drayton high road norwich norfolk nr6 5be fax: … 2015.pdfcompliance team – health records...

Compliance Team – Health Records Kestrel House

Hellesdon Hospital Drayton High Road

Norwich Norfolk

NR6 5BE

Tel: 01603 421687 Fax: 01603 421411

FOI REQUEST NUMBER 255 2015

Request: Please supply us with:

a) All information (including but not limited to quotions, estimates, invoices, reports, emails, presentations, etc.) received from April Strategy LLP.

b) Details of the process used to select and approve the use of April Strategy LLP.

Response: Thank you for your recent request under the Freedom of Information Act. I apologise for the delay in responding. I attach the original tender document and the score sheet used for the procurement process. The panel was held on Dec 23rd 2014 and consisted of:- Leigh Howlett - Executive Lead Kate Copplestone - Head of OD Debbie White - Operational Executive John Brierley - Non-Executive Director representative Alison Thomas - Operational OD lead Kevin James – Service User representative Karen O’Sullivan - Staff Governor and Medic Carol Briggs - Union representative The agreement was unanimous regarding the VFM and fit with what the Trust wanted to achieve. The quotes ranged from 60k (a not fit for purpose bid as it was entirely survey based), then 107k for April and one other company whose quote was 224k. I confirm to search and locate emails regarding April Strategy would be over the 18 hours appropriate time limit set under the Freedom of Information Act. The Trust provides a complaints procedure to deal with complaints about the Trust's handling of

requests for information. If you feel you need to make a complaint, in the first instance, you should contact a Non-Executive Director via the Chair of the Trust. If you feel you have exhausted our internal complaints procedure, you also have the right and may feel you wish to write to the Information Commissioner who can be contacted on telephone number 01625 545740 or at www.ico.gov.uk.

http://www.ico.gov.uk/

NSFT Values – Supplier Selection Panel Score Sheet 0.1

NSFT Values

Supplier Assessment Form

Instructions This score sheet is for use on 23rd December to support the supplier selection process. Please record your scores for each potential supplier once you have seen their presentation. The purpose of this is to aid your thinking but also to provide a clear audit trail of the selection process. At the end of the panel meeting please give your scores to the Chair who will lead the discussion on a final decision and collate the scores accordingly. All criteria are weighted equally. Please use a rating scale from 1 to 5 as follows: 1 - Significantly below acceptable standard; unable to demonstrate any knowledge or evidence. 2 - Below acceptable standard; some knowledge or evidence but lacks context, relevance, focus or depth. 3 - Acceptable with minor shortfalls; shows knowledge and evidence but with some limitations. 4 - Above acceptable standard; document demonstrates knowledge and evidence in context, with relevance, focus and depth. 5 - Significantly above acceptable standard; as 4 but with a higher degree of depth, professionalism or relevance.

NSFT Values – Supplier Selection Panel Score Sheet 0.1

Supplier Score Sheet NSFT Values Selection Panel Member………………………………………………………………………. Role……………………………………………………………………………………………………………. Date…………………………………………………………………………………………………………… How well do

they meet the brief deliverables and criteria?

Evidence of previous success in projects with similar deliverables and criteria

Experience in the Health and Social Care sector

Evidence of partnership working and co-production

Alignment with Health and Social Care frameworks and reports (e.g. Hard Truths)

Value for Money

Total out of 30

PRIVATE & CONFIDENTIAL

ENGAGING STAFF AND REFRESHING VALUES A proposal from April Strategy LLP

December 2014


CONTENTS

FOR FURTHER INFORMATION PLEASE CONTACT: DEBORAH HOMA PARTNER +44 7946 380804 JOHN VINCENT PARTNER +44 7887 643012

1. Introduction

2. Our approach

3. Our team and expertise

4. Resource and project plan

5. Supporting april experience


1. INTRODUCTION

• We are curious. We think differently. We see things differently. We do things differently. Our imagination, inquisitive nature and appetite for change motivates us to constantly search for ideas that will transform both our own and our clients’ organisations.

• We are connective. We are natural communicators, collaborators and connectors. We join the dots across ideas, people, products, channels, audiences, issues and operations. We know what makes people tick. We know what makes organisations tick.

• We are open. We’re open, honest and down to earth. Approachable, intuitive and transparent. Genuine, generous and appreciative. We create strong relationships based on trust.

• We are rigorous. Our specialist experience and diverse knowledge base directly informs the way we work. Everything we do is supported by high levels of professionalism, deep insight and best practice.

April Strategy, (april), is delighted to submit this response to Norfolk and Suffolk NHS Foundation Trust’s invitation to refresh the Trust’s values through Trust-wide engagement with staff and service users. april is an international consultancy that helps clients put customers at the heart of strategy. Working with private sector companies including Argos, Barclays, Visa, Proctor and Gamble, Volkswagen and Jaguar Land Rover, we have developed unique approaches to involving customers directly in developing strategy to meet their real needs and designing customer experiences that thrill them. Over the last seven years we have used these approaches to help healthcare clients within the NHS and private sector to put service users and patients at the heart of their strategy and staff engagement programmes. Our NHS clients are seeing demonstrable improvements in their levels of staff engagement and quality of patient experience. Our work on cultural transformation, values and behaviours development, organisational development and, more recently, values based recruitment, has been recognised by the King’s Fund, NHS Confederation, NHS London and NHS England as examples of good practice. Our response to your tender specification is set out as follows: SECTION 2 - describes our approach to this engagement. Our proposal is to support you to refresh your values and develop supporting behaviours through mass engagement of staff across the organisation and through pro-active involvement of service users and carers, leaders, managers and staff-side representatives and through skill transfer to your teams. Our style is not to ‘do to’ or ‘do for’ our clients. We will work with you throughout this programme to develop the outputs and outcomes you require.

