Organisational Development Plan

Transcription

1 Organisational Development Plan Improved health for the people of Wolverhampton and a future where there is less deprivation and disadvantage. Providing good quality services that are equitable, speedy, convenient and treat people with dignity.

2 Contents 1 Foreword 1 2 WCPCT s values 2 3 Description of the interim organisation structure 3 4 Enabling the PCT s strategic plan 4 5 Achieving these goals a plan for action The PCT s current position Gaps in capacity and capability 5 6 WCPCT s plan for action How we will address the gaps Action plans 14 7 Summary 14 Appendices Appendix 1 Creating the OD plan our methodology Appendix 2 The 7S organisational capability framework

3 the executives and directors to ensure each directorate has the skills to do its work the managers and supervisors to utilise those skills the employees to acquire maintain and improve them. Ultimately someone has to be responsible for the activity and we have asked the Director to be responsible for coordinating the plan for OD. But every one of us has to apply it. 1 Foreword 2,400 of us work at (WCPCT) and using our ability, knowledge and experience, our aim is to provide the people of Wolverhampton with the outstanding health service they need. Therefore we need to continually learn and enhance our abilities. The PCT already spends 900,000 every year on development to give employees the expertise that is necessary to fulfil our aims and work out how best to organise work and activity. That is why this plan for development is important. It sets out the capabilities that the Commissioner arm of the PCT needs to meet the challenge of World Class Commissioning and it describes how we should go about it. The plan for OD is not just a theoretical exercise and it is not just for this year. It has to remain relevant and it has to evolve. It will have to respond to the changing needs of the PCT. A steering group has been set up to review it every six months, to update it to meet the aims of the PCT, and to recommend how the PCT needs to change. Membership of the PCT s OD steering group has been drawn from a wide cross section of skills and expertise and includes Trades Union representatives. The aim of the plan is to give the PCT a sustainable ability to improve the health and well-being of the people of Wolverhampton in the most efficient way possible but it should not be read in isolation because it underpins the following: WCPCT strategic, operating and business plans It is ambitious but achievable and to make it a reality, a substantial financial investment has already been approved by the PCT Board to bring the plan to life. WCPCT goals, initiatives and vision World Class Commissioning. The goal of Organisation Development (OD) is to enable organisations to enhance their effectiveness, to seamlessly adapt to changes in the environment around them, to improve organisational performance through improvements in competence, organisation design and people management, communication, systems, behaviours and policies. A plan for OD is often seen as something that the Human Resources department does. Beginning with the Board, OD belongs to the whole organisation and affects every single non-executive, executive, director, manager, supervisor and employee. Each has a part to play. It is up to: the board to draw up a plan for OD to meet the aims of the PCT The OD plan reflects the significant time and effort that went into creating it and has undergone formal and informal consultation at key stages of its development. Successful implementation of the plan for OD will support the PCT s status as a World Class Commissioner and in doing so will help us to improve the health and well-being of the people of Wolverhampton. Barry Picken Chairman Jon Crockett Chief Executive We have asked the Director to be responsible for coordinating the plan for OD. But every one of us has to apply it. 1

4 2 WCPCT s values The PCT wishes to be recognised as an Employer of Choice. An Employer of Choice is characterised in part by a motivated and committed workforce made up of people who know exactly what they need to do. They demonstrate a preference for action and a will to succeed. Such organisations are founded on principles that set out the shared sense of purpose and organisational aims, the desired working environment and the expected behaviour within it. They create a psychological contract between employee and employer, which helps to achieve the organisational objectives and to create meaningful and fulfilling jobs that bring out the best in the employees. The work of the PCT is based on a number of values and beliefs that will help to create and maintain that type of organisation being reinforced by the forthcoming NHS Constitution. We shall These are our core beliefs, reflected in everything we do as an organisation. They will help the PCT to improve the health and well being of the people of Wolverhampton and will help to create the kind of working environment that provides people with challenging and rewarding jobs. Enhancing personal performance will help us to achieve our collective aim of improving the healthcare of the people of Wolverhampton. Develop partnerships for the whole community To reduce inequalities and achieve better health, people must have a real say in the planning and provision of services. The PCT will work in partnership with The Royal Wolverhampton Hospitals NHS Trust (RWHT), the City Council and other key stakeholders. We shall promote effective engagement with clinicians. Recognise interdependence Modernised and integrated pathways of care can only be achieved by adopting a whole system approach to commissioning and by providing services to meet the needs of individuals. Be open and publicly accountable The PCT must operate in an open and transparent way and be accountable to the public. Provide a service that is centred on the people Services must be convenient, organised efficiently and effectively, and help people to lead independent lives. 2

