Published: 02/06/2005, Volume II5, No. 5958 Page 30

When a primary care trust found staff had difficulty settling into a newly created role, it brought in an organisational psychologist to address the problem. Westminster PCT director of primary care Joe Gannon explains

As part of moves to decentralise its structure, Westminster primary care trust recently appointed four new locality managers. The trusts knew the new system would require considerable support, so it turned to organisational psychologist Dr Guy Lubitsch to point the way forward.

The PCT appointed locality managers because it was concerned it had kept old primary care group and health authority barriers. The new posts would be responsible for bringing together community services management, independent contractor development and delivery of government targets.

Westminster designed the posts to be senior (one step short of director level), attractive and to provide progression for what it saw as a gap in the community management career pathway.

The locality managers were capable and committed to their role. However, there was also a potentially destabilising lack of clarity to the new post.

They also found it difficult to allocate time and attention to operational and strategic aspects. On the one hand it was important to deal with the everyday operational agenda; on the other, it was vital to plan ahead to make the most of new developments, such as the new general medical services contract.

Several other themes emerged. The locality managers described the difficulty of involving and communicating to various groups across the PCT while having to deal with 'Cinderella services', with historical poor relationships and performance management issues. There was also no time for communication and knowledgesharing across localities.

With this better understanding of individual and organisational issues, Guy and the locality manager team drew up the criteria for a successful development programme. It should:

be grounded in reality and relevant;

develop internal leadership capability;

support better communication and peer support across primary care;

help the PCT achieve its key targets;

encourage ownership, responsibility and a commitment to bringing new learning and actions into the workplace.

The programme combined team meetings and five one-to-one coaching sessions. The team meetings provided space where difficulties could be shared and explored, skills and strengths acknowledged and patterns of communication established. The individual sessions were used to reflect on themes that emerged in the group conversations, provide support and challenge to issues and develop personal development plans.

The coaching created a range of positive benefits. On the individual level, these included the opportunity for participants to put time aside for reflection on work issues. This gives leaders greater clarity to their roles.

The availability of an independent coach facilitator provides support and confidence to tackle key challenges and support personal sustainability. This in turn leads to an increased willingness from managers to take ownership and step up to the leadership challenges.

There were also significant team benefits. Cross-locality projects - a new children's centre, a trust-wide clinical supervision programme and joined up locality plans to meet PCT targets - provided tangible examples of improved team working.

There was increased willingness to share knowledge and success and offer support. The quality of conversation increased all round, with more openness and honesty when discussing the core issues that were blocking progress. It was widely acknowledged that stepping out from operational work was an important aspect of the job.

The programme has provided a cornerstone for the development of managers and has stimulated thinking at an individual and organisational level in the PCT.