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‘Blueprint’ and ‘process’ approaches to planning rural development initiatives

This essay ‘from the archive’ was written for my 1997 MA (Econ) Development Administration and Management at the Institute of Development Policy and Management (IDPM) of the University of Manchester.

Introduction

This essay will explore a number of approaches to rural development and its planning, with reference to the widely contrasted notions of ‘blueprint’ and ‘process’. It will argue that, while process approaches share an appreciation of the uncertainty surrounding the development process that distinguishes them from blueprint approaches, process approaches themselves differ fundamentally in the extent to which they also embrace uncertainty with regard to the goals of development. Those that at least implicitly share the blueprint approach’s economistic assumption of development goals as fixed and certain will be termed ‘instrumental process’ approaches. Those that adopt an empowerment perspective, and so accept the goals of development to be intrinsically variable and uncertain, will be termed ‘teleological process’ approaches.

It will be argued that, while process approaches may and indeed have been synthesized with blueprint approaches, the extent to which a synthesis, or indeed any approach, may be considered effective can only be assessed in the context of its underlying assumptions regarding the goals of development. Where the goal is empowerment for the increased well-being of the rural poor as defined by themselves, and so intrinsically variable and uncertain, no economic measure of effectiveness can substitute for a wholly participative teleological process approach in which ends as well as means are defined and redefined through experimentation and learning with the poor themselves. Furthermore, given the political will, the accountability constraints of governments and donors that have been used to explain their widespread reliance on economistic approaches to date need not preclude such an empowerment-oriented approach.

The blueprint and process approaches will be introduced with reference to some of the writers who have contrasted them, and their assumptions relating to uncertainty surrounding the development process will be identified as a key factor by which they may be distinguished. The process approaches of Korten (1980) and Rondinelli (1993) will be contrasted in relation to their assumptions regarding the goals of development, and identified as teleological and instrumental respectively. An explicit attempt to synthesize blueprint and process, Brinkerhoff & Ingle’s (1989) ‘structured flexibility’ approach, will be introduced. It will be argued that, in common with blueprint and instrumental process approaches, its effectiveness in empowerment terms cannot compare with that of a teleological process approach. A case study of integrated rural development in Ethiopia will be presented to illustrate the feasibility of a truly participatory teleological process approach, even in the context of official development assistance.

Blueprint and process contrasted

The dominant approach to rural development planning of the early growth-oriented national development strategies became known as the ‘blueprint’ approach to reflect its emphasis on the project preparation process as they key to successful intervention. According to Gittinger’s 1982 text on agricultural project planning:

“Perhaps the most difficult single problem confronting agricultural administrators in developing countries is implementing development programmes. Much of this can be traced to poor project preparation” (Gittinger 1982, 3).

Moris has likened this preparation to an architect preparing his blueprint, to “generate specifications for components and to map their points of linkage into a common structure” (Moris 1990, 28). Once the blueprint is accepted, producers of the various components are expected make their respective contributions accordingly, the plan serving effectively as a substitute for management. As the focus of national development strategies shifted in the 1970s to redistribution and rural poverty alleviation, this blueprint approach was identified as an impediment to effective rural development, and contrasted with an alternative ‘process’ approach that was found to be characteristic of more effective interventions. Sweet and Weisel first drew this distinction in their 1979 study of a 1973 review of 36 field programmes (Moris 1990, 27).

Korten has characterized the blueprint approach by inter alia its emphasis on careful and detailed pre-planning, and its conceptual and actual separation of planning from implementation. He underlines the inappropriateness of such an approach to the task of rural development:

“Where knowledge is nearly non-existent, the blueprint approach calls for behaving as if knowledge were nearly perfect… Where the need is for a close integration of knowledge building, decision-making and action-taking roles, it sharply differentiates the functions and even the institutional locations of the researcher, the planner and the administrator” (Korten 1980, 497).

Rondinelli has also underlined the inappropriateness of the assumptions of the blueprint approach that exhaustive analysis will aid the understanding of complex problems, and that there will be a direct relationship between government policy, action and outcomes (Rondinelli 1993, 3). In fact, according to Long and Van der Ploeg, a major source of the uncertainty inherent in the development process is the human agency of the various social actors involved. They have described the mechanistic assumptions of causality inherent in the blueprint model as:

“a gross over-simplification of a much more complicated set of processes which involves the reinterpretation or transformation of policy during the implementation process” (Long & Van der Ploeg 1989, 227).

Thus, the assumption of the blueprint approach that uncertainty can be reduced by gathering more data and expanding the project design phase fails to recognize, as Rondinelli observes, that many constraints remain hidden until implementation (Rondinelli 1993, 17).

In order to deduce elements of approaches that work in rural development, Korten studied the cases of five Asian ‘success stories’ of rural development intervention. From the wide variation in programme and organizational variables evident among the cases, he concluded that the determinants of the programmes’ success were to be found not in their programme or organizational content, but in the process by which these had developed:

“Each project was successful because it had worked out a programme model responsive to the beneficiary needs at a particular time and place and each had built a strong organization capable of making the programme work” (Korten 1980, 496).

