09 / 11 / 2009
What we did and why
How we did it
Results and next steps
Tips for other trusts
Imperial College Healthcare NHS Trust is the largest NHS Trust in England. It was formed from the merger of Hammersmith Hospitals NHS Trust and St Mary’s Hospital NHS Trust in October 2007. Through their integration with Imperial College London they were designated as an Academic Health Science Centre by the Department of Health in April 2009.
The trust employs approximately 9,200 staff, provide training for 1,600 doctors and nursing education for 3,200 nurses.
They lead or participate in numerous clinical networks such as heart disease and cancer, neurosciences and stroke as well as providing the West London Renal service.
Imperial College Healthcare NHS trust provide services to nearly 2 million people within the north-west London health economy, serving an immediate catchment population of 650,000. They provide over 50 specialist services for adults and children.
The aim of the first phase of the project was to design an engagement process to capture staff and patient views in defining the organisational values that would support the implementation of the strategic vision.
The objective was to engage 10% of the workforce in the engagement process, encourage conversations and communication across the organisation and engage the senior management team in sponsoring, supporting and listening to the outcomes.
The aim of the second phase was to design and deliver a series of initiatives to make the values meaningful and measurable. The aim was to weave the values into operational life to ultimately improve patient, staff and stakeholder experience and individual, team and organisational performance.
Identifying values for the new organisation was part of implementing the organisational strategy. Following considerable research, a paper was presented to the Board and Clinical Programme Boards to recommend best practice in defining the local values.
The next step was to design an engagement process that would ask staff, patients and stakeholders how they did things when the trust was at its best and how the trust would aspire to be as an organisation.
A project team was identified form champions form across the organisation to contribute to the design of the engagement process and a working group to pull together the detail and act as implementers.
The “Aspire to” Project was sponsored and monitored by the Organisational Development Board, chaired by the Managing Director. The executive team were critical in championing the process.
40 volunteers were trained as facilitators to deliver appreciative inquiry workshops and run team meetings. A high profile communication campaign was launched using trust newsletters, magazine, intranet and branded emails and posters. A video of the senior team inviting participation was posted on the intranet and invitations were sent to a random selection of 10,000 staff.
Patients were sent questionnaires and existing feedback was gathered and an online poll was designed to capture staff ideas and views.
After analysis of all the stories and feedback captured, the values and behaviours were refined and re-tested. A final set of values and behaviours were approved and ratified by the CPG Boards and Trust Executive team.
This was followed by a highly promoted and visible launch trust-wide, led by the executive team. A video and posters were produced of teams and individuals who exemplified the five trust values.
The trust has now commenced Phase two of the project. Work-streams include –
branding and communications, recruitment processes, induction, appraisal, a wide-scale customer care learning package that incorporates the trust values and behaviours, “Living the Values” sessions, leadership, development and training and a re-launch of our staff achievement awards to incorporate the values.
The engagement was commissioned by the leadership team as part of implementing the Organisational Development Strategy for ICHT. A Values Board chaired by the Managing Director supported and guided the project and acted as project champions.
A project lead was identified within the organisational development team. Following consultation with a group of 20 nominated representatives from across the organisation, principles for the engagement methodology were devised. This group also acted as facilitators for the workshops and in communicating about “Aspire to”
A working group of eight worked on the details of the engagement, the revision of approach and played a key role in analysing the data captured.Regular reports were made to the organisational developmentbBoard on progress and next steps. All information and literature was available on a dedicated “Aspire to” site on the trust intranet.
• A random sample of 1000 invitations were sent to staff across the organisation inviting them to book into a workshop and share their story.
• An article to promote the project was placed in each 360 (Trust magazine) from 1st December 2008.
• Several branded emails were sent to senior teams, all leaders and managers, Heads of Nursing, project teams and HR Skills Consultants to encourage participation
• The design and launch of a dedicated “Aspire to” site with video of CEO and MD and other Directors inviting staff to tell their stories. Links to briefing packs, feedback templates and list of workshop dates and venues.
