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Examples of Our Work

Evaluation of commissioning strategy - health sector/neighbourhood renewal - older people

We were commissioned to deliver a needs assessment and action research evaluation of a large London-based multi-agency health promotion programme for older people. We undertook a full and rapid literature review and explored its implications with commissioners and stakeholders as part of an Ergo designed consultation programme. Subsequently, we applied gap and synergy analysis and evaluated the fitness for purpose of commissioning strategy in relation to national policy. We were able to leave our clients completely confident that we had fully assessed all aspects of their commissioning dilemma, and the client's commissioning programme was redesigned to take account of our findings.

Engaging hostile staff - blue chip multi-national - mobile phone operator

We were commissioned by one of the world's largest mobile phone operators to support a business restructuring. During the consultancy, it became clear to a number of key staff involved in the project team might lose their substantive post or might be redeployed, and staff discontent threatened to derail the broader project. We modelled an open and honest approach to these staff, and facilitated access to senior managers, where previously access between staff and managers was unusual if not unknown. As a result, some of the evident and damaging preconceptions held by staff were properly managed and trust and respect between the internal staff team and managers was developed. The project delivered on time and to budget.

Development of communications and engagement programme - international technical organisation - space agency

When things start to get complicated you can often hear someone say "it's not rocket science!" But for our consultants working with the European Space Programme the communications really were about rocket science! Our role was to develop a communications programme that could bridge the gap between three key groups with very different roles and responsibilities. The people concerned either highly technically competent space experts, less technically competent operational and support staff and specialist and non-specialist media. Matters were even more complicated because the organisation formally communicates in three European languages and gathers its staff from every member of the European Union.

In order to manage both the disparity between technical expertise and the use of multiple written and spoken languages, we developed creative communications that incorporated high levels of graphic content. In addition, we developed cheap "in-house" presentation media that could be easily overdubbed with different native languages to match the first language of staff members. We encouraged and supported some of the expert scientists to deliver these presentations. The commissioner reported that our approach was decisive in enabling and improving effective communication between technical and non-technical staff across the organisation.

Multi-million pound savings - local authority - asylum seekers

We were engaged by a large inner London council to assess and evaluate the consistency of service provision to asylum seekers and people subject to other types of immigration legislation. We established that eligibility criteria were not used consistently and developed and delivered a project plan across adult and children's services to ensure on the one hand, coherent and consistent assessment, and equitable service delivery on the other. Key aims of the project were to deliver a programme for reassessment of all cases; providing direct and "long arm" quality assurance of social work practice, and developing a common assessment tool that incorporated principles underpinned by both national social care guidance and practices, and that all assessments were robust and able to withstand judicial examination. We also demonstrated that the emerging legal context might require an analysis of human rights and we predicted that some of the client's assessments would be judicially examined on this basis. The client accepted this innovation, and subsequently, the project was extended to embrace cost analysis and projections of the financial risks that might arise if further responsibilities fell to the council as a result of the proposed transfer of general responsibilities for asylum seekers to the National Asylum Support Service (NASS).

The council became a recognised authority in assessment processes in relation to this group of service users, and was consulted by other councils nationally. Indeed, many of these councils adopted assessment and audit practices piloted by Ergo. We were very successful in yielding positive judicial outcomes for the council and in fact, case law was established that reflected our robust approach to assessment. Specific cases were reported in legal journals and the national press and, most importantly the authority saved £ 2 million in the first year of the project's operation.

Gaining $50 million funding - international charity - healthcare

We were commissioned by a large international charity to undertake a national situation assessment in order to establish a National Information Centre to coordinate the efforts of a wide range of non-governmental organisations (NGO) stakeholders. The client used our report support a successful application for $50 million funding from the Bill and Melinda Gates Foundation.

Managing risk - blue chip multi-national - strategic communications

While delivering a highly technical change programme for one of the UK's largest communications companies, we led the communications function among the client's internal team as well as a raft of external suppliers. The organisational environment was highly fluid because of rapid technological development on the part of competitors and the substantial technical costs that were generated to keep pace with them. This meant that delays in the programme delivery would involve substantial losses for the client, and, as the client made clear, were not sustainable or acceptable. By working face-to-face with key teams and bringing them together, often for the first time, we were able to develop system-wide change and risk management processes that moved the project away from its previous silo mentality and enhanced communication between key staff and arms of the organisation.

