Asking the right questions: Health sector strategic planning

Your strategic plan doesn't need to be groundbreaking. But it does need to fit your organisation, its clients and community. Philip Cornish digs into the right way for healthcare and community sector organisations to build a plan.

One of the things that has struck me over the decades is how similar top-line strategic plans in sectors are. Hospital or health service A might say in their big strategic plan that “we aim to provide leading care, people are our biggest asset, we will emphasise growth in capital and financial stewardship”. Health service B probably says much the same thing. I’m guessing that just about every university in Australia has had a plan to diversify income away from international students.

I'm usually more interested in the next lines in the strategic framework, below the top line.

The capacity for prospective execution is the most important part of a framing a successful plan. This should be built on the underlying situational analysis and future scanning. Of course, the process is of itself useful in getting buy-in from stakeholders, but in order to drive decisions there needs to be points specific to the service and mix. How is this service going to be different from in the past? How is it different from other services?

The model of developing the strategic framework should be suitable for the setting. In the 1990s, MBA types (like me) loved the Komatsu strategic direction slogan "surround Caterpillar”. I recall being a participant in a day-long strategic planning exercise for a public health unit in which the Komatsu example was provided as an exemplar. But it was not a useful example for the people in the room, as they didn't want to build market share. They wanted to improve services and reach.

I still find Mintzberg’s "5 Ps" on thinking about strategy useful – plan, ploy, pattern, position, perspective. So, perspective or plan? Of course, they're not mutually exclusive, and in fact I think a mix of operational plan and a positioning and perspective in the one statement is useful.

The key strategic decision is: What is the business is the of the organisation? While public health may be fixed in large part, there are still choices about platforms, specialities, locations and delivery modes. What are you really providing to the community? Treatment, local employment, speciality training, a political solution to the departure of another service?

Drucker over 40 years ago would have said that an emergency department's role is primarily to provide assurance. But a service can provide a false assurance if it is too small to provide sufficient volume to build a safe practice in speciality areas. Such trade-offs are not always made clear in co-design exercises.

Community health services, for example in Victoria, have diverged strategies around key dimensions. Some are still municipally based, others are primary health chains pretending to be community driven-rather than community-informed. Neither model is wrong, but they are not the same. Scale is a consideration.

I suggest you size the scale and the model of development for your strategic plan. Don’t believe everyone in the organisation when they say how wonderful things are. Dig deeper – this is why people from outside the organisation can often hear the truth more clearly than insiders. I don’t believe it can’t be better. And don't say "agile" unless that's your project management model. But one of the best qualities you can demonstrate when building a plan is just that: agility.

Philip can help with improving organisational performance, writing tenders and providing advice and governance for the health and community sectors. Find out more here, or connect with Philip by email, on LinkedIn or Twitter or by phone on 0419 221 652.

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