Delivering Quality Through Leadership: NHSScotland Leadership Development Strategy

4.0 PRIORITIES FOR ACTION

The review of Delivery through Leadership has confirmed that much has been achieved over the past few years in terms of leadership development - and that more is required. Just as the context and the leadership qualities and behaviours are changing, so are the priorities for investing in leadership development.

There are five priority areas for development over the next three years:

1 Work with partners to drive cultural change in support of the delivery of high quality services.
2 Build leadership and organisational development capacity and capability.
3 Develop current leaders and teams.
4 Nurture the supply of future leaders.
5 Evaluate the impact of leadership development.

These five priorities are explored below with key national actions highlighted in the shaded boxes. Details of the national and local actions that will be taken are set out in the Implementation Plan in Appendix 4. It is important that we ensure our efforts are sustained and that we build on the approaches so highly valued by our stakeholders. For this reason, under each heading, we have also outlined short vignettes of approaches to date which have been seen as effective (in the outlined boxes).

4.1 Work with partners to drive cultural change in support of the delivery of high quality services

There has been positive feedback from stakeholders about the personal contact, consultative approach and practical support demonstrated by the national leadership team. There is a sense of coherence and clarity about the national work that aligns well with local development. In moving forward, however, the leadership strategy should be more explicitly aligned with the NHS service delivery agenda.

The current national work streams ( e.g.Delivering the Future) have delivered demonstrable service benefits. However, the impact of leadership development needs to be more clearly planned and evidenced, e.g. the positive influence of leadership development on organisational culture which in turn enables service improvement, change and achievement of targets. One practical step would be to align the work of the National Leadership Unit and the Improvement & Support Team ( IST) more closely, thereby making explicit the links between behavioural development and service change and improvement.

The further pooling of effort and resources in leadership development across public services is seen as beneficial. Stakeholders feel that there is great potential in a collaborative approach to leadership development, i.e. by providing the opportunity for leaders from different organisations to share and exchange their learning across their diverse contexts. Additionally, there is scope for stronger partnership with Higher Education and Further Education. Universities and Colleges could be an integral part of the development solution, i.e. by providing theoretical and research input on leadership as well as being part of the practical delivery of leadership development.

Collaborating for Outcomes in Public Services

In May 2008, the Public Sector Leadership Development Collaboration Group was established. The group has launched a collaborative leadership development programme which is designed to:

• Provide a context in which the sixty or so participants can support each other in delivering on their own leadership challenges in contributing to Government Purpose and Outcomes
• Build capacity and links across the Public Sector to increase mutual understanding
• Increase alignment across the Public Sector
• Create sustainable networks of learning and support.

The programme is organised around the Scottish Government's five Strategic Objectives: Wealthier & Fairer; Healthier; Greener; Smarter; Safer & Stronger. Using a variety of methods including case studies, input from guest speakers, programmed visits across Scotland and Action Learning Sets, the programme will focus on each of the Strategic Objectives in turn providing opportunities for reflection on the leadership challenges of achieving successful outcomes.

Building on the relationship between excellent leadership and the delivery of high quality services, leadership development should link in closely with the performance management process for individual managers. Greater emphasis should be placed on making the leadership qualities and behaviours set out in this strategy an integral part of the performance management process for senior managers. (See Section 3.0 for ways in which the leadership qualities and behaviours might be used locally to support cultural change).

Key national actions under this priority (4.1) are as follows:

• Build and strengthen relationships with key partners and stakeholders to ensure alignment of the development and service delivery agendas.
• Work with partners through the Public Sector Leadership Collaboration to share and identify areas for mutual development.
• Support the application and sustained development of the revised leadership qualities and behaviours.
• Update the 360º feedback tool to ensure that it reflects the revised leadership qualities and behaviours.
• Work with local users and providers of the 360º tool to improve access and uptake.

4.2 Build leadership and organisational development capacity and capability

The strategy recognises that the majority of leadership development initiatives quite rightly take place within the local systems where there is a great deal of innovation and good practice. The focus of this strategy is the alignment of activity and the identification of synergies across the Boards as a way of building leadership and organisational development ( OD) capability and capacity across NHSScotland.

Much progress has already been made through the establishment and development of the OD Leads network over the past three years. This is a unique approach in public services and is highly valued by stakeholders. The OD capacity in some Boards remains small. In terms of adding value, it makes sense to focus on national activity and the pooling of resources across the service, e.g. national investment in supporting the OD leads network, sharing expertise, commissioning or developing national resources such as the 360º tool.

