The Challenge
Aintree University Hospitals Trust faced the challenge of building on their current successful strategic level partnership forum by cascading down partnership behaviour and working to unit/departmental level, in order the meet current and future challenges of organisational development and improve the overall quality of patient services.
The trust and the social partner unions identified the need to embed partnership working at operational level as a priority, because the very positive experience of existing partnership arrangements at trust level had been acknowledged to have contributed strongly to the Trust’s success. Partnership working through the forum had enabled the Trust to identify and resolve problems and to pro-actively anticipate and deal with challenges of service transformation. As a result managers and unions in the trust believe that partnership works, and there was a strong desire for this positive enthusiasm to be capitalised on. This challenge is common to many organisations and trade unions who practice partnership, but it is less often addressed – mainly due to the huge commitment required to invest in the training and development that is necessary to embed the process and make it a way of working that every member of staff can recognise.
The Approach
Four areas of the Trust were selected as pilots; Domestics, Elective Care, Theatres and Outpatients. Each one of the pilots was chosen as they faced real issues that needed to be addressed in the short term. After an initial diagnostic phase that resulted in over 20 key practitioner’s being interviewed, the IPA proposed a project outline to meet the Trust’s requirements.
During the first stage of the project, the IPA facilitated two-day workshops for each pilot area attended by line managers, trade union representatives and staff. This initial workshop unpicked the issues and developed a set of tools for the participants to use in on-going discussions. A second one-day workshop was then held to examine progress, plan strategically for the coming two years and firmly establish each pilot area’s new Partnership Group as the main body for consultation over all issues. Each Partnership Group undertook to involve all of the staff in their area by improving communication and keeping everyone informed about how the key strategic decisions were being taken. Staff would have a critical input to those decisions through both their line managers and through their representatives.
The second stage of the project was to identify a group of people in the pilot areas to roll the project through the entire trust. During the course of the workshops, the IPA identified a group of people who would undertake an intensive skills-transfer programme in order that they could facilitate workshops and develop Partnership Groups in all areas. Five people, now called Partnership Champions, were trained by the IPA over two workshops and individual coaching sessions.
The Outcome
The Trust now had over 80 staff, line managers and trade union representatives who; understood partnership working and its links to employee engagement, were using tools such as option-based consultation and the 15 Strategic Questions as a basis for creating an informed workforce, were committed to improving communication to the staff, were equally committed to ensuring the informed views of staff were heard and were able to promote the idea of partnership working to anyone else in the Trust who was unsure of its merits.
Five specialist Partnership Champions were also ready and able to ensure that the project did not end with the development of the Partnership Groups for the pilot areas. Work also began on integrating the partnership models established by the workshops with communication and engagement models being developed by other people in the Trust. Each pilot area outlined some successes as a direct result of the workshops.
The Feedback
For Theatres, the assessment was that sustainable change had been achieved as a result of the new structures. In Domestics the project sponsors reported a smooth transition, well integrated teams and a major improvement in quality of cleaning services and contributing to Aintree’s vast reduction in infection level (MRSA & C.Diff). For Elective Care there was a smooth move to new Elective Care Centre (where the 15 Strategic Questions were highly influential), redesigned patient pathways, improved day case rates and theatre efficiency. Although Outpatients is still developing, the project sponsors have reported that the implementation plan is on target, that a number of staff have been found other substantive roles already and that the service was running smoothly during transition. Several other key lessons were learned:
· Empowerment only works when staff are informed
· Higher levels of responsibility come with empowerment
· Unions have to manage staff expectations
· Managers need to develop the confidence to be open and honest
· Staff need to develop the confidence to challenge constructively
· Communicating “the what, the why and the what else” is key to engaging staff and reducing residual issues
· Staff become a key part of the solution