Capacity building - leading public sector agency - transport

We recently helped develop a consultation, stakeholder engagement and marketing strategy for an innovative freight operation scheme. We helped this business define engagement objectives, data collection requirements, communication tools and quality standards. We ensured that the agency's work was properly aligned with strategic aims and overall business plans. Following the successful delivery of this engagement strategy we were asked to undertake further strategic work.

Building cooperation - local authority - healthcare

We were commissioned by a creative and innovative inner London health promotion programme to improve effective cooperation between stakeholder and provider organisations. The programme focussed on the unmet needs of older people in deprived neighbourhood areas that also had significant multi-ethnic populations.

Over a period of two years we delivered a series of repeat consultancies we improved our client's needs assessments, monitoring and data collection and performance management systems, and brought together our client's collective workplans. We also developed service specifications, staff capacity, and delivered training and mentoring to community health promoters and other staff in using research methodologies in their routine work.

Stakeholder engagement - leading public sector agency - transport

When one of the UK's largest public sector agencies wanted to redesign the way it engaged with stakeholders, we were called in to analyse almost every aspect of its operation. It became clear that there were six specific areas that required development. These were stakeholder engagement, evaluation processes, capacity building; change management; project management and performance monitoring. Ergo delivered a fully-integrated programme of work over a 2 year period that enabled a fundamental improvement in the way the agency operated. A major outcome was that operational divisions' previously unable to undertake consultation or engagement with its customers became committed to, and competent in running high-quality, high-impact stakeholder engagement programmes.

Effective innovation- primary care trust - community healthcare

We provided a programme of action research supporting the work of a Health Trainers pilot. This included the development of a combined stock-take, advice-scripting, and data collection tools for use by Health Trainers, as well as new data collection systems and an evaluative framework to monitor and support the operation of the Health Trainers and to underpin induction training.

Improved star rating - local authority- children's services

Ergo helped a failing social services department under Ministerial Directions (also known as "special measures") achieve a one-star categorisation. We did this by working closely with senior management to develop, implement and review business and budget planning, and to link these processes to an effective commissioning strategy. Ergo helped reorganise the department and interim manage those services that needed to change the most. A significant task was to assist senior managers to properly inform Elected Members of the potential impact of proposed reductions in financial allocations, and as a result of our work, senior managers were able to convince Elected Members to increase the budget rather than reduce it. An important outcome was that for the first time the council's services for children were assessed by the Social Services Inspectorate (SSI) deserving a one star rating and the council was a removed from special measures. Subsequently, we continued to work with this council and contributed to further improvements in performance that contributed to a two-star rating for community services from the SSI.

Capacity building - national NGO support programme - harm reduction

Ergo undertook a situation assessment and developed a strategic plan for a national HIV/AIDS and drugs information centre in an East European country. We then provided mentoring and support for its first-line managers to help them deliver the strategic plan. Next we provided induction training for their initial workforce to help them understand their roles and responsibilities in delivering the strategic plan. We went on to develop an evaluation system to help the client performance manage operations against the objectives in the strategic plan. The project has thrived, won accolades, and has secured repeat and substantially increased funding.

Integration of services- local authority - statutory children's services

Ergo facilitated and project managed cross-departmental processes to scope requirements in preparation for the integration of Children's Services (IS4C) as proposed the Government. Our project plan was devised and accepted by the local authority. We managed and delivered part of the implementation, including financial restructuring and the development of a strategic financial plan for Children's Services for the next 3 years. The department has now embraced essential tenets of IS4C and has integrated previously separate departments and functions.

Making evaluation routine - internal communications department - transport

Ergo developed an evaluation handbook for teams of staff and trained them in a wide range of relevant skills and techniques whilst also mentoring them through the process of undertaking their own evaluations. The result was that the team learned how to routinely set outcome-focussed objectives for their projects, how to make evaluation an integral part of their everyday work and how to use the results of evaluation to improve service delivery.