5 3 Description of the interim organisation structure The PCT currently employs 2,400 people in a Provider arm and a Commissioner arm, the majority of whom work in the Provider arm. As a means of achieving the PCT s priorities, current reporting lines are configured vertically meaning that there are clear chains of command and employees have only one manager. The organisation is configured in a functional structure around divisions engaged in the main activities of the PCT s work Health Improvement and Public Health, Provider Services, Organisational Resources, Corporate Services and Policy Development, Communications and Public Patient Involvement. This structure helps to achieve the PCT s priorities because it does help to increase the specialisation and expertise within the divisions and gives them a high level of autonomy. But there is a risk that departmental priorities might come to overshadow the interests of the overall organisation and efforts and resources might be duplicated across groups. Work is planned to gather data on the PCT s rating against measures of organisational effectiveness including workforce productivity measures and measures of organisational cost expressed as a proportion of Whole Time Equivalent (WTE) resource. This will provide the PCT leadership with quantifiable data to pinpoint where the organisation is not as effective as it should be. An organisational audit has pinpointed gaps in functional capabilities that the PCT must have to become a World Class Commissioner. Two new posts have been added to the organisation. These are a Head of Organisation Development and a Knowledge Manager and are highlighted in the organisation chart below which illustrates the current interim structure of the PCT: This structure helps to achieve the PCT s priorities because it does help to increase the specialisation and expertise within the divisions. Figure 1: Interim organisation chart Chairman Secretary to the Board Chief Executive Assistant Chief Executive (Policy Development /Communication /PPI) Director for Health Improvement/ Public Health Director for Organisational Resources/ Finance Managing Director for Provider Services Primary Care Director of Head of Organisational Development Mental Health Head of Performance and Improvement Head of Estates Children and Family Services Commissioning IT Services Knowledge Manager Community & Rehabilitation Healthcare Governance & Infection Prevention & Control Improving Health Supporting Services and Resources Providing Services This work will be developed as part of the proposed workforce planning process for the PCT. 3

6 4 Enabling the PCT s strategic plan The work of OD is an important enabling element of the PCT s Strategic Plan. It will help the PCT organise and meet its goals and find out how (and which) resources are harnessed to achieve those goals. It also articulates internally and externally the key contributions to organisational effectiveness in pursuit of the PCT s aim-to become a World Class Commissioner. Our eleven strategic goals are: Reduce infant mortality to the West Midlands average Reduce mortality from coronary heart disease in under 75s by 40 deaths per year Halt the epidemic of childhood obesity Improve access to mental health services in primary care, especially talking therapies Reduce the impact of alcohol abuse Improve young people s use of high quality sexual health services Reduce the gap in mortality from strokes between priority and non-priority wards from 65% to 45% Reduce admissions from Ambulatory Care Sensitive conditions Improve patient safety Improve the management of risk factors for coronary heart disease by 5% within the diabetic population Intervene earlier in the prevention and diagnosis of lung and bowel cancer. To achieve these goals, we must develop a workforce that has the technical capability as well as the capacity to commission services that are high quality, effective and represent value for money. Our workforce must be committed to what the PCT is trying to achieve and is keenly motivated to provide excellent service to meet the challenges ahead. 4

