Training team coaches at Leeds Teaching Hospitals NHS Trust
About Leeds Teaching Hospitals NHS Trust
The Leeds Teaching Hospitals NHS Trust is one of the largest NHS Trusts in the UK and provides services to the population of Leeds and surrounding areas. The Trust is a complex organisation providing services through five hospital sites as well as delivering services in other Trusts. In addition the Trust is a regional centre for a number of specialist services, such as cancer and cardiac surgery. In total Leeds Teaching Hospitals employs over 14,000 staff across eight sites, treating around a million patients of a year with a budget of over £930 million.
The challenge
Leeds Teaching Hospitals NHS Trust is not the type of organisation you might expect to be at the forefront of coach training. Like many healthcare organisations, the Trust has a historically hierarchical structure that could sit awkwardly with coaching values of inclusion. The pressures of delivery in an increasingly tight financial climate have meant that sustained investment in traditional management and leadership development have not been maintained. Moreover the high stakes and time pressures involved in healthcare mean staff often look for interventions that will deliver instant results rather than schemes focused on longer term growth.
When the Trust’s Organisational Development team looked at their options for leadership development programmes, they decided coaching offered a possible solution, as it combined opportunities for real-time development, rapid improvement and a step toward a more empowered and flexible organisational culture. In 2006 they set up a steering group on coaching and then took a bold step: they decided to train two cohorts of team coaches with the eventual aim of running their own internal team coaching service.
The decision to invest in team coach training was not a wildcard but rather a pragmatic decision based on careful research. Anthony Owens, Organisational Development Lead, examined evidence from a number of sources showing that industries which have invested heavily in team performance, such as the airline industry, have shown significant reductions in reported error rates. Within the NHS there is also a growing body of research which shows that more successful teams improve patient wellbeing, and the Leeds Teaching Hospitals’ staff survey identified team effectiveness as an area for improvement. The research convinced Anthony and his colleagues that investing in team coaching was important; as he says “more effective teams in the NHS means lower mortality rates, patients getting better quicker and healthier staff”.
The Performance Coach
Representatives from the Trust met with a range of coach training firms. Their goal was to find a provider who could train managers in team coaching as distinct from facilitation or team building. The Performance Coach demonstrated these qualities and the Trust commissioned a programme led by Managing Director Charles Brook. During the course of the programme Charles aligned himself with the programme aims and provided constructive challenge to Anthony on the management and deployment of the developing coaching resource.
The Leeds Teaching Hospitals decided to have a very open selection procedure, and put out a call for applicants on the Trust’s intranet. Those who were interested were asked to submit an application form with a self-assessment section and then undergo a brief interview. The successful candidates were those whose experience, values and beliefs were best aligned with a coaching philosophy. As a result of the open application procedure, the course participants were highly varied, ranging from three Trust Directors to a Secretary who had studied coaching in her spare time.
Programme design
The Performance Coach ran two programmes for Leeds Teaching Hospitals, each lasting roughly six months. The courses took a blended learning approach: each programme included workshops, peer supervision, action learning sets, and plenty of coaching practice. This created the type of experiential programme that was most suited to the NHS participants, all of whom were very action-oriented and hands-on in their day-to-day lives.
Another element which made the programme successful was the extent to which the trainers, most especially Charles Brook, could successfully model coaching. Attending a programme led by a top coach with fifteen years of experience made a big difference to participants. They could ask coaching questions and receive genuine and personal responses. Charles also knew how to work at an appropriate pace, often slowing down the learning so that participants were able to assimilate and contextualise the materials in a practical setting.
Overall the groups found the programmes quite emotive. Participants remarked that The Performance Coach had created a learning community where they could remove the masks they wore in their day jobs, and start to be themselves. On the first programme Anthony Owens thought that such an emotional response might have been a fluke, but after it was repeated on the second programme he began to believe it was a deeper element embedded within the training. In terms of learning, the emotive element had a great effect, as the personal and imperative nature of each participant's journey improved their ability to acquire coaching skills.
The Leeds Teaching Hospitals were clear that they didn’t want to just create a training programme – they wanted to create a team coaching service. After the programme ended they decided to invest in the continuing development of their coaches, both by providing Supervision and regular Continuing Professional Development events. In time they found that the coaches were proudly stating “I am a Coach” – the shift in identity they’d been hoping for all along. They are now developing a supporting infrastructure, creating both a coach matching service and a process for monitoring the success of coaching activity.
Training team results
The team coaches have so far been primarily deployed within the Trust’s Financial Management Directorate, and have used resolve and patience to overcome organisational resistance and achieve results. The Directorate has traditionally used an expert-input model but the Trust is trying to shift this to a customer-focused consultancy-based model. By using their newly trained team coaches they have been able to identify practical ways to achieve this shift, such as inducting members of the Financial team before they start work within any new department. Operational Managers have noticed the difference, saying they now feel they are working in partnership with the Directorate. Elsewhere, a Director who trained as a team coach has been asking tough questions of her colleagues to improve the quality of her work, which includes strengthening governance arrangements to help manage risks in the region of ten million pounds. For a small coaching team, such results make their considerable effort worthwhile.
In another example, the team coaches helped a nursing sister who wanted to ensure children on her ward had protected meal times free from interruptions. Despite much communication the goal had not been met and meal times were passed alongside the hustle and bustle of a busy ward. Following a coaching session the idea of using warning barriers or just closing doors on the bays where children were eating emerged. It worked. The children are eating almost twice as much and are also experiencing earlier normalisation and socialisation. This should make their hospital experience more pleasant and expedite an earlier discharge. It is heartening to see an example where team coaching is having a direct effect on patient care. Nurses, patients, housekeepers and kids all report the new system “is great”.