Culture Change Case Study 2 - North London Hospice
The two years I spent working with the North London Hospice was truly transformative – and not just for their organisation. Working with their managers and leaders helped me develop the Time & Energy auditing model that I find profoundly valuable for many of my clients, across a wide range of different sectors.
As an organisation that deals with the emotional toll of death, clear and compassionate leadership is vital. Yet managers across the organisation were struggling, both to manage their time and to collaborate effectively. The lessons we learned along the way proved vital.
The organisation
The hospice environment offers a unique set of challenges for its people. It demands an odd mix of compassion and commercial thinking, offering a very human need in a very competition-driven world. It can also suffer from an in-between identity – are they little voluntary organisations or professional healthcare providers?
At the time, the whole industry was facing a difficult financial outlook, not only with the pressures of the economic recession, but also with the contract culture and reformation of partnership processes across the care sector. Beyond these wider issues of the industry, North London were expanding their operations into a wonderful new centre that would broaden the reach of their services across the area.
As one of the few (if not only) multi-faith hospices in the country, their culture and approach made them a cutting-edge organisation within the hospice sector. With the issues facing NLH, their senior management decided that a unified culture across their leadership would be absolutely vital.
The challenge
To help them face both their financial pressures and their expansion plans, NLH needed a programme that not only strengthens all managers, but also strengthens the capacity to be culturally one organisation, led by management together.
Like many complex organisations, they faced significant challenges of operating in silos – with sections of social carers, medics, allied health professionals, fundraising and administration all working apart. And, as we progressed through the programme, we also faced issues that went beyond normal time management. We noticed that managers and leaders would have to switch from wildly different environments and roles in very short order. Crucially, they would have to step from the empathy and grief of the hospice bedside, to the more traditional stresses of team leadership or strategic decision-making. Managing these issues would prove to be vital.
The programme
I designed and led a program of interventions. The main intervention was a bespoke ‘training program’. Our 2-year programme was designed to work across all of their managers and leaders – around 40 in total, from their IT Lead to Head of Laundry – to create a common understanding of management and leadership, a practical set of management tools and an internal induction program for any new leaders joining the organisation. Alongside the program i also led Action Learning Sets, Coaching for the Directors and some strategic planning events.
This programme would tackle difficult dynamics, not only in terms of team management and interpersonal relationships, but also in terms of balancing direct patient work and staff management. With the shifting financial climate and the planned expansion, managing change was high on the agenda, while setting and maintaining boundaries was also a major theme.
The work brought together a number of tools and techniques. After an initial workshop, to establish aims and introduce the core values, all participants went through two modules – each with facilitated workshops, followed up by a day that harnessed action learning sets. In between these modules, the participants were asked to complete a learning log, in order to facilitate discussion in their own 1-to-1 meetings and supervision sessions.
It’s not uncommon to encounter time management issues – streamlining workflow and using our time efficiently is important for any organisation. A big part of this programme was to look at where and when energy and time gets lost and becomes stuck in the systems. For NLH, it became clear that the time any particular task took wasn’t the only issue – the emotional impact of that task was also central to their effectiveness.
So I developed the Time and Energy audit – a way of assessing each individual’s workload. This wasn’t only useful as management tool for this group of leaders to more effectively lead, but also as a self-management tool for them to explore their motivations and better harness their own time. (You can read more about the audit here).
Outcomes
The programme helped lay a strong foundation for NLH, with a coherent approach to management across the organisation. This not only helped break down the barriers around silos, but also gave the leadership the tools to build stronger teams, create a more positive (and compassionate) working environment and drive a higher standard of service.
Many of the practical tools and processes we set in motion throughout that process are still in use across the organisation, with the Time & Energy tool and learning log used in 1-2-1s (like staff appraisals and HR surgeries), the questioning approaches of action learning sets, and a more listening-centred approach throughout
“It reminded me of the reasons why I chose to be part of the Hospice team.”
This has helped create a more resilient workforce, with greater integration and reflexivity, which is a crucial resource for embracing change in hospice work. The management are both more strategic and more open, operating with a greater awareness of leadership styles. Vitally, the programme also gave them a greater capacity – not only to build on the foundations of the programme to lead their own development, but also to support one another as part of a more holistic and integrated leadership structure
For me, the programme showed the value of looking at the emotional impact of our work, together with the time it takes. By monitoring and measuring the impact of both time and energy, my work with North London Hospice helped me build a tool and an approach that has been instrumental in helping a wide range of other organisations.
“It was an interesting and valuable programme which re-energised me and altered my way of approaching issues. It reminded me of the reasons why I chose to be part of the Hospice team when I joined the organisation.”