This Future Hospital Programme (FHP) case study comes from Betsi Cadwaladr University Health Board (BCUHB), one of the four development sites chosen by the Royal College of Physicians (RCP) to launch the new model of care devised by the FHP.Dr Dee Gray details how training in resilience and wellbeing offered to the Future Hospital team at BCUHB helped to secure a successful project and is having a long term positive impact on workplace performance.
Key recommendations
• Coaching NHS staff in achieving the right mind-set can help them to perform their duties to the best of their abilities.
• Management should value staff by taking responsibility for their wellbeing in the workplace. This will also reduce the risk of workplace burnout or staff disengagement.
• Increase staff knowledge and skillsets regarding self, peer and team coaching to improve individual and organisational resilience and wellbeing at work.
The challenge
Following our hospital being chosen to participate in the Future Hospital Programme (FHP), enduring organisational change risked the potential for reduced resilience and wellbeing among participating staff. Dr Olwen Williams, clinical lead, took the proactive step to counter this by arranging for members of the Future Hospital team (FHT) to undertake resilience and wellbeing training.
The solution
To this end I developed The Resilience and Wellbeing Programme©. This programme has evolved from my earlier research which looked into supporting staff to re-engage with their work where they have been involved in workplace errors. The Resilience and Wellbeing Programme was tailored specifically for the FHT, building on empirical research to identify a wellbeing coaching model to support professional coaching practice. The programme was constructed around the known transition challenges facing the FHT at BCUHB. Face-to-face delivery of the Resilience and Wellbeing Programme was arranged around FHT workloads, and importantly had sufficient time between sessions to enable actions to be implemented and reflected upon.
The lasting impact of the project is that the Future Hospital team and the organisation know that, in order to provide optimal patient care, they must also look after the staff who deliver this.
The aim of providing resilience and wellbeing training was to develop knowledge and skills that would assist the FHT individually and collectively. The assistance is two-fold:
1. Improve their [FHT] resilience to organisational stressors.
2. Increase their [FHT] workplace wellbeing.
Teaching these two facets to the FHT resulted in an increased workplace engagement and contributed to a timely delivery of BCUHB’s projected plan for the FHP.
The programme is designed for optimal learning access and requires no prior knowledge or experience of coaching and/or supporting scientific theories. We expected a barrier to the success of the programme would be that participants would not be able to take time away from demanding workloads. In practice, there were no barriers experienced in conducting the programme because all participants were fully engaged with the programme.
Outcomes
The resilience and wellbeing training was evaluated through the collection of qualitative data during delivery, as well as through qualitative questionnaires post-delivery. It was beyond the remit of this study to capture data that identified the programme intervention with improved patient outcomes, however as the connection between staff wellbeing and clinical outcomes is known we may infer that improved wellbeing has had a positive impact on clinical outcomes for the FHT at BCUHB. This may be encapsulated in the statement below;
The programme has helped me to recognise and think about my state of mind, and the ways in which I use this self-knowledge to improve my performance and wellbeing. When having a ‘bad day’ I have a framework to identify the way forward.
The following outcomes have been noted:
• improved knowledge and skills regarding resilience and wellbeing at work
• developed new knowledge and skills regarding self, peer and team coaching to improve resilience and wellbeing at work
• improved overall performance of the FHT so that the delivery of the FHP, being undertaken by BCUHB, had a greater chance of success. This in turn has contributed to the successful delivery of a new service
• reduced the challenges of workplace burnout and disengagement
• made staff feel valued during a difficult time of organisational change
• provided an intervention that has long-term impact, so that the positive effects continue to play out in the future.
Participant feedback
Below is some post-project data from FHT members after receiving resilience and wellbeing coaching:
“I have noticed my ‘score’ on wellbeing impacts others so if I’m around a ‘5-7’ I know I can be negative and proactively self-coach myself back to a better place. I have used the technique to help others in my clinical team with positive outcomes.”
“I am trying to be more conscious of my moods and to recognise and address the factors influencing me. I am also more aware of the influence my moods and attitudes has on those around me, and try to use this in a positive way.”
“ I recognise triggers and reflect how I relate to colleagues and put in interventions to bring myself back to equilibrium and nearer my ‘best self’. Also, I am more aware of this with my colleagues and often consider whether they are in a good place and how I can potentially modify my own behaviour to help the process.”
Key learning
The provision of resilience and wellbeing coaching skills and knowledge can have a positive impact on staff. The message the organisation sends to the staff is that they are valued. By valuing them the organisation also demonstrates that they place a high value on the quality of care the staff delivers.
The lasting impact of the project is that the FHT and the organisation know that in order to provide optimal patient care they must also look after the staff who deliver this. When staff resilience to workplace stressors is eroded and their wellbeing suffers, there is an impact on the quality and quantity of patient care that can be delivered. When trying to implement innovative ways of service delivery we can improve the chances of success if we coach our NHS staff into being in the right mind-set and by sharing the responsibility for their workplace wellbeing.
Who’s involved?
Dr Dee Gray, Resilience and wellbeing coach
Dee can be contacted at [email protected]
Dee’s role at BCUHB was that of resilience and wellbeing designer/trainer/coach.
Dr Dee Gray read Law at John Moores University Liverpool, and studied for the higher degrees of Teaching and Learning, Master of Philosophy, and PhD at Bangor University. Dee’s career includes that of research fellow/lecturer at Bangor University, leading programmes on learning from workplace error in the NHS, and senior manager at Welsh Government; leading the development of the Wales Leadership Academy, and public sector service reconfiguration in North Wales.
Dee gained her ILM VII Executive Coaching and Mentoring for Leadership qualification whilst working with the Welsh Government, and went on to establish the Coaching Network. Dee is a member of the Institute of Coaching – Harvard Medical School, and invited member of the National Wellbeing Institute.
Dr Olwen Williams is director sexual health services and consultant physician at BCUHB and can be contacted at [email protected]
Olwen studied medicine at Liverpool University before embarking on a career in genitourinary medicine in 1988. She was appointed to her current post as consultant in genitourinary medicine at Wrexham Maelor Hospital and Glan Clwyd Hospital in North Wales in 1992, and became director of sexual health services in 2007.
Her special interests are child sexual abuse, adolescent sexual health and HIV /AIDS. She is a member of the WAG All Wales Sexual Health Network, chairs the British Association for Sexual Health and HIV Welsh Branch and has been a statutory member Equality and Human Rights Commission Wales since 2007.
Dr Williams was made an honorary fellow of the University of Wales, Bangor in 2005 and was honoured with an OBE for services to medicine in Wales in the Queen’s Birthday Honours.