Editors' notes

The Productives Team values feedback and is continuously seeking to improve its programmes.

Below are notes on the Productive Community Services modules that will make implementation easier and keep you up to date with the latest Productive Community Services developments.

They are based on further development and learning from testing of Productive Community Services and those implementing the modules in NHS England and around the world. 

The notes are split by module and are continually updated. Please keep checking periodically for new notes.

Click on the module / guide below to take you directly to the module you are currently working on.



Executive Leader’s Guide - no notes
Programme Leader’s Guide – 3 notes
Strategic Positioning Guide – no notes
Technology Guide – no notes
Team Leader’s Guide – 1 note
Patient Perspective – 3 notes
Toolkit – 1 note
Well Organised Working Environment – 3 notes
Knowing How We Are Doing – 1 note
Patient Status at a Glance – 3 notes
Managing Caseload and Staffing – 7 notes
Planning Our Workload – 1 note
Working Better with Our Key Care Partners – 1 note
Agreeing the Care Plan with the Patient – 2 notes
Standard Care Procedures – 2 notes
Perfect Intervention – 1 note
Executive Leader's Guide

No notes
Programme Leader’s Guide
1.    Module page number 10, task 1 (amended April 2010)

Description of the Productive Community Services house and modules. The Standard Care Procedures module should now be completed before the Agreeing the Care Plan with the Patient module. See Editor’s Notes on either module for more information.

2.    Module page number 29, task 12 (amended April 2010)

The cost calculation table in step 2 states that 1/8th of the cost of a programme facilitator should be factored into the cost of implementation per team in your organisation.

This wrongly assumes that the programme facilitator stays with a team throughout implementation. The result the overall cost figure is wrong. In some cases the error can be great and overestimate the cost of roll out by a long way.

A programme facilitator, if using the model described in the PLG, only stays with a team for a short period at the start of a team’s implementation. For example four months (16 weeks – see PLG page 43). After this, the facilitator moves onto the next team. In this case a facilitator could support three cohorts (waves) in one year, not one as suggested by the 1/8th figure (8 teams per cohort).

To make the costs more representative, use a figure of 1/16 of a facilitator cost instead of 1/8th.  This represents a facilitator supporting three cohorts of 8 teams in one year – for 16 weeks per cohort.

3.    Module page number 66, task 34 (amended April 2010)

The Module Impact Summary Sheet structure (MISS) for identifying, documenting and quantifying impact has now been superseded by the Module Impact Framework (MIF).

The MIF is a more robust and easy to use framework that is web based. It still used the MISS structure as data collection but has more comprehensive data analysis to ensure you and your organisation can demonstrate the impact of your implementation. All Productives use this same structure. Allowing a more organisational and regional view of implementation. 

Click here for the MIF and guidance.

Strategic Positioning

No notes

Technology

No notes
Team Leader’s Guide
1.    Relating to the mention of module ‘Strategic Positioning’ (amended April 2010)

There is a general tendency by organisations implementing PCS to skip this module. The PCS team strongly recommends this does not happen. Without exception those organisations that have put time aside to do this have said it is extremely worthwhile.

Organisations that have skipped this have commented that they ended up with a slower implementation because the organisation and departments were not aligned around the programme – the programme ended up being a nice to have, not the way they would do business.

When starting to implement PCS the tortoise always wins. Those organisations that put time and effort into strategically aligning PCS and not rushing into PCS on the ground implementation always end up with the stronger and more sustainable implementation.
Patient Perspective
1.    V1 of the module has now been updated with V2. Only minor changes so no need to request new version. (amended April 2010)

2.    Module page number 31, task 1 (amended April 2010)
The New Perspective Exercise film is now available to download from the web address specified in the module.

3.    We have found that some teams implementing PCS are either skipping or not using this module effectively. If this is done there is a danger of missing patient perspective considerations when designing the new ways of working in the other modules. This module impacts every module.

