DEVELOPING MANAGEMENT CAPABILITY AND CAPACITY : AN INTEGRATED STRATEGY FOR THE WELSH AMBULANCE TRUST

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1 AGENDA ITEM No. 4 MEETING : TRUST BOARD DATE : 23 SEPTEMBER 2008 REPORT OF : HR DIRECTORATE Contact : James Moore, Head of Workforce Modernisation & Development Officer Tel: james.t.moore@ambulance.wales.nhs.uk DEVELOPING MANAGEMENT CAPABILITY AND CAPACITY : AN INTEGRATED STRATEGY FOR THE WELSH AMBULANCE TRUST A number of drivers have identified that the current Trust management and leadership capacity and capability could be improved. This paper explains how this can be achieved in a coherent way and makes recommendations as to how the Trust should proceed. RECOMMENDED: That the Strategy be noted and the identified actions and recommendations listed in Section 5 of the Appendix be supported.

2 1) Introduction WELSH AMBULANCE SERVICES NHS TRUST Developing Management Capability and Capacity: An integrated strategy for the Welsh Ambulance Trust There are a number of key drivers to ensure that the Trust has an integrated approach so that its managerial workforce has the capacity and is capable of meeting the Trust s objectives. Designed to Work (2006) is the Human Resources Strategy for Wales and is a strategic external driver which identifies the crucial role of effective leadership and management in NHS Wales. Additionally, evidence-based reports including the Ministerial Review (2008), Welsh Audit Office Report (2008) and NLIAH Capacity Support Plan (2008) have identified gaps in leadership and management capacity and capabilities across the Trust. In terms of understanding managerial capacity in the Trust, it is essential to undertake a review of managerial roles (and the requisite required competencies) to meet the Trust objectives. It is recognised that there has been a historic under-investment in management and leadership capability in the Trust and this needs to be rectified through appropriate learning. Additionally, this must integrate with ensuring that any new management roles identified as part of the management structure review have clear competencies and that, where required, individuals are supported with appropriately learning. 2) Review of the Management Structure In response to the drivers outlined earlier, the Trust s Chair has agreed with the Chief Executive, that a comprehensive review of the Trust s management structure will be undertaken, led by the Chairs of the HR Committee and the Risk and Modernisation Committee. The remit of the review is to examine to what extent the current structure is fit for purpose. In particular, the review will include (although it will not be limited to) examining: - Clarity over lines of accountability - The balance between HQ/corporate and regional posts - The availability of specialist HR advice - The costs of the structure - The role and structure of the Programme Management Department - Strategic capacity at Trust executive level

3 The terms of reference and arrangements for undertaking the review will be determined by the end of September. 2.1 Developing Management Competence Within this context, there is a need for the Trust to clearly define what management competencies are required to deliver the organisation s objectives. Whilst the level of these competencies may differ depending on individual roles, generic competencies apply to all managers enabling managerial talent to be identified and managed with skills gaps being addressed prior to progression as part of succession planning. On reviewing and benchmarking the development of managerial competency frameworks within other NHS organisations, these can be developed relatively simply and then included in individual KSF outlines appropriately. It is envisaged that these competencies would cover all Band 7 and 8 line managers. 2.3 Management Development Centres Having established what competencies are expected in managerial roles, it will then be imperative to assess the affected managers skill levels against these. This will achieve the following key benefits: a) Demonstrating individuals levels of competence against the competency framework. b) Allowing managers to reflect on their current practices before, during and after the development centres. c) Helping to highlight individuals key strengths and weaknesses which will be important for talent management. d) Developing insight and self awareness to allow individuals to consider whether they could be supported to work in different roles where their skill set is not suited to their current role. Any development centre would be based on using appropriate leadership/management assessment tools such as the MBTI, 16 PF, 360* LQF and group exercises. These would include a combination of self reported and peer/manager reported tools and would be supported by having appropriately trained assessors assisting the running of the centres. The information that is produced would then be fed back to individuals appropriately (which might mean accessing NHS-wide accredited 360* individuals) and would be used to inform discussions on individual s learning needs and career development. These discussions would be used as part of each individuals performance review and underpin the creation of Personal Development Plans for each individual.

