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Case Study for Requirements

Posted on April 8, 2016 in Uncategorized by

Case Study for Requirements

Introduction

In any organization, there is always the need for developing a software development framework that corresponds to the needs of system requirements due to the many competing views, cultures and needs within the entire organization’s context. The organization must choose a software development framework that can be extended to enable the analyst to capture the issues of culture, user values and user trusts. In selecting the system software development framework, the organization’s leadership must take into considerations of the requirements and the needs of the organization in order to give better services to its clients. In doing so, the management of NHS England should come up with a Dynamic Systems Development Method (DSDM) software. This will enable the users of the DSDM, which include the management, data analyst, project managers, business advisors, technical consultants, technical coordinator, and healthcare workers together with the patients they take care of, to ensure the smooth running of the organization. The DSDM considers all the needs and the requirement of the organization to meet its user’s demands and in the proper management of the organization’s resources. This paper will, therefore, integrate the DSDM software development framework to solve the issues involving cultural considerations, user trust, and user values as seen I n the organization’s operations.

The NHS

The NHS England is a body that operates independently in the arms of the government and has the responsibility for ensuring that the health outcomes of England‘s residents are improved through the provision of nationwide leadership and advancement of the quality of healthcare. It also supervises the operations of the Clinical Commission Groups (CCGs). It also assists in the allocation of resources to the CGGs as well as commissioning key healthcare and specialist services (Square and Boar Lane 2013). The NHS was established in 1948 to find a solution to the belief held for long that good healthcare must be given to everybody, irrespective of their wealth, a principle that is still its primary function. The NHS is supposedly meant to be free at any point of use by any resident of UK, except for the charges for other special services such as prescriptions and optical and dental services. The NHS serves over 64.1 million patients in the UK and approximately 53.9 million patients in England alone. In England, the NHS handles more than 1 million patients after every 36 hours. It also offers healthcare services in the regions of antenatal and routine screenings. The antenatal and routine screenings include the NHS Health Check and treatments for long-term conditions, transplants, emergency treatment, and end-of-life care.

According to facts provided on essay writing service, the NHS has an approximate number of 1.6 million employees, ranking it the biggest top five workforces in the world. Of the 1.6 million employees, the clinically qualified staffs are 40,236 general practitioners (GPs); 351,446 nurses; 18,576 ambulance staffs; and 111,963 hospitals and community health service (HCHS) medical and dental officers. The NHS gets its funds directly from the taxation. The payment system is primarily underpinned by legislation. These funds need to be managed well. The DSDM would provide the best solution to the management of the organization’s resources and meet its users’ needs. The organization’s leadership must be coordinated by the DSDM development software framework to achieve their designed roles and responsibilities.

The Secretary for Health

The Secretary of State for Health is given the overall responsibility for ensuring that the DH operates according to the outlined organization’s requirements. The Secretary for Health ensures that DH provides efficient strategic leadership for the public health, the NHS, and the social care in England. Additionally, the Secretary of the State for Health has also the responsibility of intervening about the NHS CB in which case, the NHS CB is found not to exercise tits responsibilities as required or at all or where there a risk of failing to perform the function. The Secretary of State for Health can also demand information from the Health and wellbeing boards.

The Secretary of the state is also given the responsibility of guiding the boards to be in a position in a position to depart from it as it is the mandate of the Secretary of State to the NH CB, which determines the government priorities for the NHS. The Secretary of state must explain the priorities the health and wellbeing boards has set out to deal with the demands that are identified in their JSNAs. This is not done at once, but the Secretary ensures that a small number of key strategic priorities that will have a great impact on the lives of people are selected first. At present, the Secretary of state for health is Jeremy Hunt, who was elected in September 2012.

Department of Health (DH)

The DH ensures that there is strategic leadership for the public health care, the NHS, and the social care in England. The individuals in this department must be guided by DSDM principles while performing their duties. This agency is supported by other 26 agencies and public bodies. This department also helps people to live better lives and for longer durations. The DH unit guides, shapes and funds the healthcare in England. Thus, it ensures that individuals have the support, care and the treatment they desire, with the compassion, respect and the dignity they deserve.

