Yesterday, I presented at #Leanconf 2013 in Manchester. It was the first Lean Conference covering Lean Startup in Europe. There was a great energy to the 2-day event with a variety of planned and unplanned talks plus lots of opportunity to network without the usual tradeshow conference feeling of being stalked by sales managers.
I don’t think I’ve seen a community spirit like that in a long time; every attendees helped someone else no matter how far along their own ideas were.
In the spirit of the energy that I encountered at the conference, I’ve placed the slides on slideshare. If you download the presentation, you can read the notes which will help you make more sense of the slides. Hopefully the video will be online as well soon. When it is available, I’ll update and post a link to it. The slides are at bottom of this article.
Background to the Programme
The programme I discussed in the presentation was a 2+year programme with a large city council in England. The programme was internal to the portfolio that handled Adult Social Care. It had a £1m+ budget with a team ranging from programme manager, business analysts, data analysts and communications officer, plus a governance structure and other associated stakeholders.
The aim was to make Adult Social Care more efficient, by removing waste, focussing on flow and reorganising around the value to the customer. All typical lean concepts. We did this with a mixed method that I’d developed specifically for this client. The method merged elements of Lean with Lean Startup with DSDM and Theory of Constraints, all under a typical local authority governance framework using Prince 2.
The scale of change was to alter the way of working of 200-300 social workers/care managers, their team managers, their business support plus associated teams. Most were involved in the change and took the opportunity to steer the change in ways that would benefit their service users. Additionally partner teams (e.g. those responsible for 1000+ support workers within the council, NHS staff, payments and contact centre staff) were brought into the process and contributed to the changes where possible.
Customer Development in Social Care
Due to the time available for the talk, I didn’t discuss Customer Development. I’d like to address that here. Firstly, my customers and those of the programme, were the workers on the frontline of social care. However, we also had a duty to their customers, i.e. the service users of the city and, wider still, the overall population of the city.
We used common Lean and Six Sigma techniques (e.g. Kaizenblitz, Voice of the Customer, Gemba plus interviews, workshops, etc) for understanding the wishes and activities of the frontline workers. The default position was always to go and visit the workers where they worked including a visit out to service users where possible and where permitted. There was no “ivory tower” mentality and as little desk-based research as possible.
I did want to get to the wishes of the end user, i.e. getting the answers to what mattered to the service users. We were able to do this through a service user forum and similar activities. Just to clarify, the forum is actually a real meeting, not an online forum. However the typical customer-development approach of “get out of the building” isn’t necessarily a good idea in this case. The reason is that any change has to be ethically sound; it can’t introduce discrimination nor can experiments (or MVPs from Lean Startup) that make the situation worse for those on that trial path.
The ethical dilemma is exacerbated further when you consider the concept of equitability in that any change has to be able to be applied to the entire population of service users if appropriate to them. So if you make a change to services in October, you’d better think about how you’re retrospectively going to apply those changes to service users referred back in April onwards. That could be as simple as a rule stating that they’d change at the next review point or it could be a specific project to apply it now.
A good example of the fundamental ethical issue can be found in the simple concept of asking customers “what can we do to improve?”
I love that question; it encapsulates the whole point of speaking to customers about what they want without biasing them towards a particular solution. It usually turns any negatives about current experiences into positive actions for change.
However, frontline staff wouldn’t want to ask that question of their service users in all circumstances, e.g. those with a current likelihood of being violent, those recently bereaved or in any situation where the service user or social worker is likely to come to harm. That means that the results from a survey of such a basic question would already be biased.
Similar nuances were found in almost every typical method for achieving customer development, whether phone surveys, online questionnaires, paper-questionnaires, focus-groups, questions tagged onto the end of a visit, etc.
Now, as mentioned in the slides, greenfield opportunities such as those found in newly-commissioned projects whether within local authorities or within NHS CCGs (Client Commissioning Groups) are ripe for Lean Startup and may benefit from a more thorough application of Customer Development.
What Messages Can you Take Away from the Presentation?
- That you can successfully apply Lean Startup in the public sector
- That if you can do it in local authority (which is about the worst-case scenario for successful implementations), then it should be implementable in other large, existing organisations, whether private or public.
- That you may not benefit from applying all of Lean Startup; the corollary is true in that you can benefit from using some elements of Lean Startup. It depends on what you are trying to accomplish.
- That the behaviour of staff (inherited from the culture of the organisation) will likely be your biggest obstacle.
I’d like to hear your comments, so leave a comment below or contact me