Effective Ward Manager BARTS HEALTH NHS Trust Effective Ward Manager Yvonne Blucher Deputy Chief Nurse Barts Health NHS Trust

Barts Health - a Background NHS Trust Largest NHS Trust in the UK Serve a diverse population of 2.5 million across the East London area Formed from the merger of 3 legacy Trusts in April 2012 6 Hospital Sites 3 Emergency Departments 3 Maternity Departments Community Services

Total of 117 Wards plus other Clinical Departments BARTS HEALTH NHS Trust Total of 117 Wards plus other Clinical Departments Over 5,500 Nursing Staff from a total of over 15,000 staff Different models of care across the various sites, with a wide variation in standard of physical locations. Some/many areas with good practice - BUT; CQC warning notices one year ago, significant safeguarding concerns, Leadership variations....... Need to ensure respond to potential issues following Francis Inquiry February 2013

Barts Health Approach ‘Care Campaign – Because we care’ NHS Trust Barts Health Approach ‘Care Campaign – Because we care’ Shape Culture Harm free care Leadership Quality & standards Engage across boundaries

Band 7 Leadership Care development programme established All Band 7 to go through ‘initial leading care modules 1 and 2’ Module 1 - Needs review - Leadership overview Module 2 - Harm Free Care - Leading improvement Older People Improvement Programme 14 Wards Shadow Team BARTS HEALTH NHS Trust

Empowering Improvement - how would you define it? BARTS HEALTH NHS Trust Empowering Improvement - how would you define it? “You must be the change you wish to see in the world” Mahatma Gandhi

Improvement principles BARTS HEALTH NHS Trust Improvement principles Simple Ideas that are meaningful to all Everybody matters Little things that count Visible & supportive leaders

Clinical leadership 9 Dimensions of Leadership Behaviour BARTS HEALTH NHS Trust Clinical leadership 9 Dimensions of Leadership Behaviour Inspiring shared purpose Leading with care Evaluating information Connecting our service Sharing the vision Engaging the team Holding others to account Developing capability Influencing for results NHS Leadership Academy ‘Healthcare leadership model 2013’

All of us? So what do we expect? What inspires us? What drives us? BARTS HEALTH NHS Trust All of us? So what do we expect? What inspires us? What drives us? What do we value? What are our principles? How do we fit together?

Charisma OR Inspiration BARTS HEALTH NHS Trust Charismatic Inspirational Uses the power of self Idealised Focus on the individual leader “me, me , me” Obedience of will Have “The” answer Emotional attachment “Fall in love” One way relationship Team focus Sustainable energy Resilience Hearts and minds “engage the spirit” Exploratory : “what if we...” Mature relationship Two-way/multi-way gains

12/04/2017 BARTS HEALTH NHS Trust 6 elements of Inspirational Leadership Stokes & Jolly, (2010) Said Business School University of Oxford Being the exemplar Articulating a future Sensing the situation Affirmation Having the difficult conversations Being Authentic Overview Q&A …what do we mean by the 6 elements ….being authentic? How do they retain this in their ward leadership role? COFFEE LH v1

Prerequisites for a supportive culture BARTS HEALTH NHS Trust Prerequisites for a supportive culture A shared vision and goal Leadership from the top Enabling and involving staff at all levels of the organisation, especially clinical staff Investing sufficient time, resources, education in staff development Empowering people, especially those close to the delivery of care Fostering positive relationships A focus on patient experience Patterson et al, 2011

High standards and Performance 12/04/2017 BARTS HEALTH NHS Trust High standards and Performance Expectations Thoughts How Exemplary practice Where When Impact & deliverables Who Actions Getting to A+ How would they score their ward/unit (draw on the flip chart an A+ & dotted line to E, F & U!) get them to indicate where they are on that line. What would an A+ ward look like? Who, what, where etc…evidence base? How do they know? What would it feel like to be there The red pen example…getting to a goal…if we put this red pen at the front of the class & I ask you to move forward to it….when & why is it useful? What are the problems? Do we all get there at the same time, do we need to help people? What should the strategy be..how does this relate to ward standards? LH v1

Getting to Gold BARTS HEALTH 12/04/2017 How did they do it? NHS Trust Getting to Gold How did they do it? What did they have to give up? What did they maximise? General discussion of getting to gold & the similarities or lessons to learn in healthcare leadership & self management of aspiration. LH v1

Listening to our patients BARTS HEALTH NHS Trust Listening to our patients Imagine it was your Mum there Listen to Family and Friends Feedback See who I am Maintaining identity Involve me Sharing decision-making Connect with me Creating community

To lead you need Supporters not Followers BARTS HEALTH NHS Trust To lead you need Supporters not Followers So what’s in the relationship?

BARTS HEALTH NHS Trust

Relationship-centred care Tresolini et al, 1994 BARTS HEALTH NHS Trust Relationship-centred care Tresolini et al, 1994 Security – to feel safe Belonging – to feel part of things Continuity – to experience links and connections Purpose – to have a goals to aspire to Achievement – to make progress towards these goals Significance – to feel that you matter as a person Positive relationships between patients, relatives and staff Nolan et al, 2006

The Way Forward Creating your own leadership qualities BARTS HEALTH NHS Trust The Way Forward Creating your own leadership qualities What’s at the core and heart of us What shapes us What shakes us Recognise it within yourselves Ensure regular 1 to 1 Coaching PRDP’s – goal setting with support

BARTS HEALTH NHS Trust Covey says; Leadership is communicating people’s worth and potential so clearly that they are inspired to see it in themselves. It all begins within oneself

BARTS HEALTH NHS Trust Q&A