Taken Off the Critical List

Bedfordshire and Luton Mental Health and Social Care Partnership NHS Trust

“I’d thought Gung Ho! would be a small proportion of a wider programme we wanted to put together for the Trust, but during the course of that week I realised the programme was addressing more and more of the issues that concerned us. It was a far more substantial programme than I had imagined-going well beyond the scope of the books that inspired my initial interest.”

The Challenge

Three years ago, the Bedfordshire and Luton Community NHS Trust was in trouble. The organisation was beset with financial problems, and service quality was rated poor. Employee turnover figures and vacancies were running at an all-time high, and recruitment was proving difficult. Enquiries and investigations into performance had been carried out by external organisations, and there was real concern surrounding how the Trust was operating. A new Chief Executive was appointed along with new board members at the same time the Trust was looking to move into partnership with social care staff working in the mental health and learning disability field. It was clear a period of considerable change was occuring. Gary Lees, Assistant Director of Learning and Development, was responsible for looking for initiatives to change the culture of the organisation, so that managers and staff would develope more positive attitudes toward future change and improvement. He also wanted to improve staff motivation and provide more support for frontline management.

The Solution

The Ken Blanchard Companies Gung Ho! organisational change process was chosen to underpin the planned culture change. Gary had read Ken Blanchard’s Gung Ho! and Managing by Values books, and these gave him some ideas about how a culture change might be possible. When he discovered that the Gung Ho! programme incorporates principles from both publications, he booked Blanchard trainer Garry Demerest to deliver a week-long Training for Trainers session. This served as the launchpad for rolling out training in-house.

The Approach

It was crucial for Gary Lees to secure top management buy in for the Gung Ho! programme. Therefore, he requested that six senior leaders join the programme, learning alongside the three facilitators who were to lead the in-house training.

Gary says it became clear almost immediately that Gung Ho! had far greater potential than he had first imagined. “I’d thought Gung Ho! would be a small proportion of a wider programme we wanted to put together for the Trust, but during the course of that week I realised the programme was addressing more and more of the issues that concerned us. It was a far more substantial programme than I had imagined—going well beyond the scope of the books that inspired my initial interest.”

The Training for Trainers was so successful that Gung Ho! was made mandatory for everyone with leadership or management responsibilities, including clinical leaders. This was a first. Previous mandatory progammes had been reserved for health and safety or diversity training rather than management or leadership skills.

“We were trying to make people aware that we thought management and leadership training was crucial,” says Gary. “Historically, the way managers have arrived at their positions within the NHS has been because they have risen through the ranks, perhaps from being a nurse or a doctor. They have usually had little or no training for their managerial roles. Our new message was that it’s not possible to become a good manager automatically; you have be trained to do the job.”

Initially, Gary targeted 112 people for training. It was not to be. Word got out about “this great new training course” and double that number applied for Gung Ho! Training—including the Chief Executive and the entire board of directors. Even some doctors squeezed the training into their tight schedules. Once one consultant took the course, positive feedback and word of mouth meant others soon followed.

The Trust made only one customised change to Gung Ho!—the title. Otherwise, training was delivered precisely as The Ken Blanchard Companies devised it.

“We changed the name to ‘Leadership 4 Tomorrow’ when we were advertising the programme,” explains Gary, “because Gung Ho! has certain connotations in the UK which some people at senior management had questioned. We didn’t want the name to be a barrier to people attending. We kept the name during delivery though, and now people talk about ‘Gung Ho!’ quite happily; we just felt it might be an issue at first.”

The Results

The results of introducing Gung Ho! into the Trust have been remarkable.

Organisational Impact

At an organisational level, employee turnover has decreased and the number of unfilled vacancies has dropped from 30% to 11%. The earlier recruitment problem has all but disappeared. “We’re now having trouble taking all the nursing students who are qualifying from the local university,” says Gary.

“We’ve recently been assessed as part of the NHS Improving Working Lives programme,” he adds, “and were told that the Leadership 4 Tomorrow programme contributed significantly to our positive assessment. We’ve also moved up to what is called the ‘practice plus’ level of HR expertise. The assessors felt the Leadership 4 Tomorrow programme was a significant part of our ability to demonstrate that we were trying to create better managers who treated their staff better so they were motivated and more likely to stay with the organisation.”

“While it’s not possible to say Gung Ho! was responsible for all this positive change,” says Gary, “I do know that people who have applied for jobs say they did so because they believe the Trust is now a great place to work. There is no way people would have been saying this three years ago. The rest of the NHS would have been well aware of the mess we were in then. So I do believe Gung Ho! has made a difference to our reputation.”

Impact on Management

“As far as management goes, people have told me they see people doing things differently now,” reports Gary. “I’ve certainly come across managers I felt were not the greatest in the system who are behaving very differently now— talking about the kind of relationships they want to foster within the team, for example.

“We wanted to change the way the management worked and make training ‘stick’. One of the ways we did this was post all 223 action plans individual delegates had drafted during training on public display in the conference area at our HQ building. This enables team members to see what their managers had put on their action plan and assess whether they were progressing with it.

“We’ve also made our Values and Mission statements paramount and put them on plaques that are going up everywhere. We’ve also changed our appraisal documentation to ask questions about behaviours that represent the values of the organisation.”

Gary has identified five key leader behaviour changes that he feels have contributed most to the more positive culture:

• Teams sharing personal values and purpose to build relationships
• Leaders setting SMART goals
• Leaders challenging those who are not supporting or following the Trust’s values
• New induction process
• Leaders becoming coaches

Managers have also agreed to staff requests to start sharing clear visions that trickle down through the organisation and to start giving them the whole picture about changes affecting staff, team members, or service users. To ensure they stay true to their word, one team has introduced regular coffee mornings with staff to ensure they are briefed about any developments.

Impact on the Individual

Gung Ho! has affected many individuals on a personal level. Gary Lees has received many letters from colleagues who can’t praise Gung Ho! enough. Here are some examples from those letters:

“I can’t stop talking about this course and how it has inspired me to stay with the Trust, as things are going to change for the better and we, at last, will be singing from the same hymn sheet.”

“The first thing I did when I returned from the course was laminate the Trust Mission and Values and display it on the notice board. I have also, as part of my one-to-one with my staff, started to discuss not only the Trust Mission and Values but also the Gung Ho! concept and how it interfaces with our purpose and values. Now that I know what the Trust stands for, I have been inspired to stay.”

“I really enjoyed the two-day course. It helped me to refocus on the leadership role, which I had always assumed was to tell people what to do. Now I understand that I had it all wrong. My role is much like a captain of a ship. I can’t be everywhere at once and I must trust the team to steer when I am not on the boat. I have to ensure that they are ready to man it on their own by letting them find their way with my support and gently guide each of them in the right direction. Thank you for this lightbulb moment.”

Conclusion

“Gung Ho! has clearly had a wide impact on management,” concludes Gary Lees. “We try and ‘catch people doing things right’ now, and adopt a ‘can do’ attitude. We also try harder to reward performance. We hope that because managers are treating staff better, staff will treat patients better.” Interestingly, he claims, Gung Ho! has a ripple effect on neighbouring NHS Trusts.

“Many organisatons in the NHS are going through modernisation work at the moment,” he explains. “My own belief is that you can modernise and redesign how your service works, but unless your people have the right attitudes and the right motivation, these initiatives will probably fail in the end. I feel Gung Ho! underpins and supports this work around modernisation. We’ve been talking to neighbouring NHS Trusts going through the same process and they are saying: ‘Yes, we need some of this leadership and management stuff too. We can see how it would help people get into the right frame of mind to make it work.’”