The DH also motivate the staffs in each health and care organization and help them understand and learn from the experience of people they encounter as well as applying the experience to everything they do. This can only be achieved when the individuals identify and appreciate the cultural differences of the patients they encounter. The DH also helps the integrity of the delivery system through funding, assurance of the delivery and progression of its services and accounting to the parliament in a manner that reflect the best interests of the patients, the general public, and the taxpayers. The DH has the responsibility of promoting honesty, openness, and transparency and imparting a culture that values compassion, dignity, and the greatest quality of healthcare above everything else. Nevertheless, this is not the case as it is seen that aspect of culture and trust is not taken seriously.

Clinical Commissioning Groups (CCGs)

The CCGs substituted the Primary Care Trusts and are now clinical statutory NHS branches that have the mandate to plan and commission healthcare services for their local regions (Square and Boar Lane 2013). The CCG aims at creating a project that will prolong the lives of individuals. In doing so, the CCG must ensure that the agencies meet its requirements while delivering their services to the patients. This project will only be successful through the application of the DSDM framework. The members of the CCGs are responsible for approximately 60 percent of NHS budget. They are also given the mandate to commission many of the auxiliary services such as planned hospital care centers, rehabilitation care centers, urgent and emergency care, community health care services, and the mental health and learning disability care services (Square and Boar Lane 2013).

To commission any service provider that meets the standards of NHS, the CCGs must ensure that these service providers follow the principles of DSDM to achieve better health outcomes. The service providers include NHS hospitals, charities, or private sector healthcare providers and the social enterprises. It is the duty of both the CCGs and the NHS England to engage their patients, carers, and the public in making decisions concerning the services they commission. Additionally, the NHS has set performance indicators that will assist the individual CCGs in tackling the health issues. The local CCGs term can be compared with the national conditions to find out how well the local CCG is performing. The indicators include prevention of people from dying when still young; improving the quality of life for the individuals with long-term illnesses; assisting people in recovering from episodes of sicknesses as a result of injuries, and ensuring that individuals have a positive experience of care.

The primary function of the CCG is to manage resources during times of crisis or when there is pressure. The management of resources in times of crisis or pressure in NHS is known as Surge management. The CCG and some of its partner organizations are obliged to have systems in place to help in the management of health care services during times of pressure or emergency. The surge management systems deal with rising pressure in the healthcare environment as well as unexpected emergencies. Thus, the CCG ensures that all services at the regional level within the NHS England are well-managed. Within the CCG, there must be hospitals, ambulance services, and other emergency services; clinics; non-emergency response services referred to as the UK 111 service, primary care such as the GP surgeries and local clinics; secondary care such as community beds nursing homes and specialist care centres and districts nurses; and finally the non-emergency transport.

The CCG also has the responsibility for ensuring that these services are well-provided to the patients who deserve them for the best value as they offer the necessary requirements of the population living within the CCG localities. Another crucial function of the CGC is to involve the health and wellbeing board during the preparation of their commissioning plans. This implies consulting the health and wellbeing boards on whether the plans formulated take into considerations the JSNAs and JHESs. Thus, the CCG must allow the views of the boards to be included in the published plan.

However, some of the services have not been well provided for, and CCG has been under pressure to reduce waste and costs that are involved in the provision of healthcare. The CCG has to find the most efficient means of using its available resources. This means that the CCG must adopt the DSDM software framework to ensure that timely solutions are arrived at within the specified budget as it is under pressure to meet its statutory requirements as it receives funding from the government. Therefore, the most innovative way to minimize their operation costs and provide the best health care on a timely basis is to implement the DSDM development framework. By following the DSDM principles, the CCG will be in a position to meet its statutory requirement of providing the best healthcare to the patients without any cultural discrimination. Each of the agencies that provide the commissioned services must integrate their systems and processes to run the services, and ensure that the services meet the contractual requirements of the CCG.

