Working in partnership: Walsall Healthcare NHS Trust

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The issue

Walsall Healthcare NHS Trust was placed in special measures by the Care Quality Commission (CQC) in 2016, after it was rated as ‘inadequate’ on the safety and effectiveness of its services and the quality of its leadership.

Working in collaboration with NHS Improvement, the trust board committed to developing a comprehensive improvement strategy, restructuring its leadership and developing a culture to support innovation and quality improvement. The board identified the need for organisational development (OD) to help make this happen. 

What did we do?

The trust commissioned us to deliver an OD programme to support the new clinically led divisional leadership teams – each of which comprises a clinician, nurse and operational manager ­– and 75 senior leaders from within those divisions. The aim of the programme was to help embed the new leadership structure and develop leaders’ skills and abilities, enabling them to lead service improvements and innovations.

Our approach is to work alongside the people dealing with the challenges facing an organisation, enabling them to implement change. When we started working with the trust, it was facing huge financial constraints, staff were working under enormous pressure and regulatory scrutiny was intense. In the face of this, leaders were focused on managing immediate priorities, with people working in silos and little communication between teams. The challenge was to help leaders get past the immediate pressures, build their confidence and improve relationships as a prerequisite to transforming the culture of the organisation.

Working with the OD team at the trust, we co-designed the programme and co-ordinated the work alongside programme participants. Leaders took part in facilitated workshops and worked through complex problems, testing ideas for change and improvement and clarifying roles and responsibilities. This enabled leaders to surface and understand the issues and then work through solutions together, developing more open and effective relationships.

What was the impact?

Our work with the trust in Walsall typifies our OD work: it was challenging; there was no guarantee of success; it took time to deliver results. The environment was one of constant upheaval and flux so we needed to continuously adjust our approach to meet the needs and readiness of participants to engage with the programme and, due to the pressures at the trust, not all participants were able to complete it. However, our work played an important part in helping the trust begin its improvement journey. Feedback from participants was positive, with 97 per cent agreeing that the programme improved their understanding of relationships and influence within their peer group, and 76 per cent agreeing that their learning had made a positive difference to how they lead.

Bobbie Petford, Organisational Development Practitioner at the trust, worked with the Fund’s organisational development specialists on the programme:

The King’s Fund’s approach – which focused on relationships and experiential learning – was very different to most other development our colleagues had experienced before. It was therefore initially quite challenging for some but proved highly effective. What worked well was the combination of co-creation, honesty, modelling and practical application. The change brought about by the programme is continuing to grow.
Bobbie Petford

Following on from the programme, the trust has continued to build its learning culture, setting up a Quality Improvement Faculty and continuing to support leaders with coaching and mentoring. In 2017, the CQC found considerable improvement in many areas, noting the positive impact of the new leadership structure, increased visibility of senior leaders and clearer lines of accountability. The trust moved from an overall rating of ‘inadequate’ to ‘requires improvement’.