Resilience ''Middleground'' events


03 / 11 / 2011

South West Yorkshire Partnership NHS Foundation Trust invested in a series of 'Middleground' learning sessions during which managers were encouraged to explore and understand the trust's strategic agenda and how different roles and services contribute to delivery.

The organisation

What we did and why

How we did it

Results and next steps

August 2012 Update

Tips for other trusts

Contact details

The organisation

South West Yorkshire Partnership NHS Foundation Trust provides a range of community, mental health and learning disability services to the people of Barnsley, Calderdale, Kirklees and Wakefield. The trust also provides some specialist medium secure services to the whole of the Yorkshire and Humber region.  The trust achieved Foundation Trust status in May 2009 with a commitment to being an employer of choice and this was recognised by gaining IiP status one month later. First established in 2002, the Trust now employs around 4,700 staff, in both clinical and non-clinical support services.

What we did and why

Results of a wellbeing and engagement survey highlighted many areas of strength and the Trust was encouraged that they scored highly amongst those trusts surveyed. Favourable scores were reported for:

  • Work-life balance
  • Pay and benefits
  • Work relationships
  • Perceived health.

Less positive findings included:

  • Disconnection between the board and frontline staff
  • Staff health and wellbeing was seen as the trust’s problem and not that of the individual
  • Management of change and communication of such was mixed
  • Internal turbulence.

Seeking to address the less positive findings and build on good work already undertaken to develop a learning programme for staff in the lead up to being awarded FT status, the trust developed a revised programme of learning to strengthen leadership and engagement across the trust. 

The need to develop organisational, team and individual resilience was a very important driver which led to investment in the programme.
The programme sought to equip staff to ensure the trust’s ability to cope with major change, deliver significant savings whilst maintaining service quality and organisational performance.

How we did it

Day one of the programme focuses on contextualising the trust’s place in the local health economy and the challenges and freedoms foundation trust status brings.  This includes a question and answer session with the trust board allowing honest and open discussion.

The second day focuses on team and individual resilience using the results from a personality questionnaire that participants are invited to complete. This generates two personal development reports:

  • i-resilience - describing personal resilience based on personality
  • leadership Impact - reporting on leadership style and approach linked to engagement, wellbeing and resilience.

As well as using lead facilitators, a number of internal staff have been trained as table facilitators and play an important role in keeping participants on track.

Learning and discussion activities are linked to understanding strategic investment, ensuring organisational fitness and improving the trust's performance through introducing new leadership and management arrangements. These arrangements focus particularly on clinical leadership and engagement, devolved decision making and integration of clinical, operational and financial objectives.

Following on from 'Middleground' the trust is currently repeating a full wellbeing and engagement survey with Robertson Cooper (Occupational Psychologists). The impact of 'Middleground' should be evident in the results of this survey and the results will be fed back through line managers to link with their learning from the programme.

Results and next steps

The initiative has received overwhelmingly positive feedback so far. The results of the evaluation questionnaire completed by participants that have attended, show that staff understand that resilience together with strong commitment to staff engagement are a vital part of effective leadership and the trust is committed to embedding this throughout the organisation.

  • 73 per cent of participants feel they can now better describe and understand the factors that influence the work of the trust.
  • 63 per cent of participants are more actively improving the wellbeing and resilience of their team.
  • 79 per cent of clinicians say they can now better describe and understand the factors that influence the work of the trust with 60 per cent of support service managers saying the same.
  • 67 per cent of clinicians say they do more to keep up to date with current Trust issues and with stakeholder interests with 46 per cent of support service managers who say they do more of this.

The major cost of the initiative was the release of staff to attend and facilitate the two day programmes.  Further costs included external facilitation however the trust's strategic objectives cover organisation and staff development and funding to deliver this objective had been identified in the financial plan. Programmes were run onsite which minimised travel, accommodation and catering costs.

August 2012 Update

In 2011, the trust repeated a well-being and engagement survey with Robertson Cooper (Occupational Psychologists) following the roll-out of the 'Middleground' programme. The impact of this and other initiatives were evident in the results in that:

  • Access to training and development opportunities has improved
  • Numbers of staff working long hours is lower than average
  • Number of staff reporting that they deal with unmanageable workloads and unrealistic deadlines is lower than average
  • Numbers of staff experiencing bullying and harassment has decreased from the 2009 survey
  • The extent to which staff feel engaged with their work and the organisation has improved since the 2009 survey.

The full results from the survey and proposals developed through 12 solution groups will now be used to develop a trust wide action plan to ensure that concerns raised during the programme are addressed and areas for development are considered.

The trust has developed and piloted a new stage of ‘Middleground’ to explore responsibility, accountability and behaviours necessary to ensure trust resources and effort are aligned to achieve the vision, values and goals of the organisation. This was delivered as a two day course and was used as a vehicle for engagement and communication with managers.

The target group for the pilot was Band 7 and above, clinical/professional leads, service managers and clinicians. Directors are the sponsoring group for the programme and have used their own and trust wide channels to communicate the scheme. Following the programme, directors have put in place systems to follow up on the action plans all participants produce to close the loop on learning.

Further investment is also being sought internally to increase capacity to be able to deliver the resilience program further and increase access to the staff retreats.

Tips for other trusts

Feedback received suggests that 'Middleground' style learning programmes can offer good outcomes for NHS organisations undergoing change or struggling to adapt to new pressures in the health economy and ensures staff are kept informed, supported and feel equipped to deliver on organisational objectives. The modules can be adapted to meet an organisation’s specific needs whilst addressing broader issues impacting on the NHS including QIPP and the staff health and wellbeing agenda.

Contact details

  • Maggie Bell
  • Assistant Director of HR (Leadership, Wellbeing & Research)
  • Tel: 01924 327061
  • Email:

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