Building OD capability through networking

The OD Leads network meets formally every couple of months. A recent review of the network has reiterated the value its members derive from meeting together to share ideas and come up with collaborative solutions. This review has refreshed both the purpose and ways of working of the network. The meetings now include:

Open space - an opportunity for members to bring live issues from their system and engage in dialogue with colleagues to reach practical and sometimes collaborative solutions.

OD practice-focused session - a structured opportunity for members to learn more from each other around an element of OD practice, e.g."how does OD work with redesign/improvement methodology?".

Policy context-focused session - an opportunity to hear more about the policy context and to explore what this means at the local level, e.g."how to influence at a national level for early OD engagement - around Board Development".

In this respect, coaching is a powerful development tool which has already had some positive benefits in terms of ways of working across Boards. The rigour of the coach matching process used for the Chief Executives' development framework is cited as a particular reason for the success of this service. There is a strong sense that a national approach to commissioning executive coaching will be very helpful in ensuring high quality and public value (building on the approach launched for the Chief Executives in 2008).

The linkages between the National Leadership team and the NHS Boards are strong and the inclusive approach is highly valued, e.g. the approach taken to the scoping of the Chief Executive framework. However, there is also recognition of the limitations on this approach in terms of capacity and available resources at a national level. This creates a paradox for the national team. While its focus is rightly on national delivery, there is huge value to be derived from building informal personal contacts with Boards as a way of understanding more about local activities and needs and ensuring alignment between local and national. While there is close connection between the national team and the OD Leads Network, there could be better alignment with the wider workforce agenda (as outlined in A Force for Improvement). One possibility is a named link in the national team to each Board.

Key national actions under this priority (4.2) are as follows:

• Further develop the OD Leads network and support the implementation of the revised ways of working and work plan.
• Identify national priorities for OD practitioners' development based on the OD competencies framework.
• Build into the OD Leads' work plan ways of building capacity - including co-facilitation, mentoring and sharing resources.
• Allocate a member of the National Leadership Team to each NHS Board to act as a conduit and support local OD Leads where required.
• Establish a register ("framework agreement") of individuals and organisations with a track record of working effectively at Board level.
• Agree a national approach to coaching in NHSScotland based on best practice and establish an executive level coaching service.
• Explore the feasibility of establishing a cross-sector mentoring service.
• Identify opportunity for the development of shared national leadership development resources, i.e. programme directories, e-learning, and national licences.

4.3 Develop current leaders and teams

The national work streams delivered to date (including Delivering the Future, the Chief Executive Leadership Framework, the Management Trainee Scheme, and the Frontline Leadership and Management Programme) have received positive feedback and stakeholders have seen clear value in their continuation. A nationally co-ordinated approach to the development of other key groups is welcomed, i.e. executive cohort; senior managers; and non-executives. Indeed, there was a sense of urgency about getting development programmes for these groupings up and running.

The current Framework for Developing Boards is welcomed. Providing leadership development for Chairs and Non-Executive Directors and preparing people for taking on non-executive and executive roles are seen as critical priorities. For example, the development of a framework approach for Chairs similar to the Chief Executive framework is seen as an important priority.

Framework for Chief Executive Development

A Framework for Chief Executive development was researched and published in 2007. Implementation of the framework has continued throughout 2008 and into 2009.

The framework includes the provision of Executive Coaching for Chief Executives. Each Chief Executive was offered a matching conversation that enabled them to select an Executive Coach from a register of accredited and highly experienced coaches. The fit between the client and coach has been a critical success factor in the effectiveness of the coaching process. There is some evidence already of the positive impact of coaching in terms of individual and team development.

A cross-public sector action learning set has been established for a number of the Chief Executives - an opportunity for these senior leaders to share learning with their peers across public services.

There is a strong view that development in professional silos is not helpful given the importance of working across organisations and systems to deliver the national agenda. At the same time, it is recognised that there may be situations where it is important and necessary to develop specific skills within a particular professional group. National effort around leadership development should continue to focus on offering opportunities across professional groups and leadership careers at different levels.