OUR VALUES ARE NOT JUST WORDS ON A

POSTER. THEY DRIVE OUR BUSINESS, OUR

THINKING, OUR CULTURE, OUR TONE OF

VOICE AND OUR TALENT.


We will support you to develop a Values and Behaviours Framework through insight analysis, listening and co-creation over a 5 month intense ‘engagement’ phase and beyond in a month ‘launch and embedding’ phase. Our approach will be to work flexibly with you to start from where you are so that this work builds on the work you have already done and clearly aligns to your strategy.

Section 2 also sets out how we will support you to communicate this programme to the organisation and subsequently launch the refreshed Values and Behaviours Framework. It details how we will support you to develop measures to evaluate the impact of the Values and Behaviours Framework in the future and embed this framework into your people processes.

SECTION 3 - describes our proposed team and details their relevant expertise. We are confident that our team combines a unique set of skills and experience that exactly meets the requirements of your brief. Each member of our team has deep experience of working in the NHS at senior and Board levels and is also skilled at relating to staff of all levels and developing credible relationships with wide ranges of professionals. CVs for each proposed team member detailing their individual expertise and experience are included with this proposal. SECTION 4 - details our resource and project plans. SECTION 5 - describes the april team’s previous experience of delivering similar values and behaviours development, culture transformation and service user and carer experience improvement programmes. Healthcare client details are included together with relevant case studies, examples of the impact of our programmes on improved patient experience and staff engagement, and examples of client feedback on our work and team.

“This really was a programme 'for the people,

by the people’. I would recommend april to any organisation who were

seeking to shift culture in a multi complex environment in

a way that takes the staff and client with them.”

Sue Hartley, DN, Walsall Healthcare NHST


Our understanding of your brief

Norfolk and Suffolk NHS FT (NSFT) employs around 4,000 staff delivering a wide range of mental health services across a disperse geography. In the recent past the Trust has experienced a number of events that have impacted staff engagement including a significant reorganisation, radical headcount reductions and an extended period of leadership uncertainty. Staff engagement has steadily declined over a three- year period and recent Friends and Family feedback reported strongly negative net promoter scores for all key indicators. Increases in negative service user and carer feedback (national surveys and NHS Choices) indicates, overall, patient experience has some correlation with declining staff morale. Relative to local NHS providers and national mental health providers NSFT has significant opportunities to increase staff engagement and improve service user and carer experience. With new leadership now in place, the Trust Board is committed to leading the Trust’s recovery for its service users, carers and staff. In line with the wealth of evidence supporting an NHS-wide focus on staff experience as central to improved safety, patient outcomes and organisational productivity, the Board recognises the need to focus on staff engagement as central to long-term improvement. A people strategy has been developed building on the NHS Employers Staff Engagement Framework. Locality-based improvement plans are in place and the Trust has a clear focus on staff health and well-being. The Trust now wishes to develop a refreshed Values and Behaviours Framework that will underpin its entire approach to staff engagement, providing a common thread for on-going improvement work and a strong foundation upon which to rebuild staff advocacy and motivation.

“In the year following our Patient

Experience Revolution, Whipps Cross improved in 43 of 63 indicators in the National Inpatient Survey;

there was an 11% reduction in complaints.”

Nancy Fontaine, DN, Whipps Cross University Hospital NHST


You wish to work with an experienced partner to develop a refreshed Trust Values and Behaviours Framework in true partnership with staff, staff-side representatives, service users and carers, Trust clinicians, leaders and managers. The partner should support you with expert advice, bring tools, techniques and evidence-based best practice approaches to the programme and ensure skills transfer to your teams to enable you to continue to improve staff engagement going forward. You are looking for an impartial, trusted critical friend who can bring both capacity and capability to this work. We are confident we are fully able to meet this requirement. We also believe this work should be interesting, fun and high impact. It should be something people talk about for a long time to come. The process itself should improve staff motivation, sense of contribution and advocacy. We have submitted this proposal because we believe our team and approach can genuinely help you accelerate improvement in staff engagement. We know this from the impact our work has had in organisations starting from similar positions to your own. We are inspired by the opportunity to help you achieve similar results.

“We’ve never had a program that’s been

embraced so widely and so quickly. There’s real ownership

– over 33% of staff were involved in designing ‘Patients

First’, it now drives our strategy, our story, our

reporting and the way we do things.”

Jan Bloomfield, HRD,West Suffolk NHSFT


Our ethos and evidence base

Evidence across healthcare demonstrates a fundamental link between healthy organisational culture, positive staff engagement, great patient experience, improved patient outcomes and organisational performance. In essence, people make organisations, and happy people make better organisations. We believe that culture change is about engaging and inspiring people to be at their best, and aligning processes and systems to motivate and reward the right behaviours and attitudes every day. Our approach is based on enabling mass staff, service user and carer engagement in a Trust-wide approach to discover what matters most to people, so that you can establish processes to actively appreciate what’s working now, celebrate and share best practice, and develop the systems for staff to continuously improve within a clear framework of co-created future expectations.

OUR APPROACH IS DRIVEN BY A RIGOROUS

APPLICATION OF EVIDENCE BASED BEST PRACTICE COMBINED WITH PRACTICAL AND

EXTENSIVE EXPERIENCE OF WHAT WORKS, AND

DOESN’T.


