How Guy’s and St Thomas’ NHS FT implemented an immersive coaching programme
It is perhaps a cliché to suggest that, in the NHS, the here and now is the only thing that really matters. After all, even amid a winter that has placed British hospitals under unprecedented levels of strain, health service staff have found time to reflect and innovate away from the daily rush.
The challenges of bringing an immersive programme of coaching and mentoring to one of the UK’s busiest NHS trusts cannot be underestimated, however. Guy’s and St Thomas’ NHS Foundation Trust comprises two world-famous London teaching hospitals, as well as a children’s hospital and community care services. Its 15,300 employees undertake 2.4 million patient contacts each year. If the benefits of reflective practice were obvious to the trust’s workforce team, the barriers to making it a reality were daunting.
“Our employees go above and beyond again and again,” says Hannah Datema, coaching and mentoring development manager, who was instrumental in bringing the concept of coaching to the trust in 2013. “We were concerned about whether staff would buy into it, and if they would be able to take time out of busy clinical practice to reflect on what was going on. But as soon as they were able to access a coach or mentor, they were able to see how useful it could be.”
Datema attributes the success of coaching and mentoring largely to word of mouth. But it’s clear that it has resonated deeply with clinical staff – half of the participants have been drawn from the most senior levels of the trust