We work with many NHS organisations which need to deliver transformational programmes, e.g.: Sustainable and Transformation Programmes (STP) or Cost Improvement Programmes (CIP).
STPs will help drive a genuine and sustainable transformation in health and care outcomes between 2016 and 2021.
CIP is the identification of schemes to increase efficiency or reduce expenditure. CIPs can include both recurrent (year on year) and non-recurrent (one-off) savings, increased efficiency and reduced expenditure.
The key word here is programme. Programmes are not projects and they require people, technology and processes that are appropriate to manage and govern programmes. Some project managers do not have the experience of managing a large, cross-departmental programme with different sets of stakeholders. Project processes are also inadequate to manage programmes.
Where many NHS organisations do recognise the need for specialist programme managers and programme processes, there are still ones that want to rely on tools like Excel and MS Project to manage these multi-million pound initiatives.
There can be some reluctance to spend money on PMO and programme tools when budgets are tight. This is understandable but the potential prize of these programmes means that a late delivery or a missed outcome will far exceed the cost of a programme management tool.
Tools like Excel and MS Project are, in my opinion, although you may say I am biased, not ideally suited to manage NHS transformational programmes.
I’ve set out below some of the key reasons why you need a programme tool to manage programmes.
The Programme Director cannot understand everything about all the projects in his or her programme. If he/she attempts to do this then they will either have a nervous breakdown or miss the really big issues that need to be addressed to keep the Programme on track to deliver its outcomes. Let’s look at an example.
A Programme Director will want to review a programme risk register at weekly intervals. Each project manager will also be reviewing his or her project risk register. For a sizeable programme there may be hundreds of risks in these registers. The Programme Director should not be reviewing every risk in every underlying project.
What he/she should be doing is reviewing the risks that are programme risks, i.e. the ones that, if they become issues, would have a wider impact on the programme as opposed to a project risk where the impact is contained in its project. There are no hard and fast rules on what is a project risk and a programme risk but the real point is that the Programme Director should be focusing on a sub-set of the risks rather than every risk.
This is an example of where the Programme or PMO tool you use should be able to have a programme risk view and a project risk view. To do this it needs a facility where risks and issues can be escalated to the Programme Manager or Director.
The project manager is, however, still accountable for these risks and issues. This principle of seeing the big picture also applies to milestones and plans. The programme manager needs to see the overall plan as a set of milestones and key tasks. He or she also needs the capability of drilling down into more detail if required. The tool must be capable of seeing the high-level plan that is driven from more detailed project plans.
In our tool, PM3, there is a facility to promote or escalate risks, issues and milestones higher up the work breakdown structure hierarchy. This ensures that the key information that the Programme Director needs to focus on is easily accessible and visible.
This helps to sift the wheat from the chaff. Without this facility it is difficult for the Programme Director to focus on what he or she really needs to focus on. Without this facility of promotion or escalation, there is the danger that really important programme information, that needs to be acted upon, is lost in the mass of detail in a project tool or Excel.
It is easy to copy excel sheets and create multiple copies of project information. What you really want is a tool that keeps all the information: plans, risks, issues, finances, etc. in one place with the correct versions.
As a Programme manager I do not want to have to open multiple project plans or excel charts to see my programme and its constituent projects.
The danger of accessing the wrong project plan or old excel sheet can be high. Having one version of the truth, i.e.: all plans in a single integrated tool, is a huge benefit and helps you to identify problem areas of your programme more quickly.
In our tool, PM3, you can easily attach a new project to a programme (this takes seconds) and this will, for example, automatically add up the project finances into the programme and enable you to see project information as part of your new programme. You cannot really do this easily with Excel and Project.
A programme is likely to have a number of inter-dependencies between milestones and/ or tasks in projects within the programme and also between projects in the programme and ones outside the programme.
These inter-dependencies need to be carefully managed by the Programme Manager as problems with dependencies, e.g. dependent milestones that get delayed, are the ones that tend to come as a surprise and cause delay and cost to the programme.
Your programme tool needs to be capable of showing inter and intra-project dependencies and automatically highlight any problems with these dependencies. NHS Transormation prorgrammes by their very nature have a lot of inter and intra dependencies.
A tool like PM3 will contain sets of reports at project, programme and the portfolio level. Adding a project to a programme takes 45 seconds in PM3 and then you have access to a myriad of reports at the programme level that will now contain the new project.
Excel is a brilliant reporting tool in that it can produce really high quality reports but it is a manually intensive job to do this and the danger of error is high.
A CIP or an STP Programme will consume a lot of resources (people and money) and deliver critical outcomes for the NHS. A Programme has more ‘moving parts’ than a project and therefore the risk of non-delivery or late delivery is higher.
The earlier a programme manager or sponsor can intervene in a programme to bring it back on track the less costly the over-run is likely to be and the earlier realisation of the benefits. To be able to intervene, you need to know that there is a problem and you have to intervene. A tool like PM3 will alert the programme or project manager that a milestone has been missed or a key action is overdue.
This type of alert can help the programme manager in intervening as early as possible to bring the project and programme back on track.
Even without this type of alert, the ability for a programme manager to drill down into lower levels of detail within a tool like PM3 will help the programme manager intervene early rather than at a point when it is obvious to all that there is a problem.
When it’s obvious to everyone, it usually means that intervention should have happened long before and the cost of later intervention can be very high indeed.
So, when you embark on an NHS transformational programme, e.g. CIP or STP, ensure that you are using a programme/ PMO tool to help you.
Using Excel and MS Project because they are relatively cheap is a false economy. A tool that does not have the ability of summarising and escalating information up the programme hierarchy is a tool that is not fit for purpose.
A transformational programme is too important to fail so ensure you are using the right toolset as well as the right people and processes.
Remember the old adage from Abraham Maslow:
“I suppose it is tempting, if the only tool you have is a hammer, to treat everything as if it were a nail.”
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