I would like to thank the Florence Nightingale Foundation for awarding me a Leadership Scholarship. The experience has been transformational and has served to launch me into another phase of my career. In particular I would like to thank Liz Robb OBE, Chief Executive, Florence Nightingale Foundation, for recognising my passion, providing me with feedback and supporting me through the process.
Thank you to Health Education England for their support in sponsoring my scholarship and to the shape of caring team who welcomed me into their family.
I would also like to thank Professor Kay Fawcett OBE, who mentored me through my scholarship and provided me with immense wisdom and support; helping me to believe in myself, refine my ‘big ideas’ and develop my network.
Finally, I owe a debt of gratitude to Wirral Community NHS Foundation Trust and in particular Sandra Christie, Director of Nursing, for encouraging and supporting me throughout this year. Without her consistent support and coaching, I would not be where I am today. I would also like to thank Karen Howell, Chief Executive, for sponsoring me to apply for the scholarship. Her faith in me and commitment to my development is greatly appreciated.
ABSTRACT
Introduction
This report outlines my personal learning and development journey aligned to my Florence Nightingale Leadership Scholarship. The report summarises how the diverse experiences gained through my scholarship year have enabled me to enhance my personal influence and support service and system transformation.
Background
Leadership development is lifelong and, as I commenced my scholarship journey, I recognised an opportunity to take stock and review my current position. I undertook an intense diagnostic process which culminated in a three hour coaching session, after which I developed a number of personal leadership goals for my scholarship year. A key element of the scholarship was to consider my career goals and aspirations and use planned learning to facilitate a shift to a new phase of my professional life.
The patient care improvement project selected as part of my scholarship year sits as part of a larger transformation programme which is aimed at redesigning community nursing services to meet the changing demands of the local population and evolving system. Inspired by Michael West’s seminal work on staff engagement and collective leadership, I selected to concentrate on culture and staff engagement as well as the development of a quality improvement infrastructure for my scholarship quality improvement project.
Learning and Development
During my scholarship journey I had the privilege of accessing excellent learning and development opportunities, some of which are outlined below.
Attending the five day residential Leading Change and Organisational Renewal (LCOR) programme with my fellow scholars in February 2016 provided a good foundation on which knowledge, relationships and networks have been built. The LCOR programme explored the dynamics that influence the long term success of organisations and introduced the congruence model which challenged my approach to understanding organisational issues and supported me to develop a model for transformation which I have embedded within my own organisation.
During the programme I began to examine my capacity to influence at an organisational and systems level. The group relations content was particularly impactful and created the opportunity for me to reflect on my approach to engaging with staff and colleagues. My belief is that staff have the answers to many of the difficult questions if only we would ask, listen to and support them to enact their improvement ideas.
The Westminster experience was intense, uncomfortable and very enjoyable. I was able to explore further the dynamics of power, understand political roles and functions and practice negotiation and prioritisation skills.
During September 2016, I was fortunate to attend the Ashridge course ‘Impact and Influence’. The experience was transformative and has provided me with an even deeper insight into my strengths and areas for development. I exited the course with a new network of colleagues from a range of different professional backgrounds, an insight into the positive nature of my work environment and a toolkit for enhancing my ability to influence in any situation.
Using the Mehrabian model, we had an opportunity to practice impactful communication in small groups. I found this a valuable element of the course and felt affirmed at the feedback offered to me during these sessions. Gaining a deeper understanding of strategic influencing tools, I have been successful in managing difficult work scenarios following the programme.
Travelling to Florida to attend the IHI national forum in December 2016 was a highlight of my scholarship year. The experience was intense and key note speakers inspirational.
I attended an IHI mini course ‘Learning to Coach and Coaching to improve’ which has supported my quality improvement project. I have also begun to embed the principles incorporated within the IHI white paper ‘Sustaining Improvement’ in my organisation since my return.
Patient Care Improvement Project
Following my attendance at LCOR and the Florence Nightingale Conference, I began to work with a group of community nurses who were expressing a sense of great pressure due to the demands of the job. My personal interest is in creating the right environment for facilitating effective staff engagement which will in turn generate energy for improvement and opportunities for collective leadership. The ultimate aim being to develop a workforce fit for the future, embedding the key principles of the Buurtzorg self-determining team model within multi-disciplinary community care teams.
As a group, we reflected on a number of different theories and models, some of which were showcased at the FNF conference. These included; the concept of collective leadership and service models such as Buurtzorg and Virginia Mason. In addition, we considered the potential impact of the congruence model learned through the LCOR programme and spent time out of the area visiting other community nursing services where a lot of transformation work had been embedded.
After spending much time reflecting, we developed our own transformation model which recognises that, in order for sustainable change to take place, three things have to be in balance: structure, people and skills andculture. As a group, we began to stimulate a different way of thinking which evolved into the establishment of an organisational wide transformation programme, ‘Transforming Care Together’ with a focus on implementing a new model of community care delivery in Wirral.
Key outputs to date include; higher levels of meaningful engagement with staff resulting in a more informed workforce, completion of a number of quality improvement projects, a greater sense of shared responsibility across the organisation to achieve good quality alongside financial sustainability, transformed processes to release time to care and a culture of openness, honesty and ambition.
The programme will continue to support transformation at a local level for the next two years with its learning influencing development and implementation of our local accountable care system in Wirral.
Reflections
The experience of this scholarship has been transformative, enabling me to better understand my strengths and develop areas that will increase my impact at a local and national level. Increasing my knowledge of national and international initiatives has enabled me to develop local plans to enhance patient care and staff wellbeing. Prior to the scholarship, my exposure to such innovation was limited and a key area for learning is to ensure that I maintain an outward looking approach to future developments supported by a strong network which I will continue to grow.
I believe that I am more effective in my current role as a result and am confident that my career aspirations are achievable. I feel a palpable sense of increased personal confidence and self-belief. To a large degree, this is thanks to the constant support of my mentor who, even during our first telephone conversation, affirmed me and reflected positively that my thoughts, ideas and aspirations were valid and valuable to the future NHS.
Developing and implementing the ‘Transforming Care Together’ programme has been a roller coaster ride, with tremendous high points mixed with moments of frustration, despair and disappointment. I believe strongly in the principles of the programme and am committed to retaining the approach as a means of shifting culture and empowering action at the front line to co-design the new system around what matters most to the people we serve.