disciplined service provider FM Conway, working on behalf of the council, is currently in the process of attaching the 20,000 barcodes, similar to those found on food packaging, to thousands of components.
When scanned by handheld computers, the barcodes allow the client, contractors, maintenance staff and independent inspectors to access a database of information about the maintenance record of that component, including pictures and repair logs.
The more well known structures that will have the barcodes include The Strand/Kingsway underpass and The Piccadilly Underpass, as well as Waterloo Bridge and the Golden Jubilee Footbridge.
David Yeoell, Assistant City Commissioner of Transportation at Westminster City Council, commented: -The benefits of this pioneering work will be significant. Maintenance will be focused to exact locations and problem sites analysed.
-The efficiency of the work and resources will be improved, particularly as the information is electronic and easily accessible. The information can also be used when looking at lifecycle costs and funding requirements.
The handheld scanners are an innovation that enhances the existing BridgeStation advanced asset management system, designed specifically by the London Bridges Engineering Group (LOBEG) to help with the management of bridges and other major highway structures.
Leading the work for Dartford-based FM Conway are Stuart Wilson, Service Delivery Manager, Bridges and Structures, and Bernard Hodgkinson, Director of Bridges and Structures.
Bernard commented: -This work builds on existing processes to regularly check and maintain important structures.
-The technology to house databases of information has been available for a while but this is the first time that barcodes will be applied to the components of structures so that information is fed back into the BridgeStation database.
The project to barcode components will take a team of five people until April 2010 to complete.
Melanie Teal, Chief Executive of The Consortium, the UK’s largest independent provider of school supplies, with over 30,000 products from school stationery to school furniture, looks at how resource budgets can be consolidated and money can be saved how this can benefit the whole school or college.
Schools and colleges are hard pushed and budgets are already squeezed. Whether it’s rising fuel and lighting costs bringing in unexpected costs or declining parental contributions and donations driven by the recession, many external factors are affecting how schools can stretch their often limited resources budget.
Melanie Teal explains: -Making sure you get value for money is one way of stretching any budget and has increasingly become an important priority for all those involved in ensuring schools and colleges have the right essential supplies to help deliver a high quality education. But when you are in a sector where purchasing expertise isn’t a natural requirement of the job it can quickly turn into a headache as you weigh up the pitfalls and benefits of different suppliers.” From Melanie’s experience she can recommend two approaches to any education leader looking to get the best value from its resource budget.
1. Consolidate. In recent years there has been a major focus on how schools and colleges buy. In many cases, this has resulted in an increase in the number of suppliers being used as schools have sought the lowest price for specific types of goods. The downside of this is a corresponding increase in the administrative impact of managing supplies and the disruption attached to the increased number of deliveries. So, finding suppliers who are competitively priced across a comprehensive range of products can help schools consolidate orders (and deliveries) as well as contributing positively to the environment.
2. Let schools get on and teach. The reality is that providing education has to come first and it isn’t always easy to find the time to searching out the best deal. Many teachers and school leaders end up doing this in their own time. The good news is that suppliers are out there who can help with all aspects of a school’s day to day curriculum and maintenance needs. Many of these suppliers are happy to look at a school’s overall spending requirements and tailor an offer for them. This one-off negotiation can then free up valuable and busy staff to get on with their vital role of teaching the children or managing the school. A number of local authorities have done this negotiation on behalf of their schools, e.g. Bristol, Dorset and the Welsh Assembly.
Teal expands:
-Freeing up time for either administrative or leadership staff is just one way a good resource supplier can help a school. For example easy returns, guaranteed next day delivery and even a friendly voice at the end of the phone can allow schools to reap benefits in terms of ordering their resources and quickly moving on to get their job done. This allows leadership teams and support staff to focus on the bigger things in life – namely, delivering first class education.
Case study: Manor Lodge School, a co-educational private school in Shenley, Hertfordshire with pupils ranging from 4 to 18 gradually switched its main stationery orders, its arts and crafts orders and its exercise book orders to The Consortium. The school’s purchasing manager Melanie Jawett said:
-Two years ago we started switching our orders to one supplier, The Consortium. The quality of goods, service and delivery was so high and we were particularly pleased to get all the packages individually marked as requested so we could distribute straight to classes and match the different invoices against our own systems. I estimate this has saved us at least two days work!”
Advice and guidance: The Consortium has produced some new advice and guidance to help schools and colleges countering the squeeze.
1. Whether its classroom resources, exercise books or outdoor play equipment it shouldn’t be about buying the cheapest. With high use items they need to stand the test of time so it’s important to weigh up value and hardwearing factors as well as looking at the whole-life cost of bigger spend items.
2. Look at ways technology can you save you money and help the environment. For example, many schools are seeing the benefit of online resources and whiteboard technology in bringing down the cost, both in time and paper, of endless printing and photocopying.
3. Try to encourage a staff policy of planning in advance so you aren’t racing to buy against a deadline and ensure you get what you need at key times of the year.
4. Look to build relationships with a small number of good suppliers and give staff clear guidance on who to use for what. This will speed up the buying process and reduce administrative complexity. There should be a spin off environmental benefit in reducing the number of discrete deliveries. If you choose suppliers who are also environmentally focused, you should do even better.
5. Research what all the different companies offer. Check for hidden charges on small orders, next day deliver or when returning goods. Can you place orders at times and in ways to suit you? Can you speak to a real person if you have a problem?
6. Take advantage of, and seek out, discounts. Particularly if you can take deliveries in larger quantities.
7. Check that what you are buying is fit for purpose. This works both ways, buying a premium product when a budget will do is just as wasteful as buying a poor quality product when a better one is needed.
In our experience only 1 in 50 RFPs (Requests for Pricing) in the network and applications technology space calls specifically for performance testing to be part of the package. The rest focuses attention in detailing the product requirements, which will only answers the questions -What does your device do? and -What is its functionality?, not -Will it work with my network requirements?
