With the recent announcement from the BBC that the NHS’s major complex projects management and procurement support force – the Strategic Project Team (SPT) – will be “closed down”, questions are now being asked and lessons must be learned in order to make the best of such a situation. The BBC piece talked at length about all the high-profile projects the SPT had been involved with that has failed since its inception in 2009.
The SPT themselves seem to have been caught unawares, as a tweet on their Twitter feed on 22 July indicated: “Thanks for the concern and support after the unexpected announcement to the BBC. Business as (un)usual as ever. Current service unaffected!”
Our article take more of a bird’s-eye view of the history of this team, and what it means for the NHS now that it will no longer be there to guide its multi-billion pound project portfolio.
What is the Strategic Projects Team and what does it do?
This award winning support team was created by the East of England Strategic Health Authority in 2009 and now sits under the control of the Arden & Greater East Midlands Commissioning Support Unit (CSU). It consists of a twenty-strong team of professionals from a wide variety of specialist backgrounds and, according to their website, they have delivered on over £6bn worth of projects. It was created to “support the commercial, cultural change and engagement that will ensure an NHS fit for the future”, and the team specialises in:
Re-design of patient pathways
Service reconfiguration and integration
Trust development and culture change
Patient experience, feedback and customer service development
Stakeholder engagement, communications and marketing
The BBC article’s listed issues with the Strategic Project Team
July’s article on the BBC website focussed on the two largest projects that the SPT had been a part of – the Hitchingbrooke Hospital franchise and UnitingCare – but is also cited other contributors to the problems the SPT faced: procurement process not pursued on the George Elliot Hospital project, the deal between Weston Hospital and neighbouring Taunton and Somerset NHS Foundation Trust abandoned due to unsustainability, the intention of Cambridge University Hospital NHS Foundation Trust to withdraw from The Pathology Partnership, and more.
Hitchingbrooke Hospital was to be the “first ever franchise of an NHS hospital”, and it was the SPT’s first major project. But when the private provider Circle Health announced that, just three years into their ten-year contract they were withdrawing, questions started to be asked.
UnitingCare was an £800m project to deliver healthcare for the elderly in Cambridgeshire, but just eight months in the scheme “collapsed”
Was the SPT an ICF Team?
With its mix of skilled professionals and its role in offering project and procurement management on major projects, the SPT sounds very similar to the Intelligent Client Function (ICF) teams that we have been advocating for many years. To ensure that a large public sector project is run at its most efficient, it requires a consistency of administration and relationship management that just is not employed in a traditional, compartmentalised project management structure. Such structures rely on independent teams passing the baton of responsibility as one portion of a project finishes and another begins, and their success is largely dependent on the quality of the teams’ process documentation and handover strategy. However, having an overarching team understanding both the technical and operational elements of the project from inception to implementation means a pool of knowledge is developed that can help bind the parties together to ensure that the highest levels of productivity are achieved, risks are averted and projects are realigned where necessary to achieve the best outcomes.
For the NHS to put together an ICF-like team to manage and support projects across the institution is certainly commendable. It appears from the media reports, though, that there may have been some skill gaps or capacity weaknesses if the SPT indeed contributed to the alleged issues within the projects highlighted by the BBC; as we were not involved in any of their projects, we can only speculate.
While the SPT seems to have some of the features of an ICF team there is one area where it seems they deviated from the ideals of intelligent client function – the need for outsourcing relationships to be managed in an adaptive style. It is imperative that on any project there is some “give”, where contracts, processes and even outcomes can be adapted to the changing world around them. Sticking to a plan simply because it’s “the plan”, formulated at the outset of the relationship, can be a short-sighted approach that could see a project deviating further and further from the needs of the end user.
However, the BBC article reported on quotes from those that had worked with the SPT about “their total refusal to acknowledge reality” and complaints that they had “stuck doggedly to rules”.
To make sure that your projects do not follow suit, it is important to include in your contractual agreements a commitment to meet at least once every six months with your provider’s counterparts to evaluate if and how the project should be adapted to achieve, or surpass, its stated goals.
How will the NHS cope now that the SPT is to be closed? Those who agree with the findings of the BBC report might consider that the NHS will do better on its own, but remains unclear whether the SPT were to blame or whether they were just unfortunate enough to work on a number of ill-fated projects, the demise of which had little or nothing to do with them. We would suggest that a refined version of the SPT would be the best thing for major NHS projects: a central resource for them to call upon for project, procurement and relationship management; a team that can oversee any outsourcing partnership, offer best advice and continue to learn and adapt, to develop best practices and procedures to improve efficiencies year on year, project on project.