Much of our strategy development work has focused on supporting organisations and partnership involved in developing new ways of commissioning or providing health services. We have also supported a wide range of individual organizations develop robust future business strategies. The processes we use depend on the organization and situational issues but our approaches as based on a belief that the more inclusive the approach the easier it will be to secure commitment to implementation.

As important as crafting strategies is keeping them fresh, relevant and effective. In today’s rapidly changing environment strategy testing processes that help organizations to understand the ongoing validity of their strategies and future direction are more than just a worthwhile investment – they should be an essential business management tool.

The introduction of patient choice into the health service was one such example – a small shift in the rules of play that could have a profound effect on assumptions about income, activity and the capacity an organization needs to deliver its core business. We have supported numerous organizations across England in understanding the implications of patient choice and testing the impact on their existing plans and strategies. We found that understanding policy shifts needs to go far beyond simply reading the relevant document. It requires an understanding of what it will mean in terms of shifts in incentives and behaviours of all players in the system and reflection of the implications. Dynamic and interactive approaches to strategy testing can offer profound benefits to all interest groups.

• Deliberative enquiry – many of our strategy development processes are designed to involve a wide range of players. A specific approach that we have added to our repertoire is Deliberative Enquiry.These processes directly engage citizens in the important decisions that impact on their lives such as their health and healthcare or the environment in which they live. It is a way of working with a wide range of people to consider complex issues from their differing perspectives. By working through the background evidence participants use their judgements, critically debate the implications of options or help in formulating future plans and are supported to reach consensus.
• Health service configuration and design. The health system seems to be in a constant state of flux. Much of this can be accommodated by small scale adjustments and shifts in ways of working. But there are times when clinicians and managers realize that the changes they need to make will need more radical shifts that not only affect sites and services but multiple organizations and networks. Loop2 have a range of processes that can help support the development of alternative options. With varying degrees of inclusion of your local stakeholders we have solutions that are appropriate for single or multiple interest groups, for those with similar or highly divergent perspectives, These include:
• Healthfit. Using large scale laminate maps this process is designed to engage a diverse range of stakeholders in redesigning their local health system in a way that can accommodate the range of change drivers currently pressurizing them to change.
• Squaring the triangle – originally developed for a group of hospitals exploring reconfiguration between sites, this process combines three elements. First the preparation of independent analysis of clinical guidelines and standards, modeling of activity, capacity and market share projections and other baseline information. Second the analysis and commentary of an expert clinical panel and third structured negotiation of clinical models and their application across the specific sites in question. This combination of evidence, judgement and compromise offers a powerful way of securing clinical commitment to future plans and the implementation process.
• Process mapping. A useful technique for clinicians to see the different stages the patient journey and identify ways of improving efficiency and responsiveness to patient needs.
• Particularly in demand at the moment are processes which engage or are driven by clinicians such as Strategy Tanks. These provide clinicians with support and external challenge to develop clinical service strategies which map well onto the service line reporting requirements of Foundation Trusts.