Team-building techniques - going beyond the comfort zone

A heated discussion is going on deep in the Cumbrian countryside. One junior doctor fends off accusations of foul play from another, whose colleagues feel they have wasted an entire morning traipsing through the woods.

The crime? Hiding numbered tags that unlock a box of mystery rewards at the end of a treasure hunt. Not your average NHS problem, granted, but one that can offer NHS staff a valuable exercise in teamwork and communication.

Welcome to day two of a workshop designed to develop NHS leadership skills. The 25 people who signed up to this course have already recreated a Picasso-style masterpiece from memory, raised a standard in absolute silence and attempted to transport 'hazardous chemicals' using ropes, a plastic box and heaps of initiative.

They have come from different corridors of the NHS, non-clinical included, but with a single goal - to become better leaders and team members. Benefits come thick and fast as they embrace practical tasks totally unrelated to their jobs but that demonstrate leadership (and followership) techniques that do work.

Around 1,000 NHS staff have graduated from the three-day residential programme since its inception four years ago. The programme is hosted and delivered by the North Lancashire teaching primary care trust, with funding from North West Postgraduate Deanery and North West strategic health authority.

Today's course was first commissioned exclusively for junior doctors in theNorth Westbut was quickly refined into a multidisciplinary programme for NHS teams.

North Lancashireteaching PCT chief executive Ian Cumming,one of the original brains behind the course, explains: 'We designed a programme to explore concepts of leading a team and being a team member with exercises that didn't have any real relationship to working in the NHS or even to clinical practice. By doing this, every course participant starts at the same level of knowledge - irrespective of their background.

'All participants get a chance to lead a team on something, often stepping out of their comfort zone to hone new skills. In the feedback and discussion sessions after each exercise, we then encourage exploring how key learning points can be taken back into the work environment.

'We also wanted to explore and encourage effective communication and teamworking between different professional and support staff groups. The 50:50 split on the course between doctors and those who aren't medically qualified really makes this happen and avoids cliques.'

Establishing this early on is key to the course's success. From day one, delegates are expected to solve problems and challenges with people they have never met before, then swap groups to keep things fresh. It is far more effective than the usual PowerPoint presentations in stuffy rooms led by even stuffier facilitators.

Course leader John Charlish says: 'You can stand up and talk about leadership until all the delegates have nodded off, but being able to show how things work in practice and helping them learn from mistakes gives them a visual experience they can refer back to at a later date. Doing this away from the workplace, their pagers and their phones also creates an environment where people can relax and be themselves.

'The tasks deliberately carry non-NHS themes because it would be hard to come up with a scenario to suit everyone's needs. Instead we ask everyone to concentrate on the different processes that are used and how to apply them to their individual work situations. Giving everyone an unfamiliar role makes it easier to break down barriers and leave people feeling valued.'

Course delegate John Gosling, a paediatric ward manager who considered himself an average leader but signed up because he felt there was room for improvement, says: 'It's so easy to get lost in the day-to-day tasks, but you need time like this to look at what you're doing and how you do it.

'The course has proved very thought-provoking and the challenge will be to apply the basic principles to the realities of the workplace, but it's given me the equipment to improve my leadership style and deal with different personalities who have different needs and values.'

For more details on signing up for the Creating Effective Leaders and Teams course, e-mail pat.richardson@northlancs.nhs.uk