With a good plan, everyone knows what to do

by Rob Findlay

Why don’t things turn out like the annual plan predicted? Is it because demand is too variable? Operational hiccups too unpredictable? Or is it a problem with the plan itself?

Let’s take a closer look at that plan, and sniff out any heroic assumptions that an experienced operational manager might take with a pinch of salt. Things like:

  • assuming zero growth in demand because any more is unaffordable;
  • applying similar activity increases across all services;
  • squeezing lengths of stay to fit an external benchmark or predetermined bed total;
  • assuming 18 week waits will be fine without actually calculating them;
  • assuming waiting lists will remain static, even if they’ve been growing or shrinking;
  • ignoring the link between outpatient activity and elective demand;
  • a last-minute settlement that works backwards from a financial total.

That’s quite a list. Recognise any?

The thing is, if operational managers don’t believe in the plan then they’ll fall back on their own resources. By default, that means working within the capacity and staff they already have available, and responding to pressure and variation as it happens. In other words, not following the plan. No wonder the plan ends up being a poor guide to the future.

Yet the plan lives on. Money is based on it (even if activity isn’t), and at corporate level people are comparing it with outturn. Eventually, what the operational managers are doing comes into conflict with the plan. So they end up in those absurd meetings, where the first half is about laying on extra activity to clear the backlog, and the second half is about slowing down activity because the money is running out.

There is only one solution to this problem, and that is to build a plan that passes muster with operational managers and actually gets implemented. Everyone agrees this is the right thing to do, and everyone tries to do it, every year. But (as we have seen) most struggle in practice.

So here are some things that would increase the chances of success: The assumptions must be made as simple as possible, but no simpler. The calculations must be so credible that (after initial evaluation) they can be taken on trust. Scenarios must be easy to generate and evaluate. Outputs must be easy to interpret. Collaboration must be continuous and genuine, which means operational managers must be able to use the model themselves so there is no bottleneck through a busy analyst.

If that sounds like a tall order, relax. It’s what Gooroo Planner does. Drop us an email and we’ll come and show you: info@gooroo.co.uk

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