ORGANISATIONAL DEVELOPMENT STRATEGY REFRESH

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1 1. Purpose ORGANISATIONAL DEVELOPMENT STRATEGY REFRESH The purpose of the LPFT Organisational Development (OD) Strategy refresh is to draw together the strategic plans and activities to ensure it support the Trusts objectives, priorities and values. The strategy aims to build upon the progress made to date, reflects the current and future Trust challenges viewed in the light of the recently published Francis Report and seeks to maximise the opportunities to support the provision of high quality care. It will be formally reviewed on an annual basis as an integral part of the IBP to ensure it is fit for purpose and that the issues it covers and the priorities it sets are the right ones for Trust and meets the needs of its stakeholders. This refresh has taken into account the views of the Senior Leadership Team (SLT) and wider teams and the Organisational Development Committee. 2. Background Lincolnshire Partnership Foundation Trust (LPFT) mission is to promote recovery and quality of life through effective, innovative and caring mental health, social care and specialist community services. In achieving this aim, in simple terms, our overall vision is To be the best at what we do and in doing so we must treat our patients, service users, carers and staff with an underpinning value of RESPECT. The Trust is still on a journey to achieve its mission, vision and values and recognises that there are fundamental changes which still need to take place in terms of overall culture, including, staff and management behaviours, improving the way the Trust uses its resources, develops the business, the quality of its care and the overall design of services. This document therefore sets out the overarching organisational development strategy and identifies the supporting plans that are required in order to continue to develop the Trust and improve its effectiveness. The strategy aims to give clarity and provide a framework aimed at taking a more cohesive approach to drive and support LPFT s objectives ensuring high quality patient care. In order to develop some momentum and improve levels of engagement across the organisation the Trust embarked on a programme of staff engagement called Making a Difference in 2012, with the involvement of a staff design group RESPECT was revisited, and four key areas for teams to focus on, Patient, People, Quality and Finance. It is recognised that the programme is on-going and just one strand of the cultural change that we are looking to bring about. Other key strands include a strong focus on Board Development to set the right example and tone as leadership models key to the organisation and a significant investment in leadership development at all levels of the Trust. We want our staff to be viewed as, and feel valued as partners in care. We want them to believe that they can make a positive contribution to the success of the organisation, that their views will be listened to and taken into account, that they can put forward concerns and suggestions without retribution and can see that we all have a common purpose to provide high quality care. The ultimate test is that we want our staff to recommend LPFT as an employer and as a provider of care. Our job is to support our staff to get us to this point. 1

2 3. Context The term Organisational Development (OD) is often defined as a series of planned interventions designed to facilitate change in an organisation. Capability is the combination of the people, systems and structures necessary to provide services efficiently and effectively now and in the future. There are no defined boundaries within the strategy and is concerned with the whole Trust ( one Trust ) engaging staff at all levels, it is important that OD is not seen in isolation, informed by the environment and driven by the business strategy. Organisational effectiveness will be achieved by aligning and enhancing our capability. See Figure 1 Figure 1 BUSINESS STRATEGY IBP CORPORATE PRIORITIES Influences ENVIRONMENT Drives Supports & enables transition Impacts OD STRATEGY Aligns & delivers benefits SUPPORTING PLANS In the last year there have been a number of achievements to support the progress of the OD strategy, some referred to as getting the basics right and others to support the future direction of the Trust. Most notably are; the development of the role profiles to support the Trust approach to talent management, which include effective performance reviews and recruitment, the commencement of the SLM programme, improved mandatory training and appraisal compliance, development of the leadership programme and the development of the internal communications plan. Finally through the design, development and launch of the Making a Difference staff engagement programme, 160 leaders attended the equipping leaders sessions in September and teams have commenced the leaders led team sessions. The Trust is determined to further improve how it engages with its staff and will be looking to see how it can build upon Exec visits, NED/Exec visits and focus groups arising from the staff survey results. Two way communication shall be a key focus and priority for the Trust as it meets its transformation agenda and ensure all staff are aligned to creating a successful organisation providing high quality care. Actions: Ensure clarity of Trust purpose, supporting plans, priorities and teams are aligned To ensure we capture and communicate the achievements of our staff and positive impact to our patient care Improve the alignment and effectiveness of the Senior Leadership Team (SLT) Invest in the development of our leaders 2

