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Workforce Matters South WestSupporting workforce transformation to deliver sustainable organisations and a healthy system

MODULE 2 LEADING WORKFORCE TRANSFORMATION

WELCOME



MODULE 2 LEADING WORKFORCE TRANSFORMATION

Christine BamfordWorkforce Matters

Programme Director Liz Maddocks-

BrownWorkforce Matters

Programme Lead


Workshop Day 1CIPD 360 Feedback – Emergent Findings and Feedback

Projects – Reviewing Work Streams

Engaging Leadership

Applying Engaging Leadership to projects and practice

New HR Leaders Roles

Q&A - Using Engaging Leadership in Real World Situations

Co-production and Emergent Issues

World Class HR


Workshop Day 2NHS South West: SHA Expectations and Workforce Metrics

What is a Metric? Why do you need one?

Round Table Consultancy Sessions

The looming financial climate

Group Work – What does this mean for us?

Consolidating project and practice activity streams

Commitment to Action

Co-production and Next Steps


Action Since Last WorkshopPersonal Notes

Speed Review

• 1st Person Sharing – 2 Minutes

• Listener Questions and Comments – 1 Minute

• 2nd Person Sharing – 2 Minutes


• Signatures



CIPD 360 EMERGENT FINDINGS AND TRENDS

Sarah MilesCIPD


CIPD SLIDES HERE


CIPD SLIDES HERE


Workforce Impact Project

Pairs: Reviewing Work Streams and Leadership Challenges

1. 1st Person’s project – Review, Questions, Comments and Discussion to identify leadership challenges - 10 Minutes

2. 2nd Person’s project – Review, questions, comments and discussion to identify leadership challenges - 10 Minutes

3. Plenary Discussion – 5 Minutes

Stuck project? - Sit down with a Facilitator – Chris, Liz or Phil

Professor Beverly Alimo-Metcalfe FBPsSProfessor of Leadership, University of Bradford School of Management& Chief Executive, Real World Group

Workforce Matters South West - Module 2November 30th 2009

Engaging leadership

Leadership & culture

Content

What form of leadership is needed for the NHS?

What’s the research evidence of its validity?

How can organisations build leadership capacity?

What are the implications for HR professionals?

The reality…

• “Life is going to get tougher…” as the NHS moves from a state of “real term growth of 3.5% to an absolute maximum of 1% growth for four or five years”

Source: Andy McKeon (Audit Commission’s MD for Health) in In View, NHS Institute for Innovation & Improvement, Spring 2009, p. 3

Crucial challengesof leadership…

To get more with less

To do no harm

To create cultures of improvement & quality

To build capacity & sustainability

NHS Health & Wellbeing

• Sick leave costs NHS £1.7bn a year

• Cutting by one third would make annual cost savings of over half a billion (£555m)

• More than a quarter of NHS staff absence is due to stress, depression & anxiety

• “There is significant evidence to suggest that trust performance overall is linked to higher levels of staff health and wellbeing.”

Source: Boorman Review ‘NHS Health & Wellbeing’ (August 2009)

Engagement Is…..

‘Engagement is a positive attitude held by the employee towards the organisation and its values’

‘which affects the extent to which individuals put discretionary effort into their work’

IES (2004). The Drivers of Employee Engagement

Engagement is good for staff

Wellbeing and health (Sonnentag, 2003); reduced burnout (Bakker et al., 2005)

Reduced depressive symptoms, somatic complaints and sleep disturbances (Hallberg &

Schaufeli, 2006)

Higher self efficacy and commitment (Salanova, Agut & Peiro, 2005; Schaufeli et al., 2002)

Engagement is good for organisationsCustomer satisfaction (Corrigan et al., 2000; Harter et al., 2002)

Retention/turnover (CIPD, 2004; Gallup,2004; Watson Wyatt, 2005)

Productivity (Alimo-Metcalfe et al., 2009; Judge et al., 2001; Harter et al., Geyery, 1998)

Profitability (Towers Perrin, 2006; Watson Wyatt, 2006; Sirota Survey, 2005)

Safety (Harter et al., 2002)

Leadership Competency Frameworks

• Main source of data is ‘subject matter experts’ – the ‘leaders’

• Rigorous research (sampling frame, psychometric

robustness, validity, etc)