He describes this as a process of achieving ‘fit’ between task, context and organizational variables, such that the organization’s distinctive competence fits the programme’s task requirements, the programme outputs fit the beneficiary needs, and the organizational decision-making process fits the beneficiaries’ means of expressing their needs. He refers to this bottom-up process of programme and organizational development as a ‘learning process approach’ observing that, rather than blueprints, leadership and teamwork were the key elements of these successes – they were not planned and implemented but rather evolved through a process of learning in which programme personnel and villagers worked together to create both the programmes and organizations that effectively responded to beneficiary needs.

Korten describes an idealized representation of this learning process as comprising three successive stages: ‘learning to be effective’, achieving a good fit between beneficiaries, programme and organization; ‘learning to be efficient’, reducing the ratio of input requirements to output; and ‘learning to expand’. Rondinelli advocates an incremental process of four stages of project development: experimental projects of a moderate scale, and flexibly implemented, for when problems and conditions are unknown; pilot projects, for when objectives have been well-defined, to test the results of the experiments under various conditions and to determine their relevance, transferability and acceptability; demonstration projects to exhibit the effectiveness and increase the acceptability of the project; and replication projects to test full scale production technology (Rondinelli 1993, 24-26). Both emphasize the integration of planning and management in an iterative process of learning and capacity building to achieve developmental goals in conditions of change and uncertainty.

Empowerment and the uncertainty of goals

The broad consensus among advocates of process approaches that their flexibility and learning orientation are keys to greater effectiveness in achieving development goals in conditions of change and uncertainty conceals fundamental differences in their conceptions of the nature of those goals against which effectiveness is to be measured. Rondinelli is explicit in his expression of an orthodox economistic conception of development goals:

“the essence of development is expansion of participation in economic activities through the creation of social and economic systems that draw large numbers of people into processes of production, exchange, and consumption” (Rondinelli 1978, cited Rondinelli 1993, viii).

As indicated by the title of his book ‘Development Projects as Policy Experiments’, the principal intended agents of his process approach, and concomitant learning and capacity building, are the official development administrations of governments and international assistance agencies. The goals of development are understood as essentially economic and unproblematic, and the means of their accomplishment essentially a problem of technique. In this his process approach concurs with the blueprint approach, or what Hulme has called the orthodox approach, where rural development interventions are viewed as “activities… in pursuit of the achievement of a known and stated objective or set of objectives” (Hulme 1994, 213). Although he criticizes the quantitative methods of the orthodox blueprint approach as “ineffective precisely because they tried to clarify and make technical those issues that were inherently complex and political” (ibid., 19), his process approach, regarding projects as social experiments to reduce uncertainties and unknowns, is essentially a technical solution to the problem of achieving a known goal. Thus, Rondinelli’s may be identified as an ‘instrumental process’ approach.

Korten’s approach, in contrast, centres on community organizations as the principal agent of a learning process approach with empowerment as its goal. His 1980 article, aptly entitled ‘Community Organization and Rural Development: A Learning Process Approach’, addresses the question of how to foster

“effective community controlled social organizations as important if not essential instruments… [for] the rural poor… to give meaningful expression to their views, mobilize their own resources in self-help action, and enforce their demands on the broader national political and economic systems’ (Korten 1980, 480).

Chambers more explicitly addresses the problematic nature of such a development goal in his 1993 call for a ‘new professionalism’ with Korten’s learning process approach at its core. He writes that “development is not movement towards a fixed goal but continuous adaptation to maximize well-being in changing conditions”, and its goal “is not growth as defined by normal professionals, but well-being as defined by the poor for themselves” (Chambers 1993, 10). Similarly, Uphoff writes of Korten’s learning process approach that “it presumes that neither the ends nor the means of… interventions can be fully known in advance, and that understanding and consensus on them must be built up through practical experience” (Uphoff 1993, 12). Thus, Korten’s may be identified as a teleological process approach.

From such an empowerment perspective, the critical determinant of the effectiveness of a rural development initiative will not be the extent to which the route of the journey is pre-planned, or even the extent to which its destination is decided in advance. Indeed, some goal setting and pre-planning may be a pre-requisite of any purposeful action. More important will be who participates in the planning and deciding, and how responsive they are to the changing aspirations of beneficiaries as well as unforeseen obstacles and opportunities along the way. While Korten’s process approach puts the self-expressed needs of the rural poor firmly at the centre, shaping both programme and organizational variables, participation of beneficiaries in Rondinelli’s approach is essentially instrumental and extractive, and any empowerment incidental.

Rondinelli calls for the reorientation of official development administrations “to cope more effectively with the inevitable uncertainty and complexity of the development process” (Rondinelli 1993, 5), and regards the only certainty as “that the course of development is uncertain” (ibid., 156). Korten in contrast regards effectiveness as a product of “building a supporting organization around the requirements of the programme, or… adapting the capabilities of an existing organization to fit those requirements” (Korten 1980, 497), while the programme evolves to fit beneficiaries’ needs. While Rondinelli advocates the capacity building, and integration of the planning and management functions, of official development administrations, Korten advocates the capacity building of local community-based organizations, and their full participation in an integrated learning approach to planning and management.

