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Category Archives: NHS

Marching in Step with Evolving NHS Directions in Leadership & Management

In the 2007 NHS Chief Executives Annual Report Sir David Nicholson commented as follows:

‘’The NHS, like all healthcare systems, is the sum total of the people who work in it and the day to day interactions they have with patients and colleagues. A healthcare system is a powerful coalition of organisations and professions, not just a set of individual organisations operating in a market.’’ This would indicate that certain previous NHS systems and procedures were deemed to have been insufficient and quite un-corporate.

 Changed Priorities

Here, then, was a clear call for an increase in cohesion and order, and for an improved working together of individuals and teams in a time of profound change. The implication was clear that further and on-going non-clinical training and development of staff at all levels within the NHS would play a crucial role.

The following year in his 2008 Final Report, ‘’High Quality of care for all, Next Stage Review’’ , Lord Darzi, the then Parliamentary Under Secretary of State at the Department of Health, was more explicit in the role of Leadership and Management and the need for greater focus on Leadership and Management training: ‘’making change actually happen takes leadership. It is central to our expectations of the healthcare professions of tomorrow.’’

 

What type of leadership did Lord Darzi have in mind? ’Placing a new emphasis on enabling NHS staff to lead and manage the organisations in which they work.’’and, further to this, ‘’A clear focus on improving the quality of NHS Education and Training, strengthening arrangements to ensure staff have consistent and equitable opportunities to update and develop their skills.’’

 

In point of fact, of course, the NHS had been fully aware of this need for the identification of  training needs in both individuals and groups and for the implementation of training and education long before Lord Darzi’s 2008 comments. Perhaps, as a possible criticism of their efforts, this had on occasion tended to be on an ‘ad-hoc’’ and localised basis and not with a view of the greater picture called for by Sir David Nicholson.

Out of the awareness of the need for a common approach and cohesion to training throughout the NHS there evolved in 2002 the NHS Leadership Framework [LQF], further modified in 2006 and again in September of this year in order to ensure that the qualities and behaviours identified and required in 2002 were still appropriate. Since 2002, in fact, 180.000 NHS employees have taken the LQF and it ill behoves any external training organisation to be at the very least not mindful of the LQF and its purposes and intentions! The LQF was designed, after all, ‘’to work alongside processes that guide talent management and development and recruitment.’’ This clearly includes external training providers and experts in the field of working within the sphere of Leadership and Management.

Designed specifically for the NHS, the LQF defines those abilities and qualities required of both existing and potential leaders at any level of the service.

The LQF, designed by the Hay Group, is formed of three major areas – Personal Qualities, Setting Direction and Delivery of Service. Within these are a total of 15 leadership qualities further broken down into a number of levels representing varying degrees of Leadership and Management within the NHS. The purpose of this is to identify the presence [or possible lack of] requisite behaviours, characteristics and attitudes deemed necessary.

So, in the context of the NHS, what is a good Leader?

At a recent Conference [July 2011]  Karen Lynas, Director of the NHS Top Leaders Programme asked a gathering of 800 senior leaders for words they associated with NHS Leadership over the past ten years. These included ‘’unsafe’’, ‘’top down’’, ‘’oppressive’ and ‘’risk adverse’’’. Striking a positive note, the words ‘’exciting’’ and ‘’progress’’ were used. It was widely acknowledged that the NHS approach to Leadership and Management and the addressing of revealed needs through use of the LQF had come a long way in the past decade,  and not only in approaches to coherency, cohesion and professionalism.

At the same Conference Ms Lubna Haq, Associate Director of the Hay Group, discussed and shared the data she had gathered on the subject of major current styles of leadership within the NHS, identifying: Directive, Affiliative, Participatory, Visionary, Pace Setting and Coaching.