7 5 Achieving these goals a plan for action 5.1 The PCT s current position The PCT undertook an organisational audit in July and August This involved consultation with a wide range of the PCT s staff and included Trades Union Representatives. It helped to identify 200 competences that the workforce required. Further work to identify the level of individual employee capability compared to these competences was developed. This was applied to 38 employees in key areas of the organisation and asked individuals to rate the most relevant competences to their jobs as well as rating their current level of capability. It revealed that the PCT rated itself highest in the following capabilities of individuals: Acting with trust and integrity Showing respect for others Taking responsibility for yourself Sharing information Working as part of a team. 5.2 Gaps in capacity and capability The audit also revealed the gaps in capacity and capability. These gaps were categorised into two groups organisational requirements and requirements of individual employees Organisational requirements Observations gleaned from the personal experience of those consulted during the interviews were synthesised and categorised. We found nine areas in need of development: WCPCT - objectives, vision, values Marketing Learning and development Adoption of the plan to develop the organisation. Within these 9 areas for development, 37 immediate priorities emerged through debate amongst the directors. Interventions for each priority were agreed on (see section 6) Requirements of individual employees The organisational audit found about 200 separate aspects of knowledge, skill or ability that the PCT must have to achieve its objectives and become a World Class Commissioner. These have been cross-referenced with the NHS Knowledge and Skills Framework (KSF) and included within the current 22 KSF dimensions. The workforce already has many of these and the PCT s ambition is to increase the capability in these areas. However, in some parts of the organisation, there are problems with capacity. In others, the PCT has no capability or experience. There is a need to develop new capabilities and capacity in: Marketing (and social marketing in particular) Market intelligence Legal drafting of supplier contracts Knowledge management. The key capabilities and capacity that must be increased significantly are: Organisational development Awareness of World Class Commissioning Public relations and communications Contract management Procurement skills Roles and responsibilities The use of information and knowledge Governance and business processes Clinical engagement Commissioning function Partner engagement Developing leaders and managers Clear objectives: appraisal system linked with business drivers Project management disciplines. 5

8 Each one of the 200 individual competences noted during the organisational audit was crossreferenced against the 11 WCC competences and each sub element to ensure relevance to WCC. This provided assurance that the right knowledge, skills, abilities and behaviours were revealed. 6 WCPCT s plan for action From this analysis, the executive directors of the PCT prioritised a range of interventions after considering three criteria: Relevance to the PCT s self-assessment against the 11 WCC competences Where the PCT demonstrated no current capability or capacity Timeliness of the intervention. The PCT s self-assessment against the 11 WCC competences highlighted the areas to work on. There was congruence between the self assessment and both the organisational audit and the employees validation. 6

9 6.1 How we will address the gaps The PCT identified and prioritised a number of interventions and will aim to complete these over the course of 12 months. The plan is described in Table 3. Each intervention has been categorised by means of the 7S organisational framework 1 to ensure the full range of influences on the organisation s effectiveness are considered. Directors will be responsible for ensuring completion by the date specified. Appraisals of personal performance should include measures for achievement, and progress will be monitored by a supporting Gantt chart for each developmental intervention; and measures of success will be defined. The OD steering group will meet regularly to monitor outcomes and review progress and ensure that the Plan for OD remains relevant in helping the PCT meet its aims. The 37 priorities described in Table 3 represent the beginning of the OD strategy, not the end. Over the coming months the plan will be systematically reviewed and updated to take account of the evolving needs of the organisation. Even though the specific needs will change, interventions will be drawn from a range of sources that include: Developing existing employees Increasing the awareness of our strategic intent Continually ensuring that the structure of the organisation is helping fulfil our objectives Introducing new employees in possession of relevant skills Ensuring that work is done as efficiently as possible Creating the kind of environment to do the work Reinforcing the right kind of behaviour. Directors will be responsible for ensuring completion by the date specified. 1 Organisational Development Plan - How To Plan, page 11 7