Synthesized approaches and structured flexibility

A number of authors have written of the possibility of synthesizing blueprint and process approaches. Scoones, for example, writes that “these two options are obviously not mutually exclusive” (Scoones 1994, 6), and Chambers notes that, “although they are presented… as dichotomies, the blueprint and learning process approaches can be and have been combined in many ways” (Chambers 1993, 84). He cites the ODA’s ‘planning by successive approximation’, as one example, and the ‘structured flexibility approach’ as another (ibid.).

As articulated by Brinkerhoff and Ingle (1989), the structured flexibility approach is an explicit effort to integrate the blueprint and process approaches in order to overcome “the lack of fit between the precepts of the process model and the current modalities by which the vast bulk of international development assistance is provided”, which have “restricted its use and potential for expansion” (Brinkerhoff & Ingle 1989, 489). They argue that, despite its weaknesses in terms of performance, a blueprint approach is widely favoured over the process approach for its control and specificity, because donor accountability requirements serve as a disincentive for experimentation, and because political concerns over the balance of power lead decision-makers to fear the empowerment potential of the process model.

The structured flexibility model retains the blueprint orientation to analysis, planning and specificity, but applies its analytical tools, in a participatory, process mode, to “facilitate people’s accurate assessment of opportunities and choices, and the potential actions based upon them, within a structured framework that encourages feedback and learning” (Brinkerhoff & Ingle 1989, 490). The capacity-building goal of the process model is complemented by short term product or service delivery targets, satisfying accountability requirements for measurable delivery while building long-term capacity by developing problem-solving skills in addressing concrete immediate needs:

“Management by structured flexibility… means repeating the action-research cycle of reconnaissance, design, implementation, and learning with the aim of generating initial performance gains while building the indigenous capacity required for sustainability and replicability” (Brinkerhoff & Ingle 1989, 493).

Brinkerhoff and Ingle offer three case studies of the structured flexibility approach in action to illustrate its effectiveness . A brief review of these reveals their assumptions of certainty regarding their goals. In all three cases, programmes and organizations had been created by governments and aid agencies, and their effectiveness has been assessed in relation to goals that had been defined top-down, in advance and assumed unproblematic. In the case of the Farming Systems Research and Development project of the Caribbean Agricultural Research and Development Institute (CARDI), for example, CARDI had been established by member states of the Commonwealth Caribbean Community, and the project was designed by ‘key actors’ from USAID and CARDI. “Participation was expanded to include farmer representatives” only after the goals of “building CARDI’s institutional capacity plus production of specific technical outputs over the 5-year life of the project” had been defined (Brinkerhoff and Ingle 1989, 498). An evaluation report is cited as concluding that “the project is making good progress toward its objectives”, including “realization of the End of Project Status” (ibid.).

In terms of Korten’s concept of fit, CARDI’s effectiveness relates to the fit achieved between the organization’s competence and the programme’s requirements. However, the fit between its decision-making process and the beneficiaries’ means of expressing their needs, and between those needs and the programme’s outputs, have been assumed a priori as unproblematic. While beneficiaries may participate in the learning process of programme management, they have been excluded from the fundamental stage of project identification. Due to its responsiveness to uncertainty and change, the structured flexibility approach may indeed have been more effective in achieving the programme’s goals than a blueprint approach would have been. To the extent that USAID’s accountability requirements were better satisfied, it may have been a more effective means of attracting finance than Rondinelli’s process approach. It cannot, however, be expected to have been as effective from an empowerment perspective as had a programme and organization “emerged out of a learning process in which villagers and programme personnel shared their knowledge and resources to create a programme which achieved a fit between needs and capacities of the beneficiaries and those of the outsiders who were providing assistance” (Korten 1980, 497).

It has been argued that full empowerment requires not only the ‘power to’ prevail in decisions affecting one’s interests, but also ‘power over’ defining the agenda of decisionable issues, and ‘power within’ to transcend conventional ways by which one’s interests are perceived and known (Kabeer 1994, 224-7). This latter element, the ‘power over’, is irreducibly subjective and therefore cannot be achieved except through experiential recognition of strategic as well as practical needs and interests. From such a perspective, while empowerment may be facilitated through intervention, it must ultimately be self-generated. Any approach to planning rural development interventions, be it blueprint, process or a synthesis, in which participation is not central even to project identification, will be relatively ineffective from such a perspective.

The South Wollo Community Empowerment Programme

Chambers has written that: “the essence of a good learning project is good staff put in the field and sustained for periods of months or, more likely, years, exploring and learning from and with the local people and trying to see how better they can gain what they want and need” (Chambers 1993, 86).

Brinkerhoff and Ingle’s rationale for seeking a middle-ground between blueprint and learning process approaches is that the former is ill-suited to the complexity and uncertainty of development, while the latter is ill-suited to the accountability requirements of international assistance bureaucracies. Their response, adapting the process approach to bureaucracy, fails to address the root of the problem – that ‘development’ agencies remain primarily accountable to their financiers and not their beneficiaries. This accountability structure represents a greater impediment to effective empowerment than any rural development planning or management procedure.

One example of bureaucracies transcending this accountability constraint, the case of a teleological process approach being adopted by a national government bureaucracy in partnership with an official donor agency, is offered by Bergdall (1995). He writes that in 1993 the Swedish and Ethiopian governments agreed to collaborate on a long term integrated rural development programme in South Wollo Zone of Ethiopia, and selected four districts as pilot areas. Convinced that the programme should be built from the bottom-up, based on beneficiaries’ own perceptions of their development needs, rather than designed as a blueprint by professional planners, the project Steering Committee of Zonal officials opted for a process approach. The intention was that a first phase, involving Community Participation Workshops (CPWs) in 24 sample areas of the four districts, would generate the community needs data to be input to a more conventional programme in Phase II, involving various ministries in typical sectoral activities.
Expatriate specialists in community participation were contracted to help design the CPWs and train the facilitators, in recognition of the steering committee’s lack of practical experience in such an approach. Traditional community self-help associations called kires were chosen as the organizational unit for the CPWs, in preference to the governmental Peasant Associations that tended to be larger, more political, and still strongly associated with earlier centrally planned development efforts involving coerced mobilization of labour. Twenty-two staff from the Departments of Health, Education, Natural Resources, Agriculture and Planning were assigned as facilitators for a six-month period of intensive field work. They were hosted by villagers in their homes, and traveled by foot, mule and public transportation.

Representative groups of men, women and youth were included in each CPW. The workshops had three main objectives:

  • “to provide information about local perceptions of development needs and priorities as a basis for defining sectoral projects that could be implemented by the line ministries…
  • to provide experience for the development of future community participation strategies… [and]
  • to provide an opportunity for people in a kire to think about ways of solving their own problems and to regain the initiative for their own development, thereby building a foundation for sustainable development in the long term future” (Bergdall 1995, 16).

During the workshops, each kire identified and prioritized what they considered to be their most important development needs, and drew up an action plan for addressing the top priority need through their own efforts, and using local resources.

The facilitators returned to each kire after two to three months to review progress and assist in planning new initiatives. The results of the local initiatives found during these visits led to a reconsideration of the earlier plan for Phase II. Bergdall cites examples of kires whose accomplishments exceeded their action plans, had involved broad participation of the community residents and support from previously ‘negligent’ Peasant Associations, and had instilled renewed pride and self-confidence in the communities and their capacities to accomplish projects for their own benefit. Instead of going ahead with the centralized planning of conventional sectoral programmes for line ministry implementation, the Steering Committee decided to launch a process-oriented Community Empowerment Programme with the objective “to build the capacity of rural communities to initiate and sustain their own development activities” (Bergdall 1995, 15).

In order to expand the impact of the programme, the Committee will seek to build on the experience of bottom-up development activity based on local initiative by integrating additional support components. These may include: provision of technical assistance to the local communities; facilitating community access to additional external resources; ensuring effective collaboration of government, NGO and private sector; adaptation of existing extension services to support the bottom-up approach; and fostering wider institutional linkages (Bergdall 1995, 24). Bergdall writes that diverse solutions to these issues will be allowed to evolve over time, with experimentation, reflection and learning as key operative guidelines.

Conclusion

Any discussion of effectiveness is meaningless except in relation to a goal or set of goals. What Hulme (1994) has called orthodox models of planning and managing rural development interventions are based on economistic assumptions of utility and welfare, from which are derived the certain and known economic goals of development action. This assumed certainty of goals is a feature that Rondinelli’s process approach and Brinkerhoff and Ingle’s Structured Flexibility Approach share with the conventional blueprint model. What Hulme has called political models recognize the role of power imbalances and conflicts of interest in the reality of development planning and management. Neither the choice of planning approach nor its outcome can be fully explained except in its political context.

As Hulme has observed, in the search for improved project methodologies,

“it is not simply a question of blueprint versus process… but a question of which form of blueprint or process, in which circumstances, and even of what means may be used to integrate blueprint and process approaches” (Hulme 1994, 230)

Perhaps most importantly, the question must be raised, ‘for what purpose?’ Certainly there may be projects and circumstances for which a blueprint or synthesized approach may be well suited – for example, “the construction of a large scale, physical infrastructure where the task is well defined, the outcomes terminal, the environment stable and the costs predictable” (Korten 1980, 497), or solving developing countries’ problems of “economic stagnation and poor productivity, resource gaps and debt burdens… etc.” (Brinkerhoff & Ingle 1989, 487). As Hulme & Limaoco have observed, however,

“to empower beneficiaries to be their own agents of development is more significant than any number of roads built, and subsequently not maintained” (Hulme and Limcaoco 1991, 232).