Some RFP’s call for a Performance matrix and on occasions this extends to asking -how much traffic can the device or application handle? However, without independent real world verification (performance testing) in the context of a network’s/application particular traffic types and mix, how can a direct comparison be made? How are your technical people expected to differentiate between new technologies’s of which they have little or no practical experience? What is the difference between the latest technology switch priced at £12k and a switch available at £2k, with similar functionality? More importantly how will you understand the comparative performance in the live network/application environment?
Often purchasing professionals shy away from what they consider the additional expense of performance testing, perhaps they rely on traditional negotiation skills and trust engineers to make the appropriate selection of technology and location. Contrast this with decisions based around real test results where the risk of failure is reduced. Your ability to negotiate is increased through a thorough understanding of the requirements, and it’s not uncommon for post test prices to fall 20%! Add your ability to select the right technology for the right place in your network and the direct savings could outstrip the investment 50 fold.
Why don’t more buyers include test as part of the selection programs? Is it because they don’t realise the huge potential for savings? Or perhaps they don’t know where to start?
We know from our work with West Country Universities, a very large Services Information provider, and many others who do independently test what they want to put into practice, that the outcome of adding -Independent Testing to an RFP is worth a reduction in overall bid prices of up to 20%, that equates to £1m on a £5m project! By testing and selecting the right switch for the right application the Service Information provider for example, stands to save £8m a year! Year on Year! As well as avoiding embarrassing in-service failures.
As buyers becomes better educated and informed through understanding the impact of the test results, essential RFP inclusions like ‘ensure solutions are tested pre deployment’, can be included and contractual negotiations can then be based on facts and evidence of performance .
Where to start, is simple to us, but not perhaps to the commercial buyers. Spirent provide testing methodologies appropriate to switches, routers, server load balancers, firewalls, web applications, database services, application servers, WAN acceleration and applications so that at the very least their suppliers will have to carry out contextual testing as part of their submission rather than guessing best performance. If the contract is of a significant value they might want to complete this testing independently. The cost of testing is around 1 to 2% of the value of most midsize projects, the cost of not testing is a great deal bigger than that.
For More Information Contact:
Kate Innes ZonicGroup
kinnes@zonicgroup.com
A storm is brewing.
As we head into 2010 the healthcare sector is facing many challenges. Not only are budgets being cut but many institutions are faced with growing customer numbers. This means more customer data to manage. Sophisticated technology is also adding to the problem.
Doctors are seeing an increase in super-high resolution imaging technology for diagnosing and treating patients, which in turn is leading to ever more data to manage, secure and store. Every one of these issues is causing huge headaches for the IT managers. While UK hospitals need to grow their storage capacity, many lack the budget, physical space or even sufficient energy supplies to do this. It’s the perfect storage storm.
For the budget-challenged IT manager in the healthcare sector the need to do more with less has become a sudden and harsh reality.
In the past, radiology and cardiology departments were the primary users of medical imaging systems, picture archiving and communication systems (PACs), including CT scans, MRI, cardiac catheterizations and echocardiograms. But recently medical digital imaging has exploded into many more specialties in the medical sphere. Pathologists and dermatologists are among the new users. Images of tissue samples and skin lesions improve diagnosis and track the progress of patients’ treatments.
Also, new cancer diagnostic exams involving the latest medical imaging equipment, such as digital mammography, produce thousands of high-resolution images per study. But the practical ability for most hospitals to host more equipment to store and manage more data is being severely impacted by the expectation that many UK hospital datacenters are rapidly running out of space and power.
About five years ago, the average 500-bed hospital needed less than two terabytes of storage for its medical imaging. Today, it needs 50TB to 100TB for the average 150,000 to 200,000 imaging-related procedures done annually in these facilities.
Storage efficiency is, therefore, being cited as one of the biggest drivers for hospitals determining their storage spend this year and beyond. This was confirmed in a study by analyst research firm Enterprise Strategy Group. Its survey of 504 global storage professionals found that budget-conscious storage decisions in 2009 will be driven by efficiency. The survey also identified that specific efficiency-friendly technologies enabling data reduction, intelligent tiered storage and storage reservation were among the top priorities for the next 24 months.
Intelligent tiered storage is particularly important to the healthcare industry, as it can provide hospitals with a cost-effective way of centralising their image database and other storage resources. On top of the images, hospitals also store thousands of other files that must keep on file regardless of how big they get.
However, only a fraction of this data needs to be accessed frequently; the majority of files, once they pass their useful life, are never opened again. Tiered storage automatically moves the least accessed files to the lowest-cost tier of storage. Similarly, if an infrequently accessed file later becomes more popular, this will be moved back up to the faster, more expensive storage so that it could be accessed and downloaded more quickly.
Interest in fluid storage technologies like these clearly indicates a growing trend, indeed a flight, towards greater storage efficiency. By boosting the efficiency of their storage infrastructure hospitals can accommodate data growth within strictly limited budgets. And they can do all this using a smaller hardware footprint that in turn consumes less physical space and draws down less energy. When these technologies are combined, the compounded efficiencies can be dramatic and immediate.
It’s not uncommon to see 90 percent utilisation improvements over legacy storage capacities resulting in further significant reductions in energy needs.
It sounds simple enough but a major hurdle remains. Hospitals often find it very hard to break free from the traditional and large storage brands, now pilloried for their excessive inefficiencies, to which they’ve grown accustomed to using.
They are also reluctant to move when they look back at the high investment in training and other costs they’ve incurred. However, with the economy at the fore-front of all major spending decision there is now much greater pressure on IT managers to explore new options that deliver greater efficiency. The historical reluctance to transition from the big brands is starting to erode as value and efficiency move to the top of the priority list.
Annual storage requirements for many providers are increasing at a rate of 20% to 100%. Ballooning storage requirements have resulted in a number of challenges, from cost to disaster recovery to security and access issues. IT managers need to ramp up their knowledge of intelligent tiered storage as quickly as possible and ensure that it’s a central platform for their future storage strategy. Not only will this help solve their immediate problems of data growth, budget limits, space and energy, but it can just as directly benefit their hospital’s bottom line. In this period of economic uncertainty, a healthy obsession with efficiency will be the key to weathering the storm.
