Case Study

Developing OD Mindsets: Birmingham Women's and Children's NHS Foundation Trust

In this case study, read about how the workforce development directorate implemented new ways of working across the team following a merger.

1 January 2019

The case study describes how workshops on organisation development (OD) mindsets and creating the best place to work had incredibly positive effects on the directorate; with improvements in the staff survey results, and staff reporting a greater feeling of unity and cohesion across the team, linking in with the organisation's values.


In 2017 Birmingham Children’s Hospitals and Birmingham Women’s Hospitals were due to be merged. In the run up to the merger the workforce development directorate (WDD) recognised the need for significant changes to their ways of working and as a part of the overall organisation development (OD) plan.

Key benefits and outcomes

  • CQC rated the organisation as good with outstanding for caring. The children’s site services maintained outstanding, the women’s and mental health departments made great strides forward since 2016.
  • The NHS Staff Survey response has improved to 52 per cent which is 19 per cent up from last year.
  • The organisation was recommended as a place to work has increased from 56.7 per cent in 2018 to 61 per cent in 2019 with indications of even stronger improvements in February 2020.
  • Formal casework fallen by a third over April to October 2019.
  • Sickness absence rates are improving slowly, from 4.73 per cent in January 2018 to 3.6 per cent in September 2019.
  • Workforce development business partners operate as people directors in divisions to embed the new ways of working. This has led to divisions running their own inclusion forums and staff experience listening sessions to drive improvement.

What the organisation faced

In February 2017 Birmingham Children’s Hospital and Birmingham Women’s Hospital merged to create the first ever women’s and children’s NHS foundation trust in the UK.

The workforce development directorate (WDD) consists of the HR, education, learning and development functions so had a huge role to play in supporting the merger. There was a 50 per cent increase in staff and high levels of organisation change to support pre and post-merger.

Operating how the directorate had always done was no longer sufficient. They needed to break down silos and share organisation development (OD) capability across the directorate.

What the organisation did

The WDD contacted the NHS Employers Do OD team, who helped them plan a senior team away day to discuss challenges and identify opportunities to make change. This was followed by an OD practitioner skills analysis and initial planning for the Developing an OD Mindset programme with the wider WDD team.

The HR managers and OD team came together in the same office, which helped to facilitate integrated HR and OD working. Pathway improvement projects were defined and cross WDD working groups were set up.

Teams took part in two workshops, the first was training on the Developing an OD Mindset.

The second workshop was aligned to the people plan, and the Creating the Best Place to Work team leader workshops were delivered to all team leaders. The programme aimed to reconnect leaders with the organisation’s values and how they link to an OD mindset. The programme’s aims were to:

  • understand the link between team environment and key workforce priorities
  • understand concepts of a Just & Learning Culture and how this can be used to develop culture in teams
  • recognise the principles of Civility Saves Lives and how incivility can be a gateway to bullying.

The programme focused on improving health and wellbeing, retention, people management process, tackling bullying and harassment and how they use our values to support this.

In addition, the WDD launched three new priorities which were designed to achieve the organisation goal of creating the best place to work, they are:

  • Workforce supply and attraction
  • Availability and retention
  • Leadership and engagement.

Finally, the directorate worked closely with staff side colleagues to update policies to reflect the need for informal resolution. The national profile of the Just & Learning culture approach further supported traction across the organisation on reducing formal investigations. They received encouraging feedback from team leaders about their desire to look at people issues more broadly and to move away from destructive investigations and resolve issues in a restorative way.

Results and benefits

The intervention enabled the directorate to build foundations for change. The merger meant the team faced discomfort and were able to work through problems and know that have the right approaches to support their journey.

Whilst there are still improvements to be made to the ways of working in the directorate, how the senior leadership team work together has undergone massive transformation. The unity and cohesion that has been achieved can now be mirrored in the wider directorate.

Green shoots have begun to transpire from the implementation of the Developing an OD Mindset programme. There is regular push back on formal casework and the organisations first cultural review resulted in an action plan and now begins to positively impact staff experience.

The directorate began to make links between the OD mindset and a Just & Learning Culture. Lessons from Mersey Care were helpful in helping the team work through their challenges with our new ways of working.

WDD new ways of working are resulting in more ownership of people priorities at a divisional level. Uptake in the Staff Friends and Family Test increased, they saw an increases in place to work and place to be cared for scores.

The Creating the Best Place to Work team leader workshops were successful and helped leaders to reconnect with the organisations values and how they link to a Just & Learning Culture and an OD mindset.

The WDD are seeing the benefits of the changes, OD mindsets and informal resolution of issues are becoming embedded and there is optimism for the future.

Overcoming obstacles

People struggled with new ways of working and the business pushed back against informal resolution of complaints. However, listening sessions took place with teams to understand what the issues were and then amendments were made to the process. The 2018 NHS Staff Survey results were hugely disappointing which impacted the WDD morale. Staff reported having an equivalent or worse experience across all areas. Despite those disappointing results, the survey did show an increase in the trust being recommended as a place to work, which helped to demonstrate the need to keep going with their new processes. However, the 2019 NHS Staff Survey results (about to be released) indicate a vast improvement, and this, combined with the other benefits and positive outcomes shown above, display clearly both the resilience of the team and their perseverance, and the success of the intervention as a whole.

Takeaway tips

1. Don’t underestimate the time it takes to implement change.

2. Be prepared to lose people who are unwilling or unable to be part of the journey.

3. Anticipate resistance to your new approach and plan for how you are going to overcome it.

4. Keep going because you will see results!

Further information

For more information about the work in this case study, contact Dawn Harvey, Associate Director of Workforce (OD), Birmingham Women’s and Children’s Hospital at