2. OUR APPROACH

Our approach to your brief comprises four stages summarised below:

A. Create a positive context, frame the programme and

generate momentum. Develop the leadership (Board) story for this programme, frame this for the organisation and develop a Trust-wide communications strategy for this work. Set a positive tone from the outset through appreciative and fresh insights into existing service user, carer and staff experience including FFT feedback, compliments and online feedback. Use this to generate compelling communications and positive conversations.

B. Use multiple media and mass engagement approaches to activate change at all levels of the organisation: • Listen to many hundreds of staff through set

piece workshops (In Our Shoes), online surveys and facilitated discussions to understand the experiences of staff today (what it’s like on a good day and on a bad day at work) and build a vision for how staff want their experiences to be in the future. Create a common language and shared purpose about the way we want things to be around here.

• Enable frontline staff across the organisation to reconnect with service users and carers through set piece workshops (In Your Shoes) in which staff listen on a one-to-one basis to service users and carers good and bad experiences and work together to define a vision for service user experience moving forward.

• Build leaders’ and managers’ skills and confidence to lead for values, including bespoke Board and Executive Team Development interventions, leaders and managers skills development and tailored listening interventions

A. Create a positive context for staff engagement

B. Create a social movement through mass engagement


to engage and inspire leaders and managers to increase their connections with staff, service users and carers.

C. Co-develop refreshed Trust values and

behaviours – aligned with wider NHS frameworks using staff, service user and carer language to ensure the values have meaning for the staff and service users, are described in language everyone understands and based on concepts people want to talk about. Local ownership will provide a robust platform for leaders to use in developing their teams and a solid foundation for embedding values into the Trust’s systems, processes and strategy going forward.

D. Launch and roll-out the refreshed values and behaviours and embed into the Trust’s HR processes, performance measurement systems, strategic and annual planning processes. Develop and roll out leadership and team development processes to embed the refreshed values at the frontline and across the organisation. Align with on-going improvement processes to sustain improvements in staff engagement and service user and carer experience.

Each of these four stages is described further below.

C. Co-develop refreshed values and behaviours

D. Launch and embed refreshed values and behaviours


2A. CREATING A POSITIVE CONTEXT

From the outset we will work with you to ensure you continue to improve service user experience and increase staff engagement long beyond the lifespan of this project. In our experience, critical success factors for sustained improvement include:• Upfront, and on-going, dialogue with the Board and

their commitment to active leadership of this programme.

• Early identification, involvement and development of key stakeholders at leadership and operational levels of the organisation. This particularly includes key senior and operational managers, clinicians and matrons.

• Clear governance of the programme including establishing a Steering Group to oversee the programme (and most likely meet face-to-face on a monthly basis) and a Core Project Team comprising april and Trust team members to operationally deliver the programme (to mostly likely convene by skype / teleconference fortnightly). These groups could be forums that already exist within the organisation that will lead this programme.

Our working assumptions are that: • We will facilitate a series of structured Board

Development interventions throughout this programme. This will begin with a half day leadership framing workshop at the programme outset.

• We will not launch the programme until a clear, coherent leadership narrative has been developed in partnership with the Trust Board and, as appropriate, staff side partners so that from the outset the programme is well framed and set up to succeed.

• There will be Trust project management and administrative support to this programme including the service user and carer experience (PALs) team as well as Comms and OD resource to facilitate mass involvement of staff, service users and carers.


Framing the programme and generating momentum Before communicating this programme across the Trust, we will work with the Trust’s leaders and Board to develop a powerful frame for this work in the form of a leadership story that sets out: • What the programme will deliver and achieve and what

opportunities there will be along the way. • Who can get involved and how the programme will

work. Through a mix of early one to one discovery interviews, small group meetings and facilitated workshops we will work with the Board, clinical leaders, and a cross-section of the organisation to develop an appropriate ‘frame’ (together with a narrative description and visual imagery) to ensure the programme engages frontline staff, service users and carers in its purpose and motivates mass involvement. This work will include an initial ½ day Board workshop to agree the leadership story for this programme and ensure it is clearly aligned with the strategic direction of the Trust. Setting a positive tone from the outset We will start with positive appreciation of what is great about the Trust by working with you to identify, celebrate and share best practice. This will include fresh analysis of existing documents, compliments, surveys, FFT etc. to: • Develop an honest picture of strengths and weaknesses

of service user and staff experience, opportunities and issues.

• Identify what matters most to service users, carers and staff, including the positive and negative behaviours that make the biggest difference to people experiencing and delivering Trust services.

• Frame appreciative messaging for the programme, for example using bespoke compliments wordles.


2B. MASS ENGAGEMENT TO ACTIVATE

CHANGE AT ALL LEVELS OF THE ORGANISATION

Listening to staff Over the last few years, Norfolk and Suffolk Trust staff have experienced a number of significant changes including merger, frontline service reconfiguration, radical staff reductions and leadership instability. Staff engagement has steadily declined since 2011 with the Trust consistently performing in the worst 20% of NHS Trusts in England. Reported work pressure and stress have increased with a corresponding decrease in staff reported motivation at work. In particular, staff recommending the Trust has declined. In our experience of working with Trusts in similar positions, an important step on the journey to recover staff engagment is to truly listen to staff and give them the time and space to share their experiences of the recent past. Giving staff the opportunity to reflect on how things have been, and how they want things to be in the future, as part of the process of developing refreshed shared values is, in itself, an intervention that begins to reconnect staff with the organisation’s core prupose. Our approach will be to build awareness and momentum through open and constructive listening events, on-line surveys and discussions, and facilitated debates to listen to staff first hand about their experiences and ambitions for themselves, the care they provide, the expectations staff have of their behaviour with each other and service users, and about what they want to see more of and less of around the organisation. We will work with you to develop an appropriate approach to listening locality by locality, recognising the different starting positions and needs of each different areas/ teams.

