GLOUCESTERSHIRE HOSPITALS NHS FOUNDATION TRUST ORGANISATIONAL DEVELOPMENT ACTION PLAN

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1 GLOUCESTERSHIRE HOSPITALS NHS FOUNDATION TRUST ORGANISATIONAL DEVELOPMENT ACTION PLAN 1. Aim 1.1. The purpose of this paper is to enable the Trust Main Board to; Note the summary assessment of where we are against the Organisational Development (OD) wheel Note the projects already underway to resolve key areas of weakness or gaps Agree the recommended new initiatives to resolve remaining key areas of weakness or gaps around the OD wheel 2. Background 2.1. In October 2007 the Main Board agreed to use the OD model (Appendix 1) as a means of developing our OD programme of work. The rational for starting in the top segment of the model was supported. This led to a refresh of our organisational strategy including Mission, Vision, Values and strategic objectives in the form of a balanced scorecard In Feb 2008 the Board endorsed the terms of reference for the OD Task Group. This short life working group was established to develop an OD action plan for agreement by the Board including the development of the Values visual identity and embedding these Values throughout the organisation. 3. Approach to Developing the OD Plan 3.1. The OD task group leads have conducted face to face conversations with staff groups from across the organisation. A summary of this feedback is provided at Appendix 2. This identifies what currently works well and where we have areas of weakness or gaps The OD task group reviewed the feedback from staff noting there are many pockets of good practice across the organisation. It is believed this can often be attributed to the leadership and team working skills in these areas gaps around the OD wheel were identified in the areas of; Effective leadership and accountability in teams Strategic thinking and planning. Too much fire-fighting Individuals and teams feeling connected to The Trust Effective internal communication Staff feeling valued 3.4. These issues are all multi factorial and linked. It is therefore proposed to structure the recommendations under the following project headings as this provides consistency with the structure of the OD wheel; a. Living our Values b. Leadership and Accountability c. Communication d. Objectives and KPI s (Performance Management Framework) e. Reward & Recognition OD Plan Page 1 of 7

2 Recommended Initiatives and Work Already Underway 4.1 Living Our Values The Board agreed the Values visual identity and embedding plan in July The implementation plan is on track for cut over to the new identity on 15 th September Values into - The Board have already completed the first of a number of reflective sessions to review how well they live each of the values. They have started with listening and have identified actions to ensure they are leading by example. Each Executive Director has positively committed to cascade the Values into process within their teams The need for a cascade process with all teams across our organisation has highlighted the complexity that many staff work on a day to day basis in a number of natural teams, as well as working within their professional groups. This poses a challenge for the organisation when we need to set clear expectations of individuals and teams, hold them to account and effectively cascade information from the Board to all teams across the organisation The advice to managers regarding the Values into cascade process is that they should ensure all staff are given the opportunity to participate in sessions in a way that is most meaningful to the team and individual It is also anticipated that the effectiveness of the Values into cascade process will be variable; directly linked to the skills and behaviours of the Leaders throughout our organisation. Whilst members of the Clinical Strategy and Learning and Development teams are available to support managers to deliver these sessions the work of the Leadership and Accountability project described later in section 4.2 will need to address this gap Noting these challenges the OD task group has worked to establish a number of mechanisms to monitor the effectiveness of embedding our Values; Monitor specific questions in the staff survey Monitor specific questions in the patient survey and the more frequent feedback via the Picker hand held devices Asking at mandatory training how many staff have been involved in the Values into sessions with their team Snap shot questionnaires conducted for staff attending the education centres. This can be up to 200 members of staff a day Incorporating performance review on how well staff are living our Values as part of the appraisal process It is also proposed that the measurement of the effectiveness of the Values embedding plan will be incorporated in the Performance Management Framework project described in section Leadership & Accountability GHNHSFT has a very active Leadership Development Team working with staff to develop leadership capability. The majority of the services and programmes provided are open to all professions, although recent sponsorship by Directors has requested programmes for specific professional groups; e.g. LMT (Leading and Managing Today) for band 7 nurses and ULEAD 2 for consultants. The team also provide support to OD Plan Page 2 of 7

