Northern Devon Healthcare Trust. Organisational Development Plan

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1 Northern Devon Healthcare Trust Organisational Development Plan Introduction and Context The Northern Devon Healthcare Trust is a 170 million public body directly employing over 2,600 staff and providing acute and community health and social care to the population of North Devon. Working with partners and the public the Trust s purpose is to maintain and improve the health of local people. The Trust is working towards achieving Foundation Trust status in 2010 The Trust has developed a five year Service Strategy and is in the process of developing an Estates Strategy to support the Service Strategy. In developing our service strategy, the Trust took the opportunity to revisit it s aims and objectives, our aim remains to provide high quality integrated health care services locally by promoting and investing in best clinical and employment practice. To support this aim, we developed a set of 10 strategic objectives: 1. Ensuring patient and staff safety 2. Ensuring efficient and effective services 3. Ensuring a positive patient experience 4. Ensuring care is delivered in the most appropriate setting 5. Ensuring personalised care 6. Ensuring high quality services 7 Ensuring a highly skilled and motivated workforce 8. Ensuring modern facilities.9. Ensuring effective partnerships for better public health 10. Ensuring a robust and sustainable future This Organisational Development Plan provides a framework to engage and develop staff and bring about a new organisational culture which will equip the Trust to meet the opportunities and challenges of FT status. This plan will help develop an organisation that is not only able to provide the best possible care and offer excellent employment opportunities to the community but also understands fully the business of providing health care in the 21 st century. The OD plan is an ongoing iterative process and will be subject to regular review. Personnel and Development Directorate Page 3 of 12

2 In addition to our service strategy nationally, A High Quality Workforce NHS Next Stage Review sets out the vision for the NHS that delivers high quality for all and gives staff the freedom to focus on quality. Our staff have demonstrated that they want to provide the best possible care for our patients, since 2006 there has been significant improvements in both access and quality and our plan is now to continue this improvement through a structured approach to development. 2. Summary Organisational Development is a range of interventions, carried out across the whole Trust, designed to improve organisational effectiveness. These activities will address long-term and cultural change, team development and individual development. Organisational Development applies to all areas and levels within the Trust. This includes the Senior Management Team and the Trust Board including Non-Executive Directors. In addition to the development plans set out in the plan a dedicated development programme will be put in place for the Board of Directors as part of the proposal to become a Foundation Trust. Our objectives along with the core principles that inform all the activities the Trust undertakes are contained within The Next Stage Review and are: Focused on quality Patient centred Clinically driven Flexible Valuing people Promoting life-long learning As an organisation we have also recognised the following as key areas for development: Leadership Development - for all leaders at all levels Cultural Change - developing a confident, fit for purpose organisation Effective Team Working - for clinical and management teams Personal Development - appraisal and development planning for all staff Preparing for Foundation Trust status 3. Aims The Trust aims to known as a learning organisation striving for high performance. We will achieve a successful, high performing Trust through our people. By supporting our staff to achieve these aims, the values and principles of the Trust will be embedded into the everyday business of our staff. We will achieve the cultural changes needed to effect improvements in services to move the organisation forward only by involving and developing our staff. Therefore, the key aim the strategy is the engagement, ownership and involvement of service users, partner organisations and our own staff in achieving beneficial change. The focus of our attention is to secure the commitment of individual members of staff, their managers and teams who deliver quality and safe care to our patients and value each contribution. To this end, organisational development activities will take place across all areas and all aspects of the Trust. Personnel and Development Directorate Page 4 of 12

