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					                                                      Agenda Item:        TB 08 (17)
                            East Cheshire NHS Trust
                        Trust Board – 28th February 2008
                                  Sally Campbell, Director of Human Resources &
Report of                         Organisational Development

                                     Bronwyn Barrow, Project Director of
Paper prepared by                    Organisational Development

                                     Organisational Development Plan 2008 - 2010
Subject/Title

                                     None
Background papers (if
relevant)

                                     To set out the framework within which the
Purpose of Paper                     Trusts strategic plans for organisational
                                     development will be delivered.
                                     For the Board to approve
Action/Decision required

Links to:                            NHS Operating Framework 2007
    NHS strategies and              Lord Darzi Interim Report ‘Our NHS Our Future’
       policy                        2007
   
Link to:                             Planning for the Future 2010
    Trust’s Strategic               Integrated Business Plan 2007
       Direction
    Corporate Objectives
    Healthcare Standards
                                     Resources required to meet recommended
Resource impact                      actions/workstreams for 2008-9.

                                     OD – Organisational Development
You are reminded not to use
acronyms or abbreviations
wherever possible.
However, if they appear in
the attached paper, please
list them in the adjacent box.




Sally Campbell and Bronwyn Barrow      Page 1 of 33
East Cheshire NHS Trust Organisational Development Plan – February 2008
TRUST BOARD EXECUTIVE SUMMARY

 Subject:                       Organisational Development (OD) Plan 2008-2010

 Date of Meeting:               28th February 2008

 Prepared by:                   Bronwyn Barrow, Project Director of Organisational
                                Development

 Presented by:
1.0  Introduction               Sally Campbell, Director of Human Resources &
                                Organisational Development


1.1    The purpose of this paper is to summarise the key points within the
       Trusts OD Plan 2008-2010.

2.0    Background

2.1    The Trust has undergone a significant period of change over the past
       two years and the attached plan sets out the process for delivering
       further changes. The plan has been informed by Trust Board and EMT
       members and takes account of the views of some managers and
       clinical leads.

2.2    During the process of developing the plan, four Work Streams emerged
       and these provide a framework within which a range of tasks, actions
       and development initiatives will be delivered. The Work Streams are:

       2.2.1 Culture Change

       2.2.2 Clinical Leadership

       2.2.3 Talent Management

       2.2.4 Service Improvement.

3.0    Key Issues

3.1    The Trust recognises the need to become more business focussed and
       aims to be a high performing organisation. To facilitate the change in
       culture required, the OD Plan proposes to develop a number of
       individuals to be „change facilitators‟ who will be developed and
       supported to initiate and lead on change.

3.2    The plan recognises both the specific and common development needs
       of Clinical Leaders and Non-Clinical leaders and therefore includes
       both uni-professional and multi-professional initiatives. The plan also
       recognises that development needs arise at all levels of the


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East Cheshire NHS Trust Organisational Development Plan – February 2008
       organisation and therefore includes some activities that are specific to
       the Trust Board.

3.3    A new approach to developing and retaining our talented leaders and
       managers will be introduced through a „Talent Management Strategy‟.
       This will set out how high performing individuals will be further
       developed in order to realise their full potential and to inform
       succession planning across the organisation.

3.4    Continuous improvement is key to improving both organisational and
       individual effectiveness and efficiency. Therefore, equipping our
       workforce with the tools, techniques and resources for service
       improvement is a core component of the OD Plan. Progress has
       already been made with the application of lean methodologies in some
       areas and the next step will be to agree a more structured approach to
       service improvement. The other three work streams within the plan will
       each promote service improvement as a mainstream activity and are
       designed to facilitate a leadership approach that encourages and
       rewards creativity and innovation across the workforce

3.5    The plan supports, and in turn is supported by, a range of other
       strategies and plans. In particular, whilst it does not incorporate all the
       training and development requirements of the organisation, it does
       include those that are key to achieving the organisations strategic
       aims. The Trusts Learning & Development Plan covers more general
       provision for meeting identified learning and development needs.

4.0    Summary and Conclusions

       The OD Plan aims to capture the priorities for development and will be
       kept under review to ensure that it continues to focus on the right
       priorities as circumstances change.

5.0    Recommendation

5.1    The Trust Board is asked to:-

              Consider the content of the OD Plan and provide approval

              To note that further discussion and decisions are ongoing in
               regard to finalising the Trusts strategic plans for implementing
               business units and progressing service improvement.

              To note that a resource plan for delivering the OD Plan will be
               produced upon agreement to the core components of the plan.

              To note that delivery of the plan will be subject to review by EMT
               on a monthly basis and the Trust Board will receive a bi-annual
               report in September 2008 and April 2009.


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East Cheshire NHS Trust Organisational Development Plan – February 2008
EAST CHESHIRE NHS TRUST

ORGANISATIONAL DEVELOPMENT
PLAN 2008-2010




February 2008



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East Cheshire NHS Trust Organisational Development Plan – February 2008
CONTENTS

1      Introduction

2      Culture Change

3      Out Development Approach

4      Our Emerging OD Priorities

       Culture Change
       Clinical Leadership
       Talent Management
       Service Improvement

5      Summary

Appendix 1 Our Operating Context
Appendix 2 Organisational Implementation Plan 2008-2010
Appendix 3 Progress 2006-2007
Appendix 4 Emerging Organisational Development Priorities




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East Cheshire NHS Trust Organisational Development Plan – February 2008
EAST CHESHIRE NHS TRUST
              ORGANISATIONAL DEVELOPMENT PLAN
                                     2008-2010

1.     Introduction


1.1    East Cheshire NHS Trust has undergone a rapid period of
       development over the past 2 years since our last Organisational
       Development (OD) Plan was put in place.