Given the remarkable record of economic development in generating and exacerbating rural poverty on a global scale, such empowerment is likely to also be more significant to the poor than any improvement in economic indices. Empowerment is an inescapably political process, however, and those who enjoy power and embrace a narrow economistic conception of their own welfare, including governments, official aid agencies and the institutions and people to whom they are accountable, may be expected to resist it. That the Community Empowerment Programme of South Wollo has emerged from within official aid bureaucracy may be regarded as a breakthrough. Only time will tell to what extent the programme may overcome potential political constraints to empowering the rural poor of South Wollo, but those who truly seek to serve the interests of the rural poor would do well to start similarly by adapting their organizations and programmes to their beneficiaries’ self-expressed needs.

References

Bergdall, T (1995) “…and miles to go before we sleep: closing the rhetorical gap in South Wollo, Ethiopia” in Forests Trees and People no. 26/27, 17-24

Brinkerhoff, DW & Ingle, MD (1989) “Integrating blueprint and process: a structured flexibility approach to development management” in Public Administration and Development 9, 487-503

Chambers, R (1993) Challenging the Professions IT Publications, London

Gittinger, J (1982) Economic Appraisal of Agricultural Projects

Hulme, D (1994) “Projects, Politics and Professionals: Alternative approaches for project identification and project planning” in Agricultural Systems 47, 211-233

Hulme, D & Limcaoco, J (1991) “Planning integrated rural development projects in the Philippines: from blueprint to process?” in Project Appraisal 6/4, 223-233

Long, N & Van der Ploeg, JD (1989) “Demythologizing planned intervention: an actor perspective” in Sociologia Ruralis XXIX – 3/4, 226-249

Kabeer, N (1994) Revered Realities: Gender Hierarchies in Development Thought Verso, London

Korten, DC (1980) “Community Organization and Rural Development: A Learning Process Approach” in Public Administration Review September/October 1980, 480-511

Moris, J (1990) What organization theory has to offer third world agricultural managers, mimeo, IDPM library

Rondinelli, D (1993) Development Projects As Policy Experiments Routledge, London

Scoones, I (1995) “New Directions in Pastoral Development in Africa” in Scoones, I (Ed.) Living With Uncertainty IT Publications, London

Uphoff, N (1993) Learning From Gal Oya Cornell University Press, Ithaca N

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Facilitation case study: Compact Awareness Workshops with Manchester City Council

This ToP facilitation case study from the archive was first written for and published in 2008 by ICA:UK.

Context

Manchester Compact“The Compact is an agreement between public bodies and the voluntary and community sector (VCS) setting out how they relate to each other. It is the framework for working together in a spirit of trust and respect and provides the basis to address many important issues. The government is encouraging all councils and voluntary and community sectors to form a Compact together.” – Manchester City Council.

The Manchester Compact was launched in September 2003, but it was felt that more could be done to raise awareness and understanding of it and promote its use.  A summary booklet was being prepared, intended to help to raise awareness and refer readers to the Compact itself.  However, experience of discussing the Compact with local voluntary groups and Council officers directly had suggested that a more effective means might be to work with VCS infrastructure workers and other intermediaries to support and encourage them to raise awareness and promote the use of the Compact through their work.

The Compact Task Group, including representatives of Manchester City Council and the voluntary and community sector in the city, proposed the development of a tailored half-day facilitated workshop for council officers and VCS staff, based around the use of scenarios, to be repeated around the city.

As a result, ICA:UK was approached by Manchester City Council in August 2006 to design and facilitate a series of such workshops.  We had previously worked with the council on a number of facilitated processes, including Participatory Strategic Planning events with the Voluntary Sector Policy & Grants Team and with the Area Co-ordination team.

The aims of the workshops were agreed to be as follows:

  1. for participants from support services of both the VCS and the council to increase their awareness and understanding of how the Compact can valuably be used, and their confidence and commitment to help to raise the awareness and understanding of others
  2. to begin to develop a documentary resource on how the Compact can be used
  3. for participants from the VCS and the council to better appreciate each others’ perspectives on the issues raised, and to promote a sense of collaboration among all towards the shared objective of improving services for Manchester residents.

Process

A half-day session was designed to meet the aims above, building on a number of scenarios drafted by the Compact Task Group to prompt discussion and learning on possible uses of the Compact. The process was highly participatory, and involved a combination of working in small groups and with the whole group together.

The key elements of the sessions were:

  • Opening, introductions and overview
  • Discussion – our experience of the Compact, its relevance and its use
  • Scenario exercise – creative small group work  and brief plenary reports
  • Reflection, next steps, evaluation and close
  • Lunch and informal networking

Following an initial series of three workshops from October-December 2006, a further series of three workshops were delivered in May and June 2007. Each workshop was attended by mixed groups of up to 20 participants from across the council and the VCS, usually no more than 2 or 3 from each team or organisation.

Outputs & feedback

Each workshop was documented thoroughly, including participants’ responses to the scenarios, to begin to develop a resource for others on how to use the Compact.

Also documented were participants’ names and roles, their initial questions or concerns about the Compact, common themes drawn from their reflection on the exercise, and their detailed feedback on the workshop from their closing evaluation forms.