Additional Case Study – Compellent drives 90% energy saving at University College Hospital Galway
One of Ireland’s major academic teaching hospitals, Galway’s HSE University College Hospital, was experiencing vast IT requirements spread across the various departments and hospital sections.
By June of 2008 storage levels were at a critical level for UCHG and they were on the verge of running out of storage, and were close to capacity on the model of SAN they currently had. These problems were compounded further by the fact that their existing SAN was also past the end of its product life and could not be upgraded. The only option was to buy a new one. Their existing SAN vendor was happy to sell them a new SAN but there was no way of avoiding the same problems again over the next 3 years.
Through working with Origina’s Innovation & Development team UCHG devised a pioneering new storage framework for the entire organisation. Origina storage architects designed a solution built on Compellent Storage technologies that delivered a vast variety of benefits that solved the organisation’s storage problems and, moreover, facilitated their requirements into the future. Based on Compellent’s energy-efficient storage area network (SAN) the solution is saving the hospital 90% on power and cooling costs, and with no model range, the same SAN can be used until a 900TB capacity is reached.
The news that council chiefs are set to quit amid budget and pension plan changes (Financial Times, Council Chiefs Set to Quit as Cuts Bite, 11 November issue) brings into the spotlight once more the issue of attracting the best and most qualified staff to senior roles when remuneration alone will not cut it.
With all parties looking to local government to take additional social and political responsibilities while simultaneously saving money it is quite clear that the political and business landscapes have changed. If public sector organisations are to attract and retain the best talent to cope with these changes they must realise that the manner in which they attract and retain their employees must change with them. The good news is technology can bridge this gap.
Public sector organisations today are increasingly under pressure to deliver top quality service with fewer and fewer resources. A key way to achieve this it to increase employee knowledge and maximise efficiency, so service to customers can be delivered quickly and effectively each and every time. Yet, attracting and retaining talented staff with the necessary aptitude and experience can be very challenging, particularly when budgets are tight and there is pressure to reduce costs. Top quality employees are a hot commodity and in the current economic climate, alternative incentives should be considered when a hefty pay hike or an attractive pension isn’t an option.
For instance, due to the ready availability of flexible working technologies such as videoconferencing or remote access to office functionalities, staff can better balance work and home life, so it can shift from being a -nice to have” to a -must have”. Especially when budgets are tight, organisations need to show they care about work/life balance, or that talent could go elsewhere. And without the right staff, or the right technology to retain them, everyone loses.
In addition to enabling employees to balance their home and work lives, flexible working technology can also ease the pain of the talent drain by providing organisations with the ability to staff important roles with non-traditional employees such as remote or part-time workers and retirees. This can translate to improved competition with the private sector as well as better service, faster issues resolution and more responsiveness overall.
What about costs? Fortunately, many of the technologies that can make flexible working a reality are already in place in most organisations. By combining the existing infrastructure such as VoIP with newer technology like Unified Communications, employees can work as effectively remotely as they do in the office. Unified Communications (UC) technologies such as presence or extensions to mobile applications which enable remote staff to work seamlessly regardless of location, could enable employees to work a rolling set of hours and equip them with the ability to work from anywhere they happen to be, effectively extending business hours as experienced by customers and partners without requiring employees to work a single extra minute.
Furthermore, employees are not the only ones that benefit from flexible working policies. Customers too see the benefits, through increased access to experienced, knowledgeable staff. Flexible working can allow public sector organsations to live the dream of first call resolution, becoming even more efficient with a limited set of resources.
The social and political landscapes are changing, but so is the way we work. Through increased flexibility, the public sector can become more competitive and efficient, so it can better fulfill its function – to serve.
Many agency nurses, who are an essential function of the NHS, are often treated as -second class citizens- something that needs to change to ensure maximum standards of care. That’s the message from the nurses we’ve surveyed at Arrows Group.
One agency nurse, who wishes to remain anonymous, says that there is a lot of hostility towards temporary nursing staff, that they’re given the most difficult patient and offered no support. She says, -We’re not treated like nurses- I’ve often been referred to as ‘agency nurse’ rather than by my name. Some hospitals don’t allow us to administer drugs, which I can often understand, but when that’s the case they should offer us the training to do so. We’re always willing to pay, but many won’t even offer us the option.
-There’s hostility because NHS nurses know we get paid more than them says another. -And if there are tasks we’re not permitted to do, that can mean more work for them. But that’s not our fault, and if they would work with us as a team then there wouldn’t be a problem. Permanent nurses always ask me what I’m earning, and if there’s a piece of equipment I’m not familiar with, I’ve been told ‘you’re paid a lot of money, you should know how to use it’. One nurse refused to show me how to use a new piece of machinery which everyone had been trained on whilst I was on holiday. This meant I couldn’t change a patient’s IV – I had to spend half an hour finding another nurse and take her away from her work so she could show me. Obviously not all wards in all hospitals are like this but it just shows that this treatment has a direct and negative impact on patient care.
The truth is that the NHS couldn’t function without the input of these specialist nurses. These people are highly qualified and deserve to be treated like any other nurse – and common courtesy is something that every employee is entitled to. The focus of healthcare staff should always be on patient care but it seems this is suffering due to these hostile attitudes.
Then there’s the issue of introducing new rules that state NHS nurses must have degrees, which could cause even more staffing problems for the health service. With specialist nurses already in critically short supply, narrowing the criteria for those wishing to enter the profession will lead to a drop in the number of people becoming nurses, making this problem even more acute.
This is a commendable move – the Government says that these new rules aim to improve the standard of patient care, which of course is of utmost importance. But it runs contra to the most pressing issue, which is nursing skills shortages across the NHS. By introducing these stricter requirements, the NHS may in fact find itself with lower standards of patient care, because it will struggle to find the talent it needs.
An increasingly high percentage of nurses working in the NHS are foreign nationals and raising the bar at entry point would have to be communicated clearly and rolled out internationally as the NHS is staffed by an international resource pool. There are critical staffing shortages across the NHS and the most pressing issue is looking at options that solve this rather than complicating it.