As team, make sure you are comfortable with the content and how this module works BEFORE embarking on your first module - as stated in the Programme Leader's Guide . If you are unsure of anything please contact your programme leader for help. (amended April 2010)
Toolkit
1.    Module page number 45, tool 9 round 2a (amended April 2010)

5S Game. The diagram depicting ‘the secret’ is not as clear as it could be.

The ‘secret’ sequence the numbers follow is bottom left, middle left, top left, bottom middle, centre, top middle, bottom right, middle right and top right. The next number is then back in bottom left and the sequence re-starts.
Well Organised Working Environment
1.    Module page number 38 (amended April 2010)

Inventory (stock) sheet. This must not be missed as it is vital to demonstrate impact. You need a ‘before’ inventory value from this exercise.

2.    Module page number 36, 61 (amended April 2010)

Spaghetti Diagrams. This must not be missed. Ensure you make a note of the number of steps used in collecting items / using the area before you make any changes. It is also a good idea to take a time reading for how long it takes to use the area.

3.    Module page number 78 (amended April 2010)

Recalculating inventory, steps (inventory sheet) and time reading. Ensure this is carried out otherwise you will not be able to prove you the changes you have made have had any benefit. We have found some teams skip this stage.

Enter your results (‘before’ and ‘after’) from these three areas into the Module Impact Framework (MIF).

 If you do not know what the MIF is then contact your programme leader. It is vital you use the MIF.
Knowing How We Are Doing
1.    Knowing How We Are Doing tools and the Module Impact Framework (MIF)? (amended April 2010)

In some cases the Knowing How We Are Doing tools and the MIF are getting confused. Some teams are asking which they do? The answer is both.

Knowing How We Are Doing is aimed your team using balanced measures (on staff wellbeing, patient safety and reliability of care, patient experience and productivity) to plot and guide your team’s journey to achieving your goals and vision.

The Module Impact Framework helps you demonstrate the impact of individual modules. The two complement each other.
Patient Status at a Glance
1.    Module page number ‘Prepare and Assess’ (amended April 2010)

We have found some teams are skipping the specified data collection detailed in Prepare and Assess. At an absolute minimum you should have data the following before moving onto Plan;
•    length of handover meetings
•    no. Interruptions
•    meeting reliability score

2.    Module page numbers 92 – 94 (amended April 2010)

We have found some teams are skipping the data collection in the Evaluate section of the module. This data is vital to demonstrate impact and the value of your hard work. Again, the minimum that should be collected is:
•    length of handover meetings
•    no. Interruptions
•    meeting reliability score

This, along with the data you collected in Prepare / Assess, will give you great before and after data to demonstrate the impact of your hard work.

3.    Module page number 92 – 95 (amended April 2010)

Since this module was printed, the Module Impact Framework (MIF) has been created to help demonstrate impact. Ensure you enter the impact data you have collected (‘before’ and ‘after’) into the MIF.
Managing Caseload and Staffing
1.    The majority of the tables and charts that you are writing on and using in the module, when looking at last year’s data,  are formatted Jan – Dec. If you are starting this exercise in May for example, then change the formatting (cross out the label and write in a new label) to April – Mar. Adjust to suit when you are starting the module. (amended April 2010)
2.    Module page number 22 (amended April 2010)
Total holiday hours your team are allocated. This should include bank holidays.
3.    Module page number 30 – 31 (amended April 2010)
Patient Facing Time Summary Sheet. This sheet has space to summarise 90 Patient Facing Time Audit Sheets. You do not need the full 90 (although the more you have the better as it makes your results more accurate). Just fill in the number of Patient Facing Time Audit Sheets you have.
4.    Module page number 38 (amended April 2010)
Waterfall diagram. Some organisations have queried how the waterfall diagram is constructed. Especially around the last section. Working out actual patient facing time and ‘admin / other’ time as a proportion of total available working time (column 3rd from right).

The query is if patient facing time is 39% (from your Patient Facing Time Summary Sheet) why does it work out smaller in the waterfall diagram?