1.2    This new document sets out the proposed changes that we need to
       make to take us forward during the next 2 years in line with the Trusts
       strategic aims and, perhaps more importantly, to support the culture
       change required.

       It is expected that we will need to make further changes to our OD Plan
       once we are clear about our application for Foundation Trust status.
       We are therefore looking to create a robust yet flexible arrangement
       which can respond to the inevitable influences that will affect us in the
       future both at national policy level, local health community level and
       within the organisation. A summary of the context within which we are
       operating, and which directly impacts upon our Organisational
       Development Plan, can be found at Appendix 1.

1.3    The paper covers the proposed changes to:-

            Becoming a more business focussed organisation both in the
             way we deliver excellent services and care for our patients and
             the way in which we lead and develop our talented workforce.
            Strengthening clinical (medical) leadership arrangements.
            Developing the capacity and capability within the senior
             management structure to ensure this is fit for purpose.
            Improving our systems and processes for performance
             management, governance and continuous service improvement.

1.4    This plan focuses primarily on the action we need to take during the
       next two years while providing proposals to support the organisation‟s
       development beyond this time frame. An OD Implementation Plan
       setting out the work programmes and timeframes for the next 2 years is
       included in Appendix 2 of this document. Appendix 3 sets out progress
       made during 2006-2007



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East Cheshire NHS Trust Organisational Development Plan – February 2008
2.     Culture Change

2.1    Key to the organisation achieving its strategic objectives and realising
       its vision will be its ability to survive and thrive within an increasingly
       competitive and complex health care market.

2.2    This not only means being the hospital people prefer (and choose) to
       be treated at, but it also means being the employer of choice so that
       we attract and retain high calibre staff to treat and care for our patients.

2.3    It also means that we must operate as a business, ensuring that we are
       as efficient as we can be and that we constantly look for ways of
       improving our performance, productivity, effectiveness, efficiency and
       the quality of care we provide.

2.4    Cultural change is therefore a central theme of the OD Plan and the
       various components and actions described within it are designed to
       support this primary objective.

 Figure 1 below shows the 3 Stage Culture Change Process the OD Plan will
follow.



                                           Stage 3                      Healthcare delivered
                                           Transforming                 by/through Business Units
                                           the service                  High Performing
                                                                        organisation
                                                                        Effective Talent
                                                                        Management


                          Stage 2
                          Introducing
                          the levers for
                                                      Engaging staff around clinically led
                          change                      change and supporting staff to be
                                                      ‘change facilitators’ and lead on
                                                      change


                                                      Developing our Leaders and Managers
                                                      (commenced 2006), and nurturing and
          Stage 1                                     managing talent
          Capacity in
          the system




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East Cheshire NHS Trust Organisational Development Plan – February 2008
3      Our Development Approach


3.1    We recognise that whilst we have made progress we still need to make
       some significant shifts in our thinking and approach.

3.2    Staff engagement will be key to making this shift in that, if we fail to
       involve staff in our service planning and in our decisions about how
       services will be delivered, we will not be realising the full potential of
       our workforce. This in turn could mean that we do not address the
       issues of concern to staff and/or the obstacles to effective working.

3.3    Our approach to Organisational Development is therefore designed to
       promote staff engagement through the development of „change
       facilitators‟. Our change facilitators will form a multi-professional group
       of enthusiastic individuals who have the energy and drive to make
       things better for patients, for staff and for our stakeholders. They may
       be involved in promoting small changes that make a big difference in
       their work area for example; redesigning a form or patient leaflet, or
       changing the script for answering the telephone or, alternatively, they
       may be involved in promoting big changes that make a significant
       difference for example changing work patterns, making efficiency
       savings, reducing waste or contributing to the development of care
       pathways. The Trust will support and invest in the development of its
       change facilitators to ensure that they have the right tools and
       resources to deliver change.

3.4    In parallel to developing change facilitators, the Trust will also develop
       and implement a strategy for Talent Management. The strategy will set
       out the way in which the Trust will recruit, retain and nurture talent in
       order to ensure our workforce has the capacity and capability to adapt
       and flex in response to changing requirements. The Talent
       Management Strategy will focus on recognising and rewarding staff
       creativity and innovation, while new changes to our performance
       management framework will ensure that staff, who are not performing,
       are identified early and support is put in place in a timely manner for
       them.




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East Cheshire NHS Trust Organisational Development Plan – February 2008
Figure 2 below shows the model of Talent Management we intend to follow,
together with a brief indication of the outcome measures we will use.

Approach to Talent Management

                                                              Outcomes/Measures


                                                                                     Staff are able to progress
                                                                                     their careers within the
                                                                                     organisation.
                                          Develop a
                                      Succession Plan                                The Trust has a flexible
                                      for the Trust                                  and adaptive workforce


                                                                                   Staff progress through
                             Identifying high performers                           KSF Gateways/Pay
                             and staff with potential to go                        thresholds and get the
                             into the Trusts „Talent Pool‟                         development they need
                             from which we first look to
                             appoint to our key posts
                                                                                         In addition to formal
                                                                                         appraisal and personal
                 Continually reviewing the performance of staff and                      development planning
                 checking that their development plans are aligned to                    we have a culture of
                 the Trusts objectives                                                   providing feedback
                                                                                         on performance and
                                                                                         addressing problems
             Recruiting staff against the competencies required for the job, and         early on.
             using proven assessment tools that identify potential
             performance.                                                                We recruit staff against
                                                                                         the right selection
                                                                                         criteria and make more
                                                                                         effective selection
                                                                                         decisions.




