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Case Study for Business Report: Islington General Hospital Staff Learning and Development Programme

About Islington General Hospital (IGH)

Islington General Hospital (IGH) Staff: Learning and Development Programme

Islington General Hospital is a large community hospital in North London.  It has a reputation for being one of the best hospitals in London, not only because of its excellent teaching facilities, but its modern, creative and advanced practices in many areas of medicine, including geriatric medicine and psychological services to the community.
Islington General Hospital (IGH):

•Employs 920 staff directly, and a further 237 staff in its residential establishments across North London;

•Deals with acute care medical cases in geriatric and psychology;

•The residential homes offer care for 98 patients, as well continuing social care once back in their community;

•Social care has been offered to over 300,000 patients across Ireland over the last 5 years;

•IGH has a long-standing, well-respected, reputation in the community and offers opportunities to provide an extensive range of excellent health and social care services designed to meet users’ needs, both now and in the future.

There are Government plans for changes to the way health and social care is organised, and IGH needs to review and improve its working practices, procedures and policies to ensure that it is able to retain its independent status, and thus its funding.

I. Most of the staff have worked at IGH for many years, and have, therefore, become used to their own ways of doing things.  This has resulted in a reluctance to change their behaviour, and a resistance to new ways of working. Many have been quite vocal in not wanting to adapt new working practices, despite Government funding depending on their meeting new criteria.

II. The hospital is concerned that they will lose their independent status, funding and highly regarded reputation unless working practices are upgraded, roles are reviewed, and staff adapt to changing demands.

III. The hospital governing board has issued targets for reducing patient complaints and to ensure that those received are resolved within 30 days.  IGH has made a commitment to raising the standard of professionalism amongst its entire workforce, including the clinical and managerial staff.  This has resulted in a directive from the CEO and Executive Board of IGH to the HR department to develop and deliver a programme for all staff.  The staff will include a series of professional training courses on a wide range of subjects to further support their strategic goal.

Key Issues to Address

IV. ISH has an extensive and up to date online library of information available to all staff on the hospital intranet. This includes all the hospital policies and procedural documents, minutes from meetings and Board reports. The quantity of information is too wide ranging and lacks clarity for users.  This has resulted in the library not being used frequently nor by all staff.  Most staff, including the clinicians, administrators and managers cite lack of time to use these as well as they might.

V. Appraisal and personal development courses are run within the hospital but not in the residential homes, however, attendance is low and take up of the appraisals themselves by managers is very poor. In 2017 IGH carried out a review of their appraisal processes, and discovered that:

• Only 15% of staff had been offered an appraisal during 2014/2015

• Inconsistent approaches by managers and clinicians towards appraisal with some senior clinical staff receiving this but junior staff being ignored

• Concerns about the high level of absence and sickness amongst the managers

• Staff lacked a true understanding of how they were being supported and developed in their roles and many said they didn’t see their  managers on a regular basis.

At present there is no formal system for monitoring appraisal or for managing support to managers and clinicians therefore, to improve the take up, a new policy has been developed by HR and sent round to all for reading and compliance. The target is to increase the current number of appraisals being undertaken by 60% within the next 12 months.

In April 2018 IGH appointed a new Clinical Director who began an immediate review of current systems, including the approach to clinical development alongside introducing a new competency matrix aligned to the expected performance and skill levels of the clinicians and administrative staff. A key issue highlighted was the lack of a structured career progression as often when reaching the top of their professional area, clinicians are moved into a managerial role resulting in less clinical time and more managerial admin time (80/20).

Many resent this shift and IGH are starting to lose good people externally to other parts of the healthcare system. Furthermore, clinicians are often promoted for their technical expertise and lack the ability, and particularly the emotional intelligence and people skills, to manage others.  They are excellent clinicians, but less effective at working and compromising with others, leading to conflict within teams.

Consultancy Brief

This conclusion was supported by both poor scores (and poor returns) on the annual ‘Reaching Your Potential’ employee satisfaction survey, and perceived lack of fairness around existing development opportunities for clinicians, managers and other administrative staff.  Many said they felt undeveloped and lacked support in moving into new roles.  Many also felt they lacked the people skills to be effective managers. After consideration, the Clinical Director and the Board agreed to a more structured and transparent career development structure.

They also felt that a coaching programme, with particular emphasis on people skills, emotional intelligence, stress management and well-being could be offered to staff in their career progression. This would address the lack of emotional intelligence perceived in clinicians by their colleagues, and help all senior staff and clinicians manage their workloads, and personal relationships effectively. IGH had no idea how to begin a new learning and development programme to include all of these issues and decided to call in consultants to help them.  They are keen to safeguard their future, in terms of reputation, independence, and financial security and want the very best advice in making changes.

You are a consultant at a large firm specialising in helping organisations make changes through the design and implementation of learning and development programmes.

You are asked to write a report and make recommendations on:

The key issues that need addressing for this hospital [choose 2-3 issues max]

To prioritise the training needs of all attendeesTo design the programme to suit different needs of participants including prior learning,

personality, learning style preferences, ability and any cultural differences

To demonstrate how the programme you recommend will help Islington General Hospital

a. improve their performance

b. enhance well-being at work

To make recommendations for a future change programme for the clinicians and managers

Your report will be in standard report format with heading, and sub-headings.

It will be 2200 words in total (excluding Title and References).

You will support your recommendations with researched, current articles and clear references.

A literature review, with critical analysis and relevance to the HR function is expected.

You will summarise your findings in a way which could be presented to the Board Members of the hospital.

Please see the Module Guide for extensive criteria of presenting this, as well as the marking guide.Reports are expected to be written in clear English, with appropriate grammar, spelling, punctuation and syntax addressed.  Ariel font, 1.5 spacing, single sided. Reports are submitted by Turnitin.

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