• Articulates the ‘what’ of leadership

Criticisms of Competencies • Overly reductionist, fragmenting the role of the manager,

rather than as an integrated whole (Ecclestone, 1997; Grugulis, 1998; Lester, 1994)

• Overly universalistic or generic, assuming that they are the same, no matter the nature of the situation, individual or task (Grugulis, 2000; Loan-Clarke, 1996; Swailes & Roodhouse, 2003)

• Focus on past or current performance, rather than future requirements, thereby reinforcing rather than challenging traditional ways of thinking (Cullen, 1992; Lester, 1994)

• Focus on measurable behaviours and outcomes to the exclusion of more subtle qualities, interactions and situational factors (Bell, Taylor & Thorpe, 2002)

• Result in a limited and mechanistic approach to development (Brundrett, 2000)

Bolden, R. and Gosling, J. (2006). Leadership competencies: Time to change the tune? Leadership, 2, 147-163.

Also …

“we see little evidence that these systems, in place for years now,

are producing more and better leaders in organizations”

Hollenbeck, G. P., McCall, M. W., Jr. and Silzer, R. F (2006). Leadership competency models. Leadership Quarterly, 17, 398-413.

In other words …

… being competent is necessary……but not sufficient, for effective leadership

Engaging Leadershipbehaviours

• Main source of data is - staff

• Rigorous research (sampling frame, psychometric

robustness, validity, etc)

• Articulates the ‘how’ of leadership

The Engaging Transformational Leadership Model

LEADING INDIVIDUALS

PERSONAL QUALITIES AND

VALUES

Being Honest & Consistent

Acting with Integrity

Showing Genuine Concern

Being Accessible

Enabling

Encouraging Questioning

LEADING THE ORGANISATION

Supporting a Developmental Culture

Inspiring Others

Focusing Team Effort

Being Decisive

MOVING FORWARD TOGETHER

Building Shared Vision

Networking

Resolving Complex Problems

Facilitating Change Sensitively

‘Engaging’ TLQ™ Dimensions

‘Engaging’ leadership principles

Leader as servant and partner

Leadership is a social process (‘ubuntu’)

Leadership is about connectedness through a shared vision, co-ownership, co-design and empowering partners in implementation

Evidence of validity of the engaging leadership model

Content, construct, convergent and discriminant validity

Generalisable across sectors and countries (eg Local Govt; Central Govt; Police, Prison Service, FRS, Schools, Universities, FTSE100 companies, USA, India, Pakistan, Greece, South Africa, Australia)

Alban-Metcalfe, R. J. & Alimo-Metcalfe, B. (2000). An analysis of the convergent and discriminant validity of the Transformational Leadership Questionnaire. International Journal of Selection & Assessment, 8, 3, 158-175.

The impact of TLQ engagement scales on staff in the NHS (N = 5,000)

Building leadership capacityfor sustainability

Leadership & culture

Does engaging leadership predict productivity, morale & well-being?

3-year longitudinal study

80 teams (N = 743)

Assessed leadership culture (LCCI™) (competencies & engaging behaviours)

Alimo-Metcalfe et al., (2007) ‘The impact of leadership factors in implementing change in complex health and social care environments: NHS Plan clinical priority for mental health crisis resolution teams (CRTs)` . Department of Health NHS SDO, Project 22/2002.

What did we measure?

Outcome measures:

Government targets re Team productivity

Team morale (eg motivation, job satisfaction, commitment)

Team well-being (fulfilment, self-confidence, reduced stress/emotional exhaustion)

Alimo-Metcalfe et al., (2007) ‘The impact of leadership factors in implementing change in complex health and social care environments: NHS Plan clinical priority for mental health crisis resolution teams (CRTs)` . Department of Health NHS SDO, Project 22/2002.

Contextual variables controlled for

Mental Illness Needs Index (MINI) for the team’s area

Availability of alternatives to in-patient care Age of the team Proportion of users presenting symptoms of

psychosis ‘Gate-keeping’ power of teams Extent of ‘medical cover’ Multi-disciplinary nature of team Ratio of staff to service users

Evidence that engaging leadership predicts productivity

Alimo-Metcalfe et al., 2007.