3 Healthcare is delivered by a team. The team includes clinicians, managerial staff and those in supporting roles. (For the purposes of this plan, the term clinician covers all groups of staff who provide clinical care for patients and the public) Every member of the team must be heading in the same direction, from the receptionist to the porter and for our patients the team includes staff not only employed by this Trust, it is patient and services users expectations that everyone in the NHS and social care work together to give them high quality integrated care. The principles and self-assessment of development needs as set out above lead us to focus on the following areas: Focused on quality: This means being clear about the roles of professionals in health and social care and ensuring appropriate training is offered to provide the depth of knowledge and experience required to undertake their role. Patient centred: We will place the patient at the centre of everything we do and seek to involve them and their advocates in shaping, delivering and evaluating their care. Clinically driven: The active engagement and pro-active involvement of clinicians in the development and delivery of workforce planning and education is essential in order to shape the workforce that is needed to deliver high quality care. As far as possible, clinical leaders will participate in multi-professional development activities to facilitate development of the whole team Flexible: Healthcare is constantly developing and changing with an increased emphasis on health promotion and shifting patterns of care. Consequently our plans need to build in flexibility in how we ensure continuous professional development (CPD) and life-long learning. Valuing People: This means ensuring our education, learning and development plans are sensitive to individual as well as organisational needs and acknowledge the career aspirations of staff entering into healthcare professions. Promoting life-long learning: Providing staff with opportunities to update their skills that are relevant to delivering high quality care. Traditionally staff have attended courses away from work, our plans need to include more work based learning and e-learning, coaching and mentoring. 3.1 Leadership: Specific, tailored leadership programmes will be provided for leaders at all levels in the Trust: Board Development: (Executive and Non-Executive Directors) To provide effective leadership in a challenging, complex and changing environment, it is essential to build both the capability and capacity of the Board will be built to sustain ongoing performance improvement. In addition to a structured development programme to support Board Development, members of the Board will continue to participate in the Leadership Development Programme facilitated by the Strategic Health Authority and in the Top Leaders Programme. Personnel and Development Directorate Page 5 of 12

4 Corporate Management Team (previously executive team) will be provided with the essential skills and behaviours in team working and effective leadership to enable them to perform their key leadership role in delivering the improvement agenda. Senior Managers (GMs/AGMS/Cluster Managers/Senior Clinical Managers) will be provided with the opportunity to attend a development centre to develop an understanding leadership, workforce planning, performance, finance and project management as well as strengthening their business skills to ensure they are equipped to fulfil their roles as the Trust moves towards Foundation Trust status and increased integration with health and social care. Coaching and mentoring support will be provided on an individual basis. Clinical Leads and Consultant Medical Staff have a key role to play in the leadership and change agenda within the Trust. There is a need for them to be involved fully in areas such as team development, service redesign/lean thinking that includes consideration of workforce planning and for their aspirations for the service to be linked with organisational objectives. Middle Management: This tier of managers and leaders is key to the operational success of the Trust. Therefore, development activities to include leadership and team working as well as developing business skills will be targeted at this group to ensure that their contribution is maximised. Black and Minority Ethnic Staff: Across the NHS Black and Minority Ethnic (BME) staff are unrepresented in management grades, to ensure the diversity of the services we deliver we need to ensure that opportunities are provided for BME to meet their career aspirations. Development activities such as coaching, mentoring and personal development planning will be targeted at this group to ensure they have the opportunities to fulfil their potential. Administration Team Leadership Development - The Trust is launching a coaching and development programme for admin team leaders, initially focusing on the outpatient experience and all stages of the admin pathway that interact with the outpatient part of the patient's journey. Investing in apprenticeships we will continue to invest in apprenticeships, this is because we recognise the benefits that can be obtained from apprenticeships and engaging the young workforce. This is particularly important in preparing staff for key roles. We already have apprenticeships in non-clinical areas but will do more to identify the use of apprenticeships to support clinical careers. Continuing Professional Development (non-clinical) We will continue to provide opportunities for staff who require professional qualifications to undertake their role in non-clinical areas such as Finance, IT, Procurement and Personnel and Development. 3.2 Cultural Change Our staff survey results show that staff are proud of the service they provide but there the same survey shows that many staff do not believe that senior management do not consider patient care as a priority for the Trust. We need to develop a culture that will Personnel and Development Directorate Page 6 of 12

