We supported senior leaders at Swansea Bay University Health Board to develop the relationships, skills and behaviours needed to lead and steward a complex local health system through major change.
When our programme began in January 2018, Swansea Bay – known then as Abertawe Bro Morgannwg University Health Board (ABMU) – was at a seminal point in its development. The Welsh Assembly Government had placed the health board under ‘targeted intervention’, following a critical report into failures of care at two of its hospitals. A major overhaul of structures and frontline services had begun to improve performance. A new team of executives and independent members were joining the board, after considerable turnover among senior leaders, to shape the future organisational culture collectively and to improve performance. This new leadership team was under considerable scrutiny and facing significant financial and operational challenges.
We worked with the new executive to establish them as a cohesive team; and we also worked with the wider senior leadership, building their capacity to work collectively on complex issues. This then allowed us to support the board to refresh its approach to quality, safety and governance.
Our two senior leadership consultants facilitating the programme – Deborah Homa and Matthew Rice began with relationship-building within the board.
‘With both the board and the executive team, we explored how they viewed their collective responsibilities, how they modelled the organisation’s values, how they worked together both in and out of the board room and how they wanted to be perceived and interact with the wider organisation,’ Deborah explains.
This latter point was especially important – ‘there was a thirst to get behind the numbers and understand what it was really like on the front line’, so we worked with the board to reconnect with patients and staff. To get discussions going, we brought in expert speakers on quality, governance and risk. We compared their experience of being placed under targeted intervention with the experience of NHS organisations in England placed in special measures, and we explored the board’s role in stewarding quality and safety.
This was fruitful but we suggested going further to deepen board members’ understanding of experiences across the organisation. We arranged for patients to come and talk to board members individually and for the board members to shadow different staff including community nurses, maintenance engineers, porters and cleaners, and then share their learning together as a group.
‘Having listened to patients and then spent the day with staff, the connection between staff experience and patient experience became real for them – how they’re so intertwined – and this connected to what they are actively stewards of,’ Deborah says.
Pamela Wenger, Director of Corporate Governance, was among the newly recruited members of the executive. She feels the programme has made a tangible difference to her own working, to how the executive team functions and to its rapport with the board. As a result of better understanding her and her colleagues’ preferences, she says, ‘we are working more effectively together as a strong team leading the organisation’.
Pamela’s impressions were echoed in feedback we received from the wider leadership team with whom we also worked – which included around 40 of the organisation’s top nursing, medical and general managers. They perceived a change in culture at the top, with more clarity of direction and cohesion within the executive team.
‘We’ve grown to connect with their purpose, we’ve seen them start as one organisation (ABMU) and finish as another – quite literally – as Swansea Bay’ says Matthew. ‘We’ve been proud and privileged to travel this journey with them.’