David Bradley externally appointed as the new South London & Maudsley (SLaM) CEO needed to better understand his organisation; set realistic goals; and assure their delivery.
SLaM is a complex organisation with c50 national specialties; it is the UK’s leading psychiatric teaching hospital; & works internationally. The new executive team needed to navigate competing priorities:
- Eliminating a £14m underlying deficit agreed with NHSI & funding a Trust new build project
- Forthcoming CQC inspections, SLaM was too close to an overall ‘Requires Improvement’ rating
- Wards running too hot, leading to significant use of out of area beds (poor quality/high cost)
- Poor staff survey scores especially within inpatient areas & an unclear vacancy fill gap
The VOT team introduced a process used in the military for fast moving and complex situations designed to clarify and orientate leaders and generate momentum called ‘Mission Analysis’. A key element of which is to establish a ‘main effort’. This is key to ensuring goals are achieved without dilution across competing priorities.
The initial ‘main effort’ in this case was optimisation of the core adult acute care pathway to eliminate out of area bed usage (poor quality care & multi-million cost pressure). Directorates’ mission cascade linked directly to this main effort.
This level of objective setting rigour and open cascade can be alien, so we coached the team through it. We added value further by:
- Deploying a ‘message house’ approach for the Exec to stick to when communicating internally about SLaM’s improvement plans
- Taking a lead on pulling together situational analysis to inform Mission cascade
- Facilitating Execs to form their Missions and be ready for CEO challenge
- Ensuring governance was in place to track progress with improved visibility
There was an immediate response within the adult acute pathway, which quickly and fully addressed the out of area bed overspill. Feedback was positive: ”Good surfacing of challenges” “Really enjoyable…all on board”