Health and wellbeing boards

The NHS established the Health and well-being boards for all levels of local authorities to represent the conference for local commissioners across the NHS, social care department, public health and other services. The Health and Well-being Boards are an essential element of the reforms that were established by the Health and Social Care Act of 2012. These boards have the responsibility of increasing the democratic inputs into strategic decisions about the public health and well-being services; reinforcing the current relationships between healthcare and social care services; uplifting combined commissioning and social care services. The boards are majorly meant to bring together bodies from the NHS, public health and local government, and the Healthwatch, all of which at as the voice of the patient. Together, these boards plan on how to meet best the local health care objectives and needs. These bodies also commission other services accordingly and are mostly chaired by a senior member who is elected, and an emerging chairman emanating from CCGs.

The coordination between various departments of NHS is coordinated from the DH. However, there are some policy implications such as the danger of unrealistic anticipations concerning how much health and well-being the health boards can offer and how frequent because, without any formal statutory guidance, they are not sure of their roles and powers. In such case, there are always tensions between their responsibilities and overseeing commissioning and the promotion of integration between the high-level strategic planning rather than involving the operational management of the pooled budgets or integrated services, and between tackling of the level of population matters as well as driving towards service transformations.

Public Health England

The PHE ensure that the national’s leadership and experts’ services are available to reinforce public health in collaboration with the local governments and the NHS in response to emergency cases. The PHE has the responsibility of coordinating a national public health services and also develops an evidence base that supports the local public health services; supporting the public in making health decisions as well as providing leadership to the public health delivery system; and finally, sponsoring the development of public health workforce.

 

 

Figure 1 can be integrated into the DSDM software development framework to find the solutions to health issues within the organization. The DSDM software is a framework that was initially based within the Rapid Application Development (RAD). It was backed by its consistency in user engagement in an iterative developmental and iterative approaches that are sensitive to the evolving requirements in order to come up with a system that meets the organization’s needs on time and within the budget. The DSDM was developed in the UK in the 1990’s by professionals from the field of Information System (IS) development, who brought together their best-practice experiences to come up with a new development framework. It is a project management and delivery framework that gives the best solution at the required time and within the budget. It is a leading and proven agile approach that provides directives and rigor along with agility and flexibility needed by an organization. The DSDM philosophy is that any project carried out by an organization must be created in a way that clearly defines the strategic objectives and focus on early delivery of the actual benefits to the organization. The management of NHS will benefit from DSDM as it is independent of the vendor and wraps the entire lifecycle of their project and also gives the best practice guidelines on time and in line with the budget designed for the project, with the proven adjustability that help in addressing the needs of projects of different sizes. The DSDM supports the application of numerous proven methodologies such as Facilitated Workshops, Modelling, MoSCoW Prioritization, and Timeboxing.

Facilitated Workshops

The Facilitated Workshops encourage collaborative working among the different departments and commissions and enables the achievement of higher quality team-based decisions to be made within a shorter period. The workers are harmonized as a group and usually communicate more efficiently and produce more innovative solutions to the problems within the organization. A Facilitated Workshop that is run well also delivers outcomes of higher degrees of buy-in, and ownership from the individuals who have participated. These workshops must always be operated by a person who is not a party to the project being undertaken. The facilitator must not determine the results of the workshops in order to ensure that all opinions and contributions of users are given equal weights. The Facilitator must create a situation that allows full participation of every team member. Additionally, the workshops must abide by well-defined and carefully thought-out processes. The process must incorporate the definition of the objectives, identification of the relevant participants; creation of an agenda; managing the logistics; and distribution of any pre-readings to the team members. The workshops are specifically of value when employed in activities that include requirement identification and refinement, prioritization, finding solutions to problems as it is required for NHS. In this case study, the facilitated workshops can be created from the various departments.