10 Table 3: The OD plan Number Organisational requirement 7 S category Responsible Director intervention timescales for completion Which part of WCC does this influence - WCC competence and element? How do they benefit the end user - alignment with Health outcomes? Estimate of resources required 1 Communicate the role of the Commissioning function and the concept of WCC to all PCT employees 1.Strategy Create a communications briefing and cascade A, 9B, 9C Developing awareness of commissioning processes will promote the adoption of excellent practice, allowing quality standards and outcomes to be specified 2 Specify the skills that commissioners need to meet WCC 3.Skills and systems Commissioning Recognise appropriate developmental situations and update the personal development plans for all Commissioning employees A, 8A, 8B, 9A, 9B, 9C Effective management of contracts with providers helps them to behave more responsively in their work for the PCT 3 Improve the effectiveness of communication and engagement with clinicians 1.Strategy and skills PEC Develop projects based upon the goals of the Strategic Plan A, 2B, 2C, 4A, 4B, 4C Better clinical engagement will allow more constructive partnerships to develop and increase the effectiveness and appropriateness of commissioned services through increased innovation 4 Ensure that the OD plan is owned by the Board, directors and managers 2.Systems Chief Executive Incorporate personal objectives that are specific to every manager All Ownership by line managers will ensure that OD interventions are not seen as the responsibility of someone else and are more likely to be completed 5 Create a strategy for organisational development 1.Strategy Project manage a review All The OD strategy will ensure that the PCT develops an efficient and effective organisation that is capable of achieving the challenging PCT healthcare improvements. The strategy will also help to inform the of the Strategic direction of the PCT. 6 Create an Organisational Development plan 1.Strategy Create the plan ALL The OD plan will set out how the PCT intends to make its organisation as effective as possible 8

11 Number Organisational requirement 7 S category Responsible Director intervention timescales for completion Which part of WCC does this influence - WCC competence and element? How do they benefit the end user - alignment with Health outcomes? Estimate of resources required 7 Reaffirm the values of the PCT and adopt measures to ensure they are exemplified by leaders 7.Shared values Chief Executive Solicit employee opinion,create an intranet page on values, begin an internal marketing of the values C Desired change in behaviour has to be role modelled by leaders to encourage juniors to make the same change 8 Prioritise the development of the staff of the Commissioning function 3.Skills Public Health Recognise appropriate developmental situations and update the personal development plans for all Commissioning employees A, 9B, 9C The transformation of commissioned services is a major change which requires new skills. Prioritising their development will allow the PCT to provide the local population with the envisioned improvements to health 9 Create a strategy and plans for internal and external communications 3.Skills and style Public Health Document the communications strategy A, 3A, 3B An effective communications strategy will help the PCT be recognised as the local leader of the NHS and demonstrate that services being commissioned benefit the population. It will also help to increase awareness of the PCT s objectives within the workforce 10 Consider purchaser/ provider relationship 1.Strategy MD for Provider Services Create a position paper ALL A decision will ensure that the staff of the PCT is certain about the future structure, avoiding stasis or duplication of effort 11 Clarify and articulate departmental responsibilities and interfaces for all departments 5.Structure Chief Executive Conduct process activity analysis ALL Clear roles and responsibilities will ensure that duplication of effort is avoided and that no task is missed 12 Clarify the roles and responsibilities of the Commissioning Directorate 5.Structure Public Health Create an internal SLA and KPIs for the Commissioning function A, 9B, 9C Clear roles and responsibilities will ensure that duplication of effort is avoided and that no task is missed 13 Develop organisational capacity in marketing and in particular social marketing techniques 3.Skills and structure Public Health Create a project to identify most effective solutions A, 1B, 3A, 3B, 6A Will create a better understanding of the market and directly improve ability to influence targeted groups 9