4.     Our Emerging OD Priorities

4.1    Based on the national and local drivers, our priorities set out in the
       Integrated Business Plan, and our understanding of our organisational
       strengths and development needs, the following 4 work streams have
       emerged. A more detailed description on these is included at Appendix
       4.

       The Work streams are:-

       a)      Culture Change – our aim is:

               To become more business focussed through the establishment
               of „business units‟ operating under the principle of earned
               autonomy.


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East Cheshire NHS Trust Organisational Development Plan – February 2008
               To develop our governance arrangements.

               To design new performance systems and processes including
               creating a culture that is performance focussed.

               To embed staff involvement/engagement in the culture of our
               organisation.

       b)      Clinical Leadership – our aim is:

               To develop our clinical leaders and clinical engagement to have
               a more direct impact on the way we lead and manage our
               services - by giving them the information they need to aid there
               understanding and their ability to influence strategic planning
               and decision making .

       c)      Talent Management – our aim is:

               To develop our leadership and management capability at all
               levels across the organisation from the Board to our first line
               supervisors including competency based recruitment and
               development, with a clear focus on outcomes and outputs to
               ensure a good return on our investment.

       d)      Service Improvement – our aims are:

               To develop staff at all levels within the organisation in respect of
               continuous service improvement.

               To provide opportunities for joint clinical and management
               development to enhance commonality and team working for
               service improvement

               To develop networks with local people, patients and partners to
               influence and shape services and to share good practice.

               To be rated Excellent/Excellent against the Health Care
               Standard Ratings

4.2    These Work Streams are wide ranging and the changes and
       improvements they are designed to produce cannot be delivered by
       just one or two individuals but rather they need to be championed and
       led at all levels throughout the organisation and this is why our „change
       facilitators‟ are so important.




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East Cheshire NHS Trust Organisational Development Plan – February 2008
4.3    The OD Work Streams will be delivered through an implementation
       plan which is owned and shared by the change facilitators and will be
       monitored by the Executive Management Team and reported to the
       Trust Board twice a year.

4.4    Figure 3 below aims to show the main components of the OD Plan
       which are set out in more detail in the OD Implementation Plan

Figure 3
Organisational Development Plan 2008-2010

Developing Supporting         East Cheshire NHS Trust          Developing Workforce
Structures, Systems and                                        Capacity and Capability
Processes                       “Achieving Excellence
                                   Through Change              Development Programmes
                                Programme 2008-2010”

Implement Performance         OD Plan is central to                  Establishing and
Management Framework          achieving the Trusts strategic          maintaining a talent
                              aims                                    pool for succession
                                                                      planning
Review governance
arrangements to ensure Fit    Establish a team of Change             Specific programme
for Purpose                   Facilitators who :-                     of development for
                                                                      clinical leaders

Having a plan for the         Will facilitate change and             Core development
establishment of Business     improvement                             for all managers and
Units and introduction of                                             leaders in:-
service line reporting        Are developed to use service            Service Improvement
                              improvement and OD                      Strategic Planning
Implementing a new            techniques.                             Interpreting &
Communications Strategy                                               Analysing data
                              Have leadership potential to            Decision making
Implementing a Talent         lead teams and manage                   Using data &
Management Strategy           services through continuous             information for
                              improvement                             service and
                                                                      performance
                              The EMT will monitor                    improvement
                              progress and provide                    Managing Perf.
                              biannual reports to the Trust
                              Board                               New managers
                                                                   induction and
                                                                   development
                                                                   programme

                                                                  Promoting and
                                                                   supporting multi-
                                                                   professional learning &
                                                                   development




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East Cheshire NHS Trust Organisational Development Plan – February 2008
5      Summary

5.1    This is a challenging Organisation Development Plan, however if we
       are to be successful as an organisation it must be achieved.

5.2    The progress of the plan will be monitored by the Executive Team on a
       monthly basis and reported to the Trust Board bi annually.

5.3    The effectiveness of the plan will be evaluated through the specific
       action plans associated with the key areas of delivery.




Sally Campbell
Director of HR and OD/
Bronwyn Barrow
Project Director of OD




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East Cheshire NHS Trust Organisational Development Plan – February 2008
Appendix 1

Our Operating Context

Foundation Trusts

       It is intended that all NHS hospitals should be established as
       Foundation Trusts by 2010 – giving organisations more power and a
       greater voice to local communities and frontline staff over the delivery
       and development of healthcare services. To qualify for NHS
       Foundation Status we must demonstrate through external assessment
       that we have robust financial and governance arrangements in place
       and we are able to respond positively to the challenge of delivering the
       NHS Plan. Operating as a Foundation Trust will require us to make a
       number of shifts in our approach so we become more businesslike
       whilst still maintaining our focus on providing quality and caring for our
       patients.

Governance and Safety

       In particular improving cleanliness and the reduction of infections
       acquired in hospital.

Patient and Public Involvement

       We will need to increase our engagement with our patients and local
       residents in explaining the policy changes that are taking place and
       involve them in developing approaches that best meet local needs.