3 Provide feedback loops to actively listen, engage and respond Positively support role models and encourage leading edge practice Ensure all underpinning strategies support a spirit of devolvement and accountability Equip all staff to deal confidently with service user feedback and view this as an opportunity to continuously improve what we do 4. Future engagement Whilst the achievements to-date are acknowledged the Trust recognises that there is much more to do. The current environment within which the Trust operates underlines the fact that there are significant challenges ahead with the need to save c. 5m on a year on year basis and not impact on the quality of care we provide. The approach needs to recognise the rapidly changing landscape and that doing more of the same is no longer an option. We need to move the Trust to a more agile, efficient, best value basis whilst continuing to provide a high quality patient experience through delivery of the clinical strategy. This will only be achieved by supporting the 'what' we deliver with 'how' we deliver and embracing the culture changes that need to take place. This can only be achieved when we fully engage and listen to all service users and staff. Figure 2 Aligning the Trust 3. The Trust s Mission, Vision, Values and Strategic Priorities In delivering its OD strategy, it is important the Trust does not lose sight of its overarching mission, vision, values and strategic priorities therefore it is important to re-emphasise what our ultimate organisational goals, objectives and direction. There is also recognition of our 3

4 need to brand our intent to ensure external (Connecting Care) and internal focus (Making a Difference) has maximum impact The Trust s Strategic Objectives are: (i) Improving service quality (ii) Using resources more efficiently (iii) Retaining and developing the business In support of the strategic objectives, there are three key strategies: A Clinical Strategy and supporting models of care underpinned by; An Organisational Development Strategy and supporting plans A Business Development Strategy that supports the Trusts growth and positioning in the market to enable the Trust to continue to operate effectively and successfully in a regulatory environment On an annual basis the Trust will deliver its IBP and supporting plans, and following consultation agree its annual priorities. Actions: Ensure alignment between external marketing brands and internal service delivery Have an agreed business planning process, engaging key stakeholders A robust communication plan to ensure we involve and engage our staff from the outset so that we create a virtuous cycle of continuous improvement Align internal processes to ensure the delivery of the plan 4. Strategic Intent The aim of our Making a Difference programme is to deliver Better Patient Care Family and Friends recommend us as a place for care and staff recommend us as a place of work. We will demonstrate this by our commitment to our Patients, People, Quality and Finance. The Trust s OD strategy has identified a number of key themes, which when aligned will support the delivery of better patient care. Each theme is supported by a number of deliverable plans and a logical sequence of activities, it is important that we communicate clearly so that our staff understand our plans and focus and are encouraged to be actively involved in the development, implementation and delivery. Infrastructure Organisational Capability Engagement Organisation structure Technology and clinical systems Governance and policies Systems and processes Training and Compliance Effective Leadership Talent Management Workforce Planning Capability and Skill Mix Communication Role and responsibilities Health and Wellbeing Recognition Employee Relations Associated Plans Environment Change management Making a Difference 4

5 4.1 Infrastructure The clinical strategy has already identified a number of significant changes to our service provision and infrastructure that it will be necessary to introduce to improve patient care. The Trust should continue to move swiftly to realise its true benefit. The outcomes will need to be modelled and implemented, supported by effective systems to enhance the patient experience. This will be achieved by involving and equipping our staff to deliver the changes. The engagement of Service Users and their carers in testing out and refining our proposed solutions and keeping all our stakeholders informed will become our hallmark as we strive to improve our service provision and quality of care we provide. We will ensure the Trust has appropriate structures, resources and processes, which are flexible enough to support the short, medium and long term requirements of the Trust and ensure our infrastructure is designed to primarily support better patient care. This will incorporate service redesign, the effective utilisation of the Trust s estate, service line management, strategic process review and the opportunity to learn and progress from best practice. Our ambition is to provide strong leadership to create an environment where devolved management can deliver better and quicker decisions. The implementation of service line management will improve the quality of care for patients, but also with it bring improvements in productivity and real recurrent efficiencies in the way that we do things. To support the consistent and methodical review of processes a single approach or toolkit will be adopted. This approach will include the productive series and LEAN thinking. The principle adopted will aim to: Remove waste in the organisation Prevent errors rather than correct them (getting it right first time) Streamline processes (and remove variation) Continuously improve processes or services Focus on added value activities i.e. those that add value to the patient experience of care Reward those that thrive and drive the organisation forward in improving the patient experience and provide no harm care Training staff in process review methodology and change management processes will enhance skills, develop important staff engagement and credibility, involve those closest to the point of impact and create momentum for continuous improvement. Effective change management processes should be embedded and robust to ensure projects are well planned and completed with the objectives and benefits realised and there is clear accountability for delivery. Whilst day to day change management should be managed through the line by effective face to face communication, the Programme Management Office is the key vehicle for complex and/or strategic programmes. As technology advances at speed so should the Trust to ensure that technology is embedded into the ways of working to become the enabler and not the inhibitor. The technology plan aims to ensure that the technology enablement required for the Trust to successfully implement changes and developments arising from the review of the Clinical Strategy are in place. The plan is designed to provide a strong focus on supporting staff through more effective use of technology to deliver more direct patient care by freeing up operational staff to spend time with patients and less time on administration. It also creates the space for those that can drive technological advancement forward in a way that continues to meet patient expectations in a world where the use of social networks and other creative means of communication continue to evolve and develop. 5

