Supporting strategy and cultural change at Homerton

The challenge

Homerton Healthcare NHS FT has long been a high-performing hospital trust in north east London. This was reflected in their performance against key waiting times, and an ‘Outstanding’ rating from the CQC. However, Homerton realised that operating in a new world of collaboration and system partnerships would require a shift in how the organisation worked internally and externally.

Kaleidoscope was commissioned to design and deliver a strategy process which, while giving the organisation a clear sense of direction, would also support a broader programme of cultural change. The task was not only to support the production of a strategy document, but use a range of means to facilitate how the organisation worked in a changing environment.

Our approach

Kaleidoscope, working with TogetherBetter, delivered a number of linked phases of strategy development work for Homerton.

Working closely with senior leaders and the Board, a scoping phase saw the design and agreement of a clear set of success metrics for the development process. Five ‘tests’ were agreed, including that the process must work in collaboration with Homerton’s people, embody Homerton’s strengths and ideas, and have a focus on system relationships, particularly with the ICS.

A seven-month development process followed, designed in line with these tests. There was a focus on broad engagement inside and outside of the Trust. This included:

• Using Kaleidoscope’s ‘representative group’ methodology to select and support a representative group of staff to lead key parts of the strategy process and engage with their staff colleagues. In just eight weeks the group spoke to more than 580 colleagues and received more than 400 survey responses. The work culminated in a series of recommendations direct to Homerton’s Board.
• Working closely with community groups and governors to hear views from across Homerton’s communities. This included a storytelling event involving staff, patients and members of the community to understand different stories and perspectives of the Trust.
• Reaching out to seldom-heard groups inside and outside of the Trust, including working with staff networks and community groups, and using widespread communications to reach those not previously engaged with by the Trust. This helped to create a range of new relationships with value way beyond the specific strategy work.
• A set of interviews and workshops with the Trust’s partners and key stakeholder organisations, and a series of learning seminars with the Trust’s Board featuring innovative practice from across the UK.

Following the engagement and data collection, we worked closely with the executive team to synthesise and understand implications for the Trust. A further piece of work explored the operational implications of developing the specific areas of focus.

Results

The way in which the strategy was developed sought to help Homerton act in the way the organisation wanted to be in the future. There was considerable evidence that this was achieved.

The process engaged a greater breadth and depth of staff, patients and communities than the Homerton had achieved previously. It involved more than 1,200 different interactions, helping build a full picture of how Homerton needed to adapt and change over the coming years.

There was evidence of changed relationships inside and out. There was also significant positive feedback from external partners about the tone and direction of the conversations started by the process.

Kaleidoscope have an exceptionally rare skill at facilitating genuine, sometimes difficult, conversations across an organisation, among different staff groups, and in the boardroom. They are absolute experts in helping to crystallise and shepherd these exchanges into clear strategic direction. Working with them over a period of months helped us develop a different way of thinking about, and taking forward, change. On top of all this, they are the nicest bunch of people you could ever hope to work with, truly setting an example for the principles of finding joy at work, and always acting with kindness.

Julia Simon, Director of Strategy and Partnerships,
Homerton Healthcare NHS FT

Project team

Charmian Walker-Smith
David Laszlo
Jamey Street
Maduran Sundaresan
Natalie Berry
Rich Taunt
Zoë Horwich