Are “Lean” DFGs a Realistic Approach to Delivering Government Objectives? Sarah Cambridge MA research project - summary of findings

Objectives of research To establish a clear picture of current DFG process from assessment of need to completion of works (simple) To identify “value” in the process To identify “blocks/failure” within process Develop proposals for change and streamline service delivery

Lean Thinking Method 1.Studying customer demand from the customer perspective 2.Distinguishing between “value” and “failure” work 3.Understanding whether demand is predictable or not 4.Redesign services against customer demand 5.Change the system Ref: Seddon, J. (2005) Freedom from Command and Control. Buckingham: Vanguard Education Ltd.

Lean Principles Design systems based on an understanding of customer demand Making the right decisions first time, early in the process - no waste correcting errors Doing work fast and once only Having the “experts” as first point of contact No “batching and queuing” of work The person on the spot is responsible for their own work

Methodology 1.Extensive literature search 2.Process mapping 6 cases - assessment of need to completion of works (3 owner occupier, 3 social housing) Interviews with: grants officers in three different Districts/Boroughs with OT staff who completed the assessments Staff identification of value/blocks

Methodology cont 3.Dates converted into numbers of days between events – recorded on process maps 4.Event timescales collated by case into comparison table 5.“value” and “blocks” – collated – by District/Borough

Timescales Summary Timescales: OT/As consistently complete recommendations within 30 days of allocation Grants officer intervention varies from 24 days to 539 days

“Value” summary OT/As and Grants officers within the District/Borough with the fastest completion time identified a long list of “value” tasks OT/As and Grants officers within the District/Borough with the longest completion time identified a short list of “value” tasks

“Value” examples Excellent relationships/communication between OT/A and Grants officer Grants officers do not routinely require scale drawings Use of standard recommendations/design briefs Grants officers complete applications with customer Streamlined paper processes/minimal bureaucracy

“Blocks” summary OT/As and Grants officers within the District/Borough with the fastest completion time identified a very short list of “blocks”/”failure” tasks OT/As and Grants officers within the District/Borough with the longest completion time identified a long list of “blocks”/”failure” tasks

“Blocks/failure” examples Audit requirements - delay process HIA staffing resources – availability effects speed of service Lack of customer understanding of what adaptation will look like “for real” Customer not understanding constraints within process Process too slow to support rapidly changing needs

Key Recommendations Occupational Therapy Service Ensure standard recommendations/design briefs used (Ensure all information required is included in recommendation letter to support prioritisation by Grants officers) Routine use of photographs of completed adaptations in domestic settings Routine closure of simple DFGs on Functional Assessment papers

Key Recommendations Grants officers Grants officers complete applications with customers on first visit Grants officers able to verify financial information – copies not required Agreed schedule of rates for “simple” adaptations Increased admin. support to speed up processing – prevent “batching/queuing” of work