NHS managers make decisions that affect not only the state of their business but the health of every UK citizen too. Nowhere has executive coaching been more important says Sarah-Jane North
The actions of any management team have a direct impact on the wellbeing, financial or other, of numerous people. That includes the customers, staff and shareholders, but none more so than those employed by the organisation responsible for the health of our nation.
The decisions and performance of senior executives in the National Health Service (NHS) affect the healthcare of most of the UK. Not only that, each of the UK’s citizens is a stakeholder in that organisation, as a patient and/or taxpayer.
Supporting the NHS in its work is the NHS Institute for Innovation and Improvement (NHS Institute). It aims to help transform healthcare by developing new ways of working, new technology and world-class leadership.
The institute has employed executive coaches for more than 10 years, developing an internal team of coaches and mentors. Recognising the demands on its strategic leaders, it funds four sessions of coaching for all newly appointed executive directors, chief executives and chairs, supporting them to be effective leaders who can rapidly deliver performance.
Selection process
In 2006, the institute established an assessment process for its pool of coaches. Delivered by Clutterbuck Associates, it was hailed for its rigour. Three years on the institute was looking to establish not one, but two registers.
The first would be a pool of 25 coaches to provide one-to-one coaching to those transitioning into the challenging new role of executive director, chief executive or chair. It had to align with the NHS philosophy for coaching, where the focus is on supporting individuals to learn rather than teaching or mentoring. Other requirements were for a wide geographic spread of coaches and competitive fee structures.
The second register would be a pool of 10-15 coaches to deliver team coaching. These would work with NHS boards and senior teams dealing with governance or team performance challenges. In addition they would facilitate a Board Development Tool, already being used with great effect across many NHS Trusts.
Other factors to be taken into account in delivering the assessment process were the central role the institute plays in managing and supporting coaching interventions and its desire to develop its own learning from the work, which would require a partnership approach with institute staff. Added to that was the need for effective supervision and the requirement for those on the existing register to re-apply.
This tender also presented a greater level of complexity than a standard coach assessment process that would normally focus on one-to-one coaching. Issues to be addressed included whether it was possible to design a selection process flexible enough to accommodate both individual and group contexts, how much commonality between the one-to-one and group process was achievable, and where and how a distinction would be made in the assessment methodology.
Coach assessment
The contract was awarded to i-coach academy. It had demonstrated an underpinning philosophy matching the institute’s new requirement, recognising the importance of selecting coaches for the purpose specified by the client, flexibility in meeting that requirement and a coaching approach to the tendering process. i-coach offered an assessment methodology mirroring the experiences the coaches would have once on the registers.
“The appointment of i-coach academy to design and deliver the coaching assessment process [was] a real collaboration and partnership. i-coach challenged us to really unpick what we wanted from the register and focus the criteria around this,” says Sue Mortlock from the NHS Institute.
Coaches were to be assessed against biographical, technical and behavioural criteria. “In designing the selection process we drew on our experience of coach assessment with other organisations and our work and research in developing professional coaching practice,” says Caroline Horner, director of i-coach academy, which has worked with organisations including Unilever and Standard Bank.
To mitigate bias, multiple assessors were used for each phase and they themselves had a range of criteria against which they worked. A moderator was also employed to ensure consistency of assessment across assessor pairings (with NHS assessors paired with i-coach staff) and multiple assessment days. Finally, to provide realistic scenarios, i-coach selected “clients” who were working as closely as possible to the senior level at which the registers were targeted.
Assessor training was another key part of the approach. NHS assessors were already well-versed in behavioural observation and capture techniques, allowing the training to build a shared understanding of the criteria.
Some 1,154 candidates expressed an interest (compared with 270 in 2006) when the list contracts were advertised. Each was issued a password to access the online tender documents. The latter required a large amount of information, and it was at this point that the applicants fell to 242 for the one-to-one register and 87 for the board register.
Shortlisting
A first sift was achieved by evaluating information weighted to the institute’s requirements, such as location, fees and accreditation. The second sift focused on technical criteria, resulting in an initial shortlist of 79 candidates, who were invited to take part in a 30-minute criteria-based telephone interview with both an i-coach academy and an institute assessor. These interviews sought examples of the coach’s experience of delivering coaching aligned with the requirements for the register.
“The telephone interviews were well-designed and we got a lot more evidence from the 30-minute slots than I would have anticipated,” reports one NHS assessor.
The interviews reduced the 79 to 48 applicants who were invited to participate in a half-day assessment centre, delivered in two parts. Each applicant was to coach an NHS client for one hour, discussing real issues. Candidates were then observed working in groups of six to simulate the peer supervision and community of practice work they would undertake if successful. After each exercise, applicants filled out a self-reflection questionnaire.
“The one-hour coaching session and the group supervision were excellent selection processes and really allowed us to see how the coaches worked and how they approached the process,” says another NHS assessor. “The group exercise was fascinating and created some excellent insights.”
A similar approach was taken to assessing board applicants. A paper-based sift reduced the interviewees, although the information requested, particularly on technical matters, reflected the different nature of this task. Best practice would dictate a live demonstration of coaching; however, the logistics of providing a realistic board scenario proved insurmountable and the 24 candidates were interviewed by a panel, one each from i-coach, the institute and the NHS.
Ultimately, the assessment produced 25 candidates who met the criteria and benchmark for one-to-one coaching, and 10 who met those for board coaching, of whom five met the criteria for both. “This was one of the longest, and most detailed, procurement processes I have been involved in, and everyone was thoroughly professional and efficient,” says one candidate.
Another notes: “Doing a one-hour ‘blind’ demo isn’t something I would ever do lightly again, but [it provided] a lot of learning.”
Assessment methodologies have generated much debate, but for the institute, “seeing was believing”, says Caroline.
Sue adds: “The rigour in the assessment centre closely mirrored the process for recruitment to our award-winning graduate management training schemes and I know colleagues found [it] extremely developmental.”
Ethical questions
Candidates’ differing levels of practice raised ethical questions for the assessors. At what stage should an assessor stop a demonstration because they are concerned the client is being damaged by the coach? How should an assessment team deal with behaviour they deem unethical, for example, a coach who offers gifts to the client?
The first dilemma means clients should have the chance for a debrief to discuss their experience – something provided in the i-coach/institute assessment process.
However, with the second dilemma, there is currently no formal mechanism for reporting coaches to an industry body.
The group activity, designed to simulate the institute’s existing practice of supervision and sharing, provoked mixed emotions among the candidates. Some found it a useful way to reassess their practice; others found it too challenging or felt it was unethical to discuss clients in this context.
“Some of the coaches really rose to the occasion and the discussion of their dilemma in the supervision group was illuminating, mirroring the challenges of multiple agendas that coaches negotiate,” comments one institute assessor.
The outcome
The assessment process achieved the desired result for the institute, producing two strong and diverse registers of coaches. The new registers went live in September, with the institute introducing a new template for the coach registers and running induction sessions, to ensure effective matching of coaches and clients. Some coaches have also been required to change or review their supervisory arrangements.
While evidence suggests assessment centres are more predictive of performance than other selection methods, i-coach academy and the institute have engaged the Institute for Employment Studies to run an evaluation in the first year.
“Some observers may question whether the level of investment in such a rigorous assessment process can be justified,” says Sue.
“Based on uptake from the previous executive coach register, the additional cost is around £10
per individual coaching session over the duration of the contract. We feel this investment is justified given we are working with the most senior leaders in the NHS.”
For more information about i-coach academy, visit www.i-coachacademy.com