The predominant trait appeared to be that of ‘’pacesetting’’, indicative of determination, vision and focus. Leading from the front is a salutary gift and skill, provided that one is always aware of the occasional danger of a lack of partnership with those being led. It was widely acknowledged that new and different styles of leadership needed to evolve with the fast changing environment.

A number of other desirable traits were identified. These included ‘’humanity’’ and ‘’positivity’’. The consensus is that the good leader needs to possess the ability to both inspire and to take risks. Of equal importance is the need for realism and the setting of realistic goals.

There are seven main uses of the LQF; investigation into organisational development, leadership development, coaching, assessment, selection and recruitment, team development, career development and the 360 degree feedback tool.

Those external organisations providing training support to the NHS should take due note of an increasing clarity of vision and cohesion within the NHS and increasing sophistication and refinement of diagnostic tools. This is especially the case with Organisational and Leadership development, Team development and Coaching. In taking note of all the findings, evolving attitudes and requirements in a fast changing environment the NHS and the external provider need to find common ground and march in step to provide the diagnosis and training that is required.

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Posted by on December 1, 2011 in NHS

 

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Customer Service identified as key area for improvement in NHS

The NHS needs to focus on customer service in order to improve performance, quality of care and staff morale, say senior managers in the NHS. The NHS Confederation, says the health service, should follow the example of other organisations, including the much admired John Lewis Group in the art of customer service.

Customer Service identified as key area for improvement in NHSHowever, this view has proved to be controversial in some quarters, with Unison voicing concerns and warning against the dangers of viewing patients as customers. “When you come into the health service you are extremely vulnerable. You rely on the expertise and the knowledge and skills of the staff that are going to deliver that service”. [Unison spokesperson speaking to the BBC.]

Recent high profile instances have thrown a spotlight on the need for the NHS to address perceived poor quality customer care and the need to train front line staff in best practise across the board. This is definitely gaining momentum. A poll shows 93% of the public think it is important for the NHS to focus more on customer services, such as friendlier staff.

It is widely acknowledged among NHS management that, with the right training, front line staff can make dramatic improvements by simply advocating and reinforcing basic best practise in dealing with the general public and establishing care in the forefront of NHS visible values. What is frustrating for many NHS managers is the knowledge that a poor experience at the front desk can damage the patients and their families’ perception of the overall quality of care provided, even when the clinical procedure went well and treatment had a positive outcome. In an age where perception is all and the media are hungry for any bad news, stories regarding the NHS, the customer / patient experience, must be improved if the NHS is to regain its former status and credibility with the general public.

The NHS next stage review states the good news for NHS management;  that by working with your staff in this area, you would be aligning with 5 of the 6 principles for change outlined in the NHS white paper “Customer Service in the NHS making patient care the heart of everything”

The NHS Next Stage Review document outlines these as follows:

  • focused on quality
  • Patient centred
  • Flexible
  • valuing people
  • promoting life‐long learning

Focused on quality: Education and training pathways must reflect both what clinicians expect and what is expected of them across the range of different providers. Qualityfocused means being clear about the roles of professionals and then ensuring structured training that offers the appropriate breadth and depth of knowledge and experience. Furthermore, they must support working with partners, such as social care.

 

Patient centred: The skills for listening, understanding and responding to the needs of individual patients and supporting them to manage their health in a manner that is respectful of diversity and difference must, wherever possible, be incorporated into education and training programmes and clinical practice.

 

Flexible: Healthcare is constantly in a state of development and change with increasing emphasis on health promotion, wellbeing and disease prevention and shifting patterns of care.

Training has been identified as key in achieving the improvement in customer service, and ingraining it into the NHS culture moving forward. Catalyst have been delivering effective hands on training to NHS staff in customer service for many years now, and, and In our experience, effective training needs to be designed around and to include the frontline and clinical staff themselves. It should equally Include case study scenarios which relate directly to the personal own experience of staff rather than drawing on examples from the private sector, which can alienate NHS staff and make the training appear too theoretical.  Dynamic workshop based training delivered in 90 minute sessions can provide a cost and time effective solution and has a dramatic impact on front line staff behaviour in a relatively short period of time.

