Developing an NHS trust’s 10 year organisation strategy

The challenge

East Kent Hospitals University NHS Foundation Trust was at a critical point, facing significant challenges.

The Trust had a legacy of reactive and disconnected plans, while a focus on short-term issues and daily operational pressures had resulted in a lack of long-term strategic thinking. Leadership turnover had also undermined staff trust in change efforts.

Despite this, there was clear hope across the organisation and a desire for meaningful change in the right way, aligning culture and strategy.

Our work needed to be contextually sensitive and collaborative, involving staff at all levels, and patients and system partners. The strategy development process had to deliver compelling long-term direction, while also contributing to cultural transformation.

Our approach

Our work with East Kent took place in two distinct phases across an 18 month period.

Phase 1: Strategy scoping

We conducted comprehensive scoping to understand the Trust’s specific context and requirements. We interviewed senior leaders, held discussions with key groups and reviewed the Trust’s existing strategies and plans.

Our detailed scoping report presented an honest account of the Trust’s starting position and allowed us to meet them where they were at for the design of the strategy development process, which was phase 2 of the work.

We co-created a Strategy Development Framework with the Trust Board, including five desired outcomes, and guiding principles for all our subsequent work with the Trust. This ensured the Board’s commitment and continued support, and made the strategy process itself contribute to cultural transformation.

Phase 2: Strategy development process

In Phase 2, we worked with the Trust’s strategy, communications and patient engagement teams, using the Strategy Development Framework to design and run a strategy development process that engaged staff, patients, communities, and partners. This included:

• Staff engagement: we designed and facilitated face-to-face workshops across all five hospital sites, held online forums, and ran sessions with the Trust’s Change Ambassadors. We supported targeted outreach through staff networks and conducted a digital survey, generating more than 700 interactions with staff. We also supported the Trust strategy team to bring together the insights they had already gathered from their clinical strategy work.
• Patient and community engagement: we organised patient workshops, attended community group meetings, and created accessible surveys, hearing from diverse community representatives including those from mental health, homelessness, and disability groups.
• Partner engagement: we interviewed leaders from key partner organisations, held online partner workshops, and gathered system-wide perspectives via surveys.

Throughout the engagement process, we explored three key issues: future vision, current reality, and priorities for change. We identified key themes from the insights we gathered, testing them with staff regularly and working with the Trust to develop a new 10-year strategy that genuinely reflected what had been heard.

Our impact

By understanding the Trust’s unique context and perspective, and designing and delivering a strategy development process in partnership with them, we were able to ensure a clear and compelling 10-year strategy. ‘Trusted, chosen, valued: our strategy, 2025-2035,’ establishes a new vision for for East Kent Hospitals to become “a place that patients trust, staff choose, and partners value.”

The strategy development process generated more than 900 interactions across different stakeholder groups, ensuring the final strategy was genuinely informed by diverse perspectives. In this way, the process itself became a vehicle for cultural change, modelling the open and collaborative approach the Trust wanted to embody.

The strategy provides:

• a clear purpose, mission and vision that gives direction for the next decade
• five strategic aims focused on being trusted by patients, chosen by staff, valued by partners, innovative in research and learning, and sustainable and efficient
• specific clinical service changes and supporting actions to deliver its aims
• a clear implementation approach that encourages continued collective ownership.

Kaleidoscope worked alongside us to develop our new strategy from start to finish. They supported us as a Board to make good decisions, but also energised hundreds of our staff, patients and partners to join the process too. Their approach has meant we have a strategy to be proud of, achieved through a process which has contributed to improving our culture. We couldn’t have done it without them.

Tracey Fletcher, Chief Executive,
East Kent Hospitals University NHS Foundation Trust