Developing a five year strategy with Oxleas NHS Foundation Trust

The challenge

Oxleas NHS Foundation Trust wanted a strategy for the organisation that would make sense to the people delivering it and ensure the best care for those engaging its services. Working with Kaleidoscope, Oxleas began to design a plan for the next five years with the overall goals to:

• improve the health and healthcare services of the local population
• make Oxleas a better place to work for all staff

In order to meet these goals, Oxleas and Kaleidoscope decided to put staff and service users at the centre of the development process, using the wealth of experience inside and outside of Oxleas to make the best possible decisions for the future. We wanted the process of creating the strategy to radically change the relationship with staff and service users so they felt empowered to drive change.

In November 2019, we launched ‘Our Next Step’, a set of conversations to help create the future plan for Oxleas. Oxleas’ staff, members, service users and their carers all had important perspectives to offer, and ‘Our Next Step’ aimed to actively involve them all in the process.

Our approach

Over the course of six months, we heard from approximately a third of staff employed by the Trust and more than 500 service users, in a range of face-to-face events and through surveys.

Community engagement 

Kaleidoscope held a number of events across south east London and Kent which brought staff and service users together in one forum. We asked people to reflect on what made them feel proud to be part of Oxleas and where improvement is needed. These community events were attended by over 200 people, including:

• Oxleas staff
• community members
• service users and carers
• the council of governors
• the board
• clinical leaders.

We compiled the insights provided at these events into a shortlist of 10 areas Oxleas needs to focus on to become the best organisation it can be.

Team discussions 

We took a step back from the discussion so that Oxleas staff could have more intimate conversations within their teams. In these conversations, Oxleas staff considered which of the 10 areas were most important to them, and what specific ideas would make the biggest difference to their work as a team.

Ensuring everyone’s voice was heard

Our work included holding specific focus groups with the staff equalities networks – black and minority ethnic staff, LGBTQ+ staff, those self identifying with disabilities, and those with lived experience of mental health conditions. The meetings had a dual focus: understanding their needs as employees and also gaining insight about service users with their same (protected) characteristics.

We also worked with local Mencap services to co-design a survey for service users. We produced multiple versions of the experience survey, including paper and digital easy read options. For those unable to share their experience by themselves, we created ‘survey guides’ for carers and support staff to use to ensure that the views of these individuals were not missed.

So what’s changed?

Our Next Step set out to understand and use the expert insights of the community at Oxleas. From the process, the Trust gained a framework to help it decide what matters to most and how to prioritise. The principles that will now guide decision-making are:

• staff wellbeing is at the heart of every decision we make
• kindness is the most important part of what we do
• we help people meet their goals, and help others to improve
• we engage staff at all levels when planning the future of Oxleas
• we work with service users as partners, and with our communities, to improve the care we deliver.

Before Our Next Step even wrapped, the leadership team recognised the relationship with staff needed change. The engagement process was the first step, and finding a way to embed that exchange of knowledge and insight was the second. So we worked with Oxleas to establish ‘staff assemblies’ – representatives bodies with autonomy and resources to co-design local strategies and make improvements to working lives at Oxleas.

With the onset of the Covid-19 pandemic, it was critical to keep all staff and volunteers up to speed with developments, to reassure them that the leadership team was responding quickly and responsibly to events. Internal communications increased and weekly webinars were introduced, so that three months into the pandemic, 92% of staff felt that they knew what was happening and felt well informed.

The executive team are now working on the implementation plan that will show how the trust can make meaningful improvements in other critical areas, such as leadership, quality and safety, fairness and infrastructure. They continue to ask themselves, staff and service users the big questions such as “Do we understand whether the care we deliver helps people feel better?” and “Where are we wasting time and money?” so these problems can be solved together.

We needed help to develop a new strategy that reflected our values and gave us clear direction for the future. But more than anything, it needed to excite and energise our people. Kaleidoscope gave us just that, bringing great creativity, skill and rigour across our whole process to both support and stretch us. Three years on, our strategy is going from strength to strength and is helping us to improve the care we give to our population and improve the experience of our staff, with staff survey results that buck the national trend.  I would recommend Kaleidoscope to anyone wanting a fresh and vibrant approach to strategy development.

Rachel Evans, Executive Director of Strategy and People, Oxleas NHS Foundation Trust