4 Although there would be some uniformity in the more complex competencies that all managers are expected to demonstrate, the current levels and, therefore, the gaps within the current and new management workforce will vary. This may require individual learning interventions. Costs Depending on the diagnostic assessment tools used, there will be costs associated with accessing external assessors and/or developing internal accredited assessors. The cost per individual for assessing JTI, 16PF and LQF 360* through NLIAH would be 150. It should be noted that NLIAH have limited capacity and are unlikely to be able to assess all managers whose skills need assessing as part of the management review. The above cost using non-nhs external assessors is estimated at being approximately 750 per person. The non-recurring cost of a training each internal assessor would be no more than 4,000, although there is a possibility that this could be achieved for considerably less. It should be noted that as part of the NLIAH programmes outlined below, a LQF 360* diagnosis is included as part of the package for each participant. 3) Improving Management and Leadership Capability The Staff Survey Results (2007), the Welsh Audit Office Report, and the Ministerial review (2008) all point to the need to ensure that all line managers are competent and confident to be able to undertake the critical role of managing people. Whilst some line managers have been given appropriate learning opportunities to increase their capability and confidence, many managers have been forced to rely on learnt behaviours as the basis of their practices. Therefore, it is crucial to not only ensure that all line managers have the core skills but also to develop individuals in line with their PDP s. The Trust will need to consider how it will meet the demand for development once the skills gaps have been identified. It will is important to remember that: research seems to point to the most effective management learning being based on reflection and safe experiential learning; the Trust does not have a vast suite of in-house training packages. It is proposed that the competence gaps should be filled by accessing a wide-range of learning which will include:

5 Learning from colleagues in the Trust, the wider NHS or beyond. This would include the setting up of coaching and mentoring networks which managers would be expected to be part of. Accessing support from NLIAH such as the Care to Lead programmes. The creation of tailored learning activities within the Trust. Providing the time and space for individuals to access appropriate learning material and reflect upon this. Accessing external formal learning opportunities. 3.1 Core Line Management Skills The Management Skills Learning Programme commenced in April 2008 with the remit of trying to ensure that all managers were given appropriate support when dealing with the specific issues of sickness absence, grievance, performance and discipline. As these are the staple line management issue, it was agreed that a sheep-dipping approach should be adopted, where every manager is required undertake these programmes and take part in action learning sets to support the application of learning in practice. The blended learning is delivered in three stages with the expectation that all managers attend the first two levels. 3.2 Line Managers Development (Bands 7 & 8) The evidence from the various studies into the Trust has demonstrated that the development of this key group of staff is essential if the Trust is to achieve its objectives. Given the number of managers that potentially will want/need development in order to achieve their current/new roles and given the Trust s financial position, it is recommended that NLIAH facilitated learning through the Care to Lead programme would be the most effective middle to senior management learning programmes. As part of its Care to Lead programmes, NLIAH have developed the Leading to Deliver programme. This 9 month programme is delivered regionally with participants coming from all NHS Wales organisations. This enables managers who need to work on integrated health economy issues, such as service developments and workforce planning to form close learning networks. The first wave of programmes has proved to be extremely successful with the feedback from the Executive Teams and the individuals being very positive. The programme is based on experiential and applied learning supported by expert coaching. The programme is designed to ensure that individuals develop professionally and personally through the provision of knowledge and skills relating to change management, service improvement, organisational development and the development and enhancement of core management and leadership capabilities. More details of this programme are available at:

