Adopting the LiA way of working is not easy, it is not for the faint-hearted, and it can be difficult to persuade staff at all levels that this is not just ‘another initiative’ which arrives with a bang and then fizzles out.
The Chief Executive is the main sponsor of LiA in any Trust, and it is important that their role is not just as a symbolic figurehead. The success of LiA lies with an unshakeable tenacity and unwavering belief from the top that LiA is the right thing to do and everyone must play their part.
John Saxby, Chief Executive of Pennine Acute Trust says:
“I want leaders at every level in the organisation to engage with and support our staff so that they can be really involved in making the changes we all want to see. This is the key to giving our patients the care they deserve and our staff a real pride in working here. Nothing is more important.”
Frontline staff, medics, nurses, midwives, administrative staff and others who have direct contact with patients and families are those best placed to talk about what is working and what needs to change. It is these very staff who are empowered through LiA to make the changes, but this can be challenging for people at all levels as LiA really does ‘invert the pyramid’.
Julie Owen - formerly a Matron and Divisional Nurse Manager - is the LiA lead from Pennine Acute NHS Trust. Julie says:
“There are some key success factors in getting staff to make a ‘fundamental shift’ in the way they work and lead:
- There needs to be a ‘compact’ between the top of the organisation and the teams ‘on the ground’. Key leaders need to get behind the need for a fundamental shift, making it their personal and collective mission to make this a great success and to embed LiA into operational and strategic thinking
- It is vital to involve and include staff from across traditional boundaries and structures, with clinical, medical, managerial and operational talent working together ‘in the same room’: sharing perspectives, understanding where colleagues are coming from and working together on solutions
- We need to overcome the prevailing culture of ‘learned helplessness’ from staff who have succumbed to all the usual ‘reasons why not’.... Instead we should give staff ‘permission’ to deliver the changes they want to make, encouraging them to challenge existing behaviours, break through the obstacles, and believe that they can personally and collectively fix things for themselves and their patients
- Our local clinical leaders and front-line staff need the support and direct involvement of all of their support teams - IT, HR, communications, administrative and clerical staff, and management ranks – to help them focus on their agreed clinical priorities
- A new way of working for better outcomes will only sustain if old ways of working are identified, challenged and stopped. We have to look at things that have ‘always been done that way’ through a new lens and ask what outcomes they are delivering. If the answer is none, or it is difficult to quantify, either stop the work or tackle it differently”.