• A regular feature on front page of “in- brief”
• January team meeting topic
• Posters designed and displayed across the organisation
• An online poll of values and behaviours commenced in January offering chance to win £25 voucher
• Use of personal contacts and networks to promote engagement
• 100 workshops scheduled across three sites and 40 facilitators volunteered to run workshops and attended briefing sessions and given facilitator packs.
• All workshops allocated a facilitator.
• A patient feedback template was sent to all Heads of Nursing to cascade and give to patients on discharge and in outpatient settings.
• Patients stories – requests from members of patient panels
• Use of existing feedback from patients already available
Re-evaluation of engagement methodology
The number of staff attending workshops was very low so the working group met to review how best to capture staff views to make it a meaningful and valid engagement.
As a result:
• Emphasis was shifted to running existing team meetings with a choice of original brief pack or a short questionnaire and targeted managers and team leaders. They also offered facilitators to run sessions on their behalf.
• A request made to CPG Board and senior teams to encourage engagement through team meetings and offered to visit wards and departments so staff did not have to leave workplace.
• A short questionnaire was designed based on themes from legacy values, strategy day themes and emerging themes from workshop and tested the new questionnaire in three areas. This was sent to all managers and leaders and asked to identify ten team meetings each to target. Again, they offered facilitators to attend meetings and allocate a ten minute slot- this had a positive response.
• The questionnaire was made available in training centres and post graduate areas for staff to complete.
• It was used as an online poll and 25 x £25 vouchers offered as an incentive
• The staff restaurants were visited at lunchtime to encourage staff to complete the questionnaire.
Analysis and approval
• All 900 responses were transcribed and themed/categorised.
• The project working group reviewed and refined the categories and care was taken to include the essence and language of all views represented in the values categories and behaviour statements.
• The values and behaviour statements were tested out on focus groups and some language and emphasis refined as a consequence.
• Ratification with the trust executive proved an important step as the values were again refined and retested with other groups.
Communication plan and high profile launch of the values
Launch event in July 2009 which was widely advertised through all media.
The values were launched at all three sites by the Managing Director and members of the executive team at each site fronting the event. Booklets, a video and cakes were made available and there was a good attendance by staff, patients and visitors at all main hospital sites.
Literature -The values are included on all trust communications and the branding is strong:
• Recruitment forms
• Recruitment ads
• Letters to patients
• Patient information
• 360° (Trust magazine)
• Induction video
Induction - A member of the executive team now introduces the values and plays the values video at every trust induction.
Leadership and Development Programmes – all training programmes are designed and advertised to incorporate the values.
Recruitment processes- All job descriptions include a values statement about what we expect from staff and what they can expect from us.
Interview questions and assessment centre exercises are relevant to the values and behaviours.
Living the local values campaign packs - designed to help managers to run sessions with teams to identify local interpretation ideas and initiatives and send in feedback.
Appraisal – review of process, design of behaviour measure guide and plans to incorporate review of behaviours with performance review.
Procurement of Customer care learning package – to include embedding the values and behaviours through co-design and co-delivery of a blended learning approach.
There has been a buzz from staff and a genuine interest to use the values to make them meaningful. The values are very evident in all communication articles and campaigns and are referred to in seminars and workshops.
As yet the impact in real terms has to be determined as Phase two of the implementation is in the early stages. The trust see the recruitment and appraisal work-streams as being key to impacting on staff satisfaction and thus patient satisfaction results. Aligned with this is the customer care package that they aim to deliver in a variety of ways (drama, experiential, e-learning) to all 9,200 staff. It will incorporate desired behaviours in design and the trust will select the challenged areas of staff and patient surveys to measure the impact and success of their project.
• Must be championed by senior leadership team.
• Make it an essential component of the Organisational Strategy and align with Trust strategy.
• Gain sign up from senior teams.
• Clear deliverables and timescales.
• Be flexible enough to adapt approach.
• Repeated communication and good branding.
• Be rigorous in methodology.
• Be aware of interface with other initiatives.
• Use your networks to increase engagement and share learning.
• Ratification from Executive Team and Board.
Associate Director of Organisational Development and Leadership
020 331 21946