Seeking the approaches that enable faster change in the complex world of health and social care
I’ve written some terrible business cases in my time. However, they were ‘of their culture’ and were all approved. And that’s the problem.
Imagine writing a business case that details a solution, exactly how you think it ought to be delivered. Then you generate a benefits analysis to ‘fit’ the expectations of the approving authority.
Alternatively, you might write a Business Case that magically delivers the efficiency or strategic outcome required, followed by a detailed plan or solution to ‘fit’ the expectation.
Or even, a business case so long and detailed that it gives the illusion that the analysis is so wonderfully robust that the approving authority is reassured that you know what you are doing.
Do any of these sound familiar?
All of my past business cases fit into one of these categories, designed to feed the approving authority with reassurance to get their cash or support. However, the big flaw here is that these approaches are all manipulating the approval culture by describing that if you do X, Y and Z, you will get A, B and C. Essentially, it’s like ‘painting by numbers’. In complex programmes, where there are lots of people, behaviours, politics, cultures and ego’s involved, ‘painting by numbers’ is a bit flawed.
Delivery of ‘painting by numbers’ Business Cases is very constraining unless of course the element you made ‘fit’ was based on very conservative assumptions, in which case you’re probably missing an opportunity.
The tragedy in all these Business Cases is that they leave little room for adaption, embedded evaluation or learning, all critical components of complex change. Approving authorities generally frown upon deviation from the Business Case plan, solution or underachievement against the A, B and C you said you would deliver. This is when the business case becomes a straitjacket.
Sometimes, at a later date, you can persuade them you now have a better plan, although this can be trading one straitjacket for another.
What if the Business Case concept was substituted and the cultural expectations of approving authorities changed. What if the replacement was based on, we know X, Y and Z are important strategic objectives, we’ve developed ideas A, B and C, that we want to test out to see if they will have a significant impact and if they do, we will adapt and enhance until we achieve the strategic objectives.
Alternatively, the Business Case replacement could be along the lines of, we know that A, B and C have been shown to be effective and we want to test and adapt these to maximise our strategic objectives.
Imagine if approval of these approaches was based on demonstrating how adaption and learning would be built into the change programme linked to the achievement of strategic objectives. That reassurance would shift from what a appears to be a ‘sure thing’ to one of acknowledging the uncertainty in the situation and describing a ‘quest for strategic objectives’. The assurance would then be needed from the delivery approach, engagement and associated capabilities to drive the adaption and learning processes rather than the accuracy of the crystal ball gazing needed to ‘fit’ Business Cases to expectations.
I know it’s a bit utopian, but I’d argue that by eradicating the ‘Painting by Numbers’ business case, many tragedies would be avoided and much more value would be created as a result.