GUY’S AND ST THOMAS’ NHS FOUNDATION TRUST: CARING FOR CARERS – PART 1

Just over two years ago, Guy’s and St Thomas’ NHS Foundation Trust shared in this magazine how its internal coaching and mentoring service was improving patient care, among other benefits.
In this series, we look at the Trust’s latest steps towards developing a coaching and mentoring culture.
Part 1: background, updates on the internal service, and the online learning programme.
Hannah Datema and Bhaveet Radia report

 

The NHS has experienced profound financial challenges in recent years, requiring staff to provide the best patient care possible with ever-tightening funding. In 2013, Guy’s and St Thomas’ NHS Foundation Trust decided to support staff via a coaching programme, designing a formal mechanism to offer a space for staff to discuss ideas, as well as personal and professional development, writes Hannah Datema.

As we shared in Coaching at Work in 2016*, there were two organisational objectives: staff development, support and retention, and enhancing patient care through innovation – both against a background of deep financial challenges.

Using coaching to care for staff and to ensure that morale is robust is key to enhancing patient care and creating ideas to save money. Staff are more likely to be focused, have a greater sense of purpose and show commitment to the organisation and offer discretionary effort when they feel valued and supported, have ownership over their work, and when they recognise the positive impact they have on service development. Our objective was to use coaching to release the true talents and strengths of our staff, at a time when we needed them most.

 

Our approach

The scheme offers a simple and effective introduction service. Staff register for an internal coach, and are encouraged to meet for six months to discuss their personal or professional issue.

Focus groups and surveys were held with staff. Key findings included:

  • Registration needed to be quick and easy Staff wanted excellent support with no barriers. We reviewed registration processes and stripped out anything unnecessary.
  • Staff training as coaches were unable to leave clinics for multiple days of training They requested shorter training programmes to learn practical coaching skills, with follow-up support at regular intervals to learn/practise with other coaches. We designed a one-day initial training event, supported by CPD and supervision events through the year.

The service is bespoke, so we respond to individual learning needs and match internal clients with the best coach to support their development. To support learning for all, we created an online area with 205 resources for staff to read, watch or listen to.

 

Outcomes

  • 704 staff have accessed a coach or mentor
  • 189 staff are currently formally trained as a coach or mentor and offering their services
  • 682 staff accessed Coaching Skills for Managers training in 2018 alone

 

As we shared in the previous feature, findings from an independent evaluation by London South Bank University included that the programme helped staff develop skills to deal with challenging situations, that coaching and mentoring opportunities can support and develop staff in situations such as career development, role transition and challenging work experiences, which may increase retention and morale, and that Trust staff value the programme, believing it to have benefits across the organisation.

The Trust’s chief people officer, Julie Screaton, for example, says, “The coaching service works effectively within our wider workforce strategy, and the supervision programme adds to the wellbeing, resourcing and support of the coaches, as well as creating a dynamic community of practice so the programme remains flexible and effective.”

And one internal coaching client says, “Coaching has had a profound effect on me. It has given me the space and opportunity to discuss professional and personal issues in a neutral capacity; it has helped me to gain clarity, direction and focus. The process helped me to feel valued in the organisation.”

 

Achievements to date

We are the largest internal coaching and mentoring service within the NHS, and frequently ‘mentor’ other Trusts to support them to implement a coaching service fit for purpose within their own organisations. The Trust chairs the ‘pan-London Coaching Champions Forum’, a network of 25 NHS organisations, to share best practice, ideas and economies of scale.

Our awards and recognition:

  • Gold Award, People Development Programme of the Year – Public Sector Category, The Learning Awards 2019
  • Bronze Award, Best Training Partnership and Gold Award, Best Coaching and Mentoring Programme, Training Journal Awards, December 2018
  • Finalist, Best Public Sector Programme, Training Journal Awards, December 2017
  • Gold Award, Best Coaching and Mentoring Programme, Training Journal Awards, December 2016
  • Silver Award, International Corporate and Social Responsibility Excellence Awards, August 2016

 

‘Caring for the carers’ is the biggest achievement of the service:

“I feel more able to negotiate with members of staff at a senior level who have input in decisions that affect patients to ensure I am able to put my point across, thereby positively impacting patient care for a number of patients.”

Pharmacist

 

“My mentor was excellent at listening, providing me with resources to refer to and constructive feedback. She has given me encouragement to continue to push forwards despite encountering difficulties. I felt like I received an additional boost and support during a challenging time in my career. It has shown me that improving patient care is definitely a marathon not a sprint and mentoring is a great way to keep you energised and motivated while creating sometimes difficult organisational change.”

Service transformation lead

 

“It helped me to build my confidence and gain new skills in managing a ward and approaching difficult situations differently. It also helped me to look for a positive outlook on things that I may otherwise not have had.”

Senior staff nurse

 

  • Hannah Datema is the Trust’s coaching and mentoring development manager

The Trust’s blended online training programme is increasing accessibility to high quality coach training

Coaching has gained significant traction across the Trust, however, demand for courses is constantly exceeding supply. To address this, an innovative blended training programme was developed, led by the Trust’s coaching and digital education leads and co-authors of this section of the article, Hannah Datema and digital learning development manager, Bhaveet Radia.

