Why Northamptonshire HealthcareNHS FT tore up the traditionalmanagement structure23 Jan 2020 By Eleanor WhitehouseLearning from failures at other trusts, the community and mental health care providerimplemented the concept of ‘distributed leadership’ to give staff autonomy andimprove engagementAnyone who’s ever had a job is used to the long-established leadership hierarchy.But what if you did away with … Continue reading “traditional management structure | My Assignment Tutor”
Why Northamptonshire HealthcareNHS FT tore up the traditionalmanagement structure23 Jan 2020 By Eleanor WhitehouseLearning from failures at other trusts, the community and mental health care providerimplemented the concept of ‘distributed leadership’ to give staff autonomy andimprove engagementAnyone who’s ever had a job is used to the long-established leadership hierarchy.But what if you did away with the formal ranking and gave everyone in yourorganisation the tools and confidence to solve problems without needing to deferupwards? That’s what community and mental health care provider NorthamptonshireHealthcare NHS Foundation Trust (NHFT) chose to do – and so far, the somewhatunorthodox decision is paying dividends.In 2016, with the dark cloud of a ‘requires improvement’ rating by the Care QualityCommission (CQC) the previous year hanging over it, survey results put the trust’sstaff engagement at just 3.85 out of 5. Little more than half said they wouldrecommend it as a place to work, and 15 per cent of positions stood vacant. “Theorganisation wasn’t in the best place,” admits Chris Oakes, director of HR and OD(pictured). “We had some challenges around cost improvement and high use ofagency staff.”Learning from other trusts in far worse predicaments was the first step on NHFT’sroad to recovery. Oakes describes how the 2013 Francis report into failures at MidStaffordshire NHS Foundation Trust found a ‘command and control’ structure, inwhich staff felt disempowered and unable to make decisions in the absence of theirsuperiors. “No matter how many standards you have, you need people who, whenmanagers aren’t around and things aren’t right, will do something about it,” Oakessays. That idea and the desire to break away from traditional management structuresled to the discovery of the ‘distributed leadership’ model – in which every member ofthe trust’s 4,200 staff feels like a leader and is able to make decisions withoutdeferring to a manager.But rather than simply putting its people on a one-off training course to teach them tobe leaders, Oakes and his team across HR, OD and communications worked toembed this concept across the trust’s culture. “We weren’t telling staff they had to gooff and do an MBA – it was more about agreeing how we expected them to behaveinstead of just having certain skills,” says Oakes. “We want them to see a problemand do something about it, not walk away because it’s too stressful.”And getting staff to sign up to a way of acting at work meant defining a set of agreedleadership behaviours. Crowdsourced from more than 200 employees at one of thetrust’s regular Leadership Matters conferences, the set of four defined behaviours –‘being authentic’, ‘embracing change’, ‘taking responsibility’ and ‘working together’ –are embedded across NHFT’s entire ethos. “It’s the bedrock of everything we do,”says Oakes. “It’s not just a policy that’s created and then sits on a shelf gatheringdust.” And to help staff live the behaviours, the trust’s new approach is bolstered bya range of training courses, including negotiating for influence and personal brand, tofurther empower employees. The response to the changes has, Oakes says, beenextremely positive, with the best feedback being when those who undertake thecourses go on to get promotions.But it hasn’t always been plain sailing. “It’s taken a lot of trial and error,” says Oakes.“Continuous learning has been a big part of it.” For example, targeting the courses atcertain groups of staff has helped those taking part get the most out of them, andthey are now offered as part of a portfolio of training. The trust also places emphasison improving diversity, and works with employees to overcome their individualbarriers to career progression – part of which is a reverse mentoring programme withBAME members of frontline staff. “It was incredibly enlightening,” says Oakes, whowas mentored by a nurse. “She faced so many challenges in coming to the UK andcarving out her career – it changed how I see my job.”To ensure the leadership behaviours continue to be used, they now form the basis ofappraisals and onboarding, as well as key staff communications, including a weeklyemail newsletter and a podcast that aims to maintain engagement among particularlyhard-to-reach employees. “Lots of our staff are based in the community and prisonhealthcare environments, so can’t always access our intranet or emails,” saysOakes. “But they can listen to a podcast while driving to work, and we take on boardwhat they want to hear about.”NHFT’s distributed leadership work also sits alongside its wider commitment toimproving engagement, dubbed the Let’s Talk Plan, which aims to engage staffacross different directorates by sharing and acting on specific results from the staffsurvey, as well as ensuring a joined-up approach to themes such as wellbeing anddiversity across the entire trust. “We’re doing everything through an OD lens nowand looking for more long-term solutions,” says Oakes. “It’s more holistic – not justgrabbing the policy off the shelf.”And the new strategy of empowering and communicating with staff is clearly working– the trust’s engagement score jumped to 4.01 in 2018, and vacancies in Decemberof that year sat at just 8.7 per cent. The engagement and leadership work alsoearned NHFT a string of accolades in 2019, including the CIPD People ManagementAward for best employee experience initiative; best wellbeing and staff engagementinitiative at the Nursing Times Workforce Awards; and the Health Service Journal’sstaff engagement award.What’s more, the trust is fresh from its second consecutive ‘outstanding’ CQC rating,and is now being used as an example of best practice to support other trusts. AsOakes highlights, all the work his team is doing boils down to improving care forpatients. “We need to invest in our culture to make it work,” he says. “And the rightculture will give the right care.”
