Wolverhampton City Primary Care Trust

Wolverhampton City Primary Care Trust (WCPCT) provides services to improve the health and well-being of 237,000 people, from an annual budget of around £450 million. In particular, it has to show that it is fit to apply ‘World Class Commissioning’ (WCC).

Approach

So, in July 2008, the Chief Executive asked Collinson Grant Healthcare (CGH) to help the executives draw up a Strategic Plan to submit to the Strategic Health Authority (SHA) as part of the assessment for WCC:

• to ensure that the views of the board, including non-executive directors, were fully represented
• to acknowledge the position of other stakeholders
• to review operational targets and the application of resources
• to challenge managers and other interested parties about the assumptions made
• to define the outputs and who should be responsible for them
• to prepare and debate the content of the 5-year plan
• to coach the PCT Board and senior managers in the content of the report.

The timescale was challenging. We had to work hard to win the confidence of the clinical and managerial staff and the board. It was important that everyone consulted should feel that his or her views had been properly represented. The Strategic Plan was published in October.

Secondly, we were asked to produce a coherent plan for Organisational Development. We analysed the PCT and its personnel, reviewed capabilities and the agenda for change, and consulted widely on the priorities for action. A matrix was designed to map the ‘organisational requirements’ against the competences and elements of WCC. The plan defined 37 interventions to promote organisational change in a systematic and controlled way.

• In the context of WCC, 15 key aspects of the work of the PCT were chosen and a structured interview was devised around them. This was a bespoke diagnostic tool for an Organisational Audit
• Structured 'one-to-one' interviews gathered opinion about needs for development and training
• Interviews were held with nominated Board members, Executives and Directors
• The data were gathered, analysed, categorised, and then verified with the directors and other senior managers by means of anonymous voting
• 50 employees were shown how to assess their own skills
• Approximately 200 capabilities from WCC were incorporated into the language of the NHS Knowledge and Skills Framework
• 54 organisational improvements were categorised, of which 37 were given immediate priority by the directors
• The 200 personal competences were given unique identifier codes and cross-checked for alignment with the 11 WCC competences and the strategic plan
• Interventions for development were agreed with the executives and - by means of a prioritisation matrix - directors were made accountable.

Finally, we worked with the senior and middle managers, the organisational development Steering Group and the Directors to draw up detailed, credible plans to implement the 37 prioritised interventions and achieve the agreed targets with the available resources. We defined the outcomes, specified the critical tasks and milestones, recognised the risks and registered them for future use, and consolidated the plans into a master document.

Results

These inter-linked phases produced three main outputs:

• a series of plans and related documents that helped WCPCT to articulate its desire and plans to achieve WCC status
• a recognition of the importance of developing people and skills
• agreed project plans to help senior managers put the strategy in place.

Lesson learned and transfer of skills

This project involved contact with staff throughout the organisation – from the board to frontline employees. We had to work hard to use straightforward concepts and concise language to express the precise objectives of the organisation and what everyone needed to do to achieve them. We used a number of communicating techniques, from structured and group interviews to confidential voting sessions. In preparing the Organisational Development plan, we showed many employees how to define competences and apply them to their own responsibilities.