3 operational teams who ask for help with developing their team. The feedback from staff about these programmes is very positive However, feedback from staff also suggests that whilst they really value the opportunity to come together with their peer group and other managers across the Trust, for some, when they return to the work place they find it difficult to translate the learning into tangible improvements for patients and staff. This is often because there is insufficient critical mass within the team who have experienced the leadership development. This can lead to the efforts of individuals in their natural teams becoming more diluted and staff do not always receive the required level of support from their line manager We do not currently corporately measure the impact these programmes have on delivering the Trust s balanced scorecard The most recent thinking both locally and nationally is that in order for Leadership programmes in the NHS to deliver measurable benefits and address the issues highlighted in sections and they need to; - Develop leadership skills at all levels in the organisation - Develop leadership skills within the context of the triumvirate recognising that many natural teams in the NHS have several leaders; the doctor, nurse, manager and AHP - Develop leadership skills within the context of multi disciplinary natural teams - Specifically link the required leadership skills and behaviours with the key objectives for the service / team and to be specific about which leader is to be held to account on each of the objectives - Use 360 feedback for the team and the leader as a means for evaluating current performance and monitoring process - Establish and monitor a range of key performance indicators to measure the impact on achieving the Trust s priorities The Board is asked to note the challenges highlighted in this section and to agree to establish a Leadership and Accountability project team who will further explore the potential approach described in section This group will be responsible for providing further recommendations to the Board in January 2009 including the potential costs associated with an approach of this sort. Leadership and Accountability Project Aim The aim of the project is to develop leaders in GHFT with the skills and behaviours to establish and deliver the Trust s objectives. Project Manager; Dee Gibson-Wain Project Sponsor; Director OD & HR (Jenny Lewis in the interim) Project Team; Cross section of the organisation + HR (including members of the OD task group) 1. Align the content of existing leadership programmes to focus on service improvement, patient safety and patient experience to support the delivery of Trust priorities. 2. Describe the expectations of leadership skills and behaviours for senior, middle and front line leaders in the organisation 3. Evaluate the current provision of Leadership, training and development to meet these expectations Sept Nov 08 Sept Nov 08 Sept Dec 08 OD Plan Page 3 of 7

4 4. Evaluate a range of approaches and tools to assess Sept Dec 08 current abilities and increase capability to deliver the objectives of the organisation and teams linked to section Develop the implementation approach to cover all Dec Jan 09 leaders across the organisation 6. Assess the requirements to align our recruitment and Dec Jan 09 appraisal processes to the newly defined expectations of our leaders 7. Recommendation including required resources to Jan 09 Trust Management Team & Main Board 8. Implementation As per agreed plan 4.3 Communication The need to improve two way internal communication needs to be tackled at several levels. It is proposed that the Leadership and Accountability project tackle the issue of effective communication by our leaders It is also recognised that the corporate communications team has a very key role to support OD by; Developing a clear and comprehensive internal / staff communications strategy, including the development of Divisional Communications Liaison roles Working with IT in developing a modern, fit for purpose intranet function, to advance the Trust s web-communication. Having the ability to produce professional materials similar to the standard of the Values into toolkit Providing planned and resourced communications support to individual improvement projects Providing support for corporate initiatives; - Embedding our Trust objectives throughout the organisation - Embedding the Values of the Trust throughout the organisation - Providing communications advice and support to new approaches which aim to reward and recognise staff The Board is asked to agree the internal communications requirements listed above in order that these can be combined with the external requirements and a plan established to meet these. The aim is to make a recommendation to the Board in November Communications Aim Develop excellent internal and external communications in support of achievement of the Trusts objectives. Project Manager; Yvonne Pirso Project Sponsor; Dr Sally Pearson; Executive Director Clinical Strategy Project Team; Marketing Committee 1. Identify and agree the list of requirements to deliver excellent internal and external communication 2. Review options to achieve the requirements; - reorganise existing resources within the communications team - identify new resources 3 Recommendation to Marketing Committee and November Board Sept 08 Oct Nov 08 Nov 08 OD Plan Page 4 of 7