Catalyst are running a series of topical workshop based seminars which tackle the importance of customer service and change in the NHS, and explore and discuss the most effective management tools and training courses available in conjunction with the ILM and City & Guilds. For further information on these and how Catalyst Learning & Development may be able to assist your organisation improve your customer service, please contact Richard Ayres Director of NHS services at Richard.ayres@cbduk.biz

                                                              

Please click to book on our forthcoming complimentary seminar for the NHS on the subject of Engaging for success within the NHS and eQIPPing for 2012. We would be delighted to welcome you!

 
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Posted by on November 23, 2011 in NHS

 

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NHS staff are its Foundations

The government has extended the deadline for all trusts to achieve foundation trust status by April 2014, but still expects the majority to become foundation trusts, either on their own or through merger “as soon as clinically feasible”.

The latest National Audit Office study on the subject has reported that 80% of trusts in England yet to achieve foundation status are facing financial issues. Twenty have been identified as struggling to reach Foundation status by 2014.

Achieving Foundation status does create an opportunity for Trusts to enjoy more autonomy in how they manage the trust and commission services. It also means that they will be competing with other Foundation trusts in order to provide a better quality of care and to demonstrate they are well run.  This has considerable implications for how the hospital is managed, how best business practise is ensured and employed by the Trust management and how a strict adherence to operational ‘governance guidance’ is observed.

“All NHS organisations not already an NHS Foundation trust in England have had to undertake a review of whether they can meet the financial standards required to be given the status of a foundation trust.

Some may try to merge, or be forced to, with more successful nearby NHS hospital trusts.  Others will watch what happens at Hinchinbrook with interest.  If Circle manages to maintain the range and standards of care at Hinchinbrook, but also cut costs, that in itself could put pressure on NHS managers at other hospitals to do the same”. – BBC report

NHS Foundation Trusts are more accountable to local people through their membership, made up of NHS staff, residents and stakeholder organisations.  Becoming a Foundation trust has considerable implications for the training of management staff, and will have a major impact on their  job roles, responsibilities and the hospital culture.  Senior management will also have to answer to Monitor who have been granted more teeth by the Government for ensuring FT’s adhere to best practise and strict governance and procedures.

Monitor is the independent Government appointed Department which assesses whether NHS trusts can become foundation trusts.  They then regulate them, making sure they are well run on behalf of patients and taxpayers.

NHS Trust staff will require training across management best practise, governance and adapting to change at a time when budgets are be squeezed and efficiency savings are being enforced in line with the QIPP agenda.

Flexible creative training solutions for staff will be required which both skill them up in necessary best practise and also help them adjust to the cultural change and recognise the changes in their own behaviour and working methods which may be required.

The Survey of NHS Foundation Trust Governors reported that Trust “governors believe training is important and would like more, in particular on the practical aspects of being a governor, and the roles of different bodies in the NHS”.

Trusts who meet this challenge head on and provide their staff with on going training support, both on best practise and winning the mind share, and explaining why the change is taking place will be much more likely to have productive responses from their staff, who will, after all, be at the sharp end of implementing the necessary changes and reforms.

Catalyst Learning & Development provide a broad range of cost effective and flexible training solutions either bespoke or in conjunction with the ILM and City and Guilds to help Trusts meet challenges posed by the on-going changes these challenges pose for NHS management.

Catalyst has worked with and within the NHS for a period of over 14 years. We are very proud of this association and of the wide range of training and expertise we have brought in such areas as leadership & management, soft skills, coaching, IT and project management in this time and which we continue to bring.