James Parsons, Managing Director of healthcare recruiter Arrows Group, which supplies temporary nurses to trusts across the country.
NHS Trusts have come under increasing pressure to improve the management of several £100m of assets, from medical equipment onwards, in order to reduce spiralling litigation claims and deliver far greater accountability. But with information stored not only by Finance within the capital asset register but also duplicated across Medical Equipment and Estates departments, attaining a single view of asset history, including location, maintenance and value is impossible.
Now, as it becomes apparent the NHS will face a significant financial shortfall in the near future, it is becoming ever more critical to impose control over asset management to improve performance, maximise resource utilisation and minimise mistakes.
Karen Conneely, Real Asset Management, outlines the need for a single integrated asset register.
Funding Crisis
As the NHS Confederation report reveals that the health service will face the most severe and sustained financial shortfall in its history after 2011, managers are now facing an -extremely challenging financial outlook.
This radical change in fortune comes at a time when NHS Trusts are already under pressure to improve performance through a range of measures to meet the Darzi-led demands for greater efficiencies throughout the health service. Furthermore, as growing numbers of Trusts attain – or seek – Foundation Status, senior managers are now considering the implications of significant budget cuts within an increasingly commercial business model.
The growing focus on finance comes at a time when Trusts have already come under additional scrutiny from auditors looking for greater substantiation of the balance sheet through the verification of the existence and location of capital assets that are collectively worth several million pounds.
Furthermore, Trusts are also under pressure to mitigate the risk of litigation. With the NHS paying out an estimated £650 million to patients in claims annually, often as a result of poorly-maintained equipment or equipment being used without adequate training, Trusts now recognise the need to impose far greater control over the asset register.
Complex Asset Management
But imposing this control is far from simple. Assets are distributed across each hospital- and GP surgery – and managed by different departments including Medical Equipment, Estates and Sterile Services. Furthermore, medical equipment is highly mobile and often leaves the premises on loan to patients.
Each department has its own asset management system, resulting in data duplication and inaccuracy across the Trust. It is extremely difficult to achieve full, up to date visibility of assets without hugely expensive manual data reconciliation exercises performed monthly so that Finance can have any level of confidence in the fixed asset register.
In addition, the lack of a single view of assets across the Finance, Equipment and Estates departments leads to difficulties in assessing an asset’s longer term value to the business. For those with Foundation Trust status, this inadequate visibility makes it extremely difficult to undertake the required analysis of the cost of service delivery and to determine profitable future strategies.
Integrated Solution
There is a growing awareness across the NHS in England & Wales that the only way to impose control over this key asset base is to replace these disparate systems with a single, integrated asset register that not only holds the capital asset information for the finance team but also addresses the requirements of each department.
And this is key: to meet both compliance and efficiency objectives, an integrated solution must cater for the specific needs of each department, from tracking which patient is using a piece of equipment to managing proactive maintenance for the estates department and delivering the full audit trail of equipment sterilisation through each stage of the washing cycle.
By providing each department with a customised view of the single asset register, a Trust can achieve centralised control whilst still ensuring that all operational asset management demands are met.
Critically, the previously time-consuming manual processes for condemning outdated equipment can be streamlined, with full visibility between the relevant department and the central finance team – whilst delivering an audit trail that is essential for complete accountability.
Trusts can also ensure that key compliance requirements are addressed without incurring an administrative overhead: from tracking and reporting on response times using time and date stamped maintenance logs, to creating a full audit trail of patients’ use of equipment, linked to associated training histories to minimise litigation risk.
Commercial Imperative
While a single integrated asset system will enable Trusts to meet compliance requirements and deliver cost savings, it will also enable those providing maintenance services to other organisations -including GP surgeries- with the ability to proactively monitor performance against the Service Level Agreement (SLA).
By aligning assets with service records and histories, organisations can not only assess their condition and recommend maintenance but can also determine whether they are meeting the required performance levels, costing too much in repairs or failing to contribute to the overall business strategy.
This shift to a single system also provides a platform for future innovation: organisations can look to leverage their investment by adopting wireless hand held devices, even RFID tracking, to further reduce the administrative overhead and improve real-time information access.
Maintenance technicians -both internal and third party contractors- can be provided with a PDA containing electronic versions of job tickets; as each job is completed, the information loaded into the hand-held device will automatically and immediately update the core system, removing the risk of rekeying errors and ensuring that information is consistently up to date. This will be key to improving response times to breakdown requests and to delivering ever more cost-effective services both internally and commercially.
Conclusion
The combination of escalating compliance pressure and predicted demand for annual savings of 6% for the years 2011-2014 is driving growing numbers of Trusts to look far more closely at asset management. Whilst wireless technology may not be part of the initial implementation, the ability to combine this level of automation with a single consolidated asset register offers Trusts a compelling solution. By moving from disparate sources of, often duplicated, asset information to a single, consolidated asset register, Trusts are minimising the risk of litigation, improving service levels both internally and for external customers and, critically, delivering the cost savings required to meet the forthcoming years of stringent financial control.
AS the world of primary medical care advances into the 21st century, few companies have done more to change the face of the industry than Telehealth Solutions Limited. The progressive firm, established in 2006, has made it its mission to provide a remote monitoring service for patients across the UK.
This rapidly rising young company has stepped up to the plate to offer medical professionals and patients alike the chance to embrace the future.
The Telehealth Solutions product list proudly proclaims the presence of a group of ‘pods’, which are prefixed in such a way to make them easily identifiable to both professionals and patients.
These are the CardioPod, HomePod, SurgeryPod, Check-in Pod and CarePod. Each one of these cost-effective and highly effective machines has secured its place in the medical world and is turning conventional care on its head.
One of the main benefits is that patients suffering from chronic conditions that need to be monitored regularly can now do so from home.
This has helped free up valuable time for both GPs and frontline medical professionals, who no longer have to make house calls as data is transferred from the patient on a regular basis. The CardioPod, recently launched by shadow health secretary Mary Scanlon MSP at a pharmacy in Edinburgh, is already changing the face of 21st century primary healthcare.