TRUSTS WITH HIGH LEVELS OF UNSATISFIED STAFF AND STAFF WHO INTEND TO LEAVE THEIR

JOBS HAVE LOWER LEVELS OF PATIENT SATISFACTION, AND

VICE VERSA. Prof M West, 2014


Our In Our Shoes staff listening workshops and staff Future Values Survey will begin a conversation with staff about their vision for their future experience of working at the Trust and what this might mean for organisation-wide values and behaviours. Our listening interventions include: In Our Shoes workshops to explore: • What makes a good day or a bad day at work here –

and what are the barriers to, and drivers of, staff engagement?

• The behaviours staff want to experience between each other and demonstrate to service users and carers.

• The behaviours and support staff want from leaders and managers.

On-line survey and facilitated discussions to explore: • Staff ambitions for service user and carer experience

e.g “the compliment I’d most like to receive from a service user is…”

• What gets in the way of providing a great service experience right now?

• Findings of surveys with service users and carers, to compare patient and staff ambitions.

• Understanding the ‘expectation gap’ – do staff prioritise the things that are important to service users and carers?

Given the Trust’s starting position, we recommend the Trust take the time to truly listen to, and engage with, at least 20% (and ideally more) of the total workforce across the broad geography of the patch as the refreshed values and behaviours are developed. Our preferred way of delivering this listening would be to transfer tools and skills to your organisation to enable you to sustain staff listening beyond this programme. Our proposed approach is therefore to work with your OD team to design the above interventions, in particular In Our Shoes events, and to share delivery with a team of internal facilitators (e.g. OD professionals, modern matrons, programme champions).

SEEK TO UNDERSTAND WHAT MAKES A ‘GOOD DAY’ AND A ‘BAD DAY’ AT WORK FOR STAFF – AND WHAT WE CAN DO

TO IMPROVE THIS.

‘Our values’ survey


We would envisage delivering initial events and then working with you to develop internal skills to co-deliver events with us, and then ultimately for you to deliver events independently once we have supported you to develop a skilled, confident internal team of facilitators. However, we recognise that internal capacity may mean this resource is constrained. Our proposal therefore includes an option for us to share listening delivery with you and for us to deliver it in its entirity. Connecting staff with service user and carer experience “Staff engagement is about creating an environment where employees are motivated to want to connect with their work and really care about doing a good job.” (Professor Katie Truss, 2014). An important feature of our approach to creating shared values and behaviours with NHS organisations is the direct involvement of service users and carers. We will support Trust staff drawn from all roles and grades across the whole organisation to listen 1:1 to service users and carers as they tell their stories. Our In Your Shoes listening events and In Your Shoes drop-in sessions will enable staff to listen directly to service users and carers and reconnect on a personal level with: • What was good and bad and how it made them feel? • What service users and carers would like to see ‘more

of’ and ‘less of’ from staff? • How staff behaviour impacts service users’ emotions,

recovery and well-being - “We do… so you feel”.

In Your Shoes workshops will provide direction for the Trust’s future values and behaviours and generate clear priorities for service user experience improvement that can start to happen straight away.

70% OF ENGAGED EMPLOYEES INDICATE THEY HAVE A GOOD UNDERSTANDING OF

HOW TO MEET CUSTOMER NEEDS. ONLY 17% OF NON-

ENGAGED EMPLOYEES SAY THE SAME.”

CIPD, 2006


Having facilitated hundreds of such sessions across England, Wales, the US and New Zealand, we are confident of the transformational impact of these sessions (in all care settings) upon staff who rediscover their passion and determination for change, and upon skeptics, who build self-awareness, gain new insight and become powerful advocates for the programme.

The nurse kept saying she was busy. I didn’t

want to be a bother so I kept my mouth shut.

The doctors didn’t see that while it was routine

for them, it was an anxious time for me.

Staff comments about In Your Shoes Moving. Humbling. Essential.

Made me think how to go not just the extra mile, but the extra, extra mile.

An eye-opener. All staff should come to be reminded how it feels to be a patient and the impact of positive and negative

experiences. She told me things she had never told anyone, it helped her feel

better. Of patients who attended WDHB In Your Shoes, who completed

a post-event survey, 29 of 30 would recommend it to a friend.


Our commitment to you is not just to design and deliver these interventions but to transfer skills to your teams so that you can continue to listen and learn from staff, service users and carers in the future using these tools. Again our proposed approach is to share delivery with a team of internal facilitators. For In Your Shoes sessions, we would envisage co-delivering 5 events with you, with the potential for you to deliver further events independently. We will support the design and execution of a mass communications campaign to pro-actively recruit service users and carers to attend workshops and to promote sessions to all staff. On-line listening to service users and carers In addition to listening to service users and carers in person, we propose using an on-line and paper based survey (in inpatient settings and outpatient and community clinics) to learn from service users and carers what they value most, and what they want to see and hear staff doing ‘more of’ and ‘less of’ in the future.


Building managers’ skills to lead for values A key enabler to employee engagement is the development of engaging and listening leadership and management. The MacLeod report to Government, Engaging for Success, (2009), describes this as: • “Leadership which ensures a strong, transparent and

explicit organisational culture which gives employees a line of sight between their job and the vision and aims of the organisation.

• Engaging managers who offer clarity, appreciation of employees’s effort and contribution, who treat their people as individuals and who ensure that work is organised efficiently and effectively so that employees feel they are valued, and equipped and supported to do their job.”