For details please contact Richard Ayres Director of NHS services at richard.ayres@cbduk.biz  or visit our web site

 
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Posted by on November 15, 2011 in NHS

 

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eQIPPing the NHS with engaging Leadership

eQIPPing the NHS with engaging Leadership

One of the main attributes required of our leaders and managers is a strategic agility to succeed within a very fast changing business environment. It has become very apparent that there is a world of difference between the old leadership styles, where the door of the boss was always open [but only for good news!] and the situation now whereby Leaders and Managers are required to be more strategic, engaging and much more about facilitating in order to inspire their staff.

(Image from New Statesman)

NHS out of hands

Anna Walker, Chief Executive, Healthcare Commission: ‘’Good leadership is absolutely fundamental to providing safe, effective healthcare to patients. There are fantastic examples, right across the NHS, of boards that have set a firm vision of quality care and are turning it into a reality across their organisation.

However, it is when we look at where serious failings have occurred that the importance of good leadership is most striking.

The Healthcare Commission has completed 15 investigations into serious failings of care at NHS trusts. These covered issues as diverse as learning disability services, maternity services and infection control. The consistent themes to emerge were poor leadership, management and team work in these organisations.

Boards of these trusts were not making sure that they were kept informed of important information such as rates of infection and trends in serious untoward incidents. This meant that they were unable to spot problems and take steps to fix them.

We saw boards that were focused on mergers or restructuring and so had taken their eye off what was happening to the safety of the patients. We spoke to staff who felt unable to communicate problems to their managers and who weren’t sure about who was responsible for important duties.

Boards of NHS trusts should learn from these investigations and ask themselves whether they could do more to strengthen leadership. Ultimately, the real power to drive improvements in our healthcare system lies with the leadership of NHS trusts, managers and clinicians. They need to exercise it on our behalf.”

So, can Trusts afford not to provide leadership & management training and to eQIPP their staff for the challenges that lie ahead?

Is now not the time to turn the talking into action? When does the time become right to discuss the requirements needed by staff to develop in order to build and maintain trust, communication? – to give staff the tools to cope with changes within the organisation as well as the opportunity for people at all levels to combine their strategies?

In a major study of global HR Directors the Institute of Leadership & Management has found that the traditional model for what constitutes a good leader is changing. ‘’CEOs and HR professionals now believe the ability to motivate, understand and inspire others is the characteristic that is most important when recruiting people to leadership positions.”

The NHS is charged with delivering better quality and more personalised care that is responsive to local needs and to put front line staff at the heart of running services. As Lord Darzi’s report notes, there needs to be high quality leadership at all levels of the organisation – in particular from clinical staff.

Dr Raj Kumar, National Co-ordinator for the NHS Clinical Leaders Network, NHS Connecting for Health: ‘’Good clinical leadership is absolutely vital to leading service improvement right across the NHS. To date, leadership development has been variable. However, ‘A High Quality Workforce’ report from Lord Darzi’s Next Stage Review has now placed a firm focus on developing and supporting clinical leaders to initiate positive change. Hospital doctors will be given their own budgets and GPs greater freedom under practice-based commissioning, resulting in the need for them to use their professional skills to assess the distribution of resources and take the lead in improving patient care. As a result, leadership skills are now being introduced in all medical training programmes.

Over the past two years, we have also developed the NHS Clinical Leaders Network (CLN), which empowers clinicians to lead positive change in their area through structured learning and peer group support. It also gives them direct access to policy leads, ministers and healthcare figureheads, enabling them to debate and influence policy reforms that directly impact on their working lives. With over 1,000 members participating in monthly or bi-monthly sessions, the CLN is due to be fully rolled-out across the country.’’

Catalyst delivers invaluable training programmes reflecting the QIPP agenda in conjunction with City & Guilds and the Institute of Leadership and Management (ILM). These directly address the need to bridge the skill gap across NHS management teams who are at the sharp end with generic, straightforward and jargon-free leadership and teamwork training. This allows teams to develop their skills for the future that lies ahead within the NHS.