Payment by Results

       The introduction of a national tariff ensuring we are reimbursed for the
       cost of each procedure or operation we carry out. As an organisation
       we gained significant income as a result of the introduction of PbR.
       However we will need to make changes to the way we provide services
       to ensure we maximise our income under the new system.

Efficiency

       The need to improve the way we provide services through improving
       care pathways and developing clinical practice. The need to achieve
       increased value for money from our “back office” functions and also our
       management resources. We must have the ability within the
       organisation to use information to challenge and benchmark our
       services and then to make the changes required.




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East Cheshire NHS Trust Organisational Development Plan – February 2008
Practice Based Commissioning

       Provides opportunities for GPs to directly influence the development of
       patient pathways and through the redesign of services, the opportunity
       to invest money saved to establish more local services outside of
       hospital.

Workforce

       We face a number of challenges in ensuring we have the right
       workforce for the future both in terms of numbers, skills and our staff
       feeling motivated and supported by the organisation.

Patient Choice

       Patients requiring elective treatment can now choose from a range of
       providers and the choice menu will continue to extend. The Trust must
       be the local hospital of choice if it is to succeed.

Competition/Collaboration

       As an organisation we are now in direct competition for services with
       other Acute Trusts, Community and Primary Care services and the
       independent sector yet we must also collaborate with a number of our
       competitors in order to maintain high quality local services. This
       requires a high level of sophistication from leaders and managers.

Waiting Times

       By 2008 capacity will be needed to ensure that no-one waits longer
       than 18 weeks between referral and actual treatment and beyond 2008
       this is maintained. This requires changes to systems and practice.
       This is set against a continuing need to ensure patients do not wait any
       longer than 4 hours to be treated in the Emergency Department.

Population Changes

       Our local population is ageing and we have more residents over 65
       years old than under 16 years of age.




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East Cheshire NHS Trust Organisational Development Plan – February 2008
Appendix 3

Progress 2006-2007

At the start of 2006 we published our Organisational Development Plan for the
next 18 months – 2 years. This set out an ambitious agenda which reflected
some of the step changes we needed to make as an organisation.

       We focussed on 3 key areas:-

       -       Structures and roles
       -       Systems and processes
       -       Team and individual development.

       We have made progress in a number of areas:-

Structures and Roles

           o We have made changes to the profile of the Executive Team
             and their portfolios, strengthening accountability and providing
             greater clarity in our leadership arrangements.
           o We made changes to our management structure both in the
             Clinical Divisions and Corporate Departments and we have
             moved people in to jobs which are a “better fit” and also created
             development opportunities.
           o We created a new Medical Director role 2010 to focus on the
             strategic clinical development issues for the organisation. The
             post holder was subsequently appointed to the Medical Director
             role.
           o We have streamlined and strengthened the role of the Head of
             Division and they are now members of the Executive
             Management Team and we have new individuals in post.
           o We have been developing our clinical leads‟ role involving them
             in service redesign and clinical network development.
           o We have made a number of changes to our Board and
             Committees providing greater clarity and accountability within
             the governance arrangements.

Systems and Processes

       We have been focussing on a number of key areas:-

           o The development and introduction of service improvement
             processes across the organisation including a “LEAN”
             programme.
           o Two senior manager learning sets have produced
             recommendations on how we need to strengthen – performance
             management and staff engagement. Our performance
             management process has developed with the introduction of


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East Cheshire NHS Trust Organisational Development Plan – February 2008
             KPI‟s at Board and Divisional level and the strengthening of
             Divisional Performance Reviews.
           o We have continued to focus on improving communications both
             internally and with external stakeholders. We have been using
             our Foundation Trust consultation process as a vehicle for
             promoting our services and seeking feedback. The appointment
             of a Marketing and Communications Manager has provided
             some more focussed resource in this area.
           o We have changed our approach to business planning to ensure
             it is an integrated process including service, finance and
             workforce.
           o We have began to make changes to our governance
             arrangements with a view to ensuring they are fit for purpose in
             the future.

Team and Individual Development

           o In the summer of 2006, 50 of our senior managers went through
             a Leadership Development Centre resulting in individuals having
             development plans focussed on the key competencies we
             require of our leaders in the Trust.
           o 16 of these senior managers have subsequently completed a 10
             month development programme which concluded in October
             2007. The results of the programme are yet to be evaluated
             however for some of those who attended we have seen shifts in
             behaviour and attitude.
           o The Board has been through a period of development with
             regular sessions being held in order to provide knowledge and
             understanding of the key issues for the organisation as it has
             developed its Foundation Trust application.
           o The Executive Team has continued to regularly review its
             performance and has developed plans to ensure the
             organisation has the right leadership at Executive level.




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East Cheshire NHS Trust Organisational Development Plan – February 2008
           o The Operational Management Team has been developing its
             role within the organisation with a view to ensuring there is a co-
             ordinated approach by our senior managers to the operational
             management of the Trust.
           o We have moved around a number of our senior managers as
             part of a development process to ensure we have the right
             person with the right skills in the right job.