From the outset it will be important to enable frontline leaders to get behind the cultural change you seek to make and to engage with the process and outputs of the values and behaviours engagement exercise. It will be important that senior and middle managers understand what the organisation is trying to achieve, why, how they fit in and what leadership will expect of them. It will also be important for leadership to understand the challenges facing this group. We therefore propose two half-day leadership conferences to: • Listen to leaders and managers about what helps and

hinders their ambitions to enable great patient care and meaningful staff engagement.

• Improve the motivation, skills and confidence of Trust leaders and managers to hold real-time discussions about good and poor attitude and pro-actively manage behaviour.

• Create role models of patient-centred care. • Build the confidence, capabilities, self-awareness

More of

Less of

Size of words proportional to mentions by staff when asked how managers can help them to have

more good days at work – In Staff Shoes sessions at a midlands NHS

Trust.

“THE EVIDENCE IS SIMPLE, PATIENT-

CENTRED ORGANISATIONS PAY ATTENTION TO THEIR

STAFF.”

Dr Jocelyn Cornwell, Point of Care

Foundation, 2014


and psychological skills to lead for patient-centred care, understand the importance of staff engagement and recognise the impact of their own behaviour on staff motivation. Building Trust leadership skills and confidence We will facilitate a series of bespoke leadership and management development interventions as part of our programme of work. Specifically we will work with the Board, leaders and managers to build the confidence, capabilities, self-awareness, mindfulness and psychological skills to lead for, role-model and manage values-led care. We will work with closely with your OD team to link this work to any ongoing leadership and Board development activities. Interventions we propose include: • A half day Trust Board “In Your Shoes” listening to

service users and carers workshop to enable leaders to build a personal connection with what makes the most difference for service users.

• “A day in the life of…” observation exercises where Board leaders pair with frontline staff to capture first hand experience and gain in-depth understanding of what it’s like working and being cared for across the organisation.

• Coaching the Board to lead for service user and carer experience, including consistent application of proven engagement techniques and attending listening events to increase personal visibility and build meaningful connections with service users, carers and staff.

Our working assumption is that Board Executive and Non-Executive Members will be enabled to dedicate the required time and energy to this important and high profile work.

“april helped us as a team to radically rethink our approach to customer service and to up our game in a world of increasing choice and competition. It was clever stuff, a paradigm shift, good value and a practical, lasting way forward.”

Patrick Geoghegan, CEO, SEPT


2C. CO-DEVELOP REFRESHED VALUES

Listening will generate deep insight into the specific and tangible behaviours that staff, service users and carers want to see more of and less of across the Trust. We will use word / phrase analysis to translate qualitative insight into quantitative data to enable deep understanding of the values and experiences that are important to service users, carers and to staff - and how these can differ. This approach will focus language on the words that resonate most with people, not management-speak or conceptual language, and enable us to generate a draft Trust Values and Behaviours framework that reflects what we have heard about how people want to be. At this stage we will also ensure the draft Values and Behaviours Framework aligns with wider NHS frameworks including the NHS Constitution, Nursing 6 Cs, and the language of compassion and quality identified as important by key reports including the Francis Inquiry and reports of Sir Bruce Keogh and Don Berwick. We will also generate insight into priorities for improving service user experience and staff engagement that you can start to take forward straight away. Having developed a draft framwork, we will work with the Project Core Team, Trust leaders, staff-side representatives, service users, carers and staff (who may or may not have been involved to date) to engage with the distilled insight from listening to patients and staff and use this, along with learning and evidenced good practice from elsewhere, as input to: • 4 dedicated (2 hour) co-development events: 2

aimed at frontline staff, 1 at leaders and managers, and 1 at service users and carers. Events will draw people together from across the Trust.

A TRANSPARENT, AUDITABLE

DEVELOPMENT PROCESS ROOTED IN LISTENING,

ENGAGEMENT, ANALYSIS AND INSIGHT GENERATION.


• A 2 week values feedback on-line survey and

internal campaign designed to engage staff with the insight generated through listening and involve them in the Values and Behaviours co-development process through a short series of closed and open-ended feedback questions.

The purpose of co-development interventions will be to: • Widely engage people from across the organisation

in commenting on, debating and co-developing refreshed values and underpinning behaviours.

• Identify ‘hotspots’ and potential ‘flagship’ changes that could quickly bring the refreshed values to life.

The outcome of our work will be a translation of mass listening to the experiences and ambitions of service users, carers and staff into a clear, simple, powerful, refreshed set of values that resonate across the organisation and translate into a tangible behaviour framework so people can notice when people are, or are not, living up to the values, so that staff can speak up when they see good care or poor care and so that the organisation can develop a consistent approach to measuring, managing and improving staff and service user experience. Important steps in this stage will be to: • Agree the wording of the values and content of the

behaviour framework to be presented to the Board for final sign off.

• Design the ‘visual branding’ and imagery for the Values and Behaviours Framework.

• Revisit and refine the leadership story in light of the co-developed Values and Behaviours Framework.

• Bring the values to life with practical change examples that are specific enough for staff to believe real change is happening as a result of their feedback and involvement.