6 4.2 Organisation design The organisation and structure of Trust services and departments must support the successful delivery of corporate objectives and Trust values which are designed to provide better patient care. This will require: Clear reporting lines (Leadership and supervision) Clear accountabilities for teams and individuals Decision making as near to the front line service delivery as possible Freedom to innovate to improve patient care and experience within a framework of accountability Avoidance of duplication Clear lines of communication The Trust recognises that functions are of two sorts: i) clinical functions (i.e those functions that directly provides services to patients) and ii) corporate support functions. Clinical functions will have strong operational management and clear clinical leadership to drive the organisation forward. Operational management supports service delivery, monitors performance and standards and manages resources and business priorities Clinical leadership ensures consistently high standards of clinical standards and practices and supports the development of services and of clinicians to continuously improve the way that care is provided. Corporate support function: these non-clinical functions are there primarily to support the front-line of care and include estates and facilities, finance, HR, L&D performance and Information, compliance, risk and business development. They provide strategy/policy development and /or transactional services. It is important that these support functions are; Structured appropriately aligned to the internal customers they serve Provide high quality services that support corporate objectives and values Represent good value for money Commercial and quality of service factors will determine whether support functions are provided directly by the Trust (in-house) or through third party organisations (outsourced). The relationship between corporate and clinical needs to be effective to ensure one Trust with one purpose better patient care Our ambition to be a devolved, streamlined, efficient organisation will be achieved by taking a systematic approach to managing change based on leading edge approaches. By more effectively aligning our business planning and performance management processes and continually reassessing our priorities, and by listening to our staff, service users and carers means that the way we do things will continually change and adapt so that we use our resources effectively to improve patient care. Actions: Continue the review of structures against the organisational design principles so that they support a devolved way of working that is able to respond quickly to staff and patient feedback Develop LEAN thinking as the standard process review methods in the Trust, creating and supporting champions across the Trust Establish mechanisms to benchmark the structure of clinical and corporate support functions to ensure correct alignment and demonstrate value for money 6

7 Ensure a structured approach to reviewing processes & activities and ensure effective use of technology to maximise patient care Delivery of the SLM programme across the organisation Continue with the integration of teams and one Trust principle to eliminate silo working and become more boundry-less in our pursuit of connecting care for the service user. 4.2 Organisational Capability The Trust needs to develop its organisation capability in order to respond to the changing organisation needs as outlined throughout this strategy. We will ensure that all our staff are developed to take on a leadership role to drive up quality standards and improve service effectiveness. The services will reflect the needs of patients and service users by equipping staff with the right knowledge, skills and competences to deliver excellent health and social care. The Trust s leadership framework will specify the required qualities and behaviours for staff at all levels, have a robust performance management framework and ensure all staff are clear on their roles and responsibilities and be accountable for their actions which includes the latitude to innovate. Our approach to talent management will be about enabling people to reach their potential, facilitating the creation of a workforce that is truly reflective of the needs of our service users agile and capable. Moreover, those that provide exceptional performance will be supported to stretch the boundaries even further to achieve new and higher levels of quality in care. 4.3 Leadership Inherent in the development of service delivery and staff capability across the Trust is the development of leadership capability. We need to create leaders at every level who aspire to achieve the organisations vision and drive the Trust forward. Board level development will concentrate on board effectiveness, setting the right tone, leading by example and identifying development needs as individuals and as a board. Senior Leadership development will recognise the importance of empowering individual leaders, staff and Teams across the Trust to develop and deliver quality services. Programmes of activity will be developed to promote joint working across the leadership team and the wider leadership within and across Teams. This will build on clear roles and accountabilities and will seek to develop core leadership skills at every level of the Trust. Generic leadership skills are essential to all aspiring and developing managers in the Trust. Core learning will take place through the development framework, supported by practical skills development that will include offering opportunities in service improvement projects and secondments. Actions: Invest in our leadership offering to: o Create a Board development programme based on the Effective Board model o Develop and deliver an appropriate senior leadership programme o Evaluate and re-define a programme of general leadership skills o Develop a programme to develop the wider leadership team Adopt a talent management approach, under pinned by a robust performance review process 7