12 Number Organisational requirement 7 S category Responsible Director intervention timescales for completion Which part of WCC does this influence - WCC competence and element? How do they benefit the end user - alignment with Health outcomes? Estimate of resources required 14 Clarify the new needs for development springing from WCC 3.Skills Implement an organisational audit A, 9B, 9C The transformation of commissioned services will require new skills to provide the local population with the envisioned improvements to health. These new skills must be identified and introduced to the 15 Create an information strategy 2.Systems Finance Create a project team to complete the strategy document A, 5B, 5C, 7C, 10A It is recognised the PCT does not use information to its maximum effectiveness. The identification of all knowledge and information held and required by the PCT will ensure that commissioning decisions are well considered 16 Reinforce all employees awareness of the PCT s strategic objectives, goals and values 7.Shared values Create a project group to review and upgrade internal communication ALL Employees who have clear objectives, regular assessments and a PDP are more engaged in an organisation and will make decisions with a consideration of the wider organisational aims 17 Increase the visibility of what all PCT directors do 6.Style Chief Executive Develop directors to get involved in more public events A Increasing directors visibility will ensure that juniors are fully aligned with the aims of the team and the PCT 18 Adopt ways to seek opinions about how the PCT is perceived outside the organisation 6.Style Chief Executive Implement ways to solicit direct feedback from SHA, DH, Local authorities etc A, 1B External feedback will ensure that the PCT understands the effectiveness of commissioned services as well as the effectiveness of the way they are commissioned 19 Adopt measures to encourage leaders to behave as role models 6.Style Chief Executive Add specific objectives to managers individual performance assessments C It is the PCT s responsibility to ensure that leaders display the right kind of behaviours using a variety of ways that includes policy enforcement and encouragement. Desired change in behaviour has to be role modelled by leaders to encourage juniors to make the same change 10

13 Number Organisational requirement 7 S category Responsible Director intervention timescales for completion Which part of WCC does this influence - WCC competence and element? How do they benefit the end user - alignment with Health outcomes? Estimate of resources required 20 Ensure that all employees have an appraisal and a personal development plan 2.Systems Incorporate personal objectives that are specific to every manager C Clear objectives, regular assessments and a PDP will keep employees focused on the key organisational objectives, maintain consistency across Directorates and improve the effectiveness of the 21 Embed the employees competences desired in recruitment and appraisal processes 2.Systems Create a project group to oversee the work and upgrade policies and procedures C To meet the challenge of WCC, all new recruits will need to demonstrate capability in relevant skills that will increase the effectiveness of commissioning. To hire the right recruits, all processes will need to take account of the new requirements. 22 Allocate funding for OD interventions 1.Strategy Finance Accrue financial resources for all interventions specified in OD plan ALL All interventions must be funded following the development of a clear business case for each proposal 23 Review the effectiveness of the current organisational structure 5.Structure Chief Executive Project manage a review and ALL WCC presents a significant challenge to the way healthcare is commissioned. Further analysis of the structure will show that either redesign is necessary or the current structure is appropriately configured to meet the changes anticipated.. 24 Internally publicise the PCT s success stories more actively 6.Style Create a project group to review and upgrade internal communications mechanisms A Reinforcing the PCT s success stories will allow employees to receive direct feedback on what they are doing well. It will also foster a unity of purpose and encourage employees to excel. 11

