Embarking on full-scale change in organisations is hard, and advocates for new approaches, shifting mindsets and learning new ways of working. On their journey to design a 21st-century organisation, The Union recognises that a united culture is integral to seamless health and social care services.

Working in multidisciplinary teams of staff from across the organisation, we’ve been looking at three areas of change, strategic principles, commissioning and contracts and data and insights, to help The Union set the standard for the future of decision making, culture, technology and organisational design.

We’ve recently completed our prototyping phase to understand behaviours, relationships and ways of working. Addressing organisations in this design-led approach to change allows us to collaborate on culture change from both the top and bottom, beginning the journey to one unified organisation.

Prototyping three opportunity areas

Working in three teams with people from across The Union, we looked at each area of change to begin prototyping solutions that will help us build a 21st-century approach to seamless health and social care. Bringing together a multidisciplinary team, based around skills and attitudes over seniority, we worked with teams in an agile way, guiding them through a design process, from ideation to prototyping and testing.

Focusing on tangible problems and projects, we worked from the top-down and bottom-up, testing principles and priorities and scope of what The Union does.

Working from the top and the bottom to understand the current culture

We were able to learn about the culture and ways of working that would help shape The Union’s new operating model. From getting people comfortable with asking questions rather than having answers, to protecting time to focus on work of strategic significance and being open, to iterating and improving on their work as they learn more, we’ve been able to support a shift in mindset that lays the groundwork for the next phase.

Aligning principles

A lack of consistent and well-communicated priorities makes it hard for teams to resource and deliver effective and collaborative work. The strategic principles team focused on understanding how a set of coherent priorities might impact a team’s ability to work.

Developing and testing a set of principles, including prioritising data and insight-led decisions, self-empowerment and adapting services through continuous feedback amongst others, helped uncover what types of work should sit within The Union. By being clear about what is strategically significant, teams can operate with greater autonomy, knowing that their work is aligned to what matters most for The Union.

We learned that principles don’t always apply to the business as usual work. The Union’s focus should be transformational, but principles alone don’t tell you if something is transformational. They do help define and assess where our focus should be and when aligned to a clear delivery and resourcing model, are helpful in deciding what work The Union handles and what sits within the individual, the council or CCG.

Data alone is not enough

Inconsistent access to data makes it harder for insight-led decision making and commissioning. To find opportunities for improvement, the data and insights team looked at developing prototypes that would help us explore how we use data to create insights.

Currently, ‘insight-led decision making’ is not a valued part of the decision-making process in The Union. The guidelines for data are often interpreted as rules, restricting parameters for potential decisions and while data is available, it’s mostly quantitative. It’s not yet been centralised, analysed or turned into presentable information that would provide real insight.

For The Union, it isn’t only a matter of gathering data, something that can be common across the public sector. Rather, their challenge lies in giving decision-makers the tools, support or permissions to make the most appropriate decisions. The insight we need will only come with clearer processes around data capture, more balanced qualitative and quantitative data and improved methods of presentation.

Building collaborative relationships

Every organisation has its own objectives, risks and opportunities. The things they need to get done. Where we have two organisations working together as one, this line gets blurred. Separate objectives, risks and opportunities become a shared one.

Yet, a lack of contract visibility and collaboration across both the council and the CCG is causing tension across The Union. Visibility isn’t only about what we can see on paper, but understanding the objectives and obstacles other teams face. Commissioners want to better understand what’s available in communities and providers want to be sure their teams can deliver to changing citizen needs.

Looking beyond formal contracts, the relational contract we form with our colleagues and partners is a tool that supports the sustainable, long-term connection. If we improve communication between commissioner and provider, we can build a more collaborative relationship and improve the delivery of services.

Overcoming cultural challenges

Prototyping and testing with people from across two organisations, many of whom had never met or worked together, comes with its own unique challenges. These prototypes provided us with a lot of learning about specific practices, while also laying the foundation for shifting mindsets and learning new ways of working.

The team in an ideation session for ideas around contracts and commissioning

Embarking on full-scale change will require staff to shift their diaries, time and focus beyond just this project to changing the ways the entire organisation works. While prototyping through priority areas, people are already aligning and shifting to an open culture that values new ways of working and a willingness to learn and the collaboration is displaying the characteristics of the type of people who may work in The Union.

The next step is for everything we’ve learned in prototyping to be pulled closer together, and into a live service environment. This means setting up a team to work in these new ways full time, collaborating using different tools and with a different model of executive leadership to give direction to the work. It means everything will feel real very quickly, but we’re excited to continue the journey together and to keep learning about what helps The Union be a truly 21st-century organisation.

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