Managing strategic development - local authority - community safety

Ergo provided interim management for a London council's Chief Executive Strategy Unit. This involved managing the Community Safety Unit (CSU) and the Corporate Voluntary Sector team. Both teams were accountable to Executive Elected Members. Our work with the CSU was primarily focussed on ensuring the production of the 3-year crime audit and writing the 3-year community safety strategy. Our intervention in the CVS focussed on delivering a new funding system and monitoring arrangements. The CSV was able to deliver the crime audit and the community safety strategy, both of which were signed off by the Chief Executive and were adopted by the community safety partnership. The CSV constructed a new funding system and monitoring protocols that were put into operation.

Successful serious incident investigations - health trust - mental health

Ergo were asked to project manage five internal management reviews to investigate serious incidents that occurred in NHS mental health services. This involved informally piloting 'root cause analysis' methodologies. We produced the final reports which were discussed at Trust Board level and subsequently sent to the relevant Strategic Health Authorities. Our reports were formally commended for the thoroughness of investigation processes, and the depth and appropriateness of the recommendations contained in the reports.

Reconfiguration of statutory services - local authority - asylum seekers & HIV services

Working with a large inner London local authority our remit was to evaluate and restructure services for people with HIV and people subject to immigration control that at the time of the commission were provided by a range of council departments. In order to gather useful information, we consulted with service users and key operational staff and forensically examined multiple funding streams that appeared to support the services delivered.

We discovered that overall the service had developed contingently and was characterised by poor customer care, limited accountability, inconsistent practice, chaotic funding and low staff morale.

We recommended, and subsequently designed a new, multidisciplinary assessment service that enabled the council to provide a single contact point for service users and a distinct team to gate-keep and service all new referrals and service users already being provided resources. The new service was supported by service specifications that clearly illustrated statutory expectations and operational practices and protocols to manage exceptions arising. Funding was rationalised and inter-team and external partner protocols were developed and agreed and signed off by Elected Members. The authority implemented our recommendations and the new team is currently in the pilot stage with direct management and mentoring being provided by ourselves.

Recruiting professional staff - local authority - children's services

We worked in conjunction with a London council's Human Resources Department to enhance staff resources. The objectives included reducing turnover of permanent staff, lessening the council's dependence on agency staff and recruiting front-line social workers and first-line managers to fill positions critical to delivery of statutory child-in-need services.

We designed a loyalty bonus scheme for permanent staff, and implemented a qualification scheme in partnership with a local university to train existing unqualified workers and newly recruited part-qualified workers. In order to meet recruitment targets we assisted senior managers to design and deliver assessment centres, and constructed an induction programme for newly recruited staff. In one year, staff turnover reduced from 19% to 8%, and we reduced the complement of agency staff filling front line positions from 65% to 30%.

Improving inter-agency collaboration - crime reduction partnership

We were asked to review the working of a Crime and Disorder Reduction Partnership (CDRP) in an outer London borough. We first demonstrated through documentary analysis, participant observation and survey and interview data that the partnership was not functioning at all productively. We used thorough analysis and our experience of multi-agency partnerships to restructure the working of the partnership so that it had a clear strategy, a clear set or priorities and a clear set of measurable performance targets. Subsequently we helped all stakeholders agree individual roles and a division of labour that, for the first time, clearly set out what was expected of each agency and how each agency was to be made accountable to the partnership. As a result, the CDRP became a thriving and well-functioning partnership making a measurable difference to the quality of life of the borough's citizens.

Evaluating and integrating services - drug services

We undertook three reviews of drug service provision for a DAT based in the South West. We examined needle exchange, shared care and relapse prevention services. All of these reviews were underpinned by a review of the relevant national and international policy and best practice literatures, and involved a full range of quantitative and qualitative research tools. The reviews demonstrated which services were working well and led to a commissioning round where service provision was rationalised in order to deliver better integrated and more consistent services for a wide variety of service users across the city. The reviews also highlighted services performing well and suggested ways in which performance could be further improved by adopting elements of best practice from elsewhere in the UK. All of our recommendations were accepted by commissioners and all subsequently implemented.