This remarkable machine, usually installed in pharmacies, offers patients the chance to pop in for a professionally supervised heart check that takes no longer than 20 minutes.
A small blood sample is taken, which registers blood glucose and cholesterol levels. The pharmacist then asks a series of questions and the answers given, combined with the blood results, calculates the risk of the patient having developing cardiovascular disease within the next decade.
These results appear on screen in an easy to follow format – with smiling faces representing heart health and frowning faces representing the patient’s risk of having a heart attack. A personal health check report is processed, allowing the patient to set health goals, which can be anything from smoking cessation and cutting alcohol consumption to taking more exercise.
Afterwards, a clinical report is printed out and given to the patient to take to his or her doctor, if necessary. These results can be, when the system is programmed to do so, sent to the patient’s GP for action.
The HomePod is also another groundbreaking machine for patients with a series of chronic conditions, such as diabetes, asthma or heart disease, who find themselves in and out of hospital on a regular basis. Using wireless technology, the HomePod encourages people to take control of their own health by issuing reminders to take medication, weigh themselves or go for a walk as previously discussed with their GP.
The machine also has the facility to take blood oxygen readings and monitors ailments, like coughs, through a series of targeted questions to ensure nothing is getting out of control. Results are fed back to the GP, who can keep track of the patient’s health without leaving the surgery.
Time-saving for hard-pushed GPs is also where the multilingual SurgeryPod comes in. Usually placed in waiting rooms, the machine offers the chance to have health checks before they go to see the doctor. As the information collected on health and lifestyle by the HomePod is then relayed to the GP electronically, it means they have more time to spend working out a way forward with the patient when they come in for a personal consultation.
Telehealth Solution’s executive chairman Jeremy Cummin, the force behind the emergence of the Watford-based firm three years ago, is remarkably frank about the reaction the firm’s technology has sparked among users.
Adding that he was delighted with Self-Care week and the work it does to promote the work firms like Telehealth Solutions do to encourage self-care through remote-monitoring, he said: -In short, patients love our systems as they offer them a sense of freedom and also the peace of mind that they are taking charge of their own health. It also removes the temptation for self-diagnosis, which is all too common given accessibility to the Internet, but which can be very dangerous.
-For today’s NHS professionals, most of who are bound by budget constraints, there is no doubt that offering patients the chance to take charge of their own health where appropriate – and with remote medical guidance – is a fantastic step forward.
Education is being reformed through various initiatives, and the Government’s flagship vocational qualification, the 14 – 19 diploma is playing a key role in the process.
Naturally the delivery model for diplomas must be flexible to allow for learning in a range of settings, however this affects ICT provision and many schools have not yet contemplated the sheer scope of such change. Steve Smith, director of learning at Ramesys, guides us through the key technological issues.
In response to the changing work and educational environment, the 14- 19 agenda is set to significantly transform learning as we know it. As with any change, there are challenges to tackle, and the 14 -19 agenda must be viewed strategically in order for schools and local authorities to determine the wider picture.
Many schools have spent years planning their 14 – 19 provision. Best practice examples of how schools have worked collaboratively to deliver successful outcomes are often proudly revealed, along with how employer engagement is encouraged, and other equally as encouraging reports. However there is one area that may not have received the consideration required; the technological issues within the education and wider children’s services environment.
Moving between learning environments to study is completely alien to many. After all most of us were educated in the same location for a number of years, and only experienced a change of setting when the move was made from primary to secondary school.
For today’s generation it is vastly different; they will not be restricted by location. In contrast they will study in multiple locations. Students enrolled on diploma courses will find their studies take them to more than one institution. For instance they could be required to study at school, a local college, and a work-based learning establishment to create a more holistic learning experience.
14 – 19 learners are ‘peripatetic’ learners, and therefore have a home school; a second education institution base such as another school or an FE college where they study some elements or modules that their home institution cannot provide; and a work place base where professionals support them in a particular area of study.
Flexibility is therefore crucial to ensure that learning can take place in a number of settings, and consequently ICT must be ubiquitous. As one can imagine, there are technological issues to be addressed if it is going to be possible for students and staff to move between learning centres. Registration, access control, and cashless catering plus many other elements must be considered.
It could be argued that if ICT is not thought through, technology could become a barrier, not an enabler. So, what are these issues, do they affect the staff as much as the students, and how can they be addressed?
Students on the move
Focussing on just one area as an example, student mobility requires registration information to be collected at more than one establishment. However currently the majority of MIS systems have data hosted on servers in the ‘home’ school. This raises an issue of how students register in each place of study, and how can the data be made visible to staff in different institutions? To overcome this, MIS systems should be centralised and web-based interfaces provided and views on the data.
Moving onto other systems which may be linked to the staff member or student’s identity, such as access control or cashless catering. As an example, one centre may have a system based on swipe cards, another biometrics. In one, the access control system may be used for student self registration, in another staff may still call the register and enter the data via a keyboard. Even if all centres use the same system based on swipe cards, unless the data can be centralised, identity information would need to be maintained separately at each centre.
Emma Duffield, a Year 11 student at the Piggott School in Reading explains that these are issues that need to be considered: -I currently study in just one location, but if I moved from place to place to study, the contact I need to have with ICT would be an issue. I am always misplacing things, so if I had a swipe card for each place, it would cause problems! I think biometrics is a good idea even though it sounds like something out of Star Trek!
The area that generates perhaps the most concern is the Managed Learning Environment (MLE) and the access to/submission of resources and assignments. If each learning centre has a different system, does this mean that a student will have to log-on to several according to their place of study? Would this require staff to upload materials to different MLEs to cater for students coming from different institutions? How would the work-based tutors update online resources, records and reports?
All of this highlights the need for a joined-up approach, but what about the wider children’s services area?
Collaborative children’s services
The Systems Interoperability Framework or SIF (formerly the Schools Interoperability Framework) can help overcome many of the issues highlighted.