The workshops were well received, with average participant satisfaction ratings of up to 7.8 out of 10. Participants’ feedback included:

  • [a highlight was] the mix of people from both council and voluntary sector, and… hearing all the represented groups agreeing and showing similar concerns
  • going through scenarios was really useful for putting the Compact into practice
  • my better understanding of the document and its application has increased my confidence
  • I now feel I can promote Compact as a positive tool to be used

Outcomes

Madeleine Rose, Programme Officer with the Voluntary Sector Policy and Grants Team of Manchester City Council, and the client for the workshops, wrote in February 2008:

“Manchester received a Compact Commendation for ‘Excellence in Communications’ from the Compact Commission at their annual meeting in December .  This was very much down to the success of the workshops.”

Following an enquiry to Manchester from the Rochdale Borough Compact Steering Group, the process was adapted and delivered for a series of four workshops in Rochdale in March and April 2008. Karen Salisbury of the group, which includes the Borough’s CVS, the PCT, the Centre of Diversity and the GM Fire and Rescue Service, as well as the council, wrote in May 2008:

“The Steering Group found the workshops a useful way of introducing and raising awareness of the Compact, and a good opportunity for people from different agencies and sectors to discuss the needs and views of each. We would certainly recommend the workshops to other local Compacts”.

Facilitation case study: Clinical Leadership Evaluation and Development with Manchester Primary Care Trust

This ToP facilitation case study from the archive was first written for and published in 2008 by ICA:UK.

The ToP Focused Conversation and Consensus Workshop methods are the focus of my upcoming Group Facilitation Methods course in Brussels, May 20-21. The ToP Historical Scan (Wall of Wonder) method features in two of my current projects, Celebrating the development of facilitation – world-wide and history long and Our ETF, a Journey Together. The process design and questions used were structured on the basis of the ORID model of the ToP Focused Conversation method (my ‘universal principle of facilitation‘).

Context

nhs-manchesterEffective clinical leadership is seen as central to the cultural and organisational changes expected of organisations across the health service, in the context of national reforms aimed at creating a patient-led NHS.

When ICA:UK was approached in early 2006, investments had been made in recent years in strengthening clinical leadership within the then South Manchester Primary care Trust (PCT).  These included the introduction of cluster working, and three Cluster Directors, to support extended primary care teams in multi-disciplinary and multi-agency working; and the creation of an in-house Education, Learning and Workforce Development Team, with a Practice Nurse serving as Clinical Lead.  Considerable further change was required and underway, including Agenda for Change and the merger of the three Manchester PCTs (South, North & Central).

Aims

In this context, it was felt timely to involve key stakeholders in evaluating clinical leadership within the PCT, and identifying opportunities and making plans for its further development.  ICA:UK was therefore contracted to design and facilitate a process to meet the following aims:

  1. to begin to evaluate clinical leadership across the PCT in relation to its impact on the organisation and organisational change, including the effectiveness of recent investments in clinical leadership;
  2. to identify opportunities for further development of clinical leadership, and empowering of clinical leaders, toward a culture of leadership within the PCT;
  3. to engage with and involve people in an inclusive and transparent way, that fosters a sense of ownership over the process and its outcomes.

Process

A series of tailored workshops was designed and delivered to meet these aims.  The process drew heavily on ICA’s ToP (Technology of Participation) methodology, notably the ToP Focused Conversation, Consensus Workshop, Action Planning and Historical Scan (or Wall of Wonder) methods.

A series of consecutive half-day Consultation workshops each followed a broadly similar process, but were tailored to engage with and involve three distinct stakeholder groups separately.  This approach was used in order that each group felt able to contribute frankly and without affecting each others’ contributions, and to enable triangulation of the results.  The three stakeholder groups were:

  • the clinical leaders themselves – one workshop for all 15-20 from across the PCT
  • front line clinicians without leadership roles – two workshops for approximately 30, identified by the Education, Learning and Workforce Development Team to be broadly representative of the total of 200 or so within the PCT
  • other key stakeholders with organisational responsibility for leadership – approximately 10-12 including the Education, Learning and Workforce Development Team, the three Cluster Directors and the Executive Director

Consultation workshops outline:

Arrivals & coffee/lunch
Opening & introductions, overview, ‘prouds & sorries’ & expectations
“Wall of Wonder” to map together the development of clinical leadership in SMPCT visually; to share stories & begin to discern chapters, trends, impacts, learnings, implications
Tea/Coffee break
Analysis of factors affecting clinical leadership development – what’s worked and what’s not worked, what supports & what blocks; in small groups followed brief plenary reports
Brainstorming of actions for clinical leadership development – in small groups followed brief plenary reports and prioritising by “sticky dot voting”
Reflection & close

In the event it proved impossible to bring the senior stakeholders together in person for a workshop, and so they were consulted instead by means of an email questionnaire.  The questions were tailored to generate responses compatible with those of workshop participants:

  1. In your experience, what have been 4 or 5 key events or milestones in the development of clinical leadership in SMPCT in the last 3 years? Please include dates (as best as you can).
  2. What are you particularly proud of, and sorry about, in relation to the development of clinical leadership in SMPCT?  Please list a few positives and a few negatives.  Please use examples or anecdotes to illustrate your points if you wish.
  3. In your experience and understanding, what are 4 or 5 key factors affecting clinical leadership development in the PCT?  For example – what do you think supports, and what blocks, the development of clinical leadership? 
  4. What 4 or 5 actions or changes would you recommend to support the development of clinical leadership in the PCT in the future, and address any blocks?  Feel free to suggest simple, one-off tasks or more complex, long-term projects – but please be as specific as you can.

