3.3 OUR CYCLE OF TRANSFORMATION Over the last 12 months, the TU has defined its approach to transformation by developing and refining our Cycle of Transformation (below). This approach can be applied to large scale system wide reconfigurations as well as reconfigurations of individual clinical services. It has been refined using our practical experience of rigorous external assurance processes, including an Independent Reconfiguration Panel (on behalf of the Secretary of State for Health), review by the Office of Government Commerce and NHS Improvement and a High Court Judicial Review. We recognise that the process followed to achieve a desired outcome can often be as important as the outcome itself. This is especially true given the intended outcomes are often contentious or complex in nature. The TU Cycle of Transformation can be used from start to finish or each individual step can produce effective results. INSIGHT Many transformation processes start with the desire to change and a melting pot of different ideas to make things better. This could relate to strategy, structure, systems, culture, staff or skills. The TU supports organisations in bringing together a wide range of thought leaders and stakeholders to discuss the issues and reach a common view that addresses the problem whilst aligning with the current or projected needs of the population. The TU often partners with best in class academics, national leaders and different industries to challenge the norm and to help develop a robust case for change that sets a platform for transformation to take place. ENGAGE This involves developing relationships and partnerships so that a broad group of voices are heard when considering change. This can include engagement of patients, carers, members of public, partners and other key stakeholders. Change in the public sector can often require a formal public consultation process when considering implementing a substantial change to the way services are provided or delivered. The TU has national recognition for leading two of the largest public consultations in the NHS: Making it Better (2005) and Healthier Together (2015). DESIGN This stage focusses on the detail of how a new proposition is designed, bringing together a broad range of views and opinions from related disciplines to review the latest evidence and clinical standards and consider how this feeds into a new model of care. The TU has a diverse and unique experience in NHS redesign and reconfiguration work and has a strong track record in supporting the development of a range of progressive and practical clinical solutions. After various options have been developed, the TU can help to design a framework that incorporates an options appraisal and a robust decision making process. DELIVER This stage focusses on the delivery of the agreed change, whilst supporting those who are affected by the change. The TU helps organisations in delivering transformational change by developing a comprehensive implementation process, which simplifies the introduction of new services and systems. It is critical not just to get the project over the line but to support the organisation to ensure ownership and sustainability continues after the changes are put in place. I N S I GHT ENG A G E D E L I V ER DESI G N 9