Improving culture and leadership through national and regional programmes – Liverpool University Hospitals NHS Foundation Trust
Liverpool University Hospitals NHS Foundation Trust (LUHFT) is a research active hospital, supporting and facilitating new innovative ways of providing healthcare to improve patient experience and outcome. The trust has a combined workforce of over 14,000 staff serving over 700,00 people as well as delivering a range of specialist services to a regional population of over 2 million.
Addressing Areas for Improvement
The 2022 National Staff Survey results highlighted several areas for improvement in Liverpool University Hospitals NHS Foundation Trust (LUHFT). Six out of nine survey themes had declined from the previous year, with the lowest scores in ‘We are always learning’, ‘We are recognised and rewarded’, and ‘Morale’.
LUHFT simultaneously delivered the NHS England Culture & Leadership Programme and the People Promise Exemplar Programme from 2022 to 2024.
These initiatives aimed to improve organisational culture, staff experience, and overall staff engagement through a structured framework and high-impact interventions.
The Steps to Success
The organisation engaged with and delivered the NHS England Culture and Leadership Programme: As part of this they:
- Established an internal Change team and CEO led Culture Steering Group
Established a fully recruited Culture Network, which reached over 40% of the organisation.
2200+ Leaders & colleagues attended Kindness into Action Masterclasses.
350+ Leaders attending ‘Leading the LUHFT Way’ Development programme.
Launched Leadership Framework and Self-Assessment tools.
Launched LUHFT’s first Shadow board programme.
Lunched the BAME Elevate leadership programme (in partnership with other trusts) and the Clinical Leaders Programmes.
Alongside this the organisation was part of cohort 1 of the People Promise Exemplar programme and had a dedicated People Promise Manager. The deliverables of the People Promise Exemplar Programme were:
- Launching Staff Carers Passport which supports colleagues who are unpaid carers across the trust by helping conversations around their support needed.
- Re-designing and simplifying appraisals to help colleagues to have meaningful, quality conversations. Through this compliance increased from 32% to over 80%.
- Delivering a flexible team-based rostering pilot, giving colleagues greater choice and control in their working patterns. This significantly lowered feelings of stress and increased work life balance.
- Launching an Internal Transfer Scheme which makes it easier for Nurses and Health Care Assistants to move around within the trust. This helps LUHFT retain talent.
- Launching a Staff App which helps colleagues access trust-wide information, wellbeing information and work perks from where-ever they are. Over 4500 members of the Liverpool University Hospitals NHS Foundation Trust workforce have downloaded the App so far.
The Impact of Improvement
The 2023 National Staff Survey results showed significant improvements in all nine themes, with the ‘We are always learning’ theme seeing the biggest improvement. Additionally, there was a notable increase in staff recommending LUHFT as a place to work.
LUHFT were one of the most improved organisations in the North-West region in terms of Staff Survey results between 2022 – 2023 and were the most improved People Promise Exemplar site in cohort 1.
In addition, LUHFT saw a reduction in staff turnover overall, especially for their clinical staff.
As a result of these and other improvements, LUHFT were able to exit a SOF4 Improvement process.
Key Learnings
Keep People and Culture as continuous conversations at the Board level.
Have as many people as possible leading on cultural change, the more collaboration, the better.
Hold your nerve, cultural change takes time. You may have to keep doing things for a while before you see any impact.
Be honest and thorough in identifying areas for improvement, focusing on actions. Show you’ve listened and tell colleagues what you’re doing to improve.
Continuous Improvement
The next steps include implementing the Flex Your Life at LUHFT scheme with a new flexible working policy and launching LUHFT’s People Strategic Plan for 2024-2029 in Q2 2024.
The trust will continue to understand colleagues’ needs to tailor plans and deliver on the NHS People Promise. These initiatives will be embedded as part of the new 5-year Trust Strategy, ensuring ongoing focus on staff wellbeing and engagement. The organisation is currently engaged with work to segment and understand the diverse needs, wants and motivations of different groups within their workforce to tailor future improvement initiatives.
Contact Information
For more information about this case study contact:
Pip Gaskell
Director of People Effectiveness on [email protected]