

Case study:
Central North West London NHS Trust
Building Resilience: Executive Team Development in a Changing NHS Landscape
Our client
Central and North West London NHS Foundation Trust (CNWL) is one of the largest NHS trusts in the UK. It provides a wide range of healthcare services to a diverse population across a significant portion of London. CNWL offers services in mental health, community health, and integrated care, striving to deliver high-quality, compassionate care to its patients.
According to the Kings Fund and other senior advisors to the NHS, it is clear that long-term thinking is essential to meet the challenges ahead. A failure to act to retain existing staff would be detrimental to the NHS and the health of the nation - this needs sustained action over the long-term to make the NHS a better place to work.
Like many NHS trusts, CNWL is grappling in this post pandemic world of back-to-back Teams meetings, ongoing restructures, increasingly complex systems of work, strike action, bed flow crisis, staff shortages with high agency spend – and as such finding time away from the day-to-day work pressures for the Executive team to come together has become increasingly important.
Our approach
We were initially asked to facilitate a 2-day offsite for the Trust with its senior executive team. We designed bespoke session in response to these demands with the aim to:
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Acknowledge the changes in the NHS and the impact that has on them as leaders.
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Understand themselves and their impact on others – through the use of psychometrics and the neuroscience of emotions.
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Develop working practices to get the best out of each other..
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Create high functioning team dynamics.
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Have space to think strategically on topics such as beds, finance, winter pressures and workforce.
These were all underpinned by the purpose of ensuring forward momentum of the Trusts priorities and long term future, and being a role model to their staff.
At the end of the offsite, the team made an active choice that regular sessions throughout the year were needed. Here they would continue to build and develop a highly functioning exec team to remain resilient to lead the Trust in a world of change and challenge.
Our solution and the impact
We proceeded to facilitate four Executive team development days across the year underpinned by the team principles defined by Patrick Lencioni and his “Five dysfunctions of a team”. In the lead up to each day, we undertook a diagnosis period whereby we would question to understand the key challenges and to scope the outcomes for the session. We would then design a bespoke day to meet those outcomes. Each of the sessions had a bespoke leadership development element that related to the most current issues being faced by the Executive at that time.
We have worked with this trust for the last 10 years and have supported the team during a period of substantial change both in the external environment but also in the team itself. We’ve helped to link the past of their system to the present one while always looking to the future.
We have worked supporting not only them but also their Trust staff from Board to Ward.
Over the last few years we have noticed the Executive putting increased emphasis on staff development and wellbeing. They are helping to create brave, thriving workplaces and enabling “sustained action over the long-term to make the NHS a better place to work.”
Contact us to find out more about how you can support the development and performance of your executive level leaders, enabling them to manage the tension between compassion and performance.
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Hear directly from the COO of the Trust
What made you reach out for this support?
I was building a new team of 12 senior leaders who were responsible for the clinical and managerial running of the whole trust. Initially I knew we would need some away time as a team to think about our challenges and how we would work together. From previous experience we thought that working with Ambito would be a good fit. What was obvious early on was that we would need to do this regularly to enable us to step back and reflect on what we were aiming to do, to change the culture within the organisation.
What was the experience like?
After a year of quarterly days away, it became clear to me and the Chief Nurse and Chief Medical Director that we were definitely benefitting from having a team coach and working with Ambito, taking time out of our busy clinical and operational days.
What did it enable?
We were able to operate at a more authentic level together and were able to refocus on our strategy for the next 3-6 months. We were able to build trust within the team and were able to accommodate people leaving well, with new people joining and getting to understand the culture of the team. It enabled us to understand what we needed to do differently as leaders to create trust and to set a new tone so our teams reporting to us could manage the challenges brought by the regulator at the time, and we were able to contain and support them in a very different way.
What was the impact?
We had a better outcome than expected, we built trust, and we stayed strong together, performing better than before. The trust built was critical in managing the challenges facing us, such as leading an organisation through a global pandemic.
What else comes up for you?
I can't think how any teams manage to build trust and reflect on the challenges they face if there isn’t space to step back from the day-to-day operation together as a team on a regular basis. I would also advocate having a team coach as it gives the leaders the opportunity to play a different role in the team and gain a different perspective.