Catalyst is now running a series of highly successful  FREE Leadership & Management Best Practice Seminars . These venues provide delegates from a very broad spectrum and across a diverse mix of sectors, both public and private, with a platform where people with L & D and HR responsibility can meet and discuss strategic plans and practices and to either set in place or improve and maintain staff structure and on-going development within this ever changing business environment.

 

For more information about how Catalyst could assist your organisation please contact Richard Ayres Director of NHS services at richard.ayres@cbduk.biz  or visit our web site

 
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Posted by on November 9, 2011 in NHS

 

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Are you eQIPPed for the challenges you face?

The public sector, and NHS faces it’s most challenging circumstances to date. In the face of prescribed  budget cuts of between 20-30% , Trust management are going through major restructuring whilst  still striving to maintain and increase the quality of care provided. Inevitably it’s the staff who bear the brunt of this challenge, and the managements ability to achieve more productivity from less resource will be key to achieving this.  Training has been identified as key to helping Managers meet the demanding challenge set out by the QIPP agenda, and it has long been recognised that middle management in the NHS has remained undertrained in the face of perpetual change.

Do more with lessResearch by Hays found 35% of people within the sector say making a difference to society is the main advantage to their job , thus making it by far the main motivation behind choosing a public sector career. However,  91% feel spending cuts will adversely impact on their ability to effectively deliver frontline services, and will make them consider whether they choose to remain. This suggest Trusts  can ill afford not to provide Management training to equip their staff for the challenges ahead. Retaining key staff, and helping teams adjust and move with the major structural and cultural  changes will be key to the NHS achieving its goals and meeting its challenging targets. Experience tells us that simply demanding ,more productivity from less staff, without providing the necessary support will only lead to increased  absenteeism, and the loss of  talented potential leaders to the private sector, ironically reducing productivity and moral overall.

To demonstrate that Catalyst appreciates the size of the challenge facing the NHS, we have  revised our NHS pricing schedule in line with the budget restrictions imposed by the QIPP agenda,, and are designing and delivering training programmes in conjunction with the City & Guilds and Institute of Leadership and Management (ILM) which directly address the need to bridge the  skill gap across NHS management teams at the sharp end of these challenges.

A recent example of how Catalyst are successfully engaging with NHS trusts is Sutton and Merton.

“Catalysts extensive subject knowledge and ability t relate this practically to the NHS, as in our case Primary care, has allowed us to create a meaningful management development programme, that has been blended to the needs of our employees and allowed them  to apply learning directly back in the workplace “ Sara Johnson Education and Development Lead. Sutton & Merton Community Services.

Historically a Primary Care Trust within the NHS, Sutton and Merton is now a part of the Royal Marsden Hospital, providing home and community based care services in the south west of London. The trust has gone through many changes over the past few years and wanted to create a management training programme to support new managers with their job-roles in this fast-paced, ever-changing and increasingly challenging environment.

The programme was commissioned to include the standard ILM Level 3 Award in Leadership and Management programme along with additional sessions delivered by Catalyst as well as a number of bespoke in-house delivered programmes which allowed the client to create an externally badged, Foundation, Management Development Programme for clinical and non-clinical employees progressing into management roles.  Meeting both internal and external requirements in line with QIPP and KSF guidelines.

The programme’s success in terms of providing management skills supported through publication in the workplace and through reflective Action Learning has led to re-    commissioning of this programme and the commission of additional programmes for the trust.

Candidate feedback during training sessions and subsequent action learning sets has indicated that;

Candidates have been able to practically implement course content in the workplace with the following outcomes;

  • Improved team motivation
  • Strengthened team morale
  • Increased staff productivity
  • Encouraged Management to adopt an appropriate leadership style and behaviours
  • Improved communication;
  • Enhanced overall team performance

For more information about how Catalyst could assist your organisation please contact Richard Ayres Director of NHS services at Richard.ayres@cbduk.biz  or visit our web site

 
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Posted by on November 3, 2011 in NHS

 

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