There has been a lot of debate over the last few weeks about the use of targets within the public sector and how this has caused many agencies to deviate from doing the very things they are supposed to be doing.
This has been most prominently highlighted in the case of the Mid-Staffordshire NHS Trust and the report by Robert Francis QC following the investigation into the high morbidity rates.
Mr Francis’ forensic examination of the culture and working practices at Mid-Staffs has detailed an environment of fear. An executive culture where financial consideration took precedence over all else and meeting targets became the raison d’être.
Taking things back to their most basic – what people actually wanted was to go to hospital and get better. What actually happened was that clinical decisions played second fiddle to waiting times and restructuring was based on cost not care.
The outcome? A lovely score card telling the world that everything was brilliant when in reality it is believed that up to 1200 people died unnecessarily.
The Francis report is manna from heaven for systems thinkers. It shows conclusively what can happen in extremis when organisations use the wrong methods to achieve the wrong aims.
The gathering of analytical data has become something of a cottage industry within the public sector.
An apparently simple question such as “are people satisfied with our service?” becomes broken down into minutia.
What is service? They ask.
If we look at a process from end to end how many individual “transactions” can we break service into?
It then becomes
How quickly did we answer the phone?
How quickly did we get there?
Were we visible when we got there?
Did we take positive action?
Did we look like we knew what we were doing?
Did we tell you what we were doing?
Were we polite?
Did we keep you updated afterwards?
Were you happy with the outcome?
From this we can attempt to identify where in the process we might be letting people down.
Now although I am sure that there is some merit in asking these questions and “drilling down” to identify things to the very second someone might have lost faith I have to ask whether such intense naval gazing is entirely necessary.
However, my main problem isn’t so much the fact that this information is gathered – it is what is done with this information.
I have no issue whatsoever with examining things closely and asking questions. Indeed it was @accgarethmorgan who said to me that “statistics only allow you to ask questions.”
I have heard this said before and I agree entirely with the sentiment.
I also believe that the statement should be extended slightly further.
“Statistics only allow you to ask questions. The key is who you then ask the questions of.”
This is where we come to the Theory of Assumed Incompetence.
It is a common fault of many senior leadership teams. They stop researching too early in the process.
The data analysts highlight “a problem” – they may well have been asked to do exactly that and that is fine – but once the problem is “identified” they don’t look for causes.
Instead, it is assumed that someone – usually at the business end of the process – is doing something wrong, not working hard enough or being incompetent.
Messages then come down the chain that we must “improve” our performance, or “reduce” something or “do more” of something else because it simply isn’t good enough.
In reality – about 90% of the problems are actually caused by the system itself and its not the front end users fault.
Allow me to give you two examples.
I know of a force where research suggested that they had more people on police bail than any other force.
This wasn’t good enough. The statistics showed that other forces had less so they must be doing something right and the staff at this particular force were not.
The Theory of Assumed Incompetence kicked in and messages came down the chain for supervisors to report back by Thursday exactly why their teams had so many people on bail. Then reduce it and not let it get so high again. A prime example of people being “held to account.”
The problem however, was not that officers were being incompetent at all. No-one was being lazy or carrying out a shallow investigation or bailing people for the sake of it.
Supervisors already knew why so many people on were on bail and the answers were very quickly fired back up the chain.
Approximately 95% of people on bail were on bail because of issues beyond the officer’s direct control.
Forensic analysis was required.
Hi-tech crime units needed to examine computers or phones.
Drugs needed to be tested.
CPS needed to be consulted.
In each of these cases the turnaround time could be anything up to 3-4 months. There was a shortage of availability of CPS lawyers. Hi-tech submissions took an eternity.
So the reason for bail was not incompetence on any investigating officers part – it was down to placing necessary enquiries into an inadequately resourced system.
The answer was not to whip the front line harder but to invest in the areas which weren’t coping with the backlog.
In another force a question was raised as to why so many prisoners were being placed on constant supervision.
This meant that at least one officer (often more) had to remain with a prisoner because the risk factors involved (violence, suicidal, illness etc) mean they cannot be left unsupervised in a cell with the door closed.
This can last for the entire duration of a detainee’s stay. It can last hours and hours and it means that these officers are not available to do anything else.
It is far from ideal and it drains resources but often there is no alternative.
It was right to look at the issue and ask questions but once again – once the issue was identified – the Theory of Assumed Incompetence kicked in.
The answer, it was claimed, was that Custody Sergeants were being too risk averse. Inspectors were asked to robustly challenge the decision and query why in every case. More must be documented on the custody record to explain the rationale!
This wasn’t the answer. The answer was that there was absolutely no way that these constant supervisions could be avoided. Closer examination showed that, in fact, many of those requiring constant supervision were detainees under the Mental Health Act.
Really, they shouldn’t be coming to a police station at all but because of a lack of bed space at the local Mental Health Trust hospital and some real breakdowns in the relationship between that hospital and the police, officers had nowhere else to take these people.
The hospital saying “we can’t / won’t accept them” didn’t make the problem go away. It might have done for the hospital but not for the police or the detainee. With no other option than to take them to a police cell pending assessment there was also no option other than to remain on constant supervision.
Again, it wasn’t incompetence. It wasn’t weak decision making or risk averseness. It was a strategic problem which actually required some very deep questions being asked of the mental health trust and the PCT.
Both of these issues needed a solution. It was right to ask questions but in both cases the answer was not the one expected.
Before the facts were fully established, questions were being asked of front line staff, improvements were being demanded and the sense of close supervision and micro-management became stifling.
Once again it was assumed that the breakdown was on the front line and the messages passed to the front line implied criticism, blame and the need to “do better.”
This does nothing for morale, especially when you can make a reasoned and evidenced case for the causes of the problem.
In both these cases, had the analysts gone a couple of stages further in their own research they would have identified the issues correctly.
All the supervisors would have done was interrogate the same databases for evidence that the analysts had access to. Instead – the analysts stopped at the point of saying “this is too high” and then pressure was put on the supervisors to explain themselves.
It was compounded by the language which said that there must be “improvement.”
The improvement required was well out of the hands of anyone who was initially blamed.
Statistics and data are necessary. They are absolutely required so that you can identify problems and check to see whether plans are working.
The fault with the current way of using them goes back to my point about not researching deeply enough before demanding answers from a hard pressed work force.
The solution is simple.
Use the data.
Probe more deeply.
Ask more questions.
Don’t stop UNTIL you have identified a problem AND it’s causes.
Don’t demand “improvement” until the causes are fully understood.
THEN target the messages and improvement to the people or areas where it is needed.
The Theory of Assumed Incompetence and it’s subsequent scatter-gun approach is demoralising and often misses the point. It can make a workforce feel blamed unnecessarily.
How many millions of kudos points would an SLT earn with their staff if they adopted this approach instead.
“We have identified this problem. This means we are doing too much of (this) We know you are trying to work around it at the moment. We want to make it easier for you. We know where the problem lies. We are going to do something about it and this is what we are going to do. In the meantime, thank you and keep up the good work.”
UPDATE 19/02 – I am honoured and delighted that @CllrJonSHarvey has written a lovely response to this blog which can be viewed here: