Empowering excellence: organisational development in an NHS trust
For organisational development partnership working to succeed, open, safe and trusting working relationships are essential.
At The King’s Fund, we work in partnership with organisations to craft and build organisational development approaches. We spend time getting to understand each organisation we partner with, establishing a foundation of trust and a mutually respectful and open relationship in order to create the environment in which change and improvement can happen. We get to know our clients and teams as people, enabling us to work at depth and with impact.
Embracing transformation
In 2022, we were approached by an acute trust in the south of England. The trust was in a difficult place, with issues including low morale, dissatisfaction, poor staff survey results and a high number of grievances. It was clear that to achieve change these challenges would require a collaborative, partnered approach. One of our first tasks was to hold a number of focus groups and 1-1 conversations where people could speak safely and openly about the issues confronting the trust.
The feedback from these sessions meant that by the time we sat down with senior leaders to share our initial findings we had already achieved rich and deep insight. We presented this insight to the trust and invited them to explore and design a collaborative approach to our proposed development and change work.
Working together with the trust’s Head of Organisational Development, Director of People and Strategy, Chief Medical Officer and Head of Quality Improvement, we pulled together five workstreams:
Executive support and team development to develop shared ownership and leadership of the work of change
Senior leaders working with appreciative and participative inquiry, small and large group work, with inputs on power, change and systems leadership, to create new connections, awareness and structures of emergent and planned action built on the organisation’s existing strengths and capabilities
Clinical leadership development programme to assist taking on a leadership role for a group of highly committed and eager clinical leads
Organisational development and change capability building to increase a shared practice and level of competency across the change functions of the organisation, increasing understanding of approaches, a collaborative approach and strategic coherence
Organisational design and systems leadership training to give senior leaders a comprehensive insight into the principles, foundations and choices available for the organisation-wide change they were seeking, recognising and working with interdependencies and across boundaries
We developed a timetable for these five workstreams, which included regular meetings with a small group of stakeholders to share and feed back how things were going as the work of change progressed. We also built specific review points into the schedule so that any adaptations or changes to the workstreams could be considered, enabling everyone to work with focus, drive and flexibility.
Shifting perceptions and gathering momentum
Change is never straightforward – it is often emotive and messy. Because we had invested a lot of time at the start fostering trusting and safe environments, we were able to use the feelings and emotions that emerged from the workstreams as insight for the next steps in the transformation work. As people sensed changes within the trust, we noticed a growing interest and eagerness to participate in the various workstreams, with more individuals wanting to get involved.
“Over time we also began to notice that staff were talking about the organisation differently. ”
Over time we also began to notice that staff were talking about the organisation differently. We encouraged people to capture their feelings about these changes in ways that felt natural to them – for example, in pictures, words, doodles, poems etc. We could see very obvious shifts in the colour, tone and depictions of what it felt like to work in the organisation. The mood in the trust started to brighten considerably and greater understanding of the shared work of leaders and their connection as a team was articulated. This change was backed by staff survey data, which showed significant improvements in the key areas we had initially identified as crucial to our shared theory of change.
Having developed an appetite and capability for leading change in the trust, we were able to pause, reflect and craft the next phase of work. For this, we encouraged staff members at the trust to take a more self-directed approach, setting up a coaching space for the leaders of the restructured directorates. Bringing these leaders together enabled individual, team, and leadership community of practice development to all be realised in the work.
The work of change and transformation is never easy or straightforward and requires the type of iterative, collaborative and participatory approach detailed above. Huge effort went into this from all parties. The King’s Fund is proud to have played a part in the trust’s transformational development and its positive impact on the communities it serves.
Our organisational development services
Unlike other consulting approaches, OD at The King’s Fund starts from the premise that the experts in addressing these issues are the people who face them every day.