A final half-day Review & Planning workshop was held the following week, for a representative sample of the three groups (approximately 20-30).  This workshop was designed to enable the group to reflect together on the output of the first three workshops, and agree an outline action plan for clinical leadership development within the PCT.

Review & planning workshop outline:

Arrivals & coffee
Opening & introductions, overview & expectations
Review of workshops documentation, questions of clarity; reflection & interpretation in small groups followed by brief plenary reports; writing up key actions on half-sheets, drawing on those brainstormed by means of the three Consultation workshops and email questionnaire
Tea/Coffee break
Action planning – cluster key actions by task forces, self-select into task forces to clarify & schedule actions by quarter, brief plenary reports, leadership & co-ordination
Reflection & close

Outputs & outcomes

The process used was documented in a Process Outline (June 16th 2006), and its outputs were documented in two reports, of the Consultation process (July 6th 2006) and of the Review & Planning (July 26th 2006).

A key outcome of the process was the establishment of four task forces, each comprised of 3-4 members from across the three groups, and each with its remit defined and with a first-draft work plan including quarterly milestones for the coming year and beyond. The remit of the four task-forces were:

  • Growth, Development, Training Opportunities
  • Redefinition & Clarity of Role & Responsibility & Expectations
  • Supporting Systems and Processes
  • Transparency, Communication & Access to Support

According to participants’ end-of-workshop feedback, highlights of the process included:

  • “Liked interactive style – getting up & moving around”
  • “Group interaction helped people to understand other point of view”
  • “An opportunity to speak and hopefully implement change”
  • “Feel process was moved on to something constructive”
  • “Positive actions proposed at end of session to take proposals forwards”

Follow-up process

Seven months on from the workshops, in early 2007, it was clear that the four groups had all met at least once, that their plans had progressed at least to some extent, and that at least some others had become involved.

The context of the work had changed significantly, however, with the merger of the three Manchester PCTs into one from October 2006, and with expectations of increased multi-agency working with for example Childrens’ Services & Adults’ Services, and also privatised services.  A new Associate Director of Services & Development had been appointed, whose remit was to  include clinical leadership development across the new PCT.

ICA:UK was contracted again, in early 2007, to design and facilitate a follow-up process to meet the following key aims:

  1. to engage the four task forces in reporting, and learning from, their progress together;
  2. to document their learnings in a report, including quotes, by which they may be disseminated within the new Manchester PCT
  3. to celebrate the accomplishments of the task forces and bring closure to the project, while sustaining a sense of achievement and potential for applying their learnings – at least as individuals, if not also as Manchester PCT

These aims were met by way of two related pieces of work.  An initial email questionnaire was circulated in February, to all participants and invitees of the process to date, to discern their experiences of the process and their perspectives on progress made, barriers experienced, and learnings.  A follow-up workshop was then held in March, to bring together the four task-forces and any email contributions received with the new Associate Director – to report on and celebrate progress made, to learn from experience, and to consider implications for themselves as individuals & leaders, and for the new Manchester PCT.

The email questionnaire in February comprised the following questions:

  1. As far as you know, what have been 2 or 3 key events or accomplishments that have occurred as a result of last July’s consultation and planning process?
  2. As far as you know, what have been 2 or 3 barriers or blocks that have hindered implementation of the plans made last July?
  3. What have you as an individual learned as a result of your involvement in this clinical leadership development work since last July?  How has that affected you personally, or your work?
  4. What would you identify as the one or two key lessons for the new Manchester-wide PCT to learn from this experience, relative to clinical leadership and its development?

Follow-up workshop outline:

Arrivals & coffee
Opening & introductions, overview & expectations
Evaluating progress – events & accomplishments, barriers & blocks, lessons learned; drawing both on email responses and on insight of those present
Lunch
Key learning messages for the new Manchester PCT – Consensus Workshop to weave together everyone’s insights into a single clear and concise statement
Reflection & Close

The process used was documented in a Process Outline (February 22nd 2007), and its outputs were documented in a report (April 2nd 2007).

The key output of this follow-up workshop was the output of the Consensus Workshop, a clear statement from participants of the 7-month process articulating their “key learning messages” for the new, merged Manchester PCT, from their experience of clinical leadership development:

We recommend that Manchester PCT should…

  • engage at all levels to ensure that structures, systems and behaviours are conducive to demonstrating effective leadership;
  • engage everyone in developing and communicating a shared model of effective leadership;
  • invest in the development of leadership at all levels;
  • support people in taking calculated risks within an accountability framework;
  • support clinicians to identify client needs when developing services;
  • analyse what we have, clarify what we want … and get on with it.

