Day 2 Programme for Senior Managers and Leaders Pamela Roberts, Senior Organisational Development Officer Gareth Evans, Senior Organisational Development Officer 1

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Aims & Objectives – Day 2 Aim: To provide you with a set of techniques, tools, models and frameworks for influencing behaviour, team working, mental models, productivity, staff morale and well-being, team culture and ‘whole systems’ working. Objectives: 1. Consider what do we mean by an ‘organisation’ 2. Define and explore what is meant by ‘Organisational Design and Development’ 3. Consider some of the wider contextual factors influencing how we think and behave as individuals and as an organisation 4. Explore the principles of effective team working:  What is our team here to do?  How do we operate as a team and what can other’s expect of us?  Who do we need to work with to get things done?  Identify who we need to develop our working relationships with further,  Undertake a Team Influence Audit and identify areas where you can extend and increase influence 5. Get agreement to review course use-ability with you 3 months post completion (invite you along to a focus group to explore your use of the tools back in work) 4

What is an Organisation?  Spend some time in your groups exploring the question above  Come up with your own definition for what an organisation is  What needs to be included in your definition?  Feedback to the whole group 5 Activity

Defining Organisational Development Beckhard (1969) defines Organisational Development as ‘An effort (1) planned, (2) organisation-wide, and (3) managed from the top, to (4) increase organisation effectiveness and health through (5) planned interventions in the organisation’s ‘processes’, using behavioural science knowledge’. Beckhard, R. (1969). Organization development: Strategies and models. Reading, MA: Addison-Wesley. The North West Leadership Academy defines Organisational Development as being about: “Improving organisational performance through implementing a planned process of leading and managing change that aligns key levers such as Vision, Values, Strategy, Structure, Processes, Systems, Ways of Working and People Capabilities” 6

Leading your team  In what way do you as a leader, contribute to improving performance in your service area? Group discussion (10 mins) 7 Activity

Organisational Development (OD) uses a number of different frameworks, models and activities to understand, influence and improve the overall performance and functioning of an organisation. Around projects such as:  Staff engagement  Developing effective appraisal processes  Facilitating effective team working and development  Exploring and refining systems and processes  And doing targeted work on identified systems issues, such as managing conflict, delivering on values-based working, improving leadership ability and performance, etc. Activity - Take some time to talk through your pre-course prep on the 2 OD models share your change example and why you chose your preferred model. - What insights did you gain from using it? - We will ask you to share your thoughts with the whole group 8

The Wider Context History & Challenges Future & Opportunities  Special Measures  Close Relationship with Welsh Gov  Uncertainty re Senior Leadership and Direction/Vision for BCUHB  Organisational Flux and Uncertainty  Culture (i.e. Habits of Practice and Thinking)  Ockenden Process (Tawel Fan)  Mid-staffs  Andrews Report – Trusted to Care  Austerity  Welsh Assembly Elections (May 16)  Special Measures  Close Relationship with Welsh Gov  New CEO, Integrated Medium Term Plan and Strategic Goals  Organisational Flux and Uncertainty  Reshape Culture & Habits of Practice by changing the way things get thought about, talked about and carried out  Values-based, engaging leadership  Utilising New Ways of Thinking and Effective Team Working 9

Developing Culture Awareness  This third exercise is designed to get you thinking about the team culture you work within.  It is designed to help you ‘surface’ some of the possible unspoken rules, beliefs, attitudes and habits of practice that are what give rise to work cultures and ultimately organisational culture-as-a-whole.  Work through the questions on your own 1 st. You can use the flipchart ideas on Organisational Mental Models if that helps (10 mins).  Then share your thoughts in your small groups (10 mins).  Feedback your shared discussions to the whole group (15 mins). 10 Activity

Why team based working in healthcare? 5

Team Based Working Team based working is a philosophy or attitude about the way in which organisations work – where decisions are made by teams of people rather than by individuals and at the closest possible point to the client, patient or service user. Aston Organisation Development Ltd 2014

Team working in health care  Amy Edmondson US 1990s error management  Aston Research  Healthcare team effectiveness  HR and patient mortality  Mental Health team effectiveness  Primary Healthcare team effectiveness  Team working and clinical effectiveness in breast cancer teams  Assessing organisational capacity to deliver Clinical Governance  The NHS Workforce initiative – mental health of the NHS workforce Aston Organisation Development Ltd 2014

Evidence :  Research conducted by Professor M West and C. Borill concluded that the higher the percentage of staff working in teams within a hospital, the lower the patient mortality.  On average, in hospitals where 60% of staff worked in formal teams, mortality was around 5% lower than would be otherwise expected.  Staff working in formal teams also introduced more innovations to improve the quality of patient care, show an improvement in their general well-being and have higher levels of job satisfaction. Aston Organisation Development Ltd 2014

Team working and patient mortality

Benefits of TBW NHS research  Reduced hospitalisation and costs  Increased effectiveness and innovation  Increased well-being of team members  Multi-disciplinary teams deliver high quality patient care and implement more innovations  Lower patient mortality  Reduced error rates  Reduced turnover and sickness absence Aston Organisation Development Ltd 2014 Activity