5 4.4 Objectives and Key Performance Indicators Having measurable objectives for the organisation with clarity of how we are performing is key to delivering improved performance. However it is vital that this is linked to effective leadership and behaviours, communication, improvement and reward/recognition if the information is to be used most effectively to actually make a difference Significant progress has been made at a senior level on working with the six priority areas described in the Trust Balanced Scorecard. However, feedback from staff indicates that the extent to which these have been used to generate objectives for teams and individuals in each of the six Divisions is variable The requirement to identify the key performance indicators to measure performance / progress against these objectives has already been recognised as a gap. The July 2008 Board agreed to initiate the Performance Management Framework project working with the support of an external consultancy with expertise in this area. Performance Management Framework Project Aims - To review existing performance measurement and reporting processes and systems as to their ability to assure the Board of progress towards the Strategic Objectives, and to set out an options appraisal to address any gaps in existing systems - To introduce into the Trust appropriate best practice to better enable the organisation to manage its performance, with the implementation of the preferred option in line with developing needs and aspirations of the Trust - To assist in knowledge transfer from Courtyard Group to Trust staff, to ensure the Trust is self-sufficient as soon as possible and can carry forwards this work as appropriate within the Trust, without the need to engage external consultancy support Project Manager; Helen Munro; Trust Information Manager Project Sponsor; Dr Sally Pearson; Executive Director Clinical Strategy Project Team; 1. Define the meaning of each of the 6 domains, the long Sept-Nov 08 term vision of the domain and the behaviours expected from Trust staff. 2. Define the critical success factors that must be in place to Sept-Nov 08 achieve this vision, the objectives that contribute to each domain vision and the measures that quantify performance against the objectives 3. Recommend the Key Performance Indicators and define Sept-Nov 08 the thresholds, targets and tolerances for each KPI and PI 4. Define the governance arrangements for the objectives Sept-Nov Define the key tasks for implementing PMF, roles and Sept-Nov 08 responsibilities, costs and resource implications 6. Recommendations to the Project Board Nov 08 OD Plan Page 5 of 7

6 4.5 Reward & Recognition The behaviours of leaders can strongly influence whether staff feel recognised for a job well done. This is another key area to be addressed by the Leadership and Accountability project However, reward and recognition at a corporate level will also hugely influence how valued staff feel. There are several pieces of work already underway; A recently formed group called The Reward Strategy Group has just been formed. This group currently reports to the Employment Committee. The terms of reference have yet to be agreed although the initial mandate is to review all reward (pay and benefits) policies and to align them to the Trust s key objectives ensuring that the Trust is achieving value for money from its most significant budgets The importance of being an employer of choice both within the NHS and externally has been recognised. Work has just started to assess the potential benefits of working to achieve the Investors In People (IIP) award. Both these pieces of work are currently being taken forward by the Employment Committee; the value of linking this work to the wider initiatives within the proposed OD Plan has been recognised The Board is asked to agree the following actions in order to progress this work; 1. Develop the project brief / terms of reference for the two pieces of work described in and Describe the reporting structures with links to the OD initiatives where required 2. Establish the teams and action the high level plan in the project brief Sep - Nov 08 Oct/Nov 08 onwards (as per the plan) 5. Reporting Structures 5.1 The operational input from members on the OD task group has been invaluable and we do not want to loose this key input to the next stage of the OD work. In the absence of the Director OD & HR taking this work forward as part of their leadership responsibility it is recommended that that the terms of reference for the OD task group are refreshed to give them responsibility for; - Performance management of the OD projects and action plans listed above - Supporting each of the projects as required developing the most effective solutions for the organisation in each of the project areas. 5.2 It is recommended that the project managers for the OD initiatives also join the OD task group to ensure we make the links between the separate pieces of work. 5.3 It is recommended that the OD task group report to the Main Board via the Trust Management Team. OD Plan Page 6 of 7

7 6. COMMUNICATION 6.1 To share this paper and decisions with the October 2008 Trust Management Team. 7. RECOMMENDATIONS The Board is asked to AGREE; ii) iii) The action plans setting up of 3 new projects; Leadership & Accountability, Communications and Reward & Recognition The reporting structures for taking this OD action plan forward ensuring the links are made between each of the initiatives Author: Contributors: Presented by: Jenny Lewis Associate Director Service Transformation & Organisational Development Members of the OD Task Group Dee Gibson-Wain Head Leadership Development Helen Munro Trust Information Manager Yvonne Pirso & Irwin Wilson Communications Dr Sally Pearson Executive Director Clinical Strategy : September 2008 OD Plan Page 7 of 7

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