Targets: Survive or

Thrive? Do they help

or do they hinder?

Helen Bevan @HelenBevan

#APACForum All views are my own

@HelenBevan #APACForum

The issues and challenges are well documented….

“The existence of a target may change the behaviour of service providers in ways that

have unexpected and unwanted side effects. There may be scope for

manipulation or gaming”

2010

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…and the consequences may be devastating

“Managers at Mid Staffordshire NHS Foundation Trust, where hundreds of patients died amid appalling conditions,

were so focused on hitting financial and waiting time targets that they forgot why they were there”

Norman Williams, President, Royal College of Surgeons

@HelenBevan #APACForum

Why were performance targets introduced?

• Public institutions were unwieldy, inefficient, with limited accountability

• Measures that did exist were mostly ad hoc and unsystematic

• Reformers had virtuous intentions

• Measurement based on specific quantified targets is easier than the alternatives

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Would this be the case without a performance focus?

@HelenBevan #APACForum

Would this be the case without a performance focus?

@HelenBevan #APACForum

Compliance

States a minimum standard of

performance or target that

everyone must achieve

Uses hierarchy, performance

management systems and

standardised procedures for co-

ordination and control

Threat of penalties/ sanctions/

shame creates momentum for

delivery

Focus on transaction

Commitment

States a collective, meaningful

goal that everyone can aspire to

Based on shared purpose and

shared goals (“us and us” rather

than “us and them”) for co-

ordination and control

Commitment to a common

purpose creates energy for

delivery

Focus on relationship

How are we leading?

Source: Helen Bevan

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Leaders who focus on meaning also

get compliance, without focusing on it

@JeremyScrivens

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As leaders, we are “signal generators”

“As a leader, think of yourself as a “signal generator” whose words and actions are constantly being scrutinised and interpreted, especially by those below you” [in the hierarchy]

“Signal generators reduce uncertainty and ambiguity about what is important and how to act”

Charles O’Reilly,

Leaders in Difficult Times

Source of image: vintage-radio.com

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Avoiding “de facto” purpose

• What leaders pay attention to matters to staff, and consequently staff pay attention to that too

• Shared purpose can easily be displaced by a “de facto” purpose:

hitting a target

reducing costs

reducing length of stay

eliminating waste

completing activities within a timescale

complying with an inspection regime

• If purpose isn’t explicit and shared, then it is very easy for something else to become a de facto purpose in the minds of the workforce

Source: Delivering Public Services That Work: The Vanguard Method in the Public Sector

@HelenBevan #APACForum @SimonJGuilfoyle Police Inspector and systems thinker

@HelenBevan #APACForum @SimonJGuilfoyle Police Inspector and systems thinker

@HelenBevan #APACForum

Police

@SimonJGuilfoyle Police Inspector and systems thinker

@HelenBevan #APACForum

Education

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Healthcare

@SimonJGuilfoyle Police Inspector and systems thinker

@HelenBevan #APACForum

What I see when I see targets working

1. The numerical goals are meaningful (intrinsic motivation)

2. Linked with shared purpose, not de facto purpose 3. An investment in measurement capability 4. The right performance indicators are selected in the

first place 5. Understanding of naturally occurring variation

within the performance data produced 6. Measurement for improvement, not just judgement 7. A wider systematic approach to measurement and change where metrics are aligned

Source of image: salesshq.monster.com

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....the last era of management was about how much performance we could extract from people

.....the next is all about how much humanity we can inspire

Dov Seidman

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References

Bevan G, Hood C (2006) What's measured is what matters: targets and gaming in the English public healthcare system, Public Administration 2006; 84(3):517-538

Guilfoyle S (2012) On Target?—Public sector performance management: recurrent themes, consequences and questions, Policing 6 (3): 250-260

Daily Telegraph (2014) Target culture that led to Mid Staffs still exists in NHS claims top surgeon http://www.telegraph.co.uk/health/healthnews/9824256/Target-culture-that-led-to-Mid-Staffs-still-exists-in-NHS-claims-top-surgeon.html

O’Reily C (2009) Leaders in difficult times http://www.slideshare.net/slidesharej/what-is-the-difference-between-leadership-and-management

Vanguard (2010) Delivering Public Services That Work: The Vanguard Method in the Public Sector http://www.triarchypress.net/delivering-pub-ser-vol-1.html