The pressures facing social care require no repetition, and a radical rethink is required. The new normal must consist of a greater reliance on prevention, and more focused provision of lower-cost, sustainable and safe alternatives to traditional services.

True transformation is never easy. Yet like ‘eating an elephant’ it is doable if it is broken down into manageable chunks. Below are five principles to be applied:

1: Start at the end; have a vision for where you are trying to get to

Transformation programmes are often a reaction to a crisis or an imperative to ‘do something’. It is crucial that the ‘mission statement’ is absolutely clear and communicated to everyone involved; a simple statement that can be endlessly repeated. Would stakeholders all say the same thing if you asked them what the aim of your transformation programme is?

2: Maintain a relentless focus on your top priorities

Public services are continuously scrutinised and Government, media and public opinion will demand a focus on ‘hot topics’. This can lead organisations to divert resources to areas that are in the spotlight. Yet what is urgent is not always what is important; focusing on the urgent might earn short-term relief, but one can lose sight of what is really important for long-term sustainability.

3: First know where you are; then plan how to reach your goal

Once you have identified which areas require transformation, establish precisely what their current state is. Vested interests may paint a more favourable picture than the reality. Three tips can help:

  • Perform a systematic and structured appraisal of the services in question
  • Compare yourself to best in class
  • Look at the financial implications of what being delivered
4: Drive the change, release the benefits

Too often transformation fails. Just enough change might be delivered to allow the organisation to say ‘we tried’. For real transformation to occur you must work through key steps:

1) Make the case for the change -Ensure stakeholders recognise the burning platform
2) Prepare the ground -Work with different stakeholders to define the outcomes, the path you will take and the timescales and resources needed
3) Invest real resources in making the change happen -Don’t expect busy people to manage the transition on top of their day job.
4) Drive it until it becomes business as usual- Keep hold of the change until it is the ‘new normal’ that can no longer flip back to old ways.

5: Collect hard evidence that you are moving in the right direction

Outcome monitoring and performance indicators need to be built-in to each step of the service design from the start. Don’t wait until change is underway before thinking about what would constitute evidence of effectiveness. Define the waypoints that will confirm you are on the right path and enable continued investment.


It’s a sobering fact that the majority of transformation programmes fail to deliver what was hoped for. By breaking the task into bite-size chunks, it is possible to significantly improve the chances of success.


Steve Carefull: Adult Social Care Specialist, PA Consulting 

Robert Turnbull: Care Technology Specialist, PA Consulting