Business Services | 26 November 2015

Client: General Pharmaceutical Council

Assignment: End to End Lean Review of the Fitness to Practise Process

General Pharmaceutical Council: End to End Lean Review of the FtP Process

The Problem

The General Pharmaceutical Council (GPhC) is the independent regulator for pharmacists, pharmacy technicians and pharmacy premises in Great Britain. Their job is to protect, promote and maintain the health, safety and wellbeing of members of the public by upholding standards and public trust in pharmacy. If a member of the public, patient or other body is unhappy with the service they have received from a pharmacy professional, or are worried about their health or behaviour, they can report their concern to the GPhC. The GPhC investigates complaints and concerns that indicate that a pharmacy professional’s fitness to practise may be impaired.

A pharmacy professional’s fitness to practise can be impaired for a number of reasons including misconduct, lack of competence, ill-health and through having been convicted of a criminal offence. If a pharmacy professional’s fitness to practise is found to be impaired the GPhC can issue a range of sanctions, such as a warning through to removal. The GPhC investigates a wide range of allegations that a pharmacy professional’s fitness to practise maybe impaired, however, will not investigate complaints relating to claims for compensation, Customer service issues or Contract issues.

The Solution

The Bourton Group engaged with the directorate management team and the project was sponsored by the Director of Inspection and Fitness to Practise. The project was communicated to all staff and visual management techniques were used to share the project objectives, using a Quad of aims, and an explanation of the lean methodology. A core team was identified to work with the Bourton Group. The core team was trained to use the lean tools and techniques so that the organisation can be self-sufficient in these improvement techniques going forward.

Bourton undertook a voice of the customer exercise to engage with the key stakeholders of the FtP process. In addition, the work also required the active involvement of staff members that do the day to day tasks within the FtP processes.

The overall programme took a 4 step approach:

  • Getting Started
    • Mobilisation & Initial Analysis at GPhC
    • Establish key customer & stakeholder requirements
  • End to End Lean Review
    1. Map current & future state for chosen processes
    2. Benefits modelling
      • Prioritisations of improvement actions
      • Aggregate outputs
      • Performance measurement analysis
      • Develop process rollout plan
  • Building capability
    • Skills Transfer & Training
  • Managing Success – Programme Management

Process Methodology

The Bourton Group began the programme by conducting a voice of the customer survey with key stakeholders of the FtP process. We interviewed 13 people to gain a perspective from different stakeholder groups who interact and receive output from the process. Insight was gained about the current concerns and areas for improvement.

In parallel to this activity we commenced the up-skilling of the core team through a hands-on, interactive lean awareness training course. This built the knowledge of value stream mapping, waste identification and waste removal techniques. These activities set the foundation for a series of collaborative and intense workshops with a wide range of directorate staff.

The following processes were covered:

  •  Triage
  • Investigations
    • Caution and conviction
    • Misconduct
    • Health
    • Hybrid
  • Investigation committee
  • Case progression
  • Hearings management
  • Monitoring and reporting

For each part of the process we created a high level map, using a SIPOC, before completing a detailed value stream map. We identified issues and waste before conducting a brainstorming

session to identify potential areas for improvement. Once we had identified waste and created ideas we worked on developing the future state map. This map took a projection of what the process would look like in 18-24 months’ time with new technology (case management system) in place.

We also created an interim future state map, for a view of the process in 6-9 months time. The interim future state map took into account the majority of the process improvement ideas, excluding a systems change. In addition the interim state was developed so that is was clearly a transitional step between the current to future states. After completing the mapping exercises which engaged over 30 members of the directorate, the team undertook a data collection and analysis exercise.

The data collection exercise took three sources of data:

  • Monthly Performance Management database
  • FtP data extraction
  • Manual audit of 80 cases

The data was used to support the findings from the value stream mapping exercises and was also used to help assess the impact of the potential improvements. Using the data we were

able to estimate the baseline end to end cycle time and the cycle times of key stages through the process.

The Benefits

  • Detailed current state value stream maps of the key stages of the FtP process
  • Detailed future state value stream maps for the key stages of the FtP process
  • Detailed interim future state value stream maps for the key stages of the FtP process
  • Created approximately 100 individual action plans based on over 400 ideas generated during the brainstorming and mapping activities
  • Each action was estimated in terms of impact, ease of implementation and psychological impact
  • The 100+ action plans were refined and consolidated into 18 specific projects
  • Each project had a cycle time impact assessment and an implementation time assessment
  • This generated a prioritized list of projects
  • Baseline cycle times was generated from the FtP database extract and confirmed with the audit data
  • Future state cycle times were estimated based on the implementation of the projects
  • Clear direction and a set of implementation actions were established

What General Pharmaceutical Council said about us

“The Bourton Group provided knowledge and energy to help us with a significant body of work. The output will form an essential part of our business plan going forward. The quality of the work exceeded my expectations and engaged a large number of the directorate”

Claire Bryce-Smith, Director of Inspection & Fitness to Practise