Longer term impact for organisations
On this page we share with you some of the longer term impact that our programmes have had for those that have attended, their team, their service and their patients.
Developing collective leadership at University College London Hospitals NHS Foundation Trust Critical Care Unit
Background
In late 2021, the senior leadership team of UCLH’s Critical Care Unit were considering how best to support the development of collective leadership within their department. Like many Critical Care Departments, it had undergone a rapid expansion in response to the increased prevalence of patients with severe respiratory care needs as a result of the global Covid-19 pandemic, doubling in both the number of units, and the staff required to run them.
The pace of change and increasing complexity in running a multi-site service was creating several issues with different working practices developing in different units, a lack of team cohesion across the multi-disciplinary team and collective ownership of issues, high levels of tension between team members and cultural challenges around behaviours and the treatment of staff.
What was done
The leadership team sought our support to design and deliver a bespoke four-day leadership development programme. This programme was delivered over four months.
“For me as the Matron, it was really important to invest in the team and to allow then a space where they could be together away from the department and be supported through a development programme. The programme was designed with the team at Staff College. They listened to understand the needs of our nurse leaders and what might work for them and then they came forward with what looked like an excellent programme. I fully trusted the Staff College facilitators to help us and to do their work with our leaders.”
Elaine Thorpe, Matron Critical Care Unit
At an individual level, it’s aims were to develop leaders’ awareness of their influence and impact on others, confidence to step up and do things differently and understanding of the relationship between behaviours, culture and inclusion.
At a team level, its aim was to develop stronger relationships and cohesion between peers in order to develop greater resilience and ownership within the team.
The sisters and charge nurses were supported to set up an ongoing monthly half-day forum, led by themselves, to continue to maintain and strengthen their relationships and provide time for them to address challenges within the department.
The impact for the Critical Care Unit
A year later, Staff College followed up with the leadership team, and sisters and charge nurses who attended the programme, to better understand how it had impacted on the individual and collective leadership within the Critical Care Unit.
The sisters and charge nurses had continued to meet monthly, on the recommendation of Staff College in the years since the programme. This regular protected time for the team was viewed as a crucial part of how they had continued to foster good team working, and maintain the impact of the original programme.
Some significant changes in the culture and behaviours of leaders were identified:
Better team cohesion of the sisters and charge nurses
Individuals talked about feeling that they were now part of a team with a shared purpose. They now knew members of the team they would never have previously spoken to. And that there was much greater rapport and trust within the team. They now communicated better and pulled together as a team, with a greater focus on supporting each other and looking to help each other out, in a way that hadn’t been experienced within the team previously.
Greater awareness of unit wide challenges and shared purpose
There was greater recognition that sisters and charge nurses had a common goal: to provide a really high standard of care for their patients. They had spent time rotating across the full service and now had a better understanding of the pressures across the service. They were more sympathetic to the needs of a particular unit and far more likely to pull together together to help resolve issues such as staff shortages. The culture of the service had become more supportive and proactive.
Heightened individual awareness and more thoughtful treatment of others
Attendees talked about the impact the programme had on developing their awareness of their impact on others and what they had done to be more considerate of the different needs of others. They had developed a greater awareness of their behaviours, impulses and impact on others. They had become more intentional about how they responded and adapted to the needs of others, taking greater care to treat others as individuals.
“I think generally as individuals, they stand back, they analyse, they’re curious, and they’re less reactive. They take a much more problem-solving approach and think what can I contribute right now, and what help do I need? Rather than passing everything forwards or upwards. And that’s fantastic. They really have developed their leadership insights and awareness on a much more mature level than where we are a year ago.”
Elaine Thorpe, Matron Critical Care Unit
Better leadership of their teams and improved relationships between line managers and their direct reports
Leaders talked about how they now approached leading their own teams differently, taking more time to listen to their staff. They could see that by being a more cohesive leadership team, they were better able to lead their individuals teams. They reported that staff felt happier and more welcomed at work, which had a knock on effect to providing better patient care.
This was backed up by the 2023 staff survey where Critical Care staff reported significant improvements in the way that their immediate managers worked with them.
Greater sense of ownership of issues
A key cultural shift was in the greater ownership and proactivity to responding to issues.
“The sisters and charge nurses can see what’s going on in the department through a deeper lens. Their analytical skills have developed and they want to be part of the solutions. What’s really, really impressive now is that they don’t just come with problems. They tell us about the problems there are, but what they think they should, what should be the solution or what help they need from me, from the organisation, and what resource they will need. So that’s really great. That really shows a deeper level of ownership, leadership, and engagement and really insightful to what’s going on. And I’m really, really proud of them for that.”
Elaine Thorpe, Matron Critical Care Unit
Improvement in uptake and quality of appraisals
Prior to the programme, the department’s metrics for the experience of staff who receive an appraisal was very low, as was uptake. Some of the team took ownership for developing a new process that would enable more valuable appraisals to take place.
For the two years since the programme, Critical Care has been the division with both the highest appraisal completion rates and highest number of staff survey completions for any department within UCLH.
The sisters and charge nurses have gained confidence doing them, and more staff have been motivated to take part because they now felt that the appraisal was a meaningful process.
The impact for patients and their families
A greater sense of ownership within the service has also led to an improvement in the way that patients are cared for and the experience of their families.
“We had a few complaints from relatives, where the care of patients at their end of life hadn’t gone very well. A number of the sisters and charge nurses really took this on board and really made some significant changes about how we care for patients at the end of life. They embraced the feedback rather than being defensive. They looked at what their contribution was to make sure that these things never happened again, and they solved the problem. Now they are engaged in working groups to always make sure that we can do better for patients and relatives at end of life.”
Elaine Thorpe, Matron Critical Care Unit
Other Commissioner Case Studies
Read the experiences of some of our previous commissioners who asked us to develop a bespoke programme for their organisation following their experiences of attending programmes with us: