1. Caring to Change: Compassionate Leadership and Innovation in Healthcare Sussex Community NHS Trust September 2017
Michael West

2. ‘Compassionate leadership for compassionate health services’
Attending: paying attention to staff – ‘listening with fascination’
Understanding: finding a shared understanding of the situation they face
Empathising
Helping: taking intelligent action to help

3. Developing people, improving care: A national framework for action on improvement and leadership development in NHS funded services (November 2016)

4. The framework’s goal
The goal of the framework is to help create five conditions common to high quality, high performing health and care systems in every local health and care system in England
Collective, compassionate and effective leaders at all levels
Knowledge of improvement methods and ability to use them at all levels
Leadership equipped to develop high quality local health and care systems
Enabling, supportive and aligned oversight
Support systems for learning at local, regional and national levels

5. Leadership that promotes
… innovation, continuous learning and quality improvement
Chassin & Loeb (2013). High reliability health care. Millbank Quarterly, 91,

6. Learning and innovation
Staff focused on continually improving what they do
Staff focused on ensuring zero harm
Reflective practice and learning in all areas
Staff enabled at all levels to learn about best practice
Effective schemes to promote QI and innovation
Recognition and reward for QI and innovation in every department/team/function
Inspiring Vision and Strategy
Skills, capabilities, systems and processes
Autonomy and Support
Innovation
Commit-
ment to Innovation
Positive Inclusion and Participation
Enthusiastic Team and Cross-Boundary Working

7. Key Elements for Innovation
Inspiring Vision and Strategy
Autonomy and Support
Positive Inclusion and Participation
Enthusiastic Team and Cross-Boundary Working
Commit-
ment to Innovation
Skills, capabilities, systems and processes

8. Leadership prioritising an inspirational vision and narrative
… focused on high quality, continually improving and compassionate care while modelling in their everyday behaviours the values of the organisation (with compassion as the core value)
‘To deliver continuously improving, high quality and compassionate care to all in our community’
‘To be the safest hospital in England

9. Leadership with a commitment to …
effective, efficient performance – characterised by a focus on (5 or 6) clear, agreed, challenging and aligned team goals and objectives at every level with helpful and timely feedback on performance
BMJ Quality and Safety, Sept 2013

10. Key Elements for Innovation
Inspiring Vision and Strategy
Autonomy and Support
Positive Inclusion and Participation
Enthusiastic Team and Cross-Boundary Working
Commit-
ment to Innovation
Skills, capabilities, systems and processes

11. Autonomy and Support …
… good people management fostering high employee engagement – enabled by authentic, open, supportive, positive, inclusive, appreciative and compassionate leadership

12. Collective Leadership
Leadership the responsibility of all - anyone with expertise taking responsibility when appropriate
Shared leadership in teams and across teams
Interdependent, collaborative leadership - working together to ensure high quality health and social care
Leaders and teams prioritising quality of care across the system/organisation
Consistent approach to leadership within the leadership community – continually improving, high quality and compassionate leadership
West, M. A., Lyubovnikova, J., Eckert, R., & Denis, J.L. , (2014),Collective leadership for cultures of high quality health care. Journal of Organizational Effectiveness: People and Performance, 1, 240 –

13. People management and engagement
Patient/service user satisfaction highest where staff have clear goals
Staff views of leaders linked to patients views of care quality
Staff satisfaction/commitment predicts patient/service user satisfaction
High work pressure - patients/service users
report too few staff, insufficient support,
privacy, respect.
Poor staff health and well-being, high
injury rates, audit ratings
Good HRM practices - low patient mortality

14. Positive emotion and culture
Leader positive affect, climate and performance
Processing negative emotion – ‘affective shift’
Dealing with quarrelsome or disruptive behavior and poor performance

15. Key Elements for Innovation
Inspiring Vision and Strategy
Autonomy and Support
Positive Inclusion and Participation
Enthusiastic Team and Cross-Boundary Working
Commit-
ment to Innovation
Skills, capabilities, systems and processes

16. Employee Engagement in the NHS
Leadership
Supervisors’ Support
Team Working
Job Design
Work Pressure
Having an interesting job
Feeling valued by colleagues
Overall Engagement
Advocacy
Intrinsic Engagement
Involvement
Employee Reactions
Health and Well-being
Stress
Hospital Performance
Quality of Services
Financial Performance
Absenteeism
Patient Mortality Rate
Patient Satisfaction

17. 3. Employee engagement success factors www. kingsfund. org
3. Employee engagement success factors
A compelling strategic narrative
Inclusive leadership and management styles
Putting staff in charge of service change
Values and Integrity
Successful Trusts develop a clear narrative on their purpose and aims
Salford aimed to be the safest hospital in England
The happiness of all our staff, through their worthwhile, satisfying employment in a successful business
Successful Trusts have invested in retraining staff to adopt inclusive management styles
For example, Oxleas has introduced a substantial programme to retrain middle managers in facilitative leadership
Notts Healthcare NHS FT develops leadership aligned around strategy and values
Successful Trusts give staff responsibility for leading service change
Wrightington, Wigan and Leigh works with Unipart to support staff-led change
Salford’s quality directorate supports teams of frontline staff in testing improvements
Staff survey evidence highlights importance of values and trust in senior leadership
Perceptions of unfairness are our best predictor of intention to leave
In particular, fairness of procedures, bullying and discrimination.
Stable senior leadership
Many of the Trusts with highest levels of engagement have had the same senior leaders for over a decade: CEO of Oxleas in post since 2002, CEO of Salford in post since 2002, CEO of Frimley Park in post since 1998, in comparison with an average CEO tenure of less than two years.

