'Creating a culture of learning must never be overlooked'

The urgent so often suffocates the important. But creating a learning culture at individual and organisational level must never be overlooked or considered a luxury.

With all of the workable imperfections of a large organisation, at Nottingham University Hospitals Trust we are committed to training and development. It is one of the ways in which we track our progress towards our 2016 vision of being the best acute teaching trust in the country.

“Best” means our training must place us among the top three of our peers in the country.

Last month we hosted our first trainers’ conference. We invited all staff involved in training, from mandatory training and nursing development to postgraduate medical training. We were also joined by trainers and leaders from some of our peer trusts.

We are all process owners of our own training and development. We must make time for it. In my experience one of the ways we learn best is by managing real time events, refracted through authentic reflective conversations with those we trust.

We cannot lead others until we can lead ourselves and as we prepare to lead ourselves and others through a period of immense change, which includes a redefinition of the NHS, there has never been a better time to sharpen our tools.

In 2009 we launched the trust’s new values, known as “We are here for you”, developed after consultation with more than a thousand patients and staff. Put simply, our values and behaviours describe our trust’s way of doing things.

There has previously been a focus on what we do here, but less focus on the way we do it. Over the last 18 months things have changed. Almost half of our workforce – some 6,300 staff – have now attended values and behaviours training.

Learning from how we overcome challenges defines organisations and contributes to development of a learning culture. We consider this essential.

A good example is emergency access. In August 2009 we became aware of some inconsistencies in recording performance against the four hour accident and emergency target. A review and look back exercise found some occasions where records of the time patients had been in the department had not been reported accurately.

We have been consistently open and transparent with our management of and learning from this incident. We have worked with the Appointments Commission and the NHS Institute for Innovation and Improvement to develop a training tool for new non-executive directors and chairs so the wider NHS can learn from our response and handling. The interviews with board members that formed part of this case study are now in the public domain, on YouTube.

One of the biggest positives is the trust’s focus on data quality, including development of the new data quality tool for our integrated board report, which is being shared with other trusts and is considered best practice.

As part of our whole hospitals change programme Better for You, we are looking intensely at every area of our hospitals – clinical and non-clinical – to improve our services for patients. Eighteen months since the programme launched there are now more than 2,000 staff involved in some 150 Better for You projects in all areas of the hospital – everywhere from our emergency department to cleaning teams.

The most recent project to get underway is productive training, which will initially look at the administration of mandatory training and how we can improve the systems and processes.

Reflecting on many challenges that I have faced, I have learnt, mostly through my mistakes, to manage today as a necessary past condition of the future that you want to create.  In so doing we build a bridge from a painful present to a better future.