There are two critical points in relation to national work streams. The first is that the work streams should continue to be aligned with local Board development initiatives. Wherever appropriate, national work streams should foster and support the development of local OD capability and capacity to deliver. Secondly, the consistency and sustainability of the current national programmes is seen as important. In particular, there could be value in exploring the creation of a virtual "leadership academy" through which the alumni of the several national programmes could continue their learning ( e.g. through access to coaches, mentors, buddying, and refresher national events).

Key national actions under this priority (4.3) are as follows:

• Further implement the Framework for Developing Boards work stream.
• Scope the leadership development needs of NHS Board Chairs and develop a Framework to address their needs.
• Continue the implementation of the Framework for Chief Executive Development and explore further opportunities to develop this work across the public services.
• Develop a framework for Executive level development which offers a range of opportunity to meet the diverse needs including a focus on succession planning.
• Roll out first phase of the approach to development of senior managers in the Northern region. Review and progress further roll out of the approach.
• Work across the service to identify strategic clinical leaders, e.g.ACF Chairs, who might benefit from joining a clinical leadership community of practice.
• Scope the next phase of the Frontline Leadership and Management Development Programme (beyond year 3) and identify ways of sustaining development.

4.4 Nurture the supply of future leaders

Two of the current national work streams, i.e.Delivering the Future and the Management Trainee Scheme ( MTS), focus on building leadership capacity. Capacity-building is regarded as critical and more work is needed at a national level around succession planning for leadership roles at all levels, but particularly in the executive cohort.

This is a particular concern for some functional groups where the perception is that there is no or little "leadership pipeline". There is also a particular issue about promoting leadership roles within remote and rural settings and the need to take some targeted action to attract potential candidates ( e.g. as an option within MTS).

There is a need to take a sustained approach to succession planning that aligns with local effort.

Key national actions under this priority (4.4) are as follows:

• Further implement Delivering the Future.
• Identify ways of sustaining development of strategic clinical leaders.
• Continue implementing the Management Training Scheme.
• Explore opportunity to align the MTS with other graduate training schemes, i.e.NHS finance training scheme and schemes across the public sector, to ensure best practice.
• Ensure that within the work streams outlined under 4.3 consideration is given to succession planning, i.e. identifying leaders at all levels who have potential to achieve at more senior levels.
• Within each of the work streams, explore opportunities for identifying development needs, i.e. application of the 360º tool, use of development centres, and accessing existing programmes as appropriate.

Management Training Scheme

The Scheme was re-established in 2005 with a first intake of seven graduates based in various Boards across Scotland. Up to eight people have been recruited each year since then to this two year Scheme. The trainees are NES employees with a third year commitment from host Boards to deploy them.

The recruitment and selection process is delivered by the Scheme manager and a team of trained assessors from within NHSScotland. This has added value and developed capacity and capability across the system to support competence-based recruitment. The education and learning provision is changing to reflect the nature of the NHS within Scotland but still keeping this within the broader UK and indeed European context.

Three external evaluations have identified that the Scheme exhibits robust recruitment and selection (in line with best practice), high retention rates, both on and off the Scheme and innovative development interventions ( e.g. shared action learning with doctors).

Delivering the Future

'Delivering the Future', a leadership development programme which aims to identify senior clinical leaders and prepare them for roles at Board, regional and national level, has been running since January 2006. Three cohorts (of around 25 participants) have now completed the programme and a fourth cohort is under way.

Formal evaluation has demonstrated that 80% of participants have either increased significantly their range of responsibilities or have achieved promoted posts within the year of attending the programme. It further reveals that the impact of the programme is very positive in terms of personal development with comments such as: "a learning and development experience of a lifetime … a fantastic experience from which I have gained enormously". (Spurgeon and Flannigan, 2008 Warwick University).

4.5 Evaluate the impact of leadership development

In the context of increasing scrutiny of public spending, there is a need for a clear demonstration of the return on investment as well as the public value of leadership development. While leadership is a cross-cutting theme in A Force for Improvement, there are further links to be made between leadership development, staff governance and workforce monitoring. More work is required on defining the measures of impact of leadership development (albeit indirect or qualitative). While this is set out as a separate priority, evaluation is integral to how we approach leadership development. In terms of the leadership strategy in its entirety, measures of achievement have been included in the implementation plan (in Appendix 4).

Key national actions under this priority (4.5) are as follows:

• For each area of work, an evaluation strategy is identified at the planning stage.
• Independent evaluation is undertaken for any large national programmes to ensure that aims have been met.