What is a Team? Typically no more than 12 people who:  Have shared objectives in common.  Need to work together to achieve these objectives.  Have different and defined roles in the team.  Have a team identity. Aston Organisation Development Ltd 2014

7 Key Principles of Effective Teams 1. Team Identity 2. Team Objectives 3. Role Clarity 4. Team Decision Making 5. Team Communication 6. Constructive Debate 7. Inter-Team Working Aston Organisation Development Ltd 2014

The Aston Team Performance Inventory Team task design Effort and skills Organisational support Resources Team Processes Objectives Reflexivity Participation Task focus Team conflict Creativity and innovation Individual satisfaction Attachment Team effectiveness Inter-team relationships Team innovation InputsProcessesOutputs Leadership Leading Managing Coaching Fully effective teams:

Aston Organisation Development Ltd 2014 Activity Quick Team Effectiveness Audit Do you work in a team? Be honest, no right or wrong answers! Think objectively, consider all of the team

21  What are the benefits for the organisation / team / individual team member of having a clear vision / purpose statement?  What is your team’s vision / purpose statement – (linked to pre-course work). Team Vision / Purpose Statement

Operating Principles:  ‘ways of working’ a ‘sense of how they work in the world’ - e.g. “we are the sort of team that.....”  This is about how we behave and how we treat each other, for example, do we trust each other, are we open and honest? Aston Organisation Development Ltd 2014

Operating principles:  Remember a time when you worked in a successful team – one that you enjoyed being part of and that achieved its goals  What made this team so successful?  Think about processes and behaviours  Write one feature on each post-it 29 Activity Aston Organisation Development Ltd 2014

Home team:  The team whose objectives determine the way you work in all the other teams you are involved with. Team community:  A number of teams that need to work together to achieve a higher goal e.g. a patient pathway. 18 Aston Organisation Development Ltd 2014

Inter-team working  Team based working is about whole organisations working in co-operative teams, not just about individual teams working effectively.  Team members need to have a common understanding of the team’s position in relation to other teams and organisations that it needs to interact with. Aston Organisation Development Ltd 2014

Pathway Management Team Trust Board CCG G.P.s Portering Ward Management Team Theatres Social Workers Radiology Bereavement Counselling Physio Patient Forum Regulatory Board Business Devt Group Monitor Local Authority OT CQC HR ITIT Estates Carer Networ k Care Homes 26 Example of a Community Map Aston Organisation Development Ltd 2014

 You can complete this activity individually or in pairs or in your small groups to develop your Team Community Map, following instructions within your workbook. Community Map Activity Activity

Developing co-operative relationships Using your Community Map explore the questions below and complete the attached ‘developing co-operative relationships’ action plan. 1.Identify all the areas your team needs to develop a more co-operative relationship with and then highlight your top 5 priority areas. 2.What are the key benefits of each co-operative relationship? 3.Who will be involved in the development of each relationship? 4.What actions will we take to improve or develop the relationship? Activity

 Using your Community Map and the Team Influence Audit, identify which areas you need to be able to increase influence if you are to succeed in achieving your team objectives.  Identify your top 5 priority areas and using the ‘building team influence’ questions, develop a plan in order to extend and increase influence in these areas, using the action sheet in your workbooks. Activity Influence Audit

 Write a headline about how effective team working in your area has contributed to the organisation successfully achieving its strategic goals.  Rules: Less than 10 words Dated one year from today. Say which professional journal or other relevant publication this headline appears in. You must feel proud to see this headline. Small Group Activity

Summary of Main Learning Points  Defined and explored Organisational Development, Systems Thinking & Principles of Effective Team Working  Understood how stepping back and seeing the bigger picture helps us ‘map the system’ and see patterns and deeper influences that shape day to day events  Used a number of frameworks and tools that give us ability to leverage change at a number of levels within teams and service areas  Understood the connection between mental models, systemic structures, culture and effective team working  Understood how exploring for the system’s implicit purpose reveals ways in which we can influence work place culture to improve dialogue, trust, confidence and openness to learning  Made the link between the various factors in effective team working and improved morale, productivity, staff engagement, staff capability and effective use of resources  Understood that systemic change needs time, has consequences, and that taking time to think helps us respond, design and transform (and not just react) 31

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Feedback, Reflections, Next Steps  Feedback  Please take some time to complete the evaluation form provided and make suggestions for how to improve the workshop for future groups  Reflection and observations about Day 2, and the Wider Programme  What has been the most useful aspects of the programme?  What do you think you can do to continue your learning back in the workplace?  How do you think you can apply some of the tools and techniques back in the workplace?  Next Steps  We are planning a series of CPD ‘master classes’ that build on topics we have discussed and explore related ones such as workforce modernisation, succession planning, talent management, etc – let us know if you are interested in attending any of these  Would anyone be interested in being part of a ‘systems thinking’ practice group with the aim of practicing using systems thinking to develop skills, explore workplace issues and consider possible systemic interventions? 33

Diolch Yn Fawr Thank You 34