Example frameworks


2D. LAUNCH, ROLL OUT AND EMBED THE REFRESHED VALUES AND BEHAVIOURS

Having signed off the Values and Behaviours Framework, we will work with your Comms resources to design a high impact launch of the refreshed Values and Behaviours Framework, and work with key leaders to agree the launch story, key messages and values campaign. In our experience, organisations that successfully use values to drive quality of service embed them into everything they do. Our approach will support you to integrate your refreshed values and behaviours into how you recruit, manage and develop staff, measure performance and keep listening and improving. We will work with Trust leaders, managers and OD teams to develop a Values and Behaviours alignment plan based on april’s alignment model. Our approach will include two half day alignment planning workshop with leaders, managers, HR, OD, Comms and PALs teams to plan alignment of the Values and Behaviours specifically into: • Recruitment, induction, appraisal, PDP and

recognition processes. • On-going patient and staff experience

measurement and reporting processes. • On-going staff and service-user front-line listening

and improvement processes. • On-going clinical and managerial leadership

development and capability building. • Board and Executive Team meeting structures and

processes. • An Trust-wide approach to frontline staff and team

development.

“Aligning the standards to our systems has made

the change sustainable. It’s when consultants ask you for a copy of the standards

and the competency interviewing guide, for a review panel, that you

know it’s working.“ Jan Bloomfield, DHR, West Suffolk NHSFT


3. OUR TEAM

Our team have considerable experience supporting healthcare organisations across the private and public sector, UK, USA and New Zealand to transform their organisations’ cultures through the development of patient focused strategy, values and behaviours and delivery of organisational, team and personal development interventions. The programme will be led by april partners Deborah Homa and John Vincent, supported by april Partner Tim Keogh and Consultant Rosie Banks. CVs for each team member are appended. Together the senior team we are proposing for this work has delivered successful culture, values and behaviours programmes in over 40 healthcare organisations over the past seven years. All team members have worked with organisations across multiple sites and with multi-professional staff at all levels. All Partners work at Trust Board level and all have senior managerial experience in the fields of strategy, customer experience, innovation, change and organisational development. All team members have worked with a wide range of mental health clients including Leicestershire Partnership NHS Trust, Camden and Islington NHS Trust, South Essex Partnership NHS Foundation Trust and Hertfordshire Partnership NHS Foundation Trust. We have assembled this team with your particular requirements in mind. For example:

• Deborah has over 20 years NHS experience and has held Board Director posts in NHS acute, mental health and commissioning organisations. Deborah has senior experience in health strategy formulation, organisational development, leadership development, patient and staff engagement and performance improvement.

“april ensured that they fully understood our brief to develop a set of outcome statements for our work on integrated care. They developed a successful approach, tailored to our needs, based on their expertise in working patients, carers and staff. The end product was exactly what we wanted, and the april team was at all times a pleasure to work with.” Jeremy Martin, Symphony Project Director

“april are professional, innovative and flexible in their approach. They work at pace. They bring a wide perspective to their work –experiences from other organisations – but their work with us was not constrained by it i.e. the april way is not limited to what they think the answer is, but took great consideration of our local circumstances.” David Wherrett, Workforce Director, UCLH


• John is a former Ministerial Private Secretary with a track record of working at Board level across a range of private and public sectors. John is currently working with the Boards of Jaguar Land Rover and Volkswagen improving customer experience and can bring best practice industry expertise to bear in the design and delivery of your programme. John has 7 years experience working with healthcare Boards and teams.

• Tim regularly speaks at National conferences on best practice patient experience involvement and has spoken at the King’s Fund as a guest speaker on improving patient experience. Tim has 7 years experience working with healthcare Boards and teams. Tim has a background in creative advertising and communication and has managed global accounts across Europe, the USA and Asia working on strategy, customer experience improvement and innovation.

• Rosie has supported a number of NHS Values and Behaviours development projects, is skilled in qualitative and quantative analysis, project management, working with NHS staff facilitating focus groups and in supporting all aspects of the proposed programme.

“What a positive experience it was working with all of the staff from april, who role modelled at all times the standards we were working on for our own staff as part of the ‘Patient Revolution’ work, never failing to be positive and involving of everyone taking part - including our service users who have learning disabilities and therefore a range of communication styles and methods.” Jane Parr, AHP Lead and Speech and Language Therapy Clinical Lead


4. RESOURCE AND PROJECT PLAN A. CREATING A POSITIVE CONTEXT • Project initiation • Governance – 2 hour Steering Group

Meetings x 8 plus prep • Project Management – 1½ hour Core

Team Meetings x 16 plus prep • Initial insight analysis • 1-2-1 discovery interviews and small

group meetings and distillation of key themes

• Trust Board and key management meeting presentations

• ½ day Board programme story workshop • Develop leadership story • Design launch messages, materials and

campaign • Plan the listening events, survey, team

discussions • Develop service user and staff

communications and recruitment plan and materials

DAYS

1 3 3 4 4 2 1 1 2 3 1

FEES

1,750 5,250

5,250

1,600 7,000

3,500

1,750 1,750 3,500

1,200

400

25 34,700

B. MASS LISTENING/ ENGAGEMENT • Board interventions/ development • In Leaders’ Shoes x 2 ½ day conferences

plus preparation • In Our Shoes: 14 x 2 hour workshops 15 -

20 people at each (10% staff coverage) • In Your Shoes: 5 sessions total c75

service users / 75 staff • Leaders and facilitators training for

listening events

• Nb please double In Our Shoes resource if you would want us to deliver 20% workforce coverage

• Nb please double In Your Shoes resource if you would want us to deliver the recommended 10 sessions

3 2 4

2.5

0.5

5,250 3,500

7,000

4,375

875

12 21,000

The table opposite details our resource plan for the programme as specified in section 2 above. It is based on the following assumptions: • Fees are quoted exclusive of

VAT which will be charged at 17.5%.

• All work specified will be carried out by senior Partners at a standard day rate of £1,750.

• Analysis and delivery of this programme will be supported by Consultant Rosie Banks at a standard day rate of £400.

• A standard consulting day is 7.5 hours. We do not charge clients for additional hours worked within reason.

