Challenge

Schools Health in the London Borough of Hammersmith & Fulham received a large financial investment from the local primary care trust (PCT) to help it improve school nursing. Head teachers had complained of a patchy service – the result of too few nurses spread too thinly, a lack of dedicated school nursing leadership and low morale. The funding allowed for the hiring of new nurses, but it also required the adoption of new structural and behavioural ways of working as a return on investment.

This transformation was part of a broader change that involved merging community health services from three boroughs into the Central London Community Healthcare NHS Trust (“CLCH”). Schools Health was restructured into six new clusters, necessitating team and school changes for some nurses.

A significant challenge was encouraging collaboration and cooperation throughout the organisation, in ways that the traditional siloed structure had made impossible.

To support the transition, Schools Health engaged Harpal Dhatt, an Organisational Development Facilitator at CLCH. Harpal introduced the Opportunities-Obstacles Quotient (QO2) Profile and Team Management Profile (TMP) to help the team come to terms with change.

Approach

Harpal developed a four-part program to assist the Schools Health team in identifying strategies for coping with change and challenges, accelerating team alignment, boosting morale, and developing more collaborative work practices.

1. First, Harpal introduced the QO2 as a key tool to facilitate one-to-one discussions, with the goal of helping the team understand why they felt the way they did about change.

2. Second, half-day sessions were conducted to familiarise the team with the concept of change.

3. Third, Harpal worked with senior team members to share and discuss their QO2 Profiles with each other. They then completed and shared their TMPs with the wider team as part of a whole-team workshop. This helped them understand each other’s work preferences and communication styles, which created trust and built confidence.

4. Fourth, Harpal embedded behavioural change into everyday practice by coaching the senior team on using TMPs for personal development, planning and motivation, designing work plans, and determining team objectives. Leaders moving into new teams were encouraged to share their TMPs to build mutual understanding and knowledge, which ultimately improved teamwork, effectiveness, and customer satisfaction.

Outcome

Using the QO2 and TMP, CLCH saw a marked change in attitude and receptiveness to new ways of working which led to a greatly improved service. A more open approach to working together built trust, and ultimately increased collaboration.

A greater understanding of one another led to more effective communication, improving work relationships. Leadership also improved with a more consultative approach to goal setting which helped address anxiety levels in the team. Heads of school reported positive feedback with nursing staff becoming more visible, increasing perceived availability.

"I needed to improve the way I communicated with people. I used to be selective with the information I shared, but the exercises and discussion taught me that people want the information, even if it is unpalatable or if the situation might change. A more open approach has helped to build trust. We now understand each other better and communicate more effectively which has benefited team relationships.”

Catriona Noble
Senior Manager of the Schools Health team in Hammersmith & Fulham

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