Not Protectively Marked. Scottish Ambulance Service December 2011

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1 Scottish Ambulance Service December 2011 Board Meeting For Noting Item No 3e Executive Sponsor: Director of Human Resources and Organisational Development Lead Officer: Version: 1 1 BACKGROUND The following paper was commissioned from the Leadership Development team (Jayne Dunn and Gillian Reilly) to assess the effectiveness of our leadership development programmes introduced as part of the learning strategy approved by the Board to support Working Together for Better Patient Care. The paper provides evidence of the impact of these efforts and makes recommendations for the future. The Board is asked to note the contents in anticipation of a wider discussion regarding leadership at a future Board development session at which this work can be considered in conjunction with the work being taken forward through HR and the Director of Service Delivery regarding roles and responsibilities for operational leaders. The content of this report will be shared with senior managers and management teams across the Service along with a number of developmental materials (such as posters) to highlight the progress to date, draw further attention to the career framework and continue the momentum which has undoubtedly been generated through efforts to date. The Board will also wish to note that the OD plan, which takes forward the work outlined in the HR/OD strategy Doing the Right Thing, has been flexed to reflect the outcomes and recommendations of this report. In particular the HR Directorate is currently examining ways of securing the funding to bring forward the team briefing initiative with effect from the turn of the year. 2 RECOMMENDATIONS The Board is asked to note the report. 0

2 Scottish Ambulance Service The Impact on Investment of Leadership and Management Development November 2008 to Oct

3 Executive Summary 1. Purpose: The purpose of this report is to 1. Provide evidence of the impact of investment in leadership and management development 2. Describe factors which influence the impact of investment 3. Make recommendations for future investment. 2. Evidence of impact Evaluation data is providing evidence of new learning linked to desired leadership and management qualities, changes in behaviour and contribution to desired organisational outcomes. Programmes most highly valued by managers are the CMI Introductory Diploma in Management, CMI Introductory Certificate in Management, the Graduate Management Trainee Scheme, Delivering the Future, Executive Coaching and the Seven Habits of Highly Effective People. All of these programmes provide sound return on investment. 3. Influencing factors The following factors influence the impact of leadership and management development Level of organisational commitment Degree of sustained buy in to agreed programmes Support for implementation before during, and after programme delivery Ensuring quality and effectiveness Rigorous evaluation across participant perception, new learning, changed behaviour and contribution to organisational priorities. 4. Recommendations for future investment It is recommended that Leadership and management development continues to be positioned as a mechanism for individual and organisational development All current programmes continue to be offered with the exception of Great Leaders (once resources have been used) 10,000 of the further education funding be reallocated to CMI Introductory Certificate and Diploma courses Stronger attention be given to the strategic development of clinical leadership across all levels of the Scottish Ambulance Service More rigorous evidence be gathered around organisational impact of programmes and associated contributions to culture change A strategic approach is found to capitalise on organisational learning opportunities across directorates and departments. This should relate to new learning, behaviour change, culture change and continuous improvement. 2

4 Table of Contents Contents Page Executive Summary 2 Purpose 4 Background 4 Impact of leadership and management development 5 Perceptions of programmes New Learning Changes in behaviour Organisational Impact Factors which influence the impact on investment 10 Recommendations for future investment 13 3

5 The Impact of Leadership and Management Development November 2008 and June Purpose: The purpose of this report is to 1. Provide evidence of the impact of investment in leadership and management development between November 2008 and September Describe factors which influence the impact of investment in this area 3. Make recommendations for future investment. 2. Background: In November, 2008, the Scottish Ambulance Service established a department dedicated to the development of leadership and management development across the Service. While it is acknowledged that other departments in the Service contribute to leadership development, this report relates to the activities organised through the Leadership and Management Development Department. The following activities have contributed to the positioning of leadership and management development within the Service. Realising Our Potential: A strategy for Learning was developed through engagement with staff and full backing of the Board. This strategy outlined the approach to leadership and management development and importantly, defined the leadership and management qualities believed to be required to achieve organisational targets and the aspirations in Working Together for Better Patient Care and Doing the Right Thing. In 2009, the Maximising Investment Model was developed to provide an approach to making best use of the resources allocated to leadership and management development in the Service. The Learning Strategy, together with the Maximising Investment Model provides a strong foundation for leadership and management development in the Service. The Career Framework was developed and launched in August, It provides a more strategic approach to the development of all staff and provides the Service with a means to make more informed decisions about future investments. Over 2,000 staff have accessed the Career Framework since its introduction. A high priority has been placed upon developing and maintaining collaborative networks with other NHS Boards and public sector agencies through our involvement in the NHS OD Leads, Collaborating for Outcomes in the Public Sector Design Team and the Scottish Public Sector Collaboration. This has enabled us to offer a wider range of programmes especially to senior mangers and to share learning and insight across agencies. 4

6 In 2011, we entered into partnership with the Chartered Management Institute and are now offering two qualifications for frontline and middle managers. These programmes are practical in nature and focused on the knowledge, skills and behaviours managers need to be more effective in their roles. The demand for these programmes is building, with over 78 managers now on the waiting list. Two hundred and eighty two managers have engaged in 453 leadership and management development initiatives between November, 2008 and October, Evaluative feedback from these programmes has been used to contextualise the content and continuously improve the quality and relevance. Evidence is showing that this is something staff value highly. Opportunities for leadership and management development have become increasingly more strategic and aligned to job roles during the past three years. Programmes that have been introduced since 2008 include Chartered Management Institute Introductory Certificate in Management for frontline managers Chartered Management Introductory Diploma in Management for middle managers Coaching and executive coaching for senior managers Seven Habits of Highly Effective people for all leaders Leadership: Great Leaders, Great Teams, Great Results designed to build the effectiveness of teams Collaborating for Outcomes in the Public Sector for senior managers Local initiatives which capitalise on the enthusiasm and localised innovation NHS Raising Your Game for newly appointed Directors Scottish Ambulance Service Library Chartered Management Institute on-line resource NHS Playing to your Strengths Back2Basics Raising Your Game Previous programmes which have been strengthened include Further Education NHS 360 tool Delivering for the Future NHS Post Graduate Certificate in Frontline Leadership Graduate Management Trainee Scheme Public Sector Leadership Collaboration programmes. 3. The Impact Leadership and Management Development The Scottish Ambulance Service offers a range of leadership and management development programmes internally and in collaboration with other NHS Boards and public sector agencies. The evaluation of collaborative programmes is generally done nationally. However, local evaluation has been carried out on programmes that can be influenced locally. 5

7 A copy of the full evaluation of each programme is available in the appendices at the end of this document. The following information provides a descriptive overview using Kirkpatrick s 4 level model of evaluation. The four levels include Level 1 Perceptions of programmes Level 2 new Learning Level 3 Changes in behaviour Leve1 4 Contribution to organisational outcomes Level 1 Perceptions of the programmes The first level of evaluation relates to managers perceptions of the usefulness of programmes. Quantitative and quantitative measures have been used. The Net Promoter Score runs from -100 (not valued at all) to +100 (very highly valued) and enables a comparison between programmes. Programme CMI Introductory Diploma CMI Introductory Certificate Delivering the Future Graduate Management Trainee Scheme Executive Coaching Seven Habits of Highly Effective People Leadership: Great Leaders, Great Teams, Great Results Edinburgh City Local Initiative Further Educations (Qualifications and courses) NHS 360 tool + 2 hour coaching Number of participants commenced / completed Average cost per manager for course materials only Average Net Promoter Score (Scale -100 to +100) 16 ongoing 75 First data available Dec / /1 (2 ongoing) 11/10 (ongoing) 75 /19 (15 ongoing) 65/33 (6 ongoing) Admin costs in the +100 first 2 years, employment in the 3 rd year. Internal coaches External Coaches 400 per session+vat / Not rated 39 / 35 (4 ongoing) Varies from 40-13,000 depending on programme Not available (low return rate) 53/ Not rated 6

8 Qualitative comments included I came on this course thinking you can t teach an old dog new tricks I had to eat my words. The course was a very enjoyable course which I genuinely believe will make me a better person both in my professional and private life (Seven Habits). Certainly those 3 days have helped for in my head the direction I am going and need to go to make my post work. Also appreciated the opportunity to air any thoughts and hear those of others in the team (Great Leaders).. I am actually just delighted that I have been offered a meaningful job in an area in which I want to work (Graduate Management Trainee). The impact and the experience of Delivering the Future has been significant for myself and the Service. It is not the immediate gains as they only become apparent through time, and by time I mean years not days. It s not so much about what I do differently but what I don t do anymore (Delivering the Future). The programmes most highly valued include the CMI Introductory Diploma in Management (middle managers), CMI Introductory Certificate in Management (frontline managers), Delivering the Future (Senior Managers), Graduate Management Training Scheme, Executive Coaching (Senior Managers) and the Seven Habits of Highly Effective People (all managers). Although not rated, there was strong evidence to suggest that the NHS 360 feedback tool and a local initiative involving a collaborative approach between a senior management team and consultant were also highly rated. Level 2 New Learning The new learning on each programme is determined in a range of ways including the achievement of desired competencies through assignments / exams, before and after 360 feedback, interviews with managers and their line managers, reflective questionnaires and before and after rating scales. The type of learning that occurs depends upon the desired outcomes of individual programmes The following provides a snapshot of some of the new learning. Seven Habits of Highly Effective People Managers indicated a strong intent to put the following learning into practice 29 managers has a focus on using communication and empathic listening skills 21 managers wanted to use a new approach to time management 14 managers identified that they would focus on the achievement of their top priorities (time management). 13 managers committed to become more proactive rather than reactive 7

9 10 managers wanted to improve the way they negotiated win-win solutions with others 9 managers wanted to take time to reflect and make more strategic decisions 4 managers wanted to channel their energy into things they could change rather than things they were concerned about 3 managers wanted to focus on working collaboratively with others 3 wanted to work on work-life balance. CMI Introductory Diploma Courses Managers identified the most significant areas of new learning as Greater understanding of personal development planning Understanding how to create a culture that shares good practice Understanding perspectives of patients and other stakeholders Greater focus on patients and other stakeholders Greater awareness of their own management style Great Leadership The following commitments were made by participants 32 managers agreed to focus on their most important priorities and monitor their progress against these priorities 20 managers wanted to create a team environment that would enable staff to fully utilise their talents. 16 managers agreed to develop trust and improve communication with others 10 managers made a commitment to use the time management matrix to improve their time management 5 staff intended to improve the effectiveness of their meetings 4 managers intended to improve their current systems 4 managers intended to pay closer attention to the impact they were having on others Managers were also working on a number of other areas including exploring their style as leader and manager, focusing energy on the things they could change, Level 3 changes in behaviour The is little organisational benefit to investing in any form of learning and development unless new learning is applied in the workplace and this behaviour contributes to desired organisational outcomes. Changes in behaviour are not always easy to measure, especially when related to the more subtle softer skills related to self awareness, personal governance, confidence and resilience etc. A range of data collection processes have been used including narratives from participants, interviews with line managers and coaches and pre and post 360 reviews from multiple feedback sources. The following two indicative examples provide some evidence of behaviour change. 8

10 Local Initiative A station management team have engaged in a two year programme aimed to a) Build Confidence b) Create a strong management team c) Embed a culture of continuous improvement The evaluation has shown that managers Have an improved confidence in themselves and their management capability Have a better understanding of their roles and the role of manager within that Show a greater trust, respect, understanding and appreciation of each other and the diversity of skills in the team The management team pull together and go that extra mile There is consistency of message from the management team to those who report directly to them Following outputs from development events, the language used in the 360s and now the learning from the CMI course, the management team has a shared language with which to support and challenge each other s approach and practice There is a visible and stated desire, willingness and understanding of how to continuously improve More integrated working and co-operation between A&E and PTS staff This has taken work and is based on a greater understanding of each other, motivations and a shared sense of purpose. Introductory Diploma in Management The course has given me the knowledge, skills and confidence to lead the team through the many changes and challenges we will be facing in the near future. By introducing the team to SMART objectives, there is a greater likelihood that projects will be completed. This gives me the confidence to delegate tasks to others (EMDC Manager). The skills and tools from this course have greatly helped in maintaining my performance and satisfaction at work providing greater reward. I am less likely to become frustrated in turn becoming more pro active and productive (ASM) Level 4 impact on organisational outcomes Demonstrating a causal link between a particular leadership programme and a contribution to organisational outcomes is highly problematic and beyond the scope of most organisations. However, evidence can be provided about how participation in programmes has contributed to the achievement of organisational outcomes. Evidence is largely anecdotal and tends to be related to outputs rather than outcomes. It is an area that would benefit from a more rigorous approach. 9

11 Introductory Diploma in Management In final assignments managers have demonstrated their ability and effectiveness in planning their own development, presenting analysis, conclusions and recommendations, structuring and writing reports, planning to meet stakeholders requirements specifying physical and financial resources, understanding the need for a job specification and description in selection, producing a plan to promote quality monitoring progress and outcomes, developing others skills and capabilities, addressing poor performance and identifying key legal requirements. Graduate Management Trainee Scheme The Graduate Management Trainees have contributed a great deal to the Service including a research paper on ambulance service provision, a tool kit for event managers, involvement in Learn and Improve projects and supporting others to translate strategy into practice. Executive Coaching A number of managers gave specific examples of how their approach had changed to become more effective. This included collaborative approaches with other agencies to achieve shared outcomes, improved team effectiveness, taking advantage of opportunities for continuous improvement and the achievement of projects. 4. Factors which influence the impact on investment Leaders are formed through multiple experiences The radical tasks for contemporary organisations is to create spaces for leaders and leadership to flourish (Western, 2008). A great deal has been learnt through the provision of leadership and management development in the Scottish Ambulance Service over the past three years. For example, we now have a stronger idea about our leadership profile against the NHS leadership qualities. Over 1,300 pieces of feedback have been provided by managers, line managers, direct reports and colleagues through 360 feedback processes in the past three years. A sample of NHS 360 degree profiles for middle and senior managers were aggregated for 2009/2010 to create a baseline profile. Identified strengths included Taking responsibility in personal development Taking responsibility for performance Acting with honesty and integrity Open and transparent communication Making decisions based on patient needs Recognise key priorities for delivery Identified develop needs included Communicating the vision and making it happen Setting direction and leading change 10

12 Seeking comparison and best practice outside the NHS Considering all aspects of governance in decision making Achieving win-win resolution of issues We are also more aware of factors that influence the impact of leadership and management development. These are outlined in the following table. Maximise Investment model Gain organisational commitment (entering into a partnerships with Directors, GM s and Heads of Service/Departments) Contract for proposed activity (Outlining responsibilities of Senior managers, line managers, L&MD department staff and participants) Implement activity Works well when Senior managers - see leadership and management development as a way to improve organisational effectiveness. - identify the need for leadership and management development for their teams and themselves. - take an active, high profile role in leading the leadership and management development initiatives - are willing to find creative and flexible ways to achieve the requirements. - A relationship based upon trust and integrity is established. - Contracts are shared, agreed and documented in writing - Possible risks are identified, discussed and proactive strategies are put in place to mitigate against them. - Support is agreed to before, during and after sessions. - All involved play a leading role in supporting participants to embed the learning into practice. - All parties are willing to hold each other to account. - There is senior level buy in from appropriate executive team members. - Opportunities to celebrate success are woven throughout the programme - Dates, times and resources are planned in advance. - Facilitators are organised, familiar with the programme Doesn t work well when Senior managers - See leadership development as the L&MD departments job - Fail to recognise their role in the development of others - see leadership development as an additional box to tick - see leadership development competing with performance - are unethical in determining who has access to development - use leadership development to abdicate their responsibilities as line managers - see leadership development as a quick fix i.e. one day a year. - The contract is rushed and ambiguous - Time is not taken to ensure there is a shared understanding of time and resource requirements. - Time is not take to ensure there is a shared understanding of desired outcomes. - Communication and conflict resolution processes aren t clarified and agreed - Commitment to the programme is not genuine and covert actions are put in place to prevent it from going forward. - Selection processes are unfair or not well thought through - Cancellations are made because of lack of organisation 11

13 Control and quality effectiveness Evaluate activity content and context of the group they are working with - Programme information is shared with participants and they have the opportunity to ask questions. - Participants want to attend and are clear as to why they are participating - Programmes support a range of learning needs including those with dyslexia - Senior managers are visible, actively involved and active in supporting participant to apply learning into practice. - All involved action the agreements in the contract - Adequate resourcing is in place - Participants and senior managers are involved in developing an approach to evaluation and feel comfortable to give feedback - Feedback is used to continuously improve programmes - Feedback is used to support participants to put their learning into practice - Evaluation is planned at the beginning of the programme - Effective measures and analysis are put in place - Evaluation is rigorous and includes participant perceptions, new learning, changes in behaviour and contribution to organisational outcomes - Evaluation is used to determine future investment - Facilities don t support learning i.e. participants are constantly required to leave the room to deal with the day job - IT equipment doesn t work - Senior managers prevent participants from attending without good reason - Participants fail to attend without good reason. - Prevention of attendance is not challenged. - Managers/participants do not realise that they are required to change the way they work. - Line managers overtly or covertly undermine and block attempts to change - Participants find excuses not to change including the need to deal with the next crisis. - Apathy is not challenged - Participants are excluded from the process - Feedback is not listened to Evaluation isn t completed - due to lack of time - because managers / senior managers don t want to provide opportunities for negative feedback - because participants haven t completed course requirements and do not want that to be on record - because of apathy 12

14 5. Recommendations for future investment It is recommended that Leadership and management development continues to be positioned as a mechanism for individual and organisational development 10,000 of the further education funding be reallocated to CMI Introductory Certificate and Diploma courses Stronger attention be given to the strategic development of clinical leadership across all levels of the Scottish Ambulance Service. Further consideration be given to the desired qualities for clinical leadership, leadership and management that are more closely aligned to the Scottish Ambulance Service context. More rigorous evidence be gathered around organisational impact of programmes and associated contributions to culture change A strategic approach is found to capitalise on organisational learning opportunities across directorates and departments. This should relate to new learning, behaviour change, culture change and continuous improvement. It is recommended that the following programmes continue to be funded / supported CMI Introductory Certificate in Management CMI Introductory Diploma in Management Seven Habits of Highly Effective People Graduate Management Trainee Scheme Coaching and Executive Coaching Further Education including NHS Frontline Leadership NHS 360 Leadership Qualities Tool (with a revised funding model that reflects the size of the Board) Delivering the Future Programmes through involvement in the Public Sector Collaboration It is recommended that no further investment is made in the following programmes Leadership: Great leaders, great teams, great results Scottish Government Adaptive Leadership 13