HTN Now: Embedding a benefits framework, creating an engaged and positive project culture at North Cumbria Integrated Care

For our latest HTN Now event, we were joined by members of the NHS England Blueprinting team and North Cumbria Integrated Care. The team provided a detailed overview of the Blueprinting process and explored the challenges and successes of embedding a benefits framework and how digital tools can cultivate a more inclusive shared learning experience at North Cumbria Integrated Care.

Paul Charnley, the Digital Lead for Healthy Wirral Partners and Chair of the National Blueprinting Steering Group, began the presentation with an overview of the blueprinting programme. He explained that Blueprinting was established as part of the Global Digital Exemplar Programme which aimed to demonstrate that effective knowledge sharing and partnering of organisations can accelerate digital transformation.

His slides describe a Blueprint as a ‘step by step guide that can be tailored to local needs. A structured collection of knowledge assets and associated methodology which provides peer to peer learning from digital transformation programmes. A Blueprint also describes digital initiatives to improve safety and quality of care, clinical outcomes and enhance patient and staff experience.’

Paul then outlined the team’s objectives for 2023-2024, stating that “we are looking to extend the catalogue, particularly looking into new areas such as primary care, social care and integrated care systems as they become more mainstream.” Other priorities include developing new shared learning content that engages staff through innovative and interactive channels; creating a sustainable learning eco-system that strengthens opportunities for shared learning. The Blueprinting programme also supports key national agendas such as Green NHS, EPR levelling up and the New Hospitals programme.

Embedding a benefits framework at North Cumbria Integrated Care

Nia-Maria Quinlan, senior project manager at North Cumbria Integrated Care NHS joined the discussion to share the trust’s blueprinting journey and benefits framework.

She explained that “organisations that report high benefits-realisation maturity have significantly better outcomes (92% vs 33%)” according to Project Management Institute (2017).

“We need to challenge what is often a historic financial assumption that short-term cost savings is a good strategy, and instead focus on attaining high benefits realisation maturity; significantly reducing waste and delivering best value for the public money we spend. This will help us achieve long-term financial efficiency.”

The benefits framework 

Nia: “Our work to re-profile the benefits from our RIO implementation highlighted the requirement for a standard benefits process, but also sharing knowledge within the wider programme team. In response, we developed this benefits framework which is: map the benefits, profile and plan, deliver and review. We aligned the steps to the stages that we have for projects in our programme delivery handbook, that provides our managers with an easy guide to where benefits management activities fit in to the programme activities. We aligned our documents to the national benefits templates, which helps reduce the admin burden and eases funding applications.

“We recognised that embedding this new benefits management framework approach could increase project workload, so it was important that we had the full support of the team. To do this, we delivered the training benefits framework, we developed the benefits dependency network for profiling and tracking the benefits. We delivered the training to everyone in the team, from admin to project managers to provide a wide appreciation for the benefits realisation can bring to projects. This meant that all team members could feel confident about contributing to benefits within the projects.” 

Did it work? 

Nia: “In 2021, we undertook a review of the impact of the benefits framework because we have an ethos of continual improvement; we can only keep improving if we know where we’re at. The positives were that the team were much better at understanding the benefits and how to measure them, more skilled at identifying the benefits etc. We could see there was an improved capture of risks and issues and people were using historical information and hazards those stakeholders brought to the team. There was also improved stakeholder engagement and benefits management was applied on large and funded projects.

“In terms of slightly fewer positive results, although the benefits management had improved large and funded projects – there were still projects that didn’t have full benefits management in place. There were instances where, although the benefits had been achieved, they had been miscalculated and over reported. At the root of this, the team felt that the training we delivered was too in-depth and too long for one session. As the team felt less confident, there was limited peer support within the team.”

Achieving the ambition 

Nia then shared one of the team’s central approaches which is ‘take it one bite at a time’ – stating that they “chose to start with refreshing the framework.” They looked at the other benefits frameworks out there and compiled a list of ones to consider, incorporating best practice. At 21:43 in the video, there is a graphic from the NHS Digital Advanced Benefits Training which depicts the Benefits Realisation Management cycle; beginning with the step ‘identify and quantify.’

They piloted a benefits training course with a small group, made tweaks in response to the feedback and added elective booking onto the course, which meant team members could revisit the training as many times as they liked to ensure they were completely confident in every subject. They offer practical one-to-one support when people reach certain parts of the journey, to ensure they feel supported and understand what they need to do when these challenges arise.

“With the new virtual world, we introduced the use of an interactive whiteboard (padlet) which has expanded and there are many others embedded across various teams now. This makes workshops more interactive and inclusive; these virtual tools also help to increase participation from stakeholders who are often miles apart – allowing them to join in just a few minutes rather than making the long journey” Nia explains.

“According to the feedback from our anonymous surveys, we were surprised to see how much people felt their confidence had grown since the new training had been implemented. At an individual level, we didn’t have anyone who reported that they didn’t gain anything during the refreshed training course. We then did a sixth month review, asking people how they applied the new problem statement model. Those who had used it were very positive about its effectiveness – we could see that people had really improved since adhering the benefits framework. Based on the success of this, we are going to be delivering more in house training based on bitesize courses, with all of the team being invited to share what they can provide with the training; spreading that pool of knowledge and creating more of hive mind.”

Continued impact 

Nia: “The biggest impact for us has been enabling all stakeholders to work together and crafting a joint story they all believe in and that they are inspired to collaborate on. The problem statement and how apply it is at the root of that; it has transformed our collaborative service delivery. We recognise that securing input from stakeholders is a daunting task, but moving away from the initial previous project engagement model, we’ve enabled a productive and inclusive virtual workshop to happen and there is increasingly positive feedback and interest from that.

“The new model focusses on the customer (our clinical teams) and it enables them to tell their story in their own language; it brings positivity and encourages discussions with our support services who input on how they can help deliver what the clinical teams are looking for. It did take some time to make these changes and going forward we will be updating the Blueprint to reflect this.”