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Background Care Quality Commission (CQC) is the independent regulator of health and social care in England. The Commission’s role is to monitor, inspect and regulate health and social care services in England. It is operating within the wider health care landscape with increasingly less resources. The NHS has a strong track record of delivering value for patients and the public and as a result has an enviable reputation for excellence and reliability. The challenge for the CQC is to protect this legacy within a changing environment and ensure that health and adult social care services are provided in a safe and high quality manner. According to Schein (2010), organizations similar to CQC face two key problems. One, internal integration (how we work together effectively). Two, external adaptation and survival (how we define and pursue a shared purpose). Regulatory bodies have a particular challenge in shifting to a more collaborative culture and decision making processes. Changes Made – Implementation of the program The program involved various interventions including personal coaching, action learning, virtual learning, integration events and 360° assessments. Aims Our primary research question is whether a tailored leadership development program can result in systemic, organizational, as well as individual change? Specifically, we will explore: • What impact has the development program had on individuals within CQC in terms of competence development and behavior change? • What impact has the development program had at a systems level in terms of organizational results and the transforming the culture of CQC? Overall Aim: To develop a community of leaders at all levels that help shift a hierarchical culture into a more participative, agile organization. Impact Measurement The changes in external adaptation and internal integration were evaluated using the Kirkpatrick framework. Next steps The next steps of the project involve completing final data collection stages, we hope to include CQC company metrics in our analysis as we continue to learn from the evaluation. Specific actions include putting in place more work with the executive team around strategy and how to sustain the changes and to introduce quality improvement methodologies to sustain the changes and improve the culture further… Organizational change through leadership development: The systemic impact in the UK’s Care Quality Commission by Lee Waller, Guy Lubitsh, Tessa Misiaszek & Grace Brown Outcomes Qualitative data Suggests there has been significant improvement in terms of external adaptation relating to managing key stakeholders and providers, particularly the media. There has also been positive impact on internal integration involving a new strategic framework, innovative thinking, communication, relationships and personal/team resilience. In particular, participants reported reflecting on their leadership style more so than they had done prior to the program, and reported delegating decision making to people closer to the ground. Quantitative data The table below details the percentages of respondents who (having had the opportunity) felt more confident to “some extent” “to a great extent” and “to a very great extent” in performing a particular behavior or action as a result of the program. Reflecting on Leadership style 75% Requesting feedback from others 74% Being more involved in leadership conversations 73% Adapting to uncertain situations 70% Tackling difficult conversations 74% Reflecting on personal development and progress 73% Collaborating more broadly across CQC 72% Practicing the values of CQC at work 53% Experimenting with new ways of working 74% Addressing issues openly 70% Generating alternative approaches and contingency plans in the face of challenges 74% Demonstrating resilience in the face of challenges 65% Ashridge Executive Education Ashridge, Berkhamsted, Hertfordshire, HP4 1NS Contact the Research Office Tel: +44 (0)1442 841146 | Email: [email protected] Program Design The program was designed to result in a systemic change across the cohorts through internal integration of individual change in beliefs, attitudes and behaviors around ‘whole self’, ‘leadership, power and participation’, and ‘whole organization’, and external adaptation around ‘change and continuity’ and ‘good, safe care’, creating a shift in thinking of a critical mass of leaders modeling The CQC Way across the organization and enhancing external perception of The Value of CQC outside of the organization. A multi-disciplinary team of 700+ managers were involved in the culture change program, these include professionals from hospitals, adult social care homes, primary care and intelligence and support services. Regulatory bodies have a particular challenge in shifting to a more collaborative culture and decision making processes. From our initial inquiry, we identified several internal difficulties within CQC: • Exercising power and authority is challenging, • Little trust and collaboration across Directorates • Managers or leaders need to improve self-awareness. At the same time, there were challenges on the external adaptation: • lack of clarity on the role of the organization, • not enough agility in leading change To help with the above, we have designed and delivered a leadership program to address the following; Internal integration (how we work together effectively) • Whole person: enabling CQC leaders to better understand themselves and their colleagues by learn how to develop and deploy their full talents at work, and create closer, more trusting working relationships. This in turn will foster behaviors such as better information sharing, more robust feedback seeking and giving, and a sense of shared, peer to peer responsibility for action. • Distributed: learning when and how it is appropriate for leaders to take up or give away power in CQC, will increasing the agility and productivity of the organization by reducing dependency and devolving authority to where it is most effective. • Collaborative: enhancing the quality and diversity of interactions between CQC staff. Helping them to think, talk and act together on complex challenges and better harness their collective knowledge and talents. ‘Connecting up’ External adaptation (how we define and pursue a share purpose) • Adaptive: helping people to adjust and adapt in resilient ways to the continuous change they experience, while maintaining continuity in their duties they perform. • Purposeful: better able to recognize and focus only on those activities that add value and help CQC achieve its ultimate goal. Filtering out the noise. • Creative: strengthening people’s ability to embrace innovation, continuous improvement and experimentation so that CQC plays a valued role in shaping the future of care. Post Module Program Review Forms – Level 1 Reactions Capture: participant reactions to the program e.g did you find the programme engaging/ relevant? Post-Program Impact Survey – Internal Integration and External Adaptation Capture : Evidence cultural impact through assessment of development of competences which has been designed to feed internal integration and external adaptation. Pre and Post program 1:1 interviews, focus groups, and observation – internal integration and external adaptation Capture: The change required at individual, team and cultural levels. In order to determine any change to these themes we will repeat the qualitative data collection after nine months and at the close of the program. Post Module Impact Surveys – Level 2 Learning Capture: participant learning from the module e.g did the program meet your learning objectives? 8 week Post-Program Impact Survey – Level 3 Behavior Capture: changes in beliefs and attitudes, and application of learning. Individual Change - Competence Development and Behaviour Change – Levels 1, 2 & 3 Systemic, Organizational Change – Level 4 Schein, E. H. (2010). Organizational culture and leadership (Vol. 2). John Wiley & Sons. Evaluating training programs. Tata McGraw-Hill Education, 1975.