14 Number Organisational requirement 7 S category Responsible Director intervention timescales for completion Which part of WCC does this influence - WCC competence and element? How do they benefit the end user - alignment with Health outcomes? Estimate of resources required 25 Create a Knowledge and Skills Framework (KSF) profile for all PCT posts 5.Structure Find the posts without a KSF and charge managers with providing one ALL This is an NHS policy requirement. 26 Review and improve the purpose and content of all regular internal meetings 2.Systems Create a project group to oversee the work and upgrade policies and procedures ALL Meetings that are objective, based on clear expectations and well run reach more effective conclusions more quickly and avoid wasteful use of time and resources 27 Map the career paths for Commissioners 4.Staff Public Health Review career paths of current Commissioners and identify the key experienced gained A, 9B, 9C Career paths will help develop interest in employees of high potential and encourage fresh perspectives in Commissioning. This links directly to succession planning 28 Improve the PCT s effectiveness in dealing with difficult decisions and sources of conflict 4.Staff Recognise appropriate developmental situations and update the personal development plans for all Commissioning employees B, 2C, 10B, 10C The relationship between Commissioners and Providers is based around competing interests. PCT staff must become comfortable dealing with conflict and difficult decisions without causing damage to relationships. 29 Improve the effectiveness of reviews of personal performance and time them to coincide with key business milestones 2.Systems Chief Executive Agree measures, communicate to managers and move the performance appraisal cycle to coincide with financial year events C It is recognised that the PCT could improve its appraisal process. This will provide employees with clear objectives and a timescale to achieve them. In turn this will help foster and develop a performance culture 30 Develop methods that demonstrate the risks and benefits of OD interventions (where Return on Investment cases cannot be shown) 2.Systems Finance Consider alternatives All developmental interventions must be shown to be meaningful and relevant to the PCT s objectives, so that investment decisions are well considered 12

15 Number Organisational requirement 7 S category Responsible Director intervention timescales for completion Which part of WCC does this influence - WCC competence and element? How do they benefit the end user - alignment with Health outcomes? Estimate of resources required 31 Audit that all employees have clear lines of sight between their day-to-day aims and the goals of the organisation 2.Systems audit C Employees have told us in some areas that it is difficult to link the relevance of what they do to the PCT s aims and objectives. Clear line of sight will give them that link and will encourage employees to make decisions about work that are aligned to the overall aims of the PCT. 32 Analyse and map all key PCT processes 2.Systems Conduct process activity analysis A, 5B, 5C An analysis of all key processes will identify ways to improve organisational effectiveness in the handling of tasks, information, transactions and ensure that all resources are marshalled in the right way for the PCT to meet the challenges of WCC 33 Standardise the PCT s contracts with suppliers 1.Strategy Finance Review and standardise all PCT contracts B, 9C Developing awareness of commissioning processes will promote the adoption of excellent practice, allowing quality standards to be better specified 34 Draw up a Succession Plan and review the management of talent 4.Staff Chief Executive Document the Succession plan and the approach to talent management C A succession plan will allow an assessment of the PCT s emerging talent and ensure that high potential employees are encouraged to stay within the PCT and are developed to their maximum potential 35 Establish the practice of periodically reviewing relationships between non executive directors and directors 6.Style Chairman Schedule development days ALL Increasing familiarity between NEDs and. Executives will foster the development of more effective relationships within the Board. Decision making will improve and become more efficient. 13

16 Number Organisational requirement 7 S category Responsible Director intervention timescales for completion Which part of WCC does this influence - WCC competence and element? How do they benefit the end user - alignment with Health outcomes? Estimate of resources required 36 Improve the effectiveness of Personal Development Plans 2.Systems Review existing PDPs and recommend improvements C The PCT is subject to significant and increasing amounts of change. Employees maintain and update their skills and abilities regularly to ensure that they are ready to deal with change and help the PCT achieve its overall aims. 37 Define measures showing the benefit of training (for example Return on Investment cases) to increase managerial support for development 2.Systems Finance Consider alternatives All developmental interventions must be shown to be meaningful and relevant to the PCT s objectives, so that investment decisions are well considered 6.2 Action plans We shall ensure that the implementation of our OD plan is supported by effective project management. Gantt charts will be developed, one for each area Board, VSM, supporting services and Commissioning. An Overall Gantt chart will monitor progress of the OD plan showing high-level timings, resources and owners with accountability for each priority. The PCT has allocated 2 million (non-recurrently) to the implementation of the plan. 7 Summary The link between WCC and the improved health and well being of the people of Wolverhampton is explicit: commission services more effectively and indicators of health and well being will improve. Similarly, the link between an effective organisation and being able to commission services more effectively is also explicit: a workforce that is capable, has the capacity, is committed and is motivated will do efficient and effective work. It is ambitious but achievable. The organisational audit has helped to specify the capabilities that the PCT must secure to become World Class Commissioners and it has pinpointed where organisational processes and structures should be improved. The OD plan is the result of a considered analytical methodology and it sets out how the PCT will make good the shortfalls in capability and capacity of the workforce. It is ambitious but achievable. 14