19. Key Elements for Innovation
Inspiring Vision and Strategy
Autonomy and Support
Positive Inclusion and Participation
Enthusiastic Team and Cross-Boundary Working
Commit-
ment to Innovation
Skills, capabilities, systems and processes

20. 5. Team working, cooperation and integration

21. What is a Team? Typically no more than 12 members who:
Have shared objectives in common
Need to work together to achieve these objectives
Have defined roles in the team
Meet regularly to review performance and to improve

22. Key elements for effective team working
Clear purpose, identity and boundaries
Clear, agreed, challenging objectives
Role clarity
Positivity, optimism, cohesion and efficacy
Effective communication
Appropriate involvement in decision making
Constructive debate
Good inter-team working

23. Benefits of TBW in Health and Social Care
Reduced hospitalisation and costs
Increased effectiveness and innovation
Increased well-being of team members
Multi-disciplinary teams deliver high quality patient care and more innovation
Lower patient mortality
Reduced error rates
Reduced turnover & absence
Lyubovnikova, J. & West, M.A. (2013). Why teamwork matters: Enabling health care team effectiveness for the delivery of high-quality patient care. In E. Salas et al. (eds.). Developing and enhancing teamwork in organizations. San Francisco: Jossey Bass.

24. Team leadership Offer an inspiring vision and clear direction
Ensure regular and positive team meetings
Encourage positive, supportive relationships
Resolve and prevent intense conflicts
Positive group attitudes towards diversity
Be attentive and listen carefully to the team
Lead inter-team cooperation
Nurture team learning, improvement & innovation

25. Reflexivity
Teams are 25% more effective and innovative to the extent that they routinely take time out to reflect upon their objectives, strategies, processes and environments and make changes accordingly.
Schippers, West & Dawson, 2012, Journal of Management
Tannembaum & Cerasoli, 2013, Human Factors

26. Systems Leadership – Across Boundaries
A compelling shared vision of transforming the health and well-being of communities
Frequent personal contact between leaders who need to work together to build trust and make real progress to deliver for their communities
A shared commitment to work together for the medium and long term (not only short term objectives)
A shared covenant to surface and resolve conflicts quickly, fairly, transparently and collaboratively
An overt commitment to behave altruistically towards each other’s organisations, mutually supporting system success to transform the health and well-being of communities

27. How will the organisation ensure the creation of leadership capabilities?
The challenges health care is facing require new strategies
New strategies imply new leadership capabilities
These are both individual and collective leadership capabilities
This requires new and collective leadership cultures
A Leadership Strategy
Must Deliver These
© Center for Creative Leadership, Used with permission.

28. We have designed a two-year programme to be delivered in three phases
Programme outcome
To implement a collective leadership strategy to embed cultures that enable the delivery of continuously improving, high quality, safe and compassionate care.
c. Nov 15 to Sept 16
c. Sept 16 to Mar 17
c. Mar 17 to Dec 17

29. Phase 2 - Design This work is designed to be an
interactive PDF that enables you to
access the resources you require
quickly, and without having to read
the entire document.

30. Culture Phase 2: List of evidence-based interventions
Vision and Values
Values based Recruitment
Values Based Appraisal and Performance Management
Values-based transitions and on boarding process
Succession planning (with link to 9 Box Grid)
Values-focused curricula
Annual talent cycle
Goals and Performance
Leaders role job design
Inclusive recruitment Regular (annual) leadership forecast update
Goal setting and goal reviews
Team goals
Development on providing feedback on goals, behaviour and performance
360 feedback for development
Compassionate Performance Management
Support and Compassion
Recruiting and promoting for compassion
Developing compassionate leadership
Emotional Intelligence Development
Inclusion - listening with fascination and compassion
Peer coaching
Mentoring
Inclusive leadership development
Diversity and Equal opportunities training
Compassionate behaviour training
Identity-based talent management
Team Work
Strategic recruitment for diverse teams
Selection for team orientation
Selection for team leadership capability
Leaders developing leaders
Board/Executive Team development
Team leadership training
Team working training
Team-based appraisals
Working with shared team-leadership (peer coaching)
Skills for ensuring accountability for team working quality
After action reviews and team reflexivity
Building team based working
System Leadership
Learning and Innovation
Developing cultures for innovation
Leading for QI
Secondments
Leading for innovation
Developmental assignments
Action Learning
Action Learning Sets
Recruit for commitment to innovation & QI
Development for leading innovation and Change

31. Using some or all of the toolkit….

32. Supporting the use of the tools – Join the community!
We are exploring the use of action learning sets to support use of the tools and we will continue to develop our community of practice
If you would like to get involved, please contact:
Stay up to date at:
culture-and-leadership/
changing-culture-collective-leadership

33. ‘Compassionate leadership for compassionate health services’
Attending: paying attention to staff – ‘listening with fascination’
Understanding: finding a shared understanding of the situation they face
Empathising
Helping: taking intelligent action to help

34. e.mail m.west@kingsfund.org.uk
@astonod
Thank you