5 increase the confidence levels within the Trust and help build pride in the services we provide as a Trust. It is recognised that historically the Trust has been in a difficult position but through the development of a positive culture change comes an opportunity to leave historical difficulties behind and to move forward into a positive, focussed organisation that has patients and staff at the heart of it s strategy and plans. The use of Listening into Action events will help deliver this by truly listening and acting on what staff tell us about what matters to them and how they can be supported to do the best job they can for the patients and users of the Trust. Working in partnership with our staff is key to our success, traditionally the mechanisms for engaging with staff have been through the Joint Negotiating and Consultative Committee, we value the contribution and support of the JNCC and will work with staff side to promote and develop true partnership working Effective Team Working We have identified as an urgent priority a need to develop effective leadership and decision-making, we will provide team working skills for the clinical/corporate leadership and management teams which include clinical managers. We intend to empower staff and teams at all levels, this will involve significant cultural change and will need to support this development through effective communications, training and staff development, supported by appropriate workforce policies and governance arrangements. 3.4 Personal Development We recognise that the continued development of staff is vital to the success of the Trust. The Trust is committed through the Personal Development Review (PDR) and Knowledge Skills Framework (KSF) processes to providing development opportunities and time to all staff. We acknowledge that to get the best out of these processes we need to streamline processes and reduce bureaucracy whilst ensuring that each member of staff is equipped with the essential knowledge, skills and behaviours necessary for the effective delivery of services. By working with Health and Social Care we will look for opportunities to deliver joint training where appropriate and share resources more effectively. The Trust will continue to maintain and build relationships with local education institutions and other training providers to improve training and education. It will become a personal objectives for all managers and team leaders who have staff responsibility to ensure all staff will receive an annual PDR which brings together appraisal, KSF (for Agenda for Change staff) and training needs. Our staff survey indicates that whilst PDRs takes place they are not always structured. We will support managers to ensure the process is a positive experience for staff and highlight that the process is designed to: Create an opportunity for managers and their staff to talk openly about development needs and working life. Promote equality of opportunity for all staff. Improve job satisfaction and reduce staff turnover. Promote individual effectiveness and team working. Develop management and leadership capability at all levels. Personnel and Development Directorate Page 7 of 12

6 There is also a consultant appraisal programme in place which is being rolled out across the Trust. All consultants will have a personal development plan designed to meet their career aspirations and support their continuing professional development. To support the KSF and our obligations as a responsible employer, there is a core training plan in place that is linked to the KSF and statutory and essential training. We will aim to develop this where relevant to the Leadership Qualities Framework (LQF) and build on the Free to Lead Development Programme. The core training programme is intended to be a guide during the PDR/Appraisal to ensure that learning and development is being focussed on the necessary areas of development, for both the individual and the organisation. 3.5 Preparing for Foundation Trust Status The Trust Board, through its development programme, will ensure that it is fit for purpose and will assess its performance and effectiveness through its annual appraisal and regular reviews. The Trust Board will also oversee the implementation of the Organisational Development Plan. In early 2009, the Trust Board undertook a selfassessment exercise using the Board Development Tool (BDT). This was useful in identifying the four key areas for improvement as: 1. Developing trust and support within the board 2. Developing a climate of constructive challenge 3. Ensuring the Board agenda focuses on core business 4 Building and maintaining positive relationships with PCT and other external organisations A review of the composition of the Board, Membership recruitment and engagement will be a priority. In addition to a review of the composition of the Board, our management structures will be reviewed to ensure the Trust has the right skills, capability and capacity to develop our strategic plans. 4. Our Approach Leading by Example: Of particular importance for highly influential groups such as Clinical Leads and Consultants, this is an important cultural responsibility for those in leadership and management roles at all levels. Effective Team Working: The development of teams, team working and shared leadership will be a priority. Developing Business Skills: This will include developing commercial understanding and skills in business planning and project management skills, equipping managers with the skills to use information effectively and to develop their awareness of financial, quality, risk and stakeholder issues. This will enable managers across the Trust to become more business-like and effective in delivering the Trust s objectives. Personnel and Development Directorate Page 8 of 12

