NHS Tayside Transformation Support Team: second progress report

AAG Recommendation 10 – Leadership Development

"The Board must continue to foster and enable leadership development at all levels. As NHS Tayside moves forward, strong clinical leadership will be essential to realise the ambitions of the Chief Medical Officer's Report on Realistic Medicine and the National Clinical Strategy."

NHS Tayside's Assessment

"Utilising the contemporary culture toolkit developed by King's Fund and NHS Improvement ^[14] , and working alongside the King's Fund as a strategic partner, the Board's culture and leadership development plan has progressed at pace during the year. The outcomes from the wide-ranging diagnostics phase were considered and agreed by the Board in February 2017, with the design phase endorsed and commended by NHS Tayside Board at their 7 December 2017 meeting, at which the Delivery phase was authorised. Compassionate and Inclusive Leadership Design Events were held on 21 September and 10 November 2017 attended by a cross section of staff.

A wide range of clinical and non-clinical staff from NHS Tayside and the HSCPs participated in two "Powerlabs" ^[15] sessions with very positive feedback. These sessions focused on the devolution of leadership within the organisation. A two-day Integrated Clinical Strategy event was held in September to bring together a wide range of staff, clinicians and public interest groups and our strategic workshops were completed with the Senior Leadership Team, resulting in the adoption of a test of change in January to March 2018

A refreshed Assistant Medical Director portfolio has been agreed as part of the Chief Operating Officer's leadership team restructure; this new portfolio reflects the national and Board commitment to Realistic Medicine and NHS Tayside's Quality Outcomes.

Martin Fischer, a consultant with organisational development and systems expertise, has been commissioned to work with the Executive Review Team (both management and staff side leads) to further develop the approach to collective leadership and team dynamics. Two sessions have been completed, challenging the whole team around understanding dynamics, leadership styles and engagement. Additionally, he has provided an external reference point for consulting on ideas and individuals' development requirements.

Via engagement with NHS NES, a coaching session was undertaken for Executive Directors, completed on 11 December 2017.

Next Steps

Continue with the enhanced delivery of iMatter ^[16] action planning from January 2018 via the 1,500 champions. The revised workplan for extended Senior Leadership Team to be completed with the test of change completed by March 2018 and established as "business-as-usual" from April 2018. Delivery of Culture and Leadership Development work will continue building on the strong foundations that have already been established."

TST comment

We have seen relevant evidence that the Board is taking action to address both aspects of this recommendation.

In relation to organisation-wide leadership development, NHS Tayside had already begun working with the King's Fund prior to the appointment of the Assurance and Advisory Group, with the aim of developing a strategy which not only addressed improving leadership skills, but sought to foster compassionate care. We welcome the progress being made with this work and the range of other activities being taken to respond to this recommendation.

We also recognise that it would be unrealistic to expect to be able to see much in the way of visible impact by end-December as re-setting the culture in such a large and complex organisation will take some time and requires continual cultivation. However, we believe that NHS Tayside has shown a genuine commitment to developing its leadership culture and nurturing it at all levels. This includes the Executive Team's willingness to reflect on their behaviours and skills. In taking forward its next steps, NHS Tayside must give priority to putting in place robust and transparent plans for the third, Delivery phase of its Compassionate and Inclusive Leadership work to ensure that the valuable momentum and commitment built to date is not lost.

Specifically addressing the issue of clinical leadership, although the restructuring of Associate Medical Director portfolios is still at an early stage we have seen early examples of enthusiasm, commitment and leadership in relation to the development of the ICS, the work on medical models in Perth and the review of mental health services which provide encouragement and a degree of confidence that the skills and abilities exist to ensure the revised structures deliver their potential.

TST rating in September 2017 = Amber
TST rating in January 2018 = Amber

End of assessment