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Case study in brief:
Organisational change The Healthcare Commission is an independent body set up to promote and drive improvement in the quality of healthcare and public health. It exists to:
The Healthcare Commission was established by the Government in April 2004 to build on the work of the Commission for Health Improvement. The new regulator also took over some responsibilities from the Audit Commission, covering the elements of the Audit Commission’s work relating to efficiency, effectiveness and economy of healthcare; as well as the National Care Standards Commission, taking over its private and voluntary healthcare functions. In addition, the Commission had a range of new functions including the handling of second stage NHS complaints. This meant that the new Commission had a wide remit of responsibilities and it would be relying on staff from across the organisation, both new and those from previous regulators. The Commission recognised that in order for it to succeed in its mission this organisational change needed addressing from the start. It also realised that while the organisation would be very focused on creating new systems and other deliverables to meet the challenge, that its staff were the cornerstone to its success. Mick Linsell, head of Corporate Services, explained: "We had different ways of working from three organisations, each with a different approach to leadership, different systems and cultures. The people within the organisation are key to making the Commission a success, and we wanted to identify what support they needed to make this transfer and create positive change within the organisation." Proven experience It was decided that that the organisation needed external input to ensure its people received the support they needed to deal with and thrive in the new and changing environment. Following a tendering process, the Commission selected CPCR as it had a solid track record of working with other government departments and bodies such as the Department for Trade and Industry, Food Standards Agency, Ministry of Defence and National Assembly for Wales. CPCR supported the Commission early on in the organisation's restructure, working closely with the internal organisational development team to set the agenda, prioritise what needed to be done and identify the process for achieving those goals. Shared dialogue The organisational development programme which CPCR helped the Commission to develop initially required a significant focus on the leaders within the organisation. It was essential to have them as advocates who could garner their teams' support to create positive change across the organisation. The Commission wanted to create a team that had a strong sense of collective leadership to build strong teams and deliver the right results. To achieve this, it needed to encourage the leaders to collaborate and learn together and create a flexible organisation where had confidence in them. The aim of the leadership development programme was to help the organisation to be able to deliver results by:
The initial step involved CPCR facilitating a conference for 40 of the most senior staff, who reported directly to Board members, so that they could share how they currently worked and debate ideas for the future of the Commission. This helped them identify the business areas that required immediate focus, what people's needs would be and how they could effectively tackle them. "For many of our staff the approach of coming together as a cross-organisational group was a new experience. Not only did this conference help us mark the birth of a very different organisation in its approach, it also encouraged the start of dialogue across departments. It was essential that we introduced this approach from the outset as it would be a key element in successfully achieving our goal to bring positive change to the new organisation," continued Linsell. Leadership development This conference was followed by a leadership development programme that included the most senior staff who had attended the initial conference, as well as others that reported directly to them. CPCR kicked off the leadership development programme with a bespoke 360-degree feedback approach. This asked individuals to do a self-assessment against a set of leadership competencies and also involved feedback from their line manager, staff, peers, and those outside the organisation with whom they had a working relationship. Individual results were fed back to each person during a one to one coaching session. This was followed with a two day workshop where people could discuss both individual and organisational-wide matters to identify the leadership challenges they would face personally, as well as those they would face as a group across the organisation. They also reviewed the 360 feedback data, using both individual and collective results to pinpoint development priorities and to set out tailored personal development plans. During these workshops leaders also discussed their own working practices from across the three bodies that had created the Commission to identify where change was required to meet the new organisational goals. The result was that they were able to develop ideas to take the operating plan forward as a group, and also help individuals identify the leadership areas they needed to work on to create a personal development plan. "Everyone recognised the benefits immediately of encouraging time out to discuss and share ideas and challenges, and to build relationships across the organisation. These workshops in particular helped everyone develop a very clear self awareness to help them identify honestly their own leadership challenges and how they should approach them," said Linsell. Quarterly leadership forums give the organisation's leaders the opportunity to evolve the collective view of the Commission and each individual's role in it. Action learning sets To