The answer is in the fact that in the waterfall diagram we are starting from the total contracted hours your team starts with. This is not the same starting place we calculate patient facing time audit figure from. We calculate patient facing audit figure using an audit of staff at work.

By the very essence of the fact that to be audited to get a patient facing time figure means the staff member has to be at work. If this we took this number to represent the patient facing time for every day of the year it would be an artificially high number. The staff member would not have this same figure every day as they will be at some point at training, holiday or perhaps sick.

So in the waterfall to take this into account we take the audit patient facing time figure and multiply it down so that it is taken as a proportion of contracted hours (remember to be audited they have to be at work so it is assuming the staff member is at work 100% of the time) and not the actual time at work hours figure.

In practice this means:

Patient Facing Time Audit Figure = 39% (based on being at work 100% of year)
Contracted hours = 100%
Actual hours at work (after sickness, training and holiday) = 66% (of contracted hrs)
So we need to work out what 66% of 39% to work out the patient facing time for when we are actually at work.
0.39 x 66 = 26% (PFT% for the waterfall)
5. Module page number 53, sub ref A (amended April 2010)
‘Other’ hours can be called ‘support’ hours - which is perhaps a better way of describing all of the other things you and your team does when not in direct patient care. This could include admin but this admin is often directly connected with patient care.
6.    Module page number 53, sub ref C (amended April 2010)
This instruction makes reference to ‘other’ leave when describing carer, maternity and compassionate leave.

This can get confused with ‘other’ hours which is used in row 1 of the table. To avoid confusion call this row (row 9) by its full name ‘Carer, maternity and compassionate hours’.
7.    Module page number 56, sub ref K (amended April 2010)
The instruction asks you to multiply your Non PFT % by your contracted hours. For clarification this means finding out how many contracted hours equate to your Non PFT %.

For example if your Non PFT % is 47% and your contracted hours are 500 the sum you would do is:        
0.47×500 = 235 hrs

This is the same as 500 ÷ 100 and then × by 47.
8.    Module page number 61 – 63 (amended April 2010)
In this section you are filling in holiday limits on your MCAS Staff Availability Planner.  You don’t have to do this is absolute detail as this is to control general trends.

Your staff still have to work within their holiday limits (see page 61) so there is no danger of your team going over their holiday allowance even if there are more holiday slots on the planner than your team’s total holiday allowance.
Planning Our Workload
1.    Hardcopy versions of Planning Our Workload are being despatched w/c 19/4/10. Look out for yours. (amended April 2010)
Working Better with Our Key Care Partners
1.    Hardcopy versions of Working Better with Our Key Care Partners are being despatched w/c 19/4/10. Look out for yours. (amended April 2010)
Agreeing the Care Plan with the Patient
1.    Agreeing the Care Plan with the Patient is at the design agency being produced ready for print and despatch. (amended April 2010)
2.    Through testing it has been found that it much more effective for teams to implement Standard Care Procedures before Agreeing the Care Plan with the Patient. This is the reverse of the order detailed on the Productive Community Services house. (amended April 2010)
Standard Care Procedures
1.    Standard Care Procedures is in final proofing before being sent to design agency to be produced ready for print and despatch. (amended April 2010)
2.    Through testing it has been found that it much more effective for teams to implement Standard Care Procedures before Agreeing the Care Plan with the Patient. This is the reverse of the order detailed on the Productive Community Services house. (amended April 2010)
Perfect Intervention
1.    Perfect Intervention is in final writing stage and will be designed, printed and despatched soon. (amended April 2010)




Managing Caseload and Staffing Executive Leaders Guide Programme Leaders Guide Strategic Positioning Technology Team Leaders Guide Patient Perspective Well Organised Working Environment Knowing How We Are Doing Patient Status at a Glance Toolkit Planning Our Workload Working Better with Our Key Care Partners Agreeing the Care Plan with the Patient Standard Care Procedures Perfect Intervention