• We anticipate the fees set out constitute a fixed price for this work. We will not charge for marginal additional days used.

• All expenses will be recharged at cost and will conform to standard NHS terms and conditions for expense reimbursement. We anticipate expenses in relation to travel and subsistence. Please budget around 5% allowance.

• The fee quoted includes creative design costs associated with values and behaviour branding and launch communications. It does not include printing costs associated with launch materials, for example banners, lanyards, handbooks.


C. CO-DEVELOP REFRESHED VALUES • Analysis of listening, surveys and values

campaign and development of feedback packs

• Develop draft patient vision, values and behaviours framework

• Review, refine and build the values and behaviours framework through 4 x 2 hour co-creation workshops

• Visual branding and comms materials • Leadership values story – next steps

15 1

1 2 1

6,000

1,750

1,750

3,500 1,750

20 14,750

LAUNCH, ROLL-OUT & EMBED VALUES

• Develop launch plan and materials for high impact launch values and behaviours

• 12 month values communication plan and supporting materials to keep values front of mind

• 2 x ½ day alignment workshops (and outputs) to develop alignment plan for: • Measuring values implementation and

impact • Ongoing leadership development • Values-led management development • Values driven recognition • Values-based recruitment • Values-based performance

management, appraisal • Planning / strategy (IMTP) • Frontline listening and improvement

cycle • Develop team values cascade materials

and train facilitators

2 2 2

2

3,500

3,500

3,500

3,500

8 14,000

CONSULTANCY RESOURCE 65 84,450

Listening events type-ups Nb please reduce this cost if you would prefer to type up listening event outputs in-house

2,500

Printing and listening event materials 2,000

Expenses (notionally 5% of fees) 4,200

TOTAL 91,150

Continued… • We do not anticipate any

software or licensing costs to be associated with this proposal.

• Should the scope, specification or outputs of this work change at your request we will work in partnership with you to scope and agree any additional costs.

• We will invoice monthly on the basis of time and materials used and provide a breakdown of days used, expenses and deliverables.

• Our standard terms and conditions require a 30% payment up front with the remainder then invoicable in line with an agreed schedule/ project plan.


Deliverables

We anticipate that the programme outlined above will result in the following deliverables: • A clear programme governance structure with fortnightly

skype and monthly face-to-face meetings. • Board ownership of a clear leadership story framing the

programme for the whole organisation (half day workshop).

• A clear programme launch and communications plan with supporting materials to generate significant momentum from the outset.

• Fresh insight into existing service user and carer experience and staff engagement building on listening work to date.

• A Trust-wide baseline of patient experience and staff engagement.

• Bespoke Board Development interventions to build Executive and Non-Executive leadership skills and confidence and set the Board up to succeed.

• 2 x half-day leadership conferences to build senior leadership confidence and skills in leading for values.

• 5 x “In Your Shoes” listening events covering a range of mental health settings of care (2.5 hours).

• 1 x “In Your Shoes” drop-in campaign covering community networks.

• Service user and carer future values survey. • Staff future values survey. • 14 x “In Our Shoes Staff” ‘Big Listen’ events (2 hours). • ‘A Day in the Life of’ … Board listening exercises. • 4 x 2 hour co-creation events aimed in turn at service

users and carers; leaders and managers; frontline staff. • Values Feedback On-line Survey. • Final Values and Behaviours Framework. • Visual branding and imagery for Values and Behaviours

Framework. • High impact values and behaviours launch plan, 12

month communications plan and supporting comms materials, leadership story and cascade presentation.

• Alignment plan to integrate values and behaviour standards into HR systems and processes (including recruitment, induction, recognition, appraisal and staff development).

• Recommendations for KPI measures of staff and patient experience, enabling performance management and improvement action planning at department levels.


Overview of our project plan (To be amended and agreed with you at project initiation).