Modelling

Modeling involves collaborating diagrams and pictures, which define the problem or the anticipated solution to the problem. The Models are applied in agile projects to enable the improvement of communication through visualization. Figure 1 above can be used to create a model of DSDM that can be modeled to create solution model by linking the various departments through the DH department. The project manager must follow simple rules to ensure appropriate models are built. The project manager should be able to justify the model’s value to upgrade the knowledge of the specified problem. The manager must also use a method that works for himself as well as for the organization. He or she must also do enough and no more work to ensure that the primary objective of creating the model is achieved.

MoSCoW Prioritization

MoSCoW Prioritization requires that important work to be completed and only the less important work might be excluded from the project delivery. The MoSCoW Prioritization is a straight forward method of achieving priories through prioritizing Products Backlog utilizing the following rules:

  • Must Have- these are requirements that are essential to the attainment of the solution and are critical to the success of the project. With their absence, the solution might be obtainable and to a greater extent useless if obtained. Must Have usually defined the Minimum Usable Subset that the project is set to deliver.
  • Should Have- these are fundamental requirements where there is a short-term workaround. It is usually considered as mandatory when more time is offered for the project, but even without them the objectives of the organization will still be achieved, implying that they are an important requirement, but the success of the does not necessarily depend on them.
  • Could Have- these are meant for lower value requirements, which might be omitted easily.
  • Won’t Have this time- these are for the requirements that can be incorporated into the later development of the project. They are usually eliminated from the plans of the current project delivery.

The MoSCoW Prioritization in most cases provides the background for making the decision concerning activities of the project team at all ranks. It also ensures that the expectations of the organization are outlined at the Project level, with an acceptance that the team will be in a position to deliver the Must Haves. The teams are more likely to deliver most or all of the Should Haves, as well as the Could Haves as it is the case that the project team must always guarantee the implementation of the mush-haves and should as well be determined to deliver the should-haves. On the other hand, the could-haves of the project are realizable if and only if time and resources permit their implementation. In the case of the NHS project, the CCG has the responsibility for this stage of setting prioritization rules.

Timeboxing

Application of all or some of the Timeboxing technique elements may assist the team in controlling their Sprint well and assist in translating a delivery aspiration for the Sprint into a commitment. It will enable the team to deliver what they initially promised at the exact time, for instance, it can meet the possibly releasable increments of the product at the agreed levels of equality and meet the most valuable requirements that were identified for it. It is, therefore, crucial for the team to consider the problems they might encounter and make a decision as to which, if any, of the distinct steps below, require to be put in place and determine how much effort must be linked with each.

The Kick-off phase of the project

In the kick-off stage, there must be an agreement what must be taken from the product backlog for the sprint. It is the initial stage of timeboxing.

Planning of the Splint and Investigation

In this phase, a firm foundation for the work to be done during the product refinement that trails the kick-off session is created. Here is when the project team attains the comprehension of the details of the requirements to be met and how they will be discussed as part of the evolving solution of the project. At the end of this phase, the sprint backlog of the detailed work to be completed is baselined, and after that, the team commits to deliver one or more products by the end of the sprint, depending on their investigation and estimation of the work needed to do it. It is important that at the end of the investigation, the project team members, and where useful, the other stakeholders should perform a review. This will ensure that the project team and other stakeholders performing the review have a common comprehension of what the project team plans to perform so as to address the requirements of the sprint. In the case study, this process will take place through the coordination between the CCGs and the Health and wellbeing boards.

Product Refinement phase

Under this phase is where the majority of the project’s work is carried out in the sprint, and any development work that is related to testing must be virtually completed at the termination of this period. After that, there must be a major review to check at what deliverables have been developed and determine the amendments that might be required to meet the acceptance criteria set for the meeting the projects solutions. In this phase is where the Secretary of State for Health steps in to provide his feedback and assist in the prioritization of the work to be completed in the consolidation of the sprint.

Sprint Consolidation

In this stage, the actions that are agreed upon in the product refinement review are implemented together with any final work that is necessary to satisfy organizational or project standards. Here is where final testing of the product in done and any product that does not pass the test is not put into considerations to be delivered.