Organisations must work collaboratively to ensure success, and this is a view shared by those within the industry. Robert Fitzgerald, children’s services senior product manager, from OLM Systems, part of OLM Group, the leading supplier of integrated information solutions to the care sector, explains: -The difficulties of interoperability amongst system suppliers within children’s services have risen to prominence this year with the arrival of ContactPoint. This project has provided a renewed rationale for looking again at ICT integration and has challenged authorities to look more closely at how they can execute the Information Sharing Agenda amongst all professionals working within children’s services as a whole. It is still surprisingly difficult to get an education systems supplier and a social care systems supplier to work together so that data about children in care, for example, can be appropriately shared. SIF may well be the answer.
The SIF vision is a relatively simple one, but the complexity of achieving it is significant. Proof of Concept (PoC) work in Birmingham and in Northern Ireland has formed part of Becta’s evaluation of the use of SIF in schools. Both proved a success, but the findings in respect of the Northern Ireland PoC suggest that SIF works and points the way forward, but the range of data and applications covered by SIF is currently far too limited.
So, for the utopia of complete interoperability between the plethora of school applications to be achieved, let alone meet the challenges in the wider children’s services world, the data model needs to be expanded significantly, and the number of organisations being prepared to adopt SIF needs to increase massively.
-It has been proven that the appropriate sharing of key child and family information can inform early intervention programmes, support families experiencing difficulties and improve the life chances of less fortunate children. The sharing of this information must be facilitated by ICT, not hampered by it, concludes Robert.
With the uptake of social media initiatives in the UK public sector lagging behind other European countries, what steps can this sector take to manage the associated risks and step up a gear?
The government sector in general is currently failing to impress on its level of engagement in social media initiatives such as discussion forums and blogs. These so-called ‘e-government services’ can be an effective way for local councils and individual MPs to publicise a more positive and transparent image to their constituents. Public perception of MPs certainly over the last few years has been very mixed. Often they are associated with negative attributes such as dishonesty, distrust or even having a secret ‘hidden agenda’.
By adopting a more engaging, open stance via social media, the likelihood of gaining trust and respect to a wider community of people is increased. Although it may appear that by indulging in social media MPs are opening themselves up to public scrutiny the potential knock-on effect of appearing more approachable and less guarded could be very rewarding. Social media can also help those in the public sector to reach out to people in the community that might be disillusioned by politics, with the Government anticipating that social media will help to facilitate access to the wider community that government is currently unable to talk to.
With recent research[i] suggesting that only 23 per cent of MPs are actively promoting their presence on social networks and, even though some MPs have taken the leap into social media they are still not using it effectively as a tool to encourage dialogue with their constituents. Rob Marcus, director of the social media moderation company Chat Moderators looks at why the public sector should embrace the benefits social media has to offer and gives advice on the measures should be taken to ensure they are protected.
Marcus explains, -With so few MPs using social media and only 11 per cent having their own blog, this shows that the sector in general still has a long way to go. Although engagement through social media can hold potential risks and be viewed as time consuming, many MPs still feel that they need to be participating in it but are unaware of the technologies available to them. This may be a reason why so few have actually used social networking as a communication tool in their campaigns. Another reason may be that they are less technology savvy than younger social media users that have grown up with it, and there are still misconceptions that need to be dealt with. It may save time in the long run, but people can take a while to feel confident and get to grips with new ways of communicating.
-With most MPs (92 per cent) using email, social media also offers another route for constituents who wish to get in contact with them. Members of the public often feel that their local councillors are unapproachable, but having a presence on Twitter or adding a discussion forum onto their website could help them become more visible and easier to converse with. However, when embarking on social media MPs will have both different but (in many ways) similar issues to brands when it comes to receiving negative content. The higher profile the MP is, the more they become ‘a brand’ in their own right and when people feel passionately about an issue they tend to get personal.
For large blue-chip brands this is less of a problem but when dealing with an individual public figure like an MP the chances of negative submissions are higher. Having said that an MP is less likely to receive large volumes of submissions on a daily basis as a large brand might, but a higher percentage of the submissions will be negative which increases the very real need for moderation. It is vital for a stringent moderation process to be put in place in order to protect all parties involved.
Rob Marcus suggests some ways that the public sector can get started with social media………
Do some research and see what other local councils or MPs are up to. There are resources such as Tweety Hall (tweetyhall.co.uk) that list all local councillors on Twitter and by searching for local councillor’s blogs you can get a good idea of how your peers are taking the social media plunge.
Ensure you update and communicate through your social media initiative regularly so it becomes a success. Some initiatives, such as blogs, are more high maintenance than others such as tweets, so choose wisely. Perhaps you could share the burden with a colleague?
Your existing website can be a great platform for social media. Although there are numerous third party platforms within the social media sphere such as, Facebook, Flickr and Bebo, recent figures from the Internet Advertising Bureau (IAB) have found that just five per cent of people had joined branded groups and communities on social networking sites. So your own website can probably make a great home for social media initiatives too.
Marcus concludes -The main piece of advice I would give to an MP looking to set up a social media initiative is to seek help from a professional agency, expect that there will be negative comments appearing but to go ahead and give it a go anyway with your eyes wide open.
The UK public sector is facing its most serious funding challenge for many years.
Given the state of the public finances, major spending cuts are inevitable or costs will spiral out of control. While this is starting to be recognised at all levels, there is no clear roadmap of how to get there.
To date, the focus for improvement has been placed on large scale efficiency programmes including back office and shared service functions. Deploying information technology through efficiency-based transformation programmes has driven numerous successes and secured significant cash benefits. However, the new reality of reduced resources is of a different magnitude to anything experienced in recent times.
The public sector’s traditional response to funding challenges has been to top-slice budgets. This has shared the pain but has often risked throwing both strategic ambition and delivery of citizen outcomes out of the window. Reports such as the Institute for Government’s ‘State of the Service’ study demonstrate that the biggest issues have been a lack of focus on what those outcomes should actually be and a failure to clearly understand and prioritise the investments that deliver those outcomes most effectively. The result has been that although we have massively increased public investment, this has not produced the expected degree of change.