encourage regular review of the leaders' development, and their role in affecting organisational change, CPCR and other OD consultants also facilitated 'Action Learning Sets'. This involved smaller groups of six senior managers from different parts of the organisation meeting every couple of months. The meeting content was set by the managers, enabling them to bring their current challenges into the discussion and benefit from the advice, support and challenge of their peers. The set adviser’s role was to help each individual identify how best to deal with the challenge and understand how their reaction would impact the outcome, as well as identifying how a change in their management style might help them avoid such an issue becoming a problem again. The Action Learning Sets continue to be a key part of the Commission's strategy. However, many of these are now happening without CPCR's involvement as set advisers. This planned reduction in external support was a core part of CPCR’s strategy to ensure the effective transfer of knowledge and capability into the organisations with which they work. "CPCR took a different approach to other consultancies I have worked with in the past. While they gave us the tools, they made it clear from the start that they wouldn't do it all for us! They understand the benefits a consultancy can bring but also realise that their input cannot be infinite and that it's essential that the organisation itself takes the reins and continues the good work after they have left. We wanted to make a significant investment in our people to ensure the organisational change ran as smoothly as possible but much of the good work CPCR has done with us needs to continue in the long term and it's essential that we take it forward ourselves," continued Linsell. Team culture While it was vital to get the buy-in and understanding of the leaders within the organisation, it was equally important to the Commission that every member of staff should have a first-hand experience of what the new organisation would mean for them and their role within it. Again this was achieved through a series of initiatives to accommodate different people's approaches and reactions, under the programme heading of 'engagement and climate'. The ethos of the 'engagement and climate' programme was to recognise the importance of not only communicating effectively with staff but also getting feedback from them and taking appropriate action. One initiative was 'marketplace' events which continues to encourage teams from across the business to set up small exhibitions of their current initiatives to keep the rest of the organisation informed of activity. These give staff from other teams the opportunity to discuss initiatives and share new ideas. Immediately after the launch of the Commission, CPCR also delivered a conference for all 800 staff. This gave them the opportunity to meet the new Executive team, and also meant that the vision and values of the new organisation cold be communicated consistently and early on in its life to set the agenda going forward. This direct approach also meant that staff were given the opportunity to better understand the scope of the new organisation and what needed to be done to achieve its goals. It also asked for their ideas on the behaviours needed to deliver the new remit. The outputs from this first conference fed directly into a competency framework for the whole Commission. The new competency framework focused on encouraging the behaviours, skills knowledge and attitudes that will help its staff to achieve the organisational goals. These were tightly linked to several HR processes including recruitment and development reviews. The nine core competencies encourage:
"We are now a much more regional organisation so conferences are vital to give everyone the opportunity to get together and feel like a single entity. We always wanted to make sure that our vision was communicated consistently from the start and what better way to do that than make sure everyone came together to hear that first-hand? It also helped us to ensure that everyone contributed to the competency framework so that it was a result of their input and not a 'top-down' approach. We need everyone to live and breathe these concepts so staff commitment is vital. "We are maintaining these all staff conferences as they are vital to get buy-in and support from all our staff as the organisation progresses and evolves. Once again, CPCR has taken a step back from these and has become less involved, allowing us to get to grips with it so we can continue to run effective conferences going forward," said Linsell. Team support CPCR's involvement was also extended from the general 'people element' to helping specific teams to focus on business deliverables. A consultant was allocated to work with the leadership team of each department, as coach, adviser and facilitator , to identify change issues and help the team work through them. Different departments required different levels of support, so the approach was tailored rather than 'one size fits all'. CPCR’s support therefore varied broadly from facilitating discussion within senior management, to including a wider staff group. In some cases the department head would require one-to-one coaching, in others the coaching would focus on an entire project team assigned a specific task. "CPCR has certainly helped to make a recognisable difference to our organisation as they bring a fresh perspective and the experience of similar challenges from elsewhere. While this has been a continuous challenge, as an organisation we do think about people more instinctively than we used to. We also have more courageous conversations and value others' opinions more. We are continuing to use much of CPCR's work and will be running the 360 feedback process again this year where we expect to see improvements across our senior leadership," concluded Linsell.
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