The vision of the programme was to offer an interactive and collaborative experience which has identical learning outcomes as the face-to-face programme but delivered in a more scalable way. We worked with coaches to understand how they developed their coaching skills, and the most instrumental parts in their training.

This showed the importance of:

  • Learning from other staff and sharing experiences
  • Practising the application of coaching theories and models
  • Getting feedback to consolidate their learning
  • Learning from other coaches’ experiences

The challenge was delivering an interactive, reflective and discussion-based coaching programme, through an online and asynchronous platform. To do this, we developed a unique online pedagogy (see Figure 1).

We took an agile Kanbanesque (Kanban is a scheduling system for lean manufacturing and just-in-time manufacturing developed by Toyota) approach to managing the project, where content for each section was developed and designed simultaneously. This allowed rapid creation of the course, testing of ideas and gaining feedback. We could be innovative as we weren’t limited by short development timeframes.

The real innovation of this programme is the way it uses a range of cloud-based learning tools – YouTube, H5P, Genially, Google Docs and Padlet – and houses these within authoring tool, Articulate Rise, to provide an engaging and clean learning experience accessed on any device, at any time.

We used Articulate Rise to house our programme as it lent itself to our pedagogy and allowed us to embed content from a plethora of innovative providers. This meant our ideas were not limited by a single technology, and we could pick the most appropriate tool to teach each concept.

We used interactive videos to demonstrate coaching models, which we augmented with tips and questions, and bookmarks so students can jump to particular parts of the demo.

H5P created intelligent personalised feedback to qualitative questions by using keyword matching.

We used Padlet to create discussion and sharing areas throughout the course, where students could share their experiences and start discussions.

The programme is predominantly online, where staff work through 12 sections on coaching concepts, studying for 25 hours over 3 months.

The curriculum is based on Institute of Leadership and Management standards and is delivered via short videos, interactive demonstrations, readings and games. Webinars are also scheduled over the programme to consolidate difficult subjects and to provide an opportunity for students to practise with each other.

The main objective of this programme was to increase the accessibility of high-quality coach training across the Trust. We feel we have achieved these aims because:

  • These courses offer access to coach training for all staff, at any time, from anywhere, on any device. Face-to-face courses alone simply could not meet this demand or achieve the aim of embedding a coaching culture across the Trust as a whole.
  • The courses are of particular benefit to frontline staff, who run busy clinics and often cannot get away from clinical responsibilities to attend courses, as patients come first.
  • The programme was also developed to be repurposed, and we have also created two ‘light’ versions of our main course to provide flexible training options to our diverse workforce:
  • Coaching for All: an introduction
  • Career Coaching for Managers

 

All programmes are now available to all staff and engagement is strong. We are recruiting for Cohort 3 of the full certificate course, launching in April 2019. Over 100 staff took part in Cohorts 1 and 2 and we hope these numbers will continue to rise as awareness of the course spreads.

 

Feedback from pilot participants

“I like the website. It’s clear and easy to use and videos are helpful. The self-assessment is very helpful and made me think about different areas of practice – this is very good to put in. The noticeboard is good to encourage participants to answers other people’s threads to start a dialogue.”

“Just finished module 1 – I love it! Easy to access, a variety of ways the info is expressed and the little tasks to complete are really good for motivation and consolidating the learning. A big thumbs up from me!”

 

Evaluation

Our vision was also to create a programme that had identical learning outcomes to our classroom-based provision. Therefore, long- and short-term evaluation was key. We collect evaluation data throughout the module, and will complete a longer-term research piece to explore the impact of coaching developing within the Trust. This work will form part of the Doctoral research of this article’s authors, Bhaveet Radia, started in October at Cambridge University.

We started this project by understanding what effective coach training meant to our staff. This led us down an exciting path of unpicking and articulating what effective coach development was. Once we understood this, we were uncompromising in finding the right technology to deliver it. We didn’t let the technological tail wag our coaching dog!

By curating a range of tools, we provided an educational experience which drew the best elements of learning technologies across industries, countries and disciplines. This approach, when linked with a robust educational direction, led to an outstanding coaching programme, which we believe to be unrivalled.

Working with other coaches across the Trust during development was invaluable in ensuring we created an inclusive and accessible programme. Our wonderful coaches also feature heavily within our course, which has short videos and demonstrations throughout. This breathes life into the programme, motivates our learners and helps develop a coaching culture.

We think another unique element of our pedagogy is the value we add during delivery of our module. We have weaved in online webinars at important points in the programme to give our staff the best of both worlds: flexibility and accessibility through the online module, and personal engagement through the synchronous webinars.

We also have 11 feedback points in the module at which staff can flag areas where they are struggling or need further support. We also use analytics to flag areas where staff may be struggling. We then follow this up with updates or individual calls/meetings where required.

Finally, we believe we have initiated a step change in how online learning is viewed in our organisation. We have presented our work to senior staff across the Trust, who have been pleasantly surprised by the potential of online learning to deliver such training. It has led to a paradigm shift in the way online learning is perceived and discussed.

  • Next issue: Peer supervision

* H Reed (now Datema), ‘Building a healthy trust’, in Coaching at Work, vol 11, issue 6, 2016

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