Significant change is clearly the only way forward but many organisations still struggle to either focus on or understand the potential impacts of their options due to a failure to integrate their strategic, financial and operational processes. The human aspects are as ever the most challenging consideration and to be successful we must integrate work across a wide variety of professional disciplines starting at the corporate centre.
As one example of the potential results, Birmingham City Council, the largest all purpose authority in Europe, has been working with HCL AXON through its joint venture Service Birmingham to support with all aspects of major transformational change, such as business case definition, benefits management, process design and organisational design, implementation and change management. The first part of programme is on target to deliver £518m cashable savings over 10 years, which will enable investment in improvement to front line services for Birmingham residents.
This example and others show that by creating an integrated solution, public bodies can connect political ambitions with the actual delivery of services and programmes. To make this happen, public sector bodies need to consider:
1. Strategy formulation – agreeing what’s critical and what’s not
2. Resource allocation – driving decisions by outcome aims but based on selected impact- assessed priorities
3. Planning process – delivering strategy-focused, options-based business planning, integrating financial/operational elements often for the first time
4. Performance management – evidence based interventions, supported by integrated financial and non-financial performance information, securing real value
It’s clear that as pressure increases on budgets, selecting investments by credibly linking them to outcomes will become ever more vital. Vague statements of aspiration with no evidence of effectiveness have to be things of the past. Critically in the current climate, while top slicing may begin to balance the books, indiscriminate reductions are very likely to impact delivery and ultimately fail to serve the best interests of the UK public.
By agreeing an integrated, strategic approach up front that makes sound investment decisions and maps these to measurable delivery goals, public sector leaders will be able to cut costs while delivering better, more impactful services. They will also be ready to use them in ever more effective ways to improve citizens’ lives when the economy stabilises.
In the wake of a report commissioned by the Government blaming the UK’s business leaders for low levels of staff engagement, employers working within local Government are being warned not to use the recession as an excuse for failing to acknowledge the efforts of their employees over the festive period.
The warning comes as new figures released by the Chartered Management Institute (CMI) show that almost two thirds (64 per cent) of managers in local Government believe that Christmas parties are important in helping to improve employee engagement.
The survey, of 155 managers, found that a similar number (60 per cent) claimed that the office Christmas party is vital to recognise the hard work of staff undertaken throughout the year. A higher proportion of managers in the sector (72 per cent) also believe end of year celebrations should continue in spite of the recession.
Interestingly, the findings also show that managers working in local government recognise the need for responsible reward and celebration. Asked about public perceptions, an alarming three quarters of managers in the sector agreed that an expensive party could damage their organisation’s reputation. The research also discovered that 64 per cent believe that a ‘team lunch is better than an organisation wide party’.
Commenting on the findings, Ruth Spellman, CMI chief executive, says: -There are too many examples showing that the poor quality of management and leadership in the UK lies at the heart of the disengaged workforce. Our research shows that end of year festivities are clearly still of great importance to the local Government workforce but the survey raises an interesting dilemma for UK organisations. How can employers say ‘thank you’ without incurring the wrath of the wider public? The answer is that employee engagement has never been as important as it is now, but it must come hand-in-hand with a tighter grip around the purse strings.
The results show that local government employers are being cautious about the amount being spent on end of year celebrations. Almost three quarters (74 per cent) indicate they are happy for time to be taken for a Christmas party, but will make no financial contribution. This is a massive increase compared to last year when it was only 47 per cent of employers. A mere 19 per cent have agreed to pay up to £40 per head.
With 76 per cent in the sector arguing that a warm approach to Christmas ‘is good for staff morale’ it is clear, from the survey that organisations will be going some way to improve the reported 42 per cent decline in employee engagement caused by the recession – a figure highlighted in CMI’s Economic Outlook Report, published in Autumn 2009.
Ruth Spellman continues: -The benefits to organisations of employee engagement cannot be understated. A truly engaged organisation can expect to experience high levels of staff loyalty, retention, productivity, innovation and profitability as well as low levels of absenteeism. Given the current economic climate these cannot be ignored as they are the stepping stones towards the future, long-term success of the local Government sector.
Responding to the survey, CMI has developed a micro-site providing more information on how employers can better engage with their workforce.
It can be seen at www.managers.org.uk/employeesmatter.
Today, Symantec, the world’s leading software security company, will advise the UK Parliament on the EU’s policy on protecting European governments from large scale cyber attacks against critical infrastructure.
Ilias Chantzos, Symantec’s director of government relations for Europe and Asia Pacific, will appear before a House of Lords committee at 10.30am on Wednesday 9th December to answer peers’ questions on whether European governments are right to fear cyber-attacks and how they can work together to mitigate the risks they pose.
As up to 90 percent of the critical infrastructure on which Europe depends is privately owned and crosses international boundaries, Symantec will counsel that only a co-operative between public and private sectors and Member States can secure the EU from malicious attacks and high impact, low probability -Black Swan events.
Symantec’s evidence will cover: –
How vulnerable the internet is to widespread technical failures and how it will be affected by natural disasters
Whether regulatory intervention is unavoidable to ensure the resilience and stability of the internet, and what this will cost the Internet industry
How concerned we should be about criminally operated -botnets and can the problem be tackled at a European level
Should the military be more involved in ptotecting the internet
Is the European Commission right to encourage public-private partnerships as a means of protecting critical infrastructure
Does ‘market failure’ mean that Europe is inadequately prepared for high impact Black Swan events?
Should Europe be developing its own approach or following the lead of the US?
Is the European Network and Information Security Agency (ENISA) the right body to develop national Computer Emergency Response Teams (CERTs)within EU member states
The National Heritage Debate on 2nd December was hosted by the former Heritage Link- after announcing the new name and introducing a new Chair- Loyd Grossman. The audience represented the wide range of heritage organisations all of whom have benefited from the umbrella of the organisation and its success.
Representatives from the Conservative and Labour parties each claimed the high ground on heritage protection, followed by the Liberal Democrat representative who moved the discussion from museums and monuments to include the heritage environment in its wider sense.
Provocative questions from the floor probed the future of the Heritage Protection Bill- with commitments from both sides to support this; resources for heritage- everything from support for local authorities to VAT issues and how ‘localism’ was going to be supported in the future.