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East Cheshire NHS Trust Organisational Development Plan – February 2008
Appendix 4

Emerging OD Priorities for 2008 - 2010

To develop our leadership and management capability at all levels
across the organisation from the Board to our first line supervisors
including competency based recruitment and development, with a clear
focus on outcomes and outputs to ensure a good return on our
investment.

           o Board Development Programme

               To develop the knowledge and competencies of the Board,
               collectively and as individual Board members, to enable the
               organisation to be successfully led through its next stage of
               development.

           o Executive Team

               To continue to develop the effectiveness of the EMT, providing
               leadership around the key organisational priorities.

           o Senior Managers

           o We will evaluate the outcome of the Leadership Development
             Programme and use the feedback from the development centres
             held in 2006 and consider the next steps in developing our
             senior managers.
           o We will be recruiting to at least 4 senior manager roles
             externally in order to increase leadership capacity and
             capability.
           o We will continue to develop our senior manager capability by
             moving individuals into the most appropriate posts.
           o We will set up processes to identify potential talent within the
             organisation in order to ensure we are planning proactively to fill
             our senior manager roles.
           o We will be increasing the emphasis on managing the
             performance of our senior managers and “raising the bar”
             amongst this key group.

           o There will be specific development workshops focussed on the
             areas where we need to strengthen our capability i.e.:-

               -       Service improvement skills
               -       Understanding and using information to manage
                       performance, planning and decision making
               -       Developing strategic planning capability

           o We will also ensure our line managers are supported in
             developing their leadership competencies which is vital if we are

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East Cheshire NHS Trust Organisational Development Plan – February 2008
               to achieve the level of staff involvement/engagement we are
               aspiring to in our Integrated Business Plan. We will be looking
               for the right attitudes in terms of commitment and accountability
               as well as the skills and behaviours.

To develop our clinical leaders and clinical engagement to have a more
direct impact on the way we lead and manage our services.

           o To set out the direction of how we intend to involve our clinical
             leaders in the leadership and management of the organisation
             including the role of the Head of Division, the role and actual
             number of clinical leads and to implement these arrangements.
           o To develop our approach to service line reporting which
             maximises the opportunity to engage and involve clinical
             leaders. We will be focussing on developing the leadership
             team within the business units that we expect to develop within
             the organisation e.g., emergency care, trauma and
             orthopaedics.
           o To take approximately 16 of our key clinical leaders through a
             leadership development programme during 2008/2009 which
             facilitates improved performance both individual and
             organisationally.
           o To develop the skills of clinical leaders in service improvement
             processes and to target key areas over the next 2 years as set
             out in our service strategy where service re-design and new
             clinical pathways have been identified as a priority.
           o To put in place arrangements to promote the improvement of
             clinical engagement across secondary and primary care in order
             to achieve the Trust‟s service strategy, which will be led by the
             new Clinical Director for Integrated Care.

To develop staff at all levels within the organisation in respect of
continuous service improvement.

           o To target the services within the Trust‟s Integrated Business
             Plan where changes in clinical pathways/service re-design need
             to take place and provide clinical teams and non-clinical teams
             with time out to develop their skills and take actions to take
             implement improvements/changes.
           o To review opportunities to increase the productivity /efficiency of
             our “back office functions” and to seek opportunities to develop
             appropriate shared services.

To develop networks with local people, patients and partners to
influence and shape services and to share good practice.

           o To implement the actions set out in our Marketing Strategy,
             Communications Strategy and Foundation Trust Integrated
             Business Plan in respect of engagement and involvement.


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East Cheshire NHS Trust Organisational Development Plan – February 2008
               These actions need to be integrated into one comprehensive
               plan. The areas of activity include:-

               -       Establishing/improving effective systems and processes.
               -       Raising awareness and developing staff to work in a way
                       which supports public and partner involvement/
                       engagement.

To develop our governance arrangements.

           o To take forward the recommendations of the report recently
             commissioned by the Medical Director on the changes required
             to improve our clinical governance arrangements which have
             resulted in making linkages with corporate governance
             arrangements, systems and processes.
           o To appoint an interim Project Manager to take forward the
             recommendations with a view to implementing a revised
             structure for the delivery of robust governance arrangements.

To design new performance systems and processes including creating a
culture that is performance focussed.

           o To implement the recommendations of the leadership
             development learning set on embedding a performance
             management culture.
           o To review the new arrangements in September 2008 with a view
             to ensuring their effectiveness/consider formal audit of
             arrangements.

To embed staff involvement/engagement in the culture of the
organisation.

           o To take forward the recommendations of the leadership
             development learning set as identified in their report in
             2007/2008.
           o To review the outcome of the staff satisfaction survey from 2007
             with a view to building on the approach taken from the above
             action plan in March 2008.
           o To implement a “temperature check” with staff in 2008, that
             provides continuous feedback on progress, with levels of staff
             engagement.

To become a more “business like” organisation whilst maintaining the
focus on providing excellent services and caring for patients.

           o To develop a programme which will bring about the culture
             change required within the organisation and to commence this
             work in April 2008.