Impact & feedback

Gabrielle Wilson, Public Health Consultant Nurse and the client for the process, wrote:

“The participative methods adopted throughout this work encouraged clinicians, managers and senior stakeholders to engage with the process. Evaluation and feedback indicated that this inclusive and transparent approach was valued by participants, and that clinicians welcomed the opportunity to systematically identify learning messages for the new organisation.”

Christine Pearson, new Associate Director of Services & Development, wrote:

“Although not in post to be part of the initial work, I attended the follow up workshop in March. The style of engagement adopted ensured a participative approach and effective, valuable feedback that will inform future leadership development within the organisation.”

A further indication of the impact of the process may be an increased appetite within the PCT for applying the ToP approach to participation and partnership working.

A further series of Consultation workshops and a Review & Planning workshop were delivered later in 2007, on Management and Leadership Development.  This adapted the format and process developed for Clinical Leadership Evaluation and Development in South Manchester to engage with a cross-section of staff of the new Manchester PCT – to begin to develop a consensus on “a Manchester way of managing”, a core set of leadership and management competencies to deliver this style, and a few priority actions for “quick wins” over the following months.

Since then the approach has also been applied to review and planning “away days” with individual staff teams including the Joint Occupational Therapist Unit of Manchester Equipment and Adaptations Partnership (a joint service of Manchester PCT and Manchester City Council) and the Manchester PCT Interpretation Service.

Facilitation case study: Staff Away Day with George House Trust

This ToP facilitation case study from the archive was first written for and published in 2009 by ICA:UK.

GHT Away day

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Context

George House Trust (GHT) is the HIV voluntary organisation for the North West of England.  It supports people living with and affected by HIV, and campaigns for the best quality of life for all people with HIV. ICA:UK was approached in July 2007 to design and facilitate a staff Away Day later that month.

GHT had undergone substantial change in the last couple of years – including significant expansion of the staff team and it’s service delivery, turnover of some senior staff, and subsequent restructuring of management posts.  A need had been felt for an externally facilitated process to allow staff to unpack and reflect together on this recent past, at what was felt to be a turning point before looking ahead by means of a fresh strategic planning process later in the year.

Around a dozen of the full staff team of 14 were to attend – including one very new, a few new within the past few years, and others with a long history of service.  As an organisation involved in hard campaigning on controversial issues in a sometimes highly politicised environment, the staff team comprised strong advocates and activists.

Aims

The day was designed and facilitated to provide a safe and supportive space to reflect together on the staff team’s shared recent past, and how it had affected them as individuals and the organisation as a whole. The aims of the day were articulated as follows:

  • to allow stresses, frustrations and challenges to be aired, balanced by successes and achievements as well;
  • to ‘draw a line’ under the past, and lay a firm foundation for forward strategic planning later in the year;
  • to have some fun, and rebuild stronger bonds and a sense of team spirit.

Process

The two key elements of the process design were the ToP (Technology of Participation) ‘Wall of Wonder’ (or ‘Historical Scan’) method, used in the morning to enable the group to reflect together on its recent past, and the World Café method, used in the afternoon to enable the group to articulate creatively “how it would like to be able to describe the culture of GHT”.

These were complemented by a number of shorter exercises and sessions to frame the day, set the tone and build the team.  These included sharing hopes and fears, expectations and ground rules; People Bingo, Two Truths and a Lie, and a balloon race; and a reflective self-assessment and sharing of strengths and weaknesses, and offers and wants of support. The timetable of the day was as follows:

9.30 Arrivals & coffee
10.00 Opening, housekeeping, aims & process
Expectations & ground rules
Energizer & introductions
‘Wall of Wonder’ small group work
Tea/coffee break
‘Wall of Wonder’ plenary
12.30 Lunch
1.15 ‘World Café’ conversation
Tea/coffee break
Team-building exercise
-4.00 Evaluation, next steps & close

Outputs & feedback

The documentation of the day included the aims and outline of the process, participants’ hopes & fears and ground rules, a full verbatim record of the Wall of Wonder and World Café sessions with photos of the sticky wall and decorated table cloths, and detailed feedback from participants’ evaluation forms.

Participants’ feedback included:

  • the timeline really enabled us to address many key issues for ourselves
  • lots of issues bubbling beneath the surface got a good airing
  • I feel a line has very, very clearly been drawn under some past events – I feel there will be more team cohesiveness and we will move on in strength
  • I feel we have a better understanding of each other & better ways of working

Michelle Reid, GHT Chief Executive, wrote in November 2008 of the impact of the day:

An effective team will always need to invest in “time out” in order to continue functioning well. The organisation had gone through significant change, and inevitably we needed to re-group and re-establish the frameworks that make the organisation such a formidable force to be reckoned with. ICA facilitated an excellent day which helped to enable us to go from strength to strength.