7 Exploiting Technology: The ability to gain maximum benefits from the use of appropriate technology at every level of the Trust is key to enabling change and improvement. Learning from Experience: Reflecting upon and learning from experience, both the good things that we do and the mistakes that we make, is vital to helping everyone achieve the highest standards of performance. Whilst taking full account of employee s duties we will promote a fair and open culture and encourage teams to constantly review and improve their performance. Access to Learning and Development: We will ensure learning is open to all staff and is seen as the responsibility of the individual employee as well as the Trust, fully utilising Knowledge Skills Framework (KSF)/Personal Development Review (PDR) and Consultant Appraisal. We will encourage learning within a multi-professional setting and create opportunities and a safe environment for organisational networking, learning and reflection. Making Decisions: We will ensure that staff are competent and confident to make decisions as well as driving decision-making through the structures to the level at which it is needed. Talent Spotting and Succession-Planning: We will actively promote the identification and development of current and potential future leaders. Working with Local Partner Organisations: We recognise other local health care organisations as partners and allies in the development and delivery of highquality health care services. 5. Implementation Plan To ensure the Organisational Development Plan is implemented we will develop an Implementation plan. The Plan will: Specify how future investment requirements will be met, the requirements for investment in in-house training and development resources and an estimate of the resources required for expanding training and development provision. Develop new training programmes and courses appropriate to current and future needs. Promote joint working and joint learning and development between the Executive Team/Corporate Directors and the Clinical Directors and General Managers. Introduce team development activities. Make use of external support and expertise as required on the dedicated development programmes, including coaching support and mentoring. Make use of recommendations made by the institute for Innovation and Improvement in preparing for Foundation Trust Status. 6. Resource Implications The Trust already commits around 82,000 per year to training and development for non-medical staff. This includes funds provided though annual budget setting and external funding from other organisations such as the Strategic Health Authority and Personnel and Development Directorate Page 9 of 12

8 32,000 Learning and Skills Council to support the development of NVQ qualifications and development for bands 1-4. The Trust will also identify the level of investment to provide additional funding to Leadership, Clinical Director and Team development activities. There is a further amount of resource that is dedicated to the development, training and education needs of medical staff. 7. Measuring Success Successful outcome will be measured through achievement of the Trust s service and financial objectives. The annual Staff Attitude Survey provides extremely useful feedback in how our staff feel about how the Trust support their development. All employees completing an annual D&R which includes production of an annual personal development plan and improvements in the uptake of relevant training programmes. All general managers and clinical leaders undertaking the LQF 360 degree appraisal and participating in the required development programmes. All executive, corporate directors, general managers and clinical leaders leading by example and demonstrating understanding and commitment to the values, aims and objectives of the Trust. Level of patient complaints and incidents. HR performance indicators e.g. reduced sickness absence ace, reduced bank and agency costs, lower rates of bullying and harassment cases, Health and Safety incidents. Delivery of key financial and service objectives. High productivity Personnel and Development Directorate Page 10 of 12

9 ORGANISATIONAL DEVELOPMENT PLAN Programmes All clinical Staff All non clinical Staff Middle Mgrs Senior Mgrs Clinical Leader s BME Staff Exec Board * Statutory & Essential Training Working in Teams Diversity and Equality Use of Resources Business & Finance Planning Developing Business Acumen Project Management Business Case Writing Skills Performance Management. Understanding and Managing Information Workforce Planning People Management Leading and Managing Change 360 o Appraisal LQF Learning and Personal Development Self Awareness Governance between organisations Working across Boundaries Working with External Agencies Recognising and Managing Risk Clinical Governance Corporate Governance Working with FT Members and Governors World Class Commissioning Personnel and Development Directorate Page 11 of 12

10 Performance Management. ILM 1 st Line Mgrs ILM Middle Mgrs Band 7 Development Programme Free to Lead Admin Team Development External programmes Shadowing Secondments Coaching Mentoring * Health and Safety Infection Prevention/Control Fire Manual Handling Plus others contained in the training prospectus. This plan will be updated as further development needs are identified. Personnel and Development Directorate Page 12 of 12