The Rt Hon Margaret Hodge, Minister for Culture and Tourism reminded the audience how much money had been invested by the present administration in policies and projects and the importance of projects targeting the young- such as ‘Find your talent’.
Ed Vaizey, Shadow Minister for Culture, considered the case for (the value of) heritage had already been made but the Treasury was -philistine in its approach and therefore difficult to convince regarding changes to the tax regime. It was up to local authorities, he said to be -smart about resourcing and for heritage organisations to work together.
Richard Younger-Ross, the Lib Dem’s spokesperson on Heritage, wondered how many buildings currently at risk would be lost whilst the new legislation was delayed and that Treasury support for heritage would give a very strong message to the public about its value to daily life. He called for a wider debate at Government level about heritage which might help to resolve the problem of the -fight for funding.
-This event demonstrated the commitment and level of cooperation within the heritage sector itsel said Chris Winter, HTF Director, -but it also illustrated that we have a long way to go to convince policy makers of how much is being achieved on the ground and of the need for demonstrable support from politicians at national and local levels.
-HTF has supported Heritage Link since its creation and we welcomed the new name – ‘The Heritage Alliance’ – and new Chair and look forward to working together in the coming year on the challenges facing the sector.
Matt Howell, Head of Public Services, Technology at Capgemini UK, thinks that many government IT projects are doomed to failure before they even begin, and argues that the problem won’t be solved without a much better approach to procurement.
Another day, another scandal involving a failed government IT project. Yet more blamestorming, recriminations, finger-pointing and hand-wringing. Eye-watering numbers are quoted on the millions of pounds wasted, and on the dire over-runs in timescale and cost. And another batch of ‘told you so’ experts coming out of the woodwork to offer their wise-after-the-event analysis of what went wrong.
That may sound like hyperbole but it is in fact the literal truth as I write this article, having just scanned the morning papers and tuned in to the Today programme. And although such news is, thankfully, not a daily event, it is a story that occurs with depressing frequency.
And in today’s profuse media coverage, one thing is conspicuous by its absence: any well thought-through advice on how such disasters can be avoided. Instead, there is the widespread belief (a) it’s all about over ambition and that we should somehow be less ambitious in government, and (b) somehow it all goes wrong in the design, in the build or in the rollout phase of the project. Both notions are in my view fundamentally wrong. The reality is that many government IT projects are seriously handicapped before the business users and IT providers ever meet.
Why is this so? Simply because the normal template for government procurement is one of rigid compartmentalisation, with the people supplying new IT systems (or hoping to supply them) kept isolated from the people needing and demanding those systems – the business users. In my experience the procurement function too often acts as a barrier between the users – the ones who need new IT and who initiated the procurement exercise – and the providers – the ones seeking to understand and provide what the users really want and need. There have been plenty of examples in recent years when a procurement exercise, lasting months or even years, takes place without anyone from the business and the IT provider getting to speak meaningfully. Instead we often meet one another for the first time on day one of the project. And of course, we find out then that we have different views of what the really important things are.
Of course the motivations of the procurement teams are entirely laudable. It is, after all, their job to ensure fairness, equitability and a level playing field for all the hopefuls seeking to bid for the project (and people like me would be the first to complain if they didn’t!). But the truth is that buying IT needs real dialogue between the business and the provider. As technology becomes richer and its capabilities greater, this is even more the case. The supplier needs to understand what the user really needs, and to explain what is and is not possible, what different options are available, and how they differ in cost, complexity and risk. In return, providers need to understand what is of most value to the business and what the business risks are
Such mutual understanding is an absolute must for the success of any large-scale IT project and should exist on day one of the project. But it doesn’t because in many cases the procurement team – lacking understanding of the users’ real requirements – acts as an imperfect filter and hampers success. Another consequence of this approach is that procurement has become an industry. What should be a simple process becomes multi-stage, lasts years and increasingly involves layers of expensive procurement advisors – who often act as yet another filter between the providers and the business. Everyone wastes time and effort in this process that we should all spend delivering the project.
The upshot is that often, before the project even starts, the business finds that they still own most of the risk and their provider, after months of procurement, still doesn’t fully grasp those risks, and is locked into an inputs-based contract forcing them to focus on the wrong things..
Three simple things would enable us to get more government projects right, and reduce costs:
1. Business Led Procurement
Refocus on what the project is intended to achieve, and what success really looks like. Don’t focus on just the inputs, rather focus on the results the stakeholders (users and customers) really want from the project. Particularly, let the business identify what outcomes they want, and what risks they want to transfer. Also, recognise that the business environment may change, and that some flexibility in scope and price is not a bad thing. Ensure that the business is fully involved in the procurement exercise throughout, and enable and encourage communication between senior business sponsors, users and potential providers. Professional advice from the procurement team will be vital to avoid the pitfalls and provide experience but not at the expense of business and user involvement. Enable the business to procure a delivery partner who will share their risks and focus on their business outcomes. In the private sector, the procurement and business objectives are more closely linked, and this should be the norm in the public sector.
2. Make more time for delivery
Simplify and shorten the procurement process. We need to buy intelligently, but every month spent in procurement could be a month in delivery, helping meet tight deadlines. It should not take as long as it does to procure technology services in government. There have been over 2000 OJEUs and PINs this year, and countless more non OJEU procurements. If we saved 2 months off each, that’s years of delivery time gained. It stands to reason, with immoveable go-live dates, if we save time in procurement, we will miss fewer deadlines! If we can speed up the procurement process, government could buy in smaller packages and create less risk and flexibility – but you can’t do this while it takes 6 months to procure a standard IT service.
3. Share Responsibility
Accept that in any major IT project, success will depend on the efforts of the vendor’s team and of the user community, and their ability to work effectively together. Responsibility for success is shared. Remember this in your procurement approach and you will start on the right footing
Such an approach is almost the norm in the private sector, and has been adopted with good results here and there in the public sector. And if only the collaborative approach could be applied to all government IT procurements, we could see an end to the era of costly and embarrassing scandals.
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