Mystery shopping and gap analysis - sexual health - teenage pregnancy

In order to test the accessibility of a range of family planning/young people's sexual health clinics based within an outer London borough, we recruited a panel of young people to act as 'mystery shoppers'. The young people were all thoroughly briefed by us and visited the range of services on offer across the Borough. The young people provided detailed accounts how services in general and clinics in particular met the following criteria: the ease of physical access to services; how the young people were received by staff; the usefulness of the information provided; the range of treatments offered. We used this information to offer commissioners and providers an analysis of how each service and each clinic in the study performed on these criteria. We devised a set of recommendations to commissioners about how potential gaps in service provision might be addressed and our recommendations were fully implemented.

Best Value Review - local authority - children's services and adult services

We conducted three Best Value Reviews for an inner London social services department using Government defined Best Value Review (BVR) methodologies. The reviews of domiciliary care, adoption and fostering and leaving care services respectively, all involved a very wide range of quantitative and qualitative research methodologies that we dovetailed into the over-arching BVR methodology.

Each review highlighted major shortcomings in service provision and contained detailed recommendations for addressing these problems. In all cases resolution required substantial service reconfiguration involving an element of out-sourcing to the voluntary sector, and our recommendations were accepted in full by senior managers and by Elected Members. Our reports were widely praised both by managers and members as well as the Social Service Inspectorate. We were subsequently employed to help implement our wide-ranging recommendations.

Independent evaluation noted that not only did services improve as a result, but the Council delivered better services for less money than had previously been the case.

Developing services to conform to best practice guidance - Child and Adolescent Mental Health Services (CAMHS) - children and young people

We were commissioned by an outer London borough to review tier 2 & 3 services available to young people in need of mental health services and provided by a consortium of which it was a member.

We designed a comprehensive review and consultation plan that incorporated stakeholder interviews, scrutiny of all relevant service documentation including inter-agency protocols, care pathway data and so forth in order to obtain as clear a view as possible of the tensions and associated shortcomings in service provision.

We discovered a typical tension existed between tiers 2 and 3 of what is overall a four-tiered service model. However, in this case there were additional structural shortcomings and apparent mistrust between the professionals of statutory and voluntary agencies delivering the services. By naming and confronting these issues we were able, with the support of all agencies to devise a new set of service specifications and operational protocols. The development of these working arrangements, and crucially, development processes themselves revitalised working relationships and allowed the realisation of well-functioning care pathways. Subsequent evaluation of tier 2 & 3 of CAMHS indicated that the service overall was assessing children and young people consistently and providing appropriate levels of service based on needs rather than the ad hoc provision that had prevailed previously. Moreover, the use of pathway planning ensured that children and young people were properly referred upwards and downwards through the tiers as appropriate and so conformed with best practice nationally.

Reducing health inequality - Neighbourhood Renewal Unit/Primary Care Trust - vulnerable communities

We undertook successive commissions for a Neighbourhood Renewal Unit/PCT in order to conduct a community needs assessment and report. Subsequently we were engaged to undertake action research to test and progressively modify a range of interventions that were previously highlighted and recommended in our initial report. This in turn led to delivery of a series of health promotion interventions geared to the needs of the borough's most vulnerable communities. In addition, we implemented information gathering and performance management systems which have allow stakeholders to better identify and properly measure health-related needs and to gauge success in reducing health inequalities across the borough.

Evaluation of match between policy and practice - acute services/local authorities/drug services - domestic violence/shared care services for drug users/sex workers

In a review of the three separate services described above, we were able to highlight shortcomings in screening procedures delivered by some acute trusts, the local authority and drug services. As is our usual practice, we provided a thorough examination of national and international policy and best practice literature, and seek to ensure that all our recommendations were congruent with guidance and best practice. In all of the examples above cases, it was evident that procedures had not kept pace with emerging best practice and recently issued guidance.

Procedures and practice were changed to reflect guidance and emerging practice.

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