A healthcare trust’s leadership development programme is making a significant contribution to the organisation’s success, write Julian Eve and Paul O’Neill.

Nottinghamshire Healthcare Trust is a provider of integrated healthcare in and beyond the county boundary of Nottinghamshire in the Midlands and East region. Until April 2011, the trust was the main NHS provider of mental health, substance misuse and learning disability services in the county.

Within 18 months the organisation has seen growth of 30 per cent. It employs 8,500 staff and from winning 12 offender healthcare contracts -
plus success in bidding for community healthcare services from the county’s PCT and Improving Access to Psychological Therapies service
contracts - it has a subsequent geographical spread of service configuration across Leicestershire, Nottinghamshire and Yorkshire.

The success of Nottinghamshire Healthcare is in no small way due to the leadership of the organisation, specifically how employees are informed, supported and held to account in taking on an understanding of their leadership obligations.

The vehicle to support this complex balance between growth and consolidation is a leadership development programme called Invest to Lead.

This programme is internally designed and facilitated.

It has its own branding, products and culture that dovetail with the brand and values of the organisation.

An organisational premise is that with the right support and the right opportunity people will learn, develop and grow.

Each October since 2005, a five-day Invest to Lead programme has encouraged senior grades of staff and either equal or larger numbers of selfnominated delegates from clinical and non-clinical services to learn and work together.

Delegate numbers have increased each year, with more than 1,000 people completing and graduating from the programme. Outcomes have been formally evaluated via Nottingham University and qualitative evaluation that informs the next programme is routinely taken. The programme has received validation from the Royal College of Nursing and the Institute of Mental Health.

Visible leadership

Invest to Lead is sponsored and led by the trust’s chief executive, Mike Cooke, with executive directors taking a visible role in chairing and leading the events.

They will chair, present and interview from the stage. When they are not doing this they are part of a learning group in which they take an equal role as delegates of the programme.

The value of executives taking up the challenge of this role in terms of role modelling leadership creates unique connections with the organisation. This approach ensures that the trust’s executive directors are not an unknown quantity and that their own leadership style is understood, appreciated and supported.

Organisational development

Organisational development can trip off the tongue as a term but delivering real and consistent organisational development is a sophisticated challenge and requires the effort and input to be context specific and reality based.

Invest to Lead is a model of organisational development because it has its place in the organisation’s development cycle.

No public resources should ever be wasted on something that does not have a strong rationale for spending or legitimacy to create the development required.

Wise NHS organisations know that staff need to be invested in, and that positive productive engagement and interest in the organisation - a step up from motivation - requires something that has authenticity and credibility.

Invest to Lead reinforces the values of the organisation and embraces an articulation of valuing the individual, the work clinical and non-clinical staff do and the commitment they make to their patient group.

The future

A core part of Invest to Lead is a slot of time devoted to a “horizon scan”. This term has become Nottinghamshire Healthcare’s expression of being ready for the future. It is a model that articulates and interprets the market and regional and national policy, and celebrates current successes and achievements but is delivered in a way that enables delegates to understand and be prepared for the future.

The horizon scan, delivered primarily but not exclusively by the chief executive, has become an essential building block to Invest to Lead. The objective is to be an organisation looking to the future, that understands the future and uses the information to prepare and take advantage of opportunities as they arise.

Nottinghamshire Healthcare’s purpose is to make a positive difference for patients, carers and service users. The organisation is committed to being recognised as a leading provider of mental health, substance misuse, learning disability, offender health and community services.

The organisation strives to be nationally important, locally relevant and personally valued.

Engagement of staff and stakeholders is a foundation to this and the vehicle of Invest to Lead models this by ensuring that organisational values are at the heart of creation and design of the programme. There is also plenty of opportunity for executive directors and other leaders of the organisation to espouse these values as they present to the organisation.

The expectations of Nottinghamshire Healthcare’s employees are high but not unrealistic. The organisation seeks a common skill set for its leaders and managers but acknowledges that support is needed to get it right most of the time.

The programme pushes opportunity and holds people to account for developing in areas such as appraisal, communication, team development, performance, prioritisation, problem solving and making decisions. Delegates learn both from speakers on stage as much as the shared knowledge in the room, specifically among colleagues on tables.

External speakers from other alam y health and commercial organisations add to the richness of the offer and allow different models, organisational cultures and ways of thinking to be explored and evaluated.

The Invest to Lead programme introduces two main concepts of leadership - situational leadership and distributed leadership - and creates the opportunity to discuss these principles. The organisation aims not to stifle individual styles but gives permission and frames situational leadership to encourage all delegates to demonstrate leadership to their work colleagues in whatever role they are in.

Distributed leadership is important for the wellbeing and competence of the workforce, wherever leadership responsibility is held, not just insenior management but by all employees. The principles of situational leadership are repeatedly articulated and rolemodelled throughout Invest to Lead.

The programme has given an opportunity for employees of Nottinghamshire Healthcare to consider their leadership potential in the context of the current NHS. Invest to Lead is well branded and produced to the point that employees are proud of being part of the process and will tell their colleagues that it is the leadership programme of choice.

Julian Eve is deputy associate director of learning and development at Nottinghamshire Healthcare Trust. Paul O’Neill is interim director of the East Midlands Leadership Academy.