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East Cheshire NHS Trust Organisational Development Plan – February 2008
Sally Campbell and Bronwyn Barrow      Page 21 of 33
East Cheshire NHS Trust Organisational Development Plan – February 2008
Appendix 2 OD IMPLEMENTATION PLAN 2008-2010


OD WORK STREAM                 PROGRAMME/INTERVENTION                      OUTCOME MEASURES /EVALUATION                      DATE            LEAD


WORK STREAM 1
CULTURE CHANGE
                               1.1
1.0                            Develop Business Units                      We are operating like a business – closely        30-03-08        JW
Developing a more              Development session & awareness             monitoring Income/Surplus – our cash
„business like‟ organisation   raising for the Board, EMT, OMT on          position and risks related to this
whilst maintaining the focus   implications
on excellent services and                                                  Our services are sustainable
caring for patients.           Agree pilot, time frames, resource                                                            Agreed by EMT   SN
                               requirements and staging of                 We have a “can do attitude” and a “right first
                               implementation                              time” approach

                               Specific training for clinical              We are constantly exploring opportunities for
                               leads/managers in the pilot e.g. Service    joint working both in terms of Clinical service
                               Line Reporting, Financial Management        provision and back office functions
                               requirements of FT‟s
                                                                           We are able to forecast, respond to and
                               Ensure corporate functions have the         proactively manage changes in National
                               capacity & capability to support (i.e.      Health Care policy, provision priorities and
                               finance/information)                        clinical standards and external competition
                                                                           We have effective involvement of clinicians
                                                                           in both strategy and operational issues

                               Establish culture change facilitators and                                                     01-04-08        SC Lead
                               learning set arrangements – agree the                                                                         BB to action
                               culture change project plan and
                               resources




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East Cheshire NHS Trust Organisational Development Plan – February 2008
OD WORK STREAM                 PROGRAMME/INTERVENTION                      OUTCOME MEASURES /EVALUATION                   DATE       LEAD


                               1.2
                               Marketing                                   Improved reputation and profile of the Trust
                               Develop marketing strategy and plans        – demonstrated via                             30-03-08   VA
                               for future service provision                patient choice, patient surveys, feedback
                               Strengthen internal capability & capacity   from PCT/social care partners
                               in this specialist area                     Clear plans and working arrangements with
                                                                           private sector health care
                                                                           Providers e.g. Assura
                               1.3
                               Develop our Governance Arrangements
                                                                           The governance arrangements are fit for        01-04-08   RS
                                                                           purpose and transparent,
                                                                           so staff at all levels can see the inter
                                                                           relationships of various
                                                                           Committee‟s and their core business with
                                                                           what they do in their
                                                                           day to day work.

                                                                           Terms of reference are up to date and
                                                                           relevant to the business of each
                                                                           committee – reducing duplication of work
                                                                           and ensuring that key
                                                                           issues/risks are highlighted, debated and
                                                                           reviewed by the right people at
                                                                           the right level.

                                                                           Clarity of governance arrangements, in turn
                                                                           supports greater clarity
                                                                           of individual accountability
                               Implement the changes agreed at the
                               Trust Board Time Out 17-01-08 and
                                                                           The organisations mission is right and the     01-04-08   KC/JW



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East Cheshire NHS Trust Organisational Development Plan – February 2008
OD WORK STREAM                 PROGRAMME/INTERVENTION                     OUTCOME MEASURES /EVALUATION                     DATE          LEAD

                               EMT meeting 21-01-08 i.e. moving to        Trusts values and vision support that
                               monthly Public TB meetings;                mission and are embedded/displayed top
                                                                          down.
                               -   review committee structure and
                                   terms of reference to ensure fit for   The strategic objectives are aligned to the
                                   purpose                                mission and the annual business plan and
                               -    implement new standards for           other supporting strategies and plan are also
                                   production and presentation of         aligned – he governance arrangements
                                   papers and reports                     enable a clear line of sight between the
                               -   clarify operating etiquette for        Trusts strategic objectives and the delivery
                                   committee‟s (deadlines for             of operational services
                                   distribution of papers etc)

                               -   update risk register and assurance
                                   plan – enabling TB to monitor and                                                       30-03-08      JW Lead
                                   review top strategic and operational                                                                  JC to action
                                   risks


                               1.4
                               Implement new performance

                               management arrangements

                               -   Appoint Assoc. Director of
                                                                                                                           Appointment
                                   Performance
                                                                          The Trust has a transparent approach to          made
                               -   Agree plan to implement new
                                                                          monitoring and reporting on performance
                                   performance management
                                                                          against targets and standards and is able to     30-04-08      BS
                                   framework
                                                                          identify trends and variances and work
                               -   Provide awareness training for
                                                                          proactively to address risks to these being
                                   clinical leads/line managers
                                                                          met and has the ability to better forecast and
                               -   Ensure HR policies/procedures for
                                                                          plan for the future



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East Cheshire NHS Trust Organisational Development Plan – February 2008
OD WORK STREAM                 PROGRAMME/INTERVENTION                     OUTCOME MEASURES /EVALUATION   DATE       LEAD

                                   managing individual
                                   performance/capability are in line                                    01-06-08   SC
                                   with these new arrangements
                                   (provide line managers with training
                                   where required)

                               1.5
                               Improve Trust Internal/External

                               Communications and agree new

                               Communications Strategy

                                                                                                         30-03-08   SC
                               -   Incorporate Trust strategic aims,
                                   vision & values and promote culture
                                   change via corporate induction

                               -   Review team brief to ensure key
                                                                                                         30-03-08   SC
                                   message‟s regarding service
                                   improvement and culture change
                                   are communicated

                               -   Audit effectiveness of cascade of
                                   Team Brief and, where required
                                                                                                         30-04-08   SC
                                   provide further training to line
                                   managers in effective
                                   communications

                               -   Further develop the Trust
                                   Newsletter to promote the key
                                                                                                         01-04-08   SC
                                   message‟s and initiatives of
                                   importance to the Trust and



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East Cheshire NHS Trust Organisational Development Plan – February 2008
OD WORK STREAM                 PROGRAMME/INTERVENTION                      OUTCOME MEASURES /EVALUATION                    DATE       LEAD

