How to consult your users: Piloting changes

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Chapter 8

Piloting changes

8.1 Trying out changes on a small area of your service is a useful way to test whether those changes are going to work for the whole service. It is difficult to predict all the issues that will arise when you introduce something new. The information you give people about how planned changes will impact on them may lack detail, and prevent them from providing informed comments on your proposals, so piloting the changes can give them (as well as you!) real material to consider.

Points to think about:

	Pilot area: the area you are going to pilot your changes in needs to be as typical of the rest of the service as possible, so that the lessons learned are relevant.
	Resources: the resources invested in a pilot are obviously less significant than if you were going to introduce a change to your whole service, but pilots do demand significant resources for effective monitoring and evaluation, and you need to build these in from the start.
	Presentation: you need to be clear about the status of the pilot. Some people may think that you've already decided what you are going to do. You need to convince them that you have an open mind about how the service will develop, and that you value their views.
	Managing change: throughout the pilot you need to be discussing progress and problems with people, and trying to address issues that arise. You don't need to wait until the end of the pilot to adjust things if it's very clear that something isn't going to work - take the opportunity to try something else. But do give changes a chance to be properly considered. Recognise that people at first may be suspicious and negative, but they may change their views when they have given the changes a chance.
	Evaluation: the point of a pilot is to test how well something works on a small scale so you can decide whether to extend it. Evaluation of any exercise is therefore fundamental. You need to establish clearly both what you are going to measure (your success and failure criteria), and how you are going to measure it (including different ways of asking people for their views).

Pros

	Enables informed judgements to be made about costs and benefits.
	Allows discussion with users and potential users to resolve problems at pilot stage.

Cons

	There may be suspicion that the results are a foregone conclusion.
	Evaluation needs to be very carefully planned.
	Circumstances may change during the life of the pilot so that the lessons are less relevant to the whole service.
	If unsuccessful, can prejudice people against possible changes in the future.

Costs: cheaper than introducing change to whole area - but evaluation costs may be high.

Use to: try out significant changes to service that could be controversial.

The area you are going to pilot your changes in needs to be as typical of the rest of the service as possible.

North Kent Healthcare NHS Trust – Speech and Language Therapy Department ‘Can’t wait to talk’ pilot project

By the end of 1994, waiting lists for therapy were ranging from 70 to 172 in community clinics; waiting times for initial assessments were reaching 10 months. Once children were assessed, they were put on a waiting list for therapy (up to 12 months’ wait). Complaints were at their highest, and many parents were concerned that their children were waiting at overburdened clinics.

Ł40,000 was allocated by West Kent Health Authority, and with this one Speech and Language Therapist and two Assistants were appointed. Four clinics with the worst waiting lists had one day/week allocated for the visiting therapist/assistant team. During the day, four therapy groups were arranged with approximately six children in each group.

The pilot project aimed to review:

	the effects of group therapy on clinic waiting lists;
	the efficiency of group therapy;
	the type of groups that were most effective;
	consumer satisfaction with the mode of delivery; and
	the broader effects of the project on service delivery. The group ran from 21 November 1994 to 9 November 1995. 83 groups were held. There were five blocks of therapy during the year, each block lasting between six to eight weeks. The results of the pilot were:
	waiting lists decreased significantly;
	quality therapy packs were produced for use in the continuation of the project and to sell to others; and
	training and systems were put in place to ensure the continuation of quality group therapy.

Contact: Terri Horton tel: 01634 833711 fax: 01634 848332

The area you are going to pilot your changes in needs to be typical of the rest of the service as possible.

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