Sprint Review

The sprint review stage in many instances takes the form of a demonstration of the product increment that is deliverable by the project team. It considers that work the team delivered in the sprint and either accepts that the increment of the delivered product is fit for the purpose or highlights where it is not fit. In this phase is when any requirement that was intended to be meet but was not addressed is noted. Additionally, any other thing that was planned to be delivered but was not delivered will also be considered for incorporation in the later sprint at the next planning session.

Sprint Retrospective

Sprint retrospective offers an opportunity for the project team to explore the efficiency of the way they worked in the sprint. They may be specific attention to any issue dealing with anything else that results in the solution or aspects of it that is considered not fit for purpose. Again, the project team may look at the reasons behind why any requirements were not considered.

From its operations, it is clear that the NHS management and clinical officers encounter a broad spectrum of individuals from different cultures, whose values must be met and ensure that the user trust is maintained. Culture may be referred to as, the way people live (Paul 1955). It is true that culture affects the way people do things, from how they treat themselves to how they treat others (Paul 1955). Culture shapes the health of individuals, in the same manner, their genes do. The manner in which people define themselves culturally, for instance, by disability, religious beliefs, political affiliation, sexual alignment, disability, and age categories, will probably affect what they can do with their own health and those of others. It is therefore recommended that a good healthcare provider must recognize the differences in cultures of the patients and try to learn about the many cultures of their patients. It is also recommended for the health care provider to learn more about the overall health beliefs and experience of a given cultural group. In the case study, the CGG’s agencies have cultural issues affecting their operations.

The agencies have different languages and terminologies that they use that makes decision-making process difficult. It implies that each agency in under pressure to deliver its own services, which creates a silo thinking as each agency is concerned only with its own issues. This, therefore, calls for the CCG to ensure that all services provided a function in an integrated manner. The CCGs management noticed that integrated all the agencies to work in an integrated way are quite a challenging task. This can be made possible by the DSDM software as it allows the analyst to include a cultural aspect in its framework. The complexity of sharing data within the CCG agencies can only be made possible if the DSDM principles are followed to the later. Each of the agencies must be integrated into the DSDM developmental software framework system to make sure that the requirements of CCG are fully met. The partners in the agencies must learn and appreciate each other’s’ cultures and learn from the experience of the patients and each other.

From the problems CCG faces, the DSDM framework implementation would be appropriate. The DSDM promotes user involvement, further, it promotes the working relationships between the partners among the agencies as it balances the cultural differences and creating trust while meeting the user requirements (Bustard et al. 2013).

The DSDM also recognizes the user values that incorporates concepts such as individuality, choice, privacy, independence, dignity, respect equality, inclusion, and partnership. This implies that the NHS management must respect that everyone is different and make ensure that they are all involved in their care (Sandström 2009). The software development framework should be able to meet the equality and inclusion that relates to areas such age, gender, race, disability, sexual orientations and religious views. The DSDM framework is designed in a way to recognizes that people have the same rights to get proper care irrespective of their background or beliefs. Healthcare workers, therefore, do not only need to be aware of it but also to actively promote it in their practice (Sandström 2009). The equality value and inclusion does not only apply to the people they support but also to their workmates. Equality and inclusion are two social values that underpin social healthcare. Every employee, therefore, needs to understand what social values mean to them personally as they will reflect on their own views and behaviors while performing their duties.

Trust is also another area where DSDM plays a critical role. It is believed that trust is always practically crucial to the provision of healthcare as it is branded by uncertainties and elements of risk relating to the competence and the targets of the practitioners on whom the patients are reliant (Bustard et al. 2013). There is a need for trust between individuals, which must relate to the vulnerability that is linked with being sick including information asymmetries and balanced relationships that result from the specialized natural scientific and medical understanding (Van den Brink-Muinen 2006). In the NHS trust plays an important role in the relationship among its three primary actors, that is, the state, the health care practitioners, and the patients and the public. Trust is an important attribute in that, it gives medical relationships an intrinsic value and also acts as instrumental fashion (Van den Brink-Muinen 2006). It is crucial to patients’ willingness to seeking care, revealing private information, submit to treatment and adhere to physician’s recommendations.

The DSDM allows the analyst to include the element of trust in its framework so as to create a favourable environment both for the healthcare workers and the patients. The DSDM allows for a higher degree of involvement of the caregiver in the project, whereas the requirements of the caregiver must be parallel with the system’s requirements. This creates trust between the caregiver and the patient as well as creating trust among the teams as it encourages effective teamwork and a condition where each partner can express his or her ideas. This ensures that the clinical system’s strategies are delivered through the adoption of an iterative approach. The requirements of the underlying project will be given priorities during the iterative lifecycle.

The NHS should use DSDM, an agile delivery framework since this is the framework that carries much of the current understanding of the project management and the problems its agencies face. It can also be applied to find solutions to complex problems within the organization as it can be implemented for an agile and traditional development processes. It is a simple, extensible and straightforward framework that is primarily based on the best principles to begin implementing a project structure. It can represent as in the framework below:

Figure 1 Project Structure

The DSDM has nine principles that guides the achievement of the answers for all situations that adhere to them (Voigt et al. 2004). Ignoring any of the principles will result in a break of the frameworks philosophy and adversely increase the project risks the nine principles include the following; the principles consider active user involvement as imperative; it enables teams to be empowered to make good decisions; it focuses on successive delivery of services to the patients; it considers well-being for NHS business purpose as a crucial criterion for the assent of deliverables; it also recognizes that iterative and gradual developments are required to congregate with the accurate NHS solutions; again, all the transformations at the time of the development can be reversed; the requirements are outlined from a higher level; testing is incorporated via the life-cycle; and finally, a collaborative approach between all stakeholders is considered as important factor (Voigt et al. 2004). The DSDM focuses on user and customer involvements. As it recognizes that many of the issues observed during software development are mainly caused by people’s problems (Bustard et al. 2013). It, therefore, aspires to keep the process not dependent on tools while assisting individuals to collaborate and work efficiently. These principles can be represented through the Life Cycle Diagram.

The Project Life Cycle

DSDM requires that a complete life cycle is beginning from Pre-project phase to the Post-Project. It usually requires iterative and intensive works but majorly centres on the project, which is prolonging the lives of individuals rather than other activities.

The Pre-project Phase.

This stage is crucial for the achievement of the goals of any successful project. In this phase, the projects are not yet identified, but rather they are to be set up from the beginning to make sure they succeed (Bustard et al. 2013). Under this stage in line with the DSDM requirements, is that the best business values emerge when projects are drawn to a clear business objectives. This phase ensures that only the right projects are commenced and that they must be set up in a rightful way, based on well-defined goals. The pre-project activities usually depend on the local working practices for the commencement of the project. There must be assessment and prioritization of the project within the organization’s portfolio extend beyond the scope of DSDM (Voigt et al. 2004). The following are the key requirements in this phase:

There is a preliminary definition of the organizational issues, which need to be addressed during the creation of framework necessary for the examination that is to be undertaken when conducting the Feasibility Study.

  • Deciding on whether to continue with the project as planned.
  • Assigning the Project and Visionary project managers.
  • Developing initial feasibility study plans.
  • Confirming the alignment of the project with the required strategies of the organization.
  • Budgeting and allocating resources to be used in the Feasibility Study as well as outlining the budget or the resources for approval in the development phases.
  • There must be an initial governance of the project.

Feasibility Study

The feasibility stage is primarily meant to establish quickly whether the proposed project has the likelihood of being feasible considering technical perspectives involved and whether the project appears to be cost effective from a business point of view. The efforts related to feasibility must be reasonable enough to decide whether any further investigation is justifiable, or whether the project should be halted now because it has the unlikelihood of being viable enough. The stage aims at establishing if the proposed developmental framework will meet the requirements of the users. It also helps in evaluating the appropriateness of the application of the DSDM developmental framework. Additionally, it helps to outline the feasible technical remedies to the organization’s issues of concern and to achieve minimized estimates of timescale and the costs involved (Bustard et al. 2013). The Key Products from the Feasibility Study include Feasibility and Prototype Reports, an outline plan, and the Risk log. In the project, the CCG is concerned as information is not well shared between the various agencies. A feasibility study must be undertaken out to identify the information shared among the agencies that are extracted from the data warehouses and legal systems.

The primary functions of the NHS and the CCG are to manage the resources in times of crisis. They do this through the Surge management. The CCG is obliged to have a system to manage health services and care during a crisis. However, the Westheath reviewed how the Surge management has been carrying out emergencies and has identified that the surge has been unable to meet its responsibilities of data management, which does not meet the CCGs’ requirement as there are difficulties in sharing of information between agencies and a lot of time wastage when sharing information from each agency. The organization can only be met by the implementation of the DSDM framework. The actions that are set must be well monitored to evaluate whether they have been implemented.

Implementation phase

The implementation phase focuses on obtaining the solution and putting them into operational use for the market. The number of passes through the implementation stage will depend on the number of releases that were scheduled as part of the project. The implementation stage plays the role of ensuring that the Tested System in the working environment of the user is well organized. It also ensures that the users of the new system are trained. Further, it establishes the future developmental requirements. Additionally, the implementation stage ensures that the operators of the system are well trained and support staffs on issues of health that affects the operations of the organization. The review of what has been performed and the actual implementation of the project into operational use is evaluated. After the final implementation, the project is officially closed. The entire project team then holds a retrospective review of the overall performance of the project, by considering both the technical point of view and the process viewpoint as well as from the business point of view. Finally, the post-project phase checks on how well the anticipated business gains have been realized. This will ensure that the requirements of the CCG are met, and the patients are given better care.

In conclusion, it is clear that DSDM software framework provides the best practices that meets the needs of system requirements as with the many competing views, cultures and needs within the entire organization’s framework. The NHS England can effectively improve the health of its patients who are the customers while enhancing the performance of the organization. The CCG can also realize that its responsibilities are met when it puts pressure on its agencies to ensure that they provide proper care to the patient. The CCG has the responsibility to organize the agencies to work together as a team to achieve the common goal of ensuring long lives of the people of England.

 

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Skill fairs feature a chance for potential customers you could use an amazing various sorts of artworks placed according to a rooftop. Most international fine art fairs are easy to use, subsequently, many individuals often sign up for them creative art fairs no matter what their a better standard of knowledge in skill. They feature skill fans that have an informal possible opportunity to talk with various artists. Purchasers get a way to pick countless creative reports. This will show how global craft fairs supply you with a amazing chance for world wide online community to take pleasure from fine art. They also promote technique vendors a terrific chance to encounter buyers and access buy and sell advice in art work industry. Because of this, this pieces of paper will examine the amount of pictures part of the menu of several popular intercontinental fine art fairs, and the significance of working with analogue photos. Continue reading

Pin point the wilderness through the use of skill tasks. Reputation of Art and It’s Progression

Posted on February 23, 2015 in Discover Character Through Artwork Efforts by

Pin point the wilderness through the use of skill tasks. Reputation of Art and It's Progression Art galleries

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Locate makeup by using technique work. Reputation of It’s and Art Progress

Posted on February 20, 2015 in Background of It`s and Art Enhancement by

Locate makeup by using technique work. Reputation of It's and Art Progress digital photography

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Identify mother nature in method jobs. Story of Art and It’s Creation

Posted on February 18, 2015 in Discover Character Through Artwork Efforts by

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Find the outdoors through the use of craft do the trick. Reputation Art and It’s Improvement

Posted on February 16, 2015 in Background of It`s and Art Enhancement by

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