                                   workforce
                               -    promote staff involvement in
                                   developing the content of the
                                   newsletter to ensure it s content is
                                   relevant and communicated
                                   effectively
                               -   review mechanisms for ensuring
                                   that the Trust continues to be public                                                   01-06-08   JW
                                   facing with the reduction of public
                                   Board meetings reduces
WORK STREAM 2
CLINICAL LEADERSHIP

2.0To develop our clinical     2.1
                               Developing HOD‟s and Clinical Leads
leaders and clinical           in appraisal, performance review and        Clinical leads/managers are equipped with       30-04-08   RS
                               job planning                                the skills and information they require to
engagement to have a more                                                  undertake effective appraisal and personal
                               Refresher training on appraisal, job        development planning reviews with Dr‟s.
direct impact on the way we    planning and PDP (in house)
                                                                           Job plans are agreed and are arranged in a
lead and manage our services                                               way that optimises the available time for
                                                                           direct clinical care and facilitates the
                                                                           involvement of clinicians in decision making,
                                                                           service planning and improvement

                                                                           All Consultants and Non-Consultant Career
                                                                           Grade have up-to-date competency based
                                                                           Job Description‟s, job plans and
                                                                            PDP‟s that reflect clinical, managerial and
                                                                           business objectives.

                                                                           The appraisal process supports the



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East Cheshire NHS Trust Organisational Development Plan – February 2008
OD WORK STREAM                 PROGRAMME/INTERVENTION                     OUTCOME MEASURES /EVALUATION                        DATE          LEAD

                                                                          identification of future talent – so the Trust is
                                                                          more effective at succession planning for
                                                                          medical managers and leaders

                               2.2 Developing core leadership and                                                             Training      RS (lead)
                               management competency for medical                                                              programme     SC/BB to
                               managers, core topics to include;                                                              01-04-08 to   action
                                                                                                                              30-03-09
                               New Guidance and training on
                               preparing and presenting business          HOD‟s/Clinical leads are able to develop
                               cases to be provided                       and/or contribute to successful business
                                                                          cases, They will be equipped to make
                                                                          clinical decisions that are congruent with the
                                                                          organisations business objectives and
                                                                          financial plans

                               Managing difficult Dr‟s and Dr‟s in
                               difficulty (managing performance)          HOD‟s/Clinical leads are equipped to tackle
                                                                          poor performance or conduct issues and feel
                                                                          supported in taking the initiative to address
                                                                          issues of concern that could have an
                                                                          adverse impact on patient care

                                                                          HOD‟s ensure that effective systems
                                                                          and processes are in place for: -
                               Governance and Clinical & Non-Clinical
                               Risk Management. (incl. root cause         risk management and governance, HOD‟s/
                               analysis)                                  CL‟s are able to work smarter through
                                                                          understanding the organisations systems
                                                                          and learning from incidents and near misses
                               Service Line Reporting and financial
                               management.                                HOD‟s/CL‟s are well informed and equipped
                                                                          to influence investment decisions for service



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East Cheshire NHS Trust Organisational Development Plan – February 2008
OD WORK STREAM                 PROGRAMME/INTERVENTION                     OUTCOME MEASURES /EVALUATION                   DATE   LEAD

                                                                          improvements/developments in the context
                                                                          of corporate priorities and pressures
                                                                          financial management (and Service Line
                                                                          Reporting)
                               Workforce and succession Planning and
                               talent management awareness                HOD‟s/CL‟s are able to forecast medical
                                                                          workforce requirements based upon what
                                                                          they know about service priorities and
                                                                          developments in clinical practice. This,
                                                                          combined with data from comprehensive
                                                                          appraisals and job planning reviews –
                                                                          provides medical managers with more
                                                                          reliable and accurate information to assist
                                                                          with getting the medical manpower right


                               Service improvement skills
                                                                          HOD‟s/clinical leads are able to lead and/or
                                                                          contribute to service review ,redesign and
                                                                          continuous improvement
                               Develop clinical networks and clinical
                               engagement for integrated care             HOD‟s/CL‟s have well established
                                                                          relationships and networks with health and
                                                                          social care partners and this has further
                                                                          improved the delivery of seamless care, the
                                                                          roll out of integrated care pathways and
                                                                          reducing delayed discharge awaiting out of
                                                                          hospital care packages assessments to be
                               2.3                                        undertaken.
                               Developing clinical team working

                               Agree a development plan to support
                                                                          Multi-professional team working is improved,



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East Cheshire NHS Trust Organisational Development Plan – February 2008
OD WORK STREAM                  PROGRAMME/INTERVENTION                    OUTCOME MEASURES /EVALUATION                     DATE       LEAD

                                multi professional clinical teams to
                                improve their effectiveness and           Clinical decision‟s and judgements are more
                                efficiency – using service improvement    accurate and quality of care
                                tools and team building techniques        Improves. Clinical risk is reduced

                                Where appropriate/required commission
                                Clinical Simulation training based on
                                human factors and inter-relationship
                                with clinical decision making

WORK STREAM 3
TALENT MANAGEMENT


3.0 Developing the capacity
and capability within the       3.1
senior management               Profile of Board competence and
structure to ensure it is fit   capability – and development plan         The Board has the competencies and               01-06-08   KC/JW
for purpose                     (Board and Individual)                    capability to lead the organisation through to
                                                                          becoming a successful Foundation Trust
                                   Review board competencies and
                                   align individual and whole Board       The Board is focussed on continuous
                                   development plans to address any       improvement, both of the organisation and
                                   gaps.                                  the Board itself – thus leading by example