17 Appendix 1 Creating the OD plan our methodology This plan recognises that the responsibility for OD should rest with managers and employees. Managers, following debate will be assigned personal objectives to ensure continuing focus on the outcomes of OD interventions. The senior leaders of the PCT agreed on some guiding principles for creating the plan for OD: Leadership of OD is a responsibility of the Board. PCT managers would help do the work of OD. Directors would make decisions at each key stage, based on discussions with stakeholders. The work of OD should be communicated as widely as possible. The methodology chosen would be applied first to four groups Directors, Very Senior Managers (VSM), Commissioning employees, and Supporting Services employees. To find out how the PCT viewed its knowledge, skills, abilities and behaviour in the context of World Class Commissioning, non-executive directors and senior members of its staff were interviewed. Their statements revealed that the PCT believes it has wider needs than simply to raise employees competence. The interview-based approach sharpened insight because, to spell out why specific points were relevant, respondents used examples they had either experienced personally or seen at work. Much of what was described was encouraging. The interviewees used many examples that highlighted the positive aspects of the way the PCT operated. Several of them described how responsive and focused the organisation was when dealing with unexpected problems. In those examples, the ability to rally around and achieve exceptional results despite a difficult environment was described in detail and with pride. The interviewees also gave examples of lessons learned, when reflection had suggested where improvements could be made to the way the PCT operated. These were then collated and summarised. The PCT applied pre-existing diagnostic tools to the work of OD, which saved the PCT considerable time in working out the personal competences required by World Class Commissioning. To keep the managers of the PCT involved in the OD work, the consultant briefed the OD steering group on the actions to be taken and the PCT s managers were asked to cascade the work through specific areas. The Directors were asked to review the actions to date, to confirm that the employees competences and the organisation s requirements were accurately defined, and finally to agree on the interventions recommended. In parallel, information was made widely available to employees via The Negotiating Committee. The programme of work: A formal project plan was drawn up and agreed. In the context of WCC, 15 key aspects of the work of the PCT were chosen and a structured interview was devised around them. This was the diagnostic tool of an Organisational Audit (Appendix 1). The structured one to one interview gathered opinion about the needs of the organisation. 12 interviews were held with nominated Board members, Executives and Directors. The data were gathered, analysed, and categorised. All data were verified with directors and other senior managers by means of a system of anonymous voting. 38 employees (in three of the four groups) assessed their own skills. Appendix 1 1

18 Approximately 200 capabilities stimulated by WCC were incorporated into the language of the NHS Knowledge and Skills Framework. 54 organisational improvements were categorised. 37 given immediate priority by the directors. The 200 personal competences were given unique identifier codes and cross-checked with the 11 WCC competences (see Appendix 2) and the PCT s strategic plan to ensure alignment. Interventions for development were agreed with the executives and - by means of a prioritisation matrix - directors responsible. A plan was documented. Regular reporting on OD will also be a standing item of discussion, with clear measures of progress, at every Board meeting. and a report on OD will provide members with assurance that the plan for OD continues to help the PCT to achieve the 11 goals in the Strategic Plan to implement new initiatives, such as World Class Commissioning (WCC) to configure the organisation to meet its objectives to raise the knowledge, skills and abilities of the workforce. Any plan for OD is by its nature inward-looking. But this one was drawn up with reference to external factors, and in particular to the needs of the workforce to support the strategic plan the demographics of the labour market in Wolverhampton results from the latest employee survey the current and future skills shortages over coming years and the increasing reliance on older workers to fill posts the current needs for healthcare of the people of Wolverhampton and future trends current understanding of the characteristics of effective organisations The OD plan will coordinate activities to develop the individual and to develop the organisation. Our aim is for our employees to fulfil their career ambitions and in the process, help the PCT become a World Class organisation. Appendix 1 2