Results

A Culture of ‘engaging’ leadership significantly predicts:

High levels of motivation High levels of job satisfaction High levels of job & org. commitment Reduced stress & emotional exhaustion and…. High levels of Team Productivity

Source: Alimo-Metcalfe, B., Alban-Metcalfe, J., Samele, C. Bradley, M. & Mariathasan, J. (2007) ‘The impact of leadership factors in implementing change in complex health and social care environments: NHS Plan clinical priority for mental health crisis resolution teams (CRTs)` . Department of Health NHS SDO, Project 22/2002.

Competencies did not predict effectiveness

Lessons from supporting cultural transformation• Top management buy-in is crucial:

• Only start if organisation is ready, and committed

• Be Transparent

• Diagnose what’s needed where – not scattergun

• Don’t stop there!

• Relate everything to the values & aims

• Ensure HR processes consistent with this

• Evaluate ‘chain of impact’ (ROI) – publicise successes

• Build Capacity, not dependency

Implications for leadershipin the NHS & for HR professionals

• ‘Engaging’ leadership significantly increases productivity, and motivation and well-being

• Competencies are necessary, but not sufficient

• Leadership should be viewed as a shared or distributed process, embedded in the culture

• Recruitment, appraisal, development processes should be scrutinised

• Leadership development should focus on increasing both ‘human capital’ & ‘social capital’ (Equality & Diversity)

• Building genuine cross-community partnerships

[email protected]

Real World GroupStewart HouseSt Andrew’s CourtLeeds LS3 1JY

0845 6017708

www.realworld-group.com



BREAK

Back@ 5.30pm



WORLD CLASS HR

Dean RoylesExecutive Director

Workforce and Education

NHS North West Peter Reilly

Director, HR Research and Consultancy

IES

the institute for employment studies

World Class HR

Peter Reilly

Building the model…

What HR is trying to achieve:●delivering a range of services●adding value in different ways ●making a strategic contribution

The impact of people management:●lots of relevant factors involved

}People and performance (health sector)

Perceptions of fair treatment

Org. flexibility/concern

for wellbeing

Work-lifebalance

Opps for personalgrowth &

development

Employerconcernfor H&S

Involvement indecision-making

Job characteristicsesp job scope(enrichment)

Good relationshipswith managers& colleagues

Perceptions of org.justice/commitment

to employees

Trust inemployer

Feeling of beingvalued & involved

Opportunitiesfor promotion

Jobsatisfaction

Employee’sorganisationalcommitment

• Increased job performance

• Reduced lateness

• Decreased turnover/ intention to leave

• Reduced absenteeism

• Increased altruism

• Increased conscientiousness

IES report for NHSI

Org. flexibility/concern

for wellbeing

Building the model…

What HR is trying to achieve:●delivering a range of services●adding value in different ways ●making a strategic contribution

The impact of people management:● lots of relevant factors involved●delivering better results (for patients)●various models link people to performance

A summation of these elements

HR’s purpose and role:● deliverer of services● facilitator of people management● provider of a policy and practice framework● guardian of organisational values● manager of risk

To drive organisational performance thru people

To do this it has to:● be efficient as well as effective● be business aligned and offer strategic focus

The model

Supportspeople

management

IMPACT

World Class HR Practice

Createvalue

Addedvalue

Valuefor

money

Sustainableinnovation

Continuousimprove-

ment

Customer focus

Gets thebasicsright

Achieves desiredresults for

the business

Aligns & integrateswith the business

Has a compellingemployee

proposition

Proactivelyleads the

people agenda

The world class HR process

Step 6

Peer review

Step 1Orientatio

n‘Where are you now?’

Step 2Stakehold

er feedback surveys & discussion

s

Step 3Collect

hard data including capacity

Step 4Collating

& analysing findings

Step 5Action

planning workshop

Linking self-assessment to the model

Laying foundations

Factor 1• Gets basics right• …

Factor 2• Supports people

mgmt• …

Data options•…•…

Data options•…•…

Stakeholderfeedback•…

Stakeholderfeedback•…

Aligns &integrates withthe business

Proactivelyleads the

people agenda

Achieves desiredresults for

the business

Has a compellingemployee

proposition

Gets thebasicsright

Supportspeople

management

IM

PACT

World Class HR Practice

Createvalue

Addedvalue

Valuefor

money

Sustainableinnovation

Continuousimprove-

ment

Customer focus

… thank you

www.employment-studies.co.uk

For further information contact:

www.employment-studies.co.uk

[email protected]



QUESTIONS



BREAK AND NETWORKING

[email protected]



QUESTIONS



MODULE 2 - DAY 2 LEADING WORKFORCE TRANSFORMATION

WELCOME


Workforce Matters South West

Supporting workforce transformation to deliver sustainable organisations and a healthy system

WORKSHOP INTRODUCTION

Christine Bamford

Workforce Matters Programme Director


Workshop Day 2NHS South West: SHA Expectations and Workforce Metrics

What is a Metric? Why do you need one?

Round Table Consultancy Sessions

The looming financial climate

Group Work – What does this mean for us?

Consolidating project and practice activity streams

Commitment to Action

Co-production and Next Steps




NHS SOUTH WEST:SHA EXPECTATIONS AND WORKFORCE METRICS

Christine Whitehead

NHS South West




WHAT IS A METRIC?WHY DO YOU NEED ONE?

Mike DavidgeInterim Head of

MeasurementNHS Institute


Mike Davidge Metrics Slides Here



ROUND TABLE CONSULTANCYBriefing

Philip SweetWorkforce Matters Programme Facilitator

& Evaluation Lead


Round Table Consultancy


Round Table Consultancy 1. 1 minute per person - Round Robin

Project Owner: Outline what you know and don't know in relation to the work stream that is the table subject Group: listens and makes notes Total 6 minutes

2. Facilitator summarise the issues and:Either:Asks questions offers consultancy to help participants address common issues Or:One by one to focus on each project to ask questions/offer consultancy Total15 minutes

3. Summarise key questions and issues to flip chart Total 5 minutes

Groups move tables to break state/refresh prior to next round.



THE LOOMING FINANCIAL CLIMATE

Bill BoaAssociate director of

Commissioning and Performance

NHS South West

Quality, Innovation, Productivity and Prevention

and the Financial outlook

Bill Boa, Deputy Director of FinanceStrategic Workforce Programme - Taunton

1 December 2009

Quality, Innovation, Productivity and Prevention agenda (QIPP)

QIPP is the acronym used to describe the agenda that will support the NHS to deliver its quality and efficiency commitments

Quality must be the organising principle

Not a cost cutting exercise and supports the objective of driving up quality, improving productivity and increasing tax payer value

Future change in the NHS will be measured against the four key components of QIPP

Builds on the success of ‘High Quality Care for All’

Size of the challenge

National Picture

2010/11 – £500 million Value for Money savings

requirement– Forecast £1 billion revenue surplus

2011/12 onwards (likely)– Flat cash settlement– £15 billion to £20 billion productivity

savings requirement– Some surplus deployed in a planned

and managed way by 2013/14– 1.5% to 2% recurring uncommitted

headroom

NHS South West

2010/11 £50 million Value for Money estimate Forecast £120 million revenue

surplus(1.5% Resource Limit) Non recurrent expenditure plans of

circa £40 million(0.5% Resource Limit) per the local Strategic Investment Fund strategy

2011/12 onwards Flat cash settlement modelled £2.7 billion productivity savings

estimate Surplus deployed per the local

operating framework 2% recurring uncommitted headroom Further progress towards NHS South

West strategic ambitions

5.5

6.0

6.5

7.0

7.5

8.0

8.5

9.0

9.5

10.0

10.5

11.0

2006/7 2016/172015/162014/152013/142012/132011/122010/112009/102008/92007/8

Flat cash scenario projection, NHS South West will have to make productivity savings of ~£1.35b

in the first CSR period

PCT revenue limits, £billion

% % of current revenue limit

x Spend gap, £b

Expenditure projection

Flat-cash scenario

Growth in allocations

17%

£1.35b

Expenditure forecast, including

projected inflation, growth and

demographic changes

33%

£2.7b

10 Key Focus Areas that can deliver QIPP1 Reducing procedures with limited clinical benefit £40 - £44m

2 Optimising urgent care pathways £45 - £57m

3 Adopting best practice pathways for long term conditions

£125 – £163m

4 Shifting settings of care £72 - £169m

5 Improving prescribing £28 - £40m

6 Addressing variability in primary and community care £130 - £225m

7 Improving Mental Health & Learning Disabilities £126 - £211m

8 Optimising elective care pathways £405 - £468m

9 Supply chain optimisation and back office productivity £125 - £184m

10 Estates optimisation £51 - £77m

POTENTIAL OPPORTUNITY £1,147 - £1,638m

Working group established to develop a series of initiatives for each theme

1 Reducing procedures with limited clinical benefit

£40 - £44m

2 Optimising urgent care pathways

£45 - £57m

3 Adopting best practice pathways for long term conditions

£125 - £163m

4 Shifting settings of care £72 - £169m

5 Improving prescribing £28 - £40m

6 Addressing variability in primary and community care

£130 - £225m

7 Improving Mental Health & Learning Disabilities

£126 - £211m

8 Optimising elective care pathways

£405 - £468m

9 Supply chain optimisation and back office productivity

£125 - £184m

10

Estates optimisation £51 - £77m

POTENTIAL OPPORTUNITY £1,147 -£1,638m

Eight Working Groups

Each group is led by CEO and lead Clinician

Multi disciplinary teams to identify initiatives around each themes

Pilot plans in Health Community for 6 months

Optimising care pathways 1,2,8

Shifting settings of care and optimising urgent care

4

Best practice care pathways for LTC

3

Improving Prescribing 5

Improving Primary & Community care

6

Improving Mental Health 7

Improving Learning Disabilities 7

Improving non-clinical productivity 9,10

The working groups will develop a coherent set of initiatives for each theme to be piloted in a specific health

community

Identify best-practices in

specific theme

Develop plan for implementation in a community

Submit coherent set of key initiatives

Pilots and system

implementation

Nov 09

Dec 09

Jan 09

From Feb 09

▪ Build on strategic framework to agree on international and national best-practices in relation to quality and productivity

▪ Assess various initiatives for suitability and likelihood of success in the South West

▪ Further develop the ‘golden rules’

TimelineDescription

▪ Prioritise selected initiatives ▪ Develop a coherent set of initiatives▪ Translate potential quality outcomes and expected financial

impact into operational targets

▪ Write detailed plan for how to implement the initiatives within the lead CE’s health community

▪ Identify concrete deliverables, resources needed and potential risks and barriers to be overcome

▪ Pilot plan in CE’s community for 6 months▪ Update working group on implementation progress and issues arising▪ Following pilot, feed lessons learned into wider system implementation plan

NHS South West Response Local Operating Framework Policy

Strategic Investment Fund Policy (uncommitted headroom) CQUIN (national and local scheme and gateways) Corporate approach to managing risk Strong leadership and clinical engagement

Payment by Results Tariff, including Expectation of net tariff reduction in line with World Class

Commissioning planning assumptions, although enhanced

CQUIN scheme to incentive change Payment by Results local business rules and incentives

QIPP 10 key opportunity themes to initially focus on Workforce planning All future change and decisions to in future be measured against the four components of QIPP

And Finally……

–A NHS South West QIPP strategy has been developed and will be further refined to take account of announcements in the Operating Framework and feedback from the NHS South West QIPP pilots

–Enormous scope to redesign services and reduce variation in the South West

–The productivity agenda is seen as an opportunity to drive up quality and improve taxpayers value

–The challenge for the NHS is to manage growing demand, improve quality and patient safety and save money all at the same time

–The Strategic Ambitions of NHS South West are still the same as 12 months ago but economic constraint will be a real driver for change



THELOOMIMG FINANCIAL CLIMATEWHAT DOES IT MEAN FOR:MY ORGANISATION?MY PROJECT?MY PRACTICE?

Group Discussion



LUNCH

Back@ 1.30pm




CONSOLIDATING THE 5 STREAMS

Liz Maddocks-BrownWM Programme Lead

Philip SweetWM Programme

Facilitator & Evaluation Lead


Consolidating the 5 Streams1. Consolidate notes – 15 Minutes

• Identify impact Your Project Your Professional Development and Practice

2. Pairs – 5 Minutes each• Discuss/Questions

3. Key Issues to Flip Chart – 5 Minutes



ACTION PRIOR TO THE NEXT WORKSHOP

Philip SweetWorkforce Matters Programme Facilitator

& Evaluation Lead


Action prior to the next workshopPersonal Notes – 5 Minutes

Speed Review

• 1st Person Sharing – 2 Minutes


• 2nd Person Sharing – 2 Minutes


• Signatures




CO-PRODUCTIONPREPARING FOR MODULE 3 AND NEXT STEPS

Christine BamfordWM Programme Director

Liz Maddocks-Brown

WM Programme Lead



HAVE A SAFE JOURNEY HOME

THANK YOU

Documents

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