                                Build in regular time for Board to        The Board is open to constructive feedback       30-03-08   SC Lead
                                evaluate/take stock of progress and       and challenge, Board level competency can                   BB to action
                                ongoing                                   be measured against clearly defined
                                                                          and objective criteria – this sets a solid
                                                                          foundation upon which to develop other
                                                                          senior managers through succession
                                                                          planning and talent management




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East Cheshire NHS Trust Organisational Development Plan – February 2008
OD WORK STREAM                 PROGRAMME/INTERVENTION                     OUTCOME MEASURES /EVALUATION                   DATE              LEAD


                               3.2

                               Building on the Leadership &

                               Management Development

                               Programme 06/07

                               Review contribution of initiatives
                                                                          The benefits realised and outstanding          01-03-08
                               including:-                                development needs inform 2008-10                                 SC Lead
                                                                          leadership and management development                            BB to action
                                                                          priorities and plans
                               Action Learning Sets

                               Leaders in Service Improvement
                               Programme

                               3.3
                               Address core T&D needs identified
                               for Clinical & Non-Clinical Managers       Those in leadership and management roles       01-04-08 launch
                               via a leadership and management            understand the interconnections of the         31-03-10 end of   SC to lead
                               development programme for 2008-            organisations systems and processes for        programme         BB to action
                               2010. Topics to include: -                 planning, objective setting, risk assessing,
                                                                          financial and workforce planning.
                                     Service improvement skills
                                                                          They have the skills and tools to and are
                                     Understanding and using              lead and manage change for improvements
                                     information to manage                in; the quality of care, efficiency and
                                     performance, for forecasting and     effectiveness, the patient and employees
                                                                          experience.



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East Cheshire NHS Trust Organisational Development Plan – February 2008
OD WORK STREAM                 PROGRAMME/INTERVENTION                      OUTCOME MEASURES /EVALUATION                      DATE              LEAD

                                   planning and decision making

                                   Developing strategic planning
                                   capability

                                   Developing and presenting
                                   business cases


                               3.4
                               Developing a Strategy for Managing our
                               Talent.
                                                                           The Trust has implemented a Talent
                               -   Agree a Talent Management               management framework and is able to fill
                                   Strategy                                most hard to recruit to posts form its existing   01-05-08 launch   SC lead
                               -   Identify people for the talent pool     workforce                                                           BB action
                                   (using findings from development
                                   centres and outcomes of                 Increased recruitment and retention of key        30-04-08          EMT
                                   appraisal/PDP‟s                         people
                               -   Identify individual and common
                                   development needs and deliver           Increased productivity and performance –
                                   programme to meet these needs           more motivated workforce Where innovation,
                               -   Establish process for progress          creativity and achievement are recognised
                                   monitoring and reporting                and rewarded and obstacles to performance
                               -   Produce a succession plan for filling   proactively addressed
                                   future posts
                               -   Incorporate succession plan within      Raises the standard of management and
                                   workforce plan and learning and         leadership across the organisation
                                   development plan
                               -   Evaluate effectiveness of Talent        New managers feel supported and make an
                                   Management Strategy (interim            early contribution
                                   review at 12 months, full review at 2
                                   years) following launch                 The Board has clear measures for assessing        01-06-09          SC lead



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East Cheshire NHS Trust Organisational Development Plan – February 2008
OD WORK STREAM                 PROGRAMME/INTERVENTION                     OUTCOME MEASURES /EVALUATION                    DATE       LEAD

                                                                          the return on the investment in talent                     BB action
WORK STREAM 4
                               4.1
SERVICE IMPROVEMENT            Agree strategy for service
                               improvement – including priorities,
                               plans, approach, timetable for
                               delivery

                               -   Assess capacity & capability for
                                   delivering service improvement         There are strong linkages between the IBP,      01-04-08   VA Lead
                                   plans, including resource              annual plans, CRES, Workforce, Business                    EMT to action
                                   requirements and learning and          plans and service developments - it is
                                   development needs                      possible to see the direct contribution our
                                                                          investment in service improvement initiatives
                               -   Establish arrangements for             have made
                                   performance monitoring and review                                                      01-04-08   EMT
                                   in order to realise the benefits and
                                   measure the contribution to
                                   improving patient
                                   care/effectiveness/efficiency/produc
                                   tivity

                               -   Identify plan for involving/engaging
                                   staff, stakeholders/patients/primary   There is raised awareness among staff
                                   and social care partners (where        /stakeholders of ways of working that           01-04-08   VA
                                   appropriate)                           support PPI/engagement

                               Review opportunities for increasing
                               productivity/efficiency of back office                                                     01-04-08   EMT
                               functions and opportunities for shared
                               services




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East Cheshire NHS Trust Organisational Development Plan – February 2008
Key:

VA                               Val Aherne, Director of Strategy and Deputy Chief Executive
BB                               Bronwyn Barrow, Project Director of Organisational Development
JC                               John Clarke, Project Manager
KC                               Kathy Cowell, Chairman
SC                               Sally Campbell, Director of Human Resources and Organisational Development
SN                               Stuart North, Director of Finance
BS                               Bernie Salisbury, Director of Nursing and Operations
JW                               John Wilbraham, Chief Executive
EMT                              Executive Management Team Members




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East Cheshire NHS Trust Organisational Development Plan – February 2008

				
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