19 The structure of the organisation was analysed. The findings revealed the need for a further, more detailed analysis of the organisational structure. We discovered the following in Commissioning and Supporting Services: There is a maximum of seven layers of management. Span of control is inconsistent. For example at ¾ ¾ ¾ Level 1 the span of control is 1:5 (Level 1 is the Chief Executive Officer) Level 2 the span of control is 1:4, 1:8, 1:7 Level 3 the span of control is: Finance 1:4, 1:3, 1:2, 1:3, Directorate 1:1 (in three specialist areas) 1:5, 1:3, 1:16, Public Health 1:2, 1:6, 1:2. The average ratio of managers to individual contributors is approximately 1:4 in the areas analysed. Ratio of support staff (by function) to Full Time Equivalent resources (FTEs): ¾ ¾ ¾ IT = 1:40. Finance = 1:45. HR = 1:59. Appendix 1 3

20 Table 1: 37 priorities for organisational development Communicate the role of the Commissioning function and the concept of WCC to all PCT employees Specify the skills that commissioners need to meet WCC Improve the effectiveness of communication and engagement with clinicians Ensure that the OD plan is owned by the Board, directors and managers Create an Organisational Development plan Reaffirm the values of the PCT and adopt measures to ensure they are exemplified by leaders Prioritise the development of the staff of the Commissioning function Create a strategy and plans for internal and external communications Consider purchaser/provider relationship Clarify and articulate departmental responsibilities and interfaces for all departments Create a strategy for organisational development Clarify the roles and responsibilities of the Commissioning Directorate Develop organisational capacity and capability in marketing and social marketing techniques Clarify the new needs for development springing from WCC Create an information strategy Reinforce all employees awareness of the PCT s strategic objectives, goals and values Increase the visibility of what PCT directors do Adopt ways to seek opinions about how the PCT is perceived outside the organisation Adopt measures to encourage leaders to behave as role models Ensure that all employees have an appraisal and a personal development plan Embed the employees competences desired in recruitment and appraisal processes Allocate funding for OD interventions Review the effectiveness of the current organisational structure Internally publicise the PCT s success stories more actively Create a Knowledge and Skills Framework (KSF) profile for all PCT posts Review and improve the purpose and content of all regular internal meetings Map the career paths for Commissioners Improve the PCT s effectiveness in dealing with difficult decisions and sources of conflict Improve the effectiveness of reviews of personal performance and time them to coincide with key business milestones Develop methods that demonstrate the risks and benefits of OD interventions (where Return on Investment cases cannot be shown) Audit that all employees have clear lines of sight between their day-to-day aims and the goals of the organisation Analyse and map all key PCT processes Standardise the PCT s contracts with suppliers Draw up a Succession Plan and review the management of talent Establish the practice of periodically reviewing relationships between non executive directors and directors Improve the effectiveness of Personal Development Plans Define measures showing the benefit of training (for example Return on Investment cases) to increase managerial support for development Appendix 1 4

21 To provide assurance that the skills and capabilities identified would help the PCT achieve WCC, they were assessed against each of the WCC competences. Table 2: Knowledge, skills and abilities mapped to the WCC competences Knowledge, skill or ability Most relevant WCC competence Social marketing 6 Market intelligence 1,3,7 Legal drafting of contracts with suppliers 9 Knowledge management 5 Organisational development 1 World Class Commissioning awareness All Public Relations, Marketing and Communications 1,3,7 Contract Management 9 Procurement skills 9 The use of information and knowledge 8,10 Clinical engagement 4 Appendix 1 5

22 Appendix 2 The 7S organisational capability framework Appendix 2 1

23 2