Activity: JANUARY FEBRUARY MARCH APRIL MAY JUNE

W/C 5th$ 19th$ 2nd$ 16th$ 2nd$ 16th$ 6th$$$$$$$$$$$$$20th$ 4th$ 18th$ 1st$ 15th$

Project initiation and set up

One-to-one interviews

Board/management presentations

Board development sessions

Initial insight analysis

Plan listening events

Communication and recruitment

On-line staff and patient surveys

Facilitated discussions

‘In Our Shoes’ staff listening

‘In Your Shoes’ patient listening

Listening analysis

Framework development

Co-creation workshops

Visual branding and materials

Plan high-impact launch

Alignment workshops x2

Prepare for values cascade

Governance: JANUARY FEBRUARY MARCH APRIL MAY JUNE

Steering Group face-to-face

Core Project Team Skype


5. SUPPORTING APRIL EXPERIENCE

april’s extensive client base includes many multi-site health organisations delivering community, secondary, tertiary and mental health services including: Ashford and St Peter’s Hospitals; Barnet and Chase Farm Hospitals; Buckinghamshire Healthcare NHS Trust; East Kent Hospitals; Guy’s and St Thomas’ NHSFT; Heatherwood and Wexham Park Hospitals; Hertfordshire Partnership Foundation Trust; Leicestershire Partnership NHS Trust; Nottingham University Hospitals; Sherwood Forest Hospitals; South Essex Partnership Trust; Southport and Ormskirk Hospitals; and University College London Hospitals. We have supported many of our clients to deliver values-based patient, service user, carer and staff engagement events and have successfully developed values and behaviour frameworks with organisations including: ABMU Health Board, Cambridge University Hospitals; Buckinghamshire Healthcare; Central Surrey Health; Camden and Islington NHSFT; Colchester University FT; East Kent Hospitals NHSFT; Great Ormond Street Hospital for Children; Heatherwood and Wexham Park Hospitals; Hertfordshire Partnership; The Ipswich Hospital NHST; James Paget University Hospital FT; Kingston Hospital; Leicestershire Partnership NHST; Milton Keynes Hospital; North Middlesex University Hospital NHST; Nottingham University Hospitals NHST; The Royal Free London NHSFT; Sherwood Forest Hospitals NHSFT; Sussex Partnership NHSFT; South Essex Partnership NHSFT; University College London NHSFT; Walsall Healthcare NHST; West Suffolk NHSFT and Whipps Cross NHST. We have delivered Board Development programmes at a number of healthcare organisations including: ABMU Health Board, South Wales; NHS Leicester City; NHS Great Yarmouth and Waveney; North Middlesex Hospital; East Kent Hospitals NHSFT; and Leicestershire Partnership NHST.


Case study: developing values and behaviours and sustaining improved staff engagement Approach – we: • Engaged 10% of staff in completing the Denison

Organisational Culture Analysis™ and Manchester Patient Safety Audit tools to baseline JPUH’s culture.

• Facilitated ‘In Your Shoes’ workshops to listen to patients’ stories / experiences.

• Triangulated findings with insight from textual analysis of patient and staff stories and large-scale listening events for patients and frontline staff to produce a baseline diagnostic.

• Enabled 20% of staff to participate in an online ‘future values’ survey and a further 100 staff in workshops to define behavioural standards and set out agreed behavioural expectations in a staff handbook.

• Developed the Trust’s 3 year OD strategy. • Designed internal and external communication

campaigns to communicate the values and behaviours widely to all patients and staff.

• Developed bespoke leader, manager and frontline staff training interventions to embed the new culture.

• Delivered team development activities to 150 leaders and trained 10 Trust trainers to cascade the interventions across the organisation.

• Delivered a bespoke “Leading for Values” Board Development programme for the Trust Board.

Impact Between the 2011 and 2012 NHS Staff Survey overall staff engagement at JPUH improved from 3.57 – 3.69. Scores increased further to 3.85 in 2013 with statistically significant increases in scores for job satisfaction, recommending the Trust as a place to work (58 to 63) and as a place to receive treatment (3.63 to 3.81). The Denison survey, repeated in 2013, showed improvements across all cultural domains. CQC restrictions and Monitor authorisation breaches have been removed.

april were retained by James Paget University Hospitals NHSFT (JPUH) to develop its OD Strategy, deliver a Trust-wide cultural transformation programme and develop a Trust-wide values and behaviours framework. In November 2011 the CQC issued two formal warnings following a dignity and nutrition inspection and Monitor found the Trust in significant breach of its authorisation. Both regulators cited the Trust’s culture as a significant concern and contributory factor and the Trust’s commissioner required an immediate improvement plan. The april brief was to engage hundreds of staff and patients in the design of refreshed organisational values and behaviours and develop an OD strategy to enable the Trust to transform its culture through leadership and team development and appropriate OD interventions (including measurement processes). Key outputs included a cultural diagnostic, an OD strategy, refreshed Trust values and an associated behaviours framework and a cascade programme of team development activities tailored to each of leaders, middle managers and frontline staff.


Case study: developing values and behaviours and sustaining improved patient experience Approach – we: • Engaged hundreds of staff in listening to their own and

patients’ experiences asking what its like “In Your Shoes” and “In Our Shoes” to develop organisation-wide values and create a growing movement of passionate, self-aware and intolerant advocates.

• Inspired staff to set expectations they wanted to have of each others’ attitudes, behaviours and communication and identify the support they needed to live the values day to day.

• Ensured sustainability by embedding values and standards into management of people, planning, performance and improvement.

• Aligned Trust HR processes (recruitment, induction, appraisal and recognition) with the new values and behaviours.

• Built skills and capability in self-awareness and role modeling in leaders and developed a staff values training programme delivered by Trust Trainers to every member of Trust staff over a 12 month period.

• Packaged the values and behaviours into a clear story, communications plan and developed supporting staff handbooks, communication materials and train the trainer materials.

• Facilitated skills transfer in patient engagement, listening and continuous improvement to enable the organisation to continue to listen to patients and staff moving forward.

Impact Within one year 67/70 NHS Inpatient Survey indicators improved. Improvements were sustained and further built upon in year two. The Trust is now a reference site for improvement across the Midlands.

april were retained by Walsall Healthcare NHS Trust to develop Trust-wide patient experience improvement programme including developing a Trust-wide values and behaviours framework. The april brief was to design and deliver a programme to unify the newly formed combined acute and community services organisation around the delivery of the best possible patient experience, in a way that: • Placed the needs of

patients at the centre – visibly for patients and staff.

• Involved staff in shaping a shared culture for the new organisation – by co-creating values and service standards defining expectations of one another.

• Helped staff understand the impact of their behaviour on others - and learn new skills to deliver the shared service standards consistently.

• Empowered clinical leaders and frontline teams to identify, prioritise and make improvements to their patients’ experiences.

• Aligns the new organisation’s key management mechanisms - people recruitment, development and management; business planning, performance improvement and measurement; governance and communications - to embed and sustain the new vision, service standards and continuous improvement.


We would be happy to discuss any aspect of this proposal further and would be delighted to work with you on this programme. We confirm we can begin to work with you as soon as you would want us to.

For further information please contact Deborah Homa or John Vincent, Partners For and on behalf of April Strategy LLP

2nd Floor One Alfred Place

London WC1E 7EB

www.aprilstrategy.com

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