8 Continuous development of the SLT and ODG group to ensure effectiveness and alignment Utilise and maximise external programmes provided by the regional and national leadership centres to add additional capacity and external thinking and challenge. 4.4 Alignment with professional bodies The Trust will ensure that our staff are able to access the leadership, knowledge and skills they require whether they are a newly qualified professional or a highly experienced clinical specialist through working with professional bodies, higher education institutions, NHS educational and research bodies and our own Trust professional leaders. 4.5 Talent Management Leading organisations view talent management as a strategic priority and an important long term investment that needs reviewing, refining and reinventing as needs and priorities change. The Trust will develop a talent management process that supports business priorities, market conditions and cultural factors. The confirmation of roles, knowledge and skill requirements and measures of success through the implementation of role profiles, and an effective performance review and appraisal system will support the seeking out and management of talent and succession planning within the Trust. 5. Engagement There is growing body of evidence to support the link between involved and engaged staff and the quality of patient care and satisfaction. Good internal communication is essential to help staff understand the Trust purpose and objectives and their role in achieving them ( organisation alignment ). The Trust will continue with and further develop the staff engagement and internal communications framework that will support the delivery of the management & staff behavior as this is of crucial importance to our success. Internal communications sits within LPFT s Marketing & Communications framework, which comprises of four elements: The Internal Communications Plan focuses on seven key strands: Managing Public and Service User opinion Managing staff opinion and attitudes LPFT Brand Managing key accounts, stakeholders and opinion formers Maximising business retention/growth Communicating the Trust s strategic direction Supporting the change management programmes required for the service reconfiguration identified in the Clinical Strategy Supporting the cultural change outlined in the new Organisational Development Strategy/People Plan Supporting the objectives of the Business Development Strategy Communicating routine Trust developments Engaging staff in national/partner campaigns where applicable Creating a culture of open and two-way communications throughout the Trust Setting quality standards for internal communications 8

9 Giving Information Getting Information Forums for debate Participation Partnership The key messages are as follows: Theme Messages and behaviours - 3 strategic objectives: quality, efficiency and growth - 5 areas of focus for 2012/13 Trust Direction - Ensuring staff explore and understand how their role support these objectives - Topline aspirations Clinical Strategy - Specific community proposals - Specific inpatient and specialist service proposals - Infrastructure OD Strategy - Organisational Capability - Engagement Business Development - Branding Strategy - Developing a Trust-wide approach to marketing Routine developments - As required National/partner campaigns - Where appropriate e.g. National dementia campaign - Defining responsibilities Communications culture - Providing training and support - Defining quality standards for internal communications Quality communication - Developing communication protocols The potential impact the level of engagement can have on morale, productivity, organisational performance and patient experience should not be under-estimated. The success of the OD strategy rests upon the Trust s ability to fully involve and engage with all staff at every levels starting with a value based recruitment process which is timely, through induction and on-going on a day to day basis. Evidence from the annual staff survey indicates; that there is clearly more to be done to ensure that staff feel involved and engaged. Staff engagement at its best will be demonstrated through true partnership working and everyday behaviours in way that is positively led and modeled by the Board of Directors and all the in a position of leadership. Minimum Engagement Maximum Engagement 5.1 Communication In respect of broader staff communication, it is clear that staff are directly affected by external news stories, local press concerns and national adverse publicity about the NHS do affect staff opinion. A more concerted approach to both public relations/media management and to internal staff communications is required to convey timely, accurate messages and real achievements of the Trust and its staff. Internal communications have been reviewed and a revised plan developed. The plan employs a broad range of channels and media, which will be targeted according to the message and intended audience. The communications mix has five main components all of 9

10 which are designed to enhance communication, improve feedback loops and support continuous improvement in quality; Digital communications - Development and promotion of the intranet - Introduction of blogs, RSS feeds and networking tools Direct communications - E-bulletins/Newsletters - Reinforcing the monthly 2-way team brief system Events - Roadshows/Q&A sessions - Webinars/Seminars Skills - Development of a communications network - Communications/media training Auditing - Monitoring effectiveness - Monitoring communications preferences Actions: Publish our communications strategy and continue to evaluate its effectiveness Develop our technology to enhance our communications Develop a plan to manage two-way communication from frontline to leaders, leaders to front line Develop communication skills training 5.2 Making a Difference Programme Processes to involve and engage staff in the development of the Making a Difference programme represents a move forward from merely informing staff about developments and activities. The programme, whilst developed is at an early stage, but has already demonstrated the power of teams coming together for a common purpose - The Big Picture Focus on People, Patient, Quality and Finance The Making a Difference programme will continue to play a lead role in creating the innovative organisational environment and conditions that will underpin, enable and promote transformational health and service improvement, embedding principles of value for money and keeping the patient at the heart of everything that we do. This is a strong feature of our move to embrace staff as acknowledged experts and partners in improving how we deliver care. We will aim to make a step change towards an organisation that demonstrates a clear line of sight between what we do and the patient and service user experience. Our staff are best placed to provide this. This will ensure we have a patient centred approach and that staff and managers have clear lines of accountability and the appropriate actions, attitudes and behaviours. The Trust will become a will do high performing organisation. Actions: Continue with the Making a Difference leader led sessions Act on those teams that are not involved and engaged to understand why Actively support those Teams that wish to drive the organisation even further forward Keep the design team involved and continuous review of feedback and action plans Undertake a health check of staff views in spring 2013 and take appropriate action 10

11 Develop vision for Making a Difference phase 2 incorporating a balance scorecard approach from Trust to team level. Ensure the brand is visible 6. Supporting Plans Once the strategy is approved, a number of supporting plans will be committed to and will outline the time table for the next 3 years to support the delivery of the OD Strategy. The plans clearly outline the direction of travel of the Trust, progress has been made in the first year, however it must be recognised that in order to achieve true transformation we must continue to get the basics right. Figure 3 below indicates the trajectory of change. Figure 3 The supporting plans will be living documents which will evolve and continue to develop to demonstrate the actions that have been achieved and growing ambition of the Trust. The timescales and measurements will be monitored and reported quarterly to the Board. All strategies, plans and activities of the Trust must drive towards continuous improvement and our desire for better patient care. 7. Trust Priorities The OD strategy will support the delivery of the Trust priorities, primarily focussed on preparing, supporting and enabling the workforce for the required behavioural change that will be necessary to support the achievement of the Trust Strategic Priorities as outlined below: 11

12 2013/14 Priorities 1. Maintaining and improving quality and safety 2. Single Point of Access 3. RAID pilot 4. Leading dementia developments 5. Improving access to community services - waits 6. Develop rehabilitation step down support 7. Integrated health and social care 8. Managed Care Network/SHINE 9. TMHS consultation 10. Preparation for Payments by Results 11. Technological advancement 12. CCG market expansion 13. Relationships with CCGs, LCC and H&WB 14. Bringing our staff on the journey 15. Leadership development 16. Service Line Management/ Clinical engagement and performance 17. Fit for purpose estate 18. Technology and clinical systems 8. How We Will Know When We Have Arrived? Whilst the Trust is evolving through the anticipated change, our ambition is to have a high performing organisation evidenced through better patient care, where Family, Friends and staff recommend us as a place for care and as a place of work. We will demonstrate this by our commitment to our Patients, People, Quality and Finance. Staff at all levels will speak with one voice (one Trust), engaging in the making a Difference programme and recognising their role in contributing to the patient journey. We will have high rates of staff attendance at work and our turnover will demonstrate an employer who is able to recruit and retain where necessary. Our leaders will be strong and capable positive role models and accountable for what they do in supporting the Trust through effective, productive and efficient clinical and non- clinical services that offer value for money and delivery high quality patient outcomes. 12