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Difrent
Nov. 5, 2019

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Difrent in Partnership with NHS BSA - Improving our Overseas Healthcare Digital Service - Together

I eagerly started my new Scrum Master contract through Difrent in NHS BSA mid-July returning from a great trip with lots of Mickey Mouse memories from Disney, Orlando. Whilst I should have had holiday blues as I’d had a fantastic magical time, I was looking forward to this new role, with a new company called Difrent and looking forward to making a difference and adding value to the NHS, an important partner to them. Difrent’s hashtag strapline is #techforgood and their values are about doing the right thing and bringing positive disruption - this matches my values and ethos too - and I’d read about the case studies and looked into the great stuff they are doing with the NHS - that’s why I was so passionate about joining these two great forces. This short blog is about my small journey so far and about the steps we are taking in supporting the NHS in their digital deliveries.

So, I’m about 13 weeks into the role now, which is about 6 retrospectives, 6 Sprint Reviews, numerous backlog refinement sessions, and probably around 65 Daily Scrums!

My experience so far in the NHS BSA is a brilliant set up, great culture and a great environment to work in - however, I’m sure the team wouldn’t mind me saying that when I walked in at 10am on my first day and I was walked straight into a team session, I was taken by surprise. This was not a good session. The team were all on separate paths, they seemed demotivated, it was awkward for me as a new starter, and as I found out later, they had been working on the same delivery for a while, without focus, without vision and they were at crossed wires.

Whilst each individual is fantastic, intelligent, and extremely knowledgeable about their craft, without that vision or where they were heading, they were doing great work but weren’t sure why or where it fits into the bigger picture. They were coasting I’d say - not through a fault of their own, or the NHS really, just that’s what was happening and at that phase of the delivery. Story pointing was done in Sprint planning 2 minutes before the Sprint started, retrospectives didn’t happen, a Sprint Review was done without conviction, structure (or people!), and as no stories were refined or pointed, I guess, too few (if any) backlog refinement sessions were happening either. Everyone was good at their own individual roles, just not working together. Good people in a great place - just without structure, leadership or direction.

Observations

So, I wanted to observe and see what the team was all about. The last thing I like to do when in a new role is come in and say how the team should work, preach about agile or say that this scrum thing is the way we will work and no other way works - That’s the last thing I do - in fact, not the last thing, it's something I would never do! My style is to observe, to see what is going on, and then discuss alternatives, talk about all our experiences, present different frameworks, talk about what works, what doesn’t, what could be improved, what should be stopped and go from there. The team know best, so finding this out is imperative. I firmly believe you can’t make any changes unless the team can see the benefit. The team must want to try something new or be open enough that, even though it may not look broken or it’s been done that way for months, there is always a way of adapting or improving. Even if you think it’s the best process, the best board, the best framework - there are always improvements somewhere! I can guarantee that.

One of the first things I did during observation and in the first retrospective using the starfish as a creative, was to find out from the team what was working, what wasn't working, what could be improved, what could be reduced, then take actions from this to remediate, implement and stop unnecessary activity. Wow, we created a large action list from that session! Which I loved. I think it’s fantastic to see a team that is so open, transparent, honest and passionate - and an action list which I can see as totally achievable - in time, and with owners.

My initial direction from Difrent and NHS BSA was to drive the team forward with the aim of completing the first phase of a service into the Overseas Healthcare Service (OHS) system which was built last year. That was our work vision, but also to structure the team and provide a scrum cadence. This is the bit that I love and relish in!

Progress

So, we have made great progress so far and achieved our delivery of bringing Customer Claims into OHS and completed the transition of reciprocal healthcare to OHS. Not only that though, as that wasn’t good enough for our architects and developers, they also added in additional validation and improved the layout, content and flow which has created a smoother journey for our Contact Centre colleagues, making their experience of the system much improved.

We’ve also added note functionality to the system. This has seen huge benefits in giving colleagues increased knowledge of the customer situation enabling them to have prior knowledge of the customer situation and position so they can adapt their conversations to avoid potential complaints whilst streamlining the process significantly - giving a much richer and enhanced customer experience too.

And, whilst our service is only internal (at the minute anyway - hopefully, customer-facing in time! That’s a story for another blog), we have improved our service by implementing user interface enhancements to assist our users with disabilities, or who may temporarily be unable to fully interact with a device. We are very proud of this and hope that these improvements have helped current and future users.

We’ve smashed it all! So far.

Where now?

Hang on - it’s going too smoothly - what can possibly change our direction now - Oh yes - Brexit! It was hot on our heels, and a major drive on our team and expertly firmly placed itself on our JIRA and physical boards! That didn't stop us though - we have collaborated as a team, working with our Product Owner and Business Analysts and the team are working on some great stories from these conversations and using fantastic prototypes to develop new digital services for the potentially new UK. The team are fully focussed on making our service appropriate for deal, no deal and every other outcome! This means different questions, new UK forms, different customer flows - but fear not - we are nearly ready for all eventualities and whatever the decision is, we will provide the digital service required! We have achieved this by working closely with our colleagues in the ‘business’ areas, Contact Centre, Admin teams, policy and communications to ensure we deliver a service that compliments the decision and our existing processes and services. The collaboration between the teams has been amazing, as we work together more closely. We exchange more frequently through discussions and get together on a more regular basis - making us one team - and we all know teamwork makes the dream work. Cliche but so true.

We are also now releasing live functionality at least every 2 weeks, and working again with our business team, we have made this process so streamlined, collaborative and full of communication.

What else?

Through this working together, the architect on the team noticed that colleagues had experienced a ‘waiting’ prompt when waiting for data to be returned and they saw this regularly without complaining - they just got on with their day job. However, as our architect had his ‘let’s make things better’ hat on (which he always wears incidentally!), he immediately came back and started to see how this could be improved. He spoke with people and found out by increasing storage at a small cost, we would negate these annoying messages, and within 2 weeks had implemented this permanent fix. This is amazing, and it’s great to have people on your team with a mindset like this - always looking for improvements and doing something about it. This guy saved the NHS £100k p.a. through this improvement!

Not only are we smashing through the work now, but we also have a structure, we have a cadence and follow the scrum framework where we regularly review, release, improve, adapt and bring efficiencies EVERY single sprint. We’re also looking at Kanban, temporarily, and will utilise the best bits of these frameworks to use what’s right for us at this time. Once our vision is cemented, we’ll revert back to the scrum framework and smash our sprints each and every time. Until then, as a team, we are learning, experimenting and adapting to the external situation, and utilising frameworks and tools to flex and deliver to achieve the best outcome for the customer and for the NHS.

We’ve got new physical boards, new JIRA boards, a TV showing our dashboard and we are being noticed now for the good things. We are showcasing our service to other teams and the Senior Leadership Team and we are being mentioned positively in communications. We are changing. We are a team who is talking, collaborating, motivated, standing around whiteboards - just enthusiastic - and that makes me smile.

Adding value, being efficient and delivering great customer journeys is our game and what we relish. We are different. We are motivated. We are focussed.

I’m proud to be part of that ONE team - not a digital team working with another business team or partnership company - we are ONE team helping to deliver awesome stuff. And we’ve just started!

We are now excited about the future, the difference we can make and the great stuff we can deliver to our users.

Bring it on.


Written by Richard Haydon- Scrum Master
@Richardhaydon24

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