6 Having already scoped the ability for the Trust s managers to participate in the next available programme, the Trust s managers would need to join the next cohorts: Mid & West Wales January/February 2009 start North Wales March/April 2009 start South East Wales June/July 2009 start It is recommended that the Trust engages NLIAH to ensure it secures the maximum number of available places for the next available cohorts. Current planning suggests that this will be no more than 12 WAST participants per region. It is recommended that the managers who would benefit the most are prioritised to be part of the next programme. It is likely that the Trust will be given 2 free places but will need to pay for any additional participants at a cost of 1,200 plus travel and subsistence each. If 12 managers per region were to attend, this would equate to a cost of 12,000, but this could be spread of the financial years of 2008/9 and 2009/ Regional Director Level Development As previously described, it is imperative to develop management capability at the middle to senior management levels. This can only be achieved by first and second tier senior managers (i.e. Executive and Regional Directors) being appropriately skilled, motivated and developed. NLIAH have developed Leading to Inspire, a programme for Executive Directors and Directorate/Regional Manager level. The programme is delivered on a regional basis and is open to employees from all NHS organisations. This year long programme provides participants with the learning to help develop the participant s knowledge, skills and behaviour. More information can be found at: Having already scoped the ability for appropriate managers within the Trust to participate in the next available programmes, the Trust s managers would need to join the next cohorts: Mid & West Wales Nov 08 North Wales TBC South East Wales TBC It is recommended that individuals are identified for this programme and submit an application is quickly as possible. One participant will be given a free place. The cost of each subsequent participant from the Trust would be 1,500 plus travel and subsistence.

7 In addition to this programme, NLIAH have developed as part of the Care to Lead package a Wales-wide two year programme for future Executive Directors, the Aspiring Directors Programme for each specialty within the NHS (e.g. HR, Nursing, Finance, AHP and Chief Executives). This might be appropriate longer term development and talent management for some individuals. More information about these can be found at There are currently two senior managers within the Trust who are participants of these programmes (Nursing and HR) with the only costs to the Trust being travel and subsistence 3.4 Board Development To support the development of Trust Board s, to ensure that these are able to provide appropriate leadership, NLIAH has developed a suite of Board Development activities which dovetail into the Care to Lead programmes both across Wales and also locally. The available packages include: Two at the Top - Chief Executive and Chair Development Top Team Development Workshops Specific non-officer and non-executive development - delivered in partnership with the NHS Confederation Whole Board Development Programme including: o Setting the Direction edition 4 o Induction Workshop o Case Study - Board meeting o Governance in Health reviews o Matrix Interview Reports (where applicable) More details about are available at: Having already scoped NLIAH s ability to work with the Board, it is recommended that the Trust engages NLIAH to assist with Board development. There will be no cost to the Trust from these interventions. 4) Summary Recent reviews, audits and reports concerning the Trust have indicated that the Trust needs to develop its managerial capacity and capability. In addressing the issue of managerial capacity, it is anticipated that the review of the management structures will help provide a clear way forward for both the operational elements of the Trust but also the support elements (such as HR, USCD, the Programme Office etc).in relation to the development of managerial capability, it is recognised that there is limited capacity within the Trust currently to deliver an

8 internal cost-effective solution to cover all requirements. Additionally, in order to meet the objective of better integrating the trust with other parts of NHS Wales, accessing NLIAH programmes will provide the most appropriate basis for developing the Trust s management and leadership capacity. Some of the benefits to the Trust of investing in this integrated approach are: A skilled management workforce which is fit for purpose. A key group of staff who, having undertaken appropriate learning, will be able to help create a learning culture. A clear message to the organisation and beyond that the Trust is investing in this area and takes the development of its staff seriously. The likelihood of reduced conflict within the workplace as the managers will have developed the skills to recognise and respond to issues. A more pro-active and re-energised management workforce. 5) Recommendations It is recommended that: The Board note the contents of this paper. Provide all assistance it can with the review of the management structure. Continue to support the delivery of the Management Skills Learning Programme. Engage NLIAH to ensure that the maximum number of appropriate Trust managers form part of the next cohort of Leading to Deliver in each region. Submit applications for appropriate individuals in each region to participate in the next Leading to Inspire Identify through Personal Development Plans appropriate individuals to be considered for the Aspiring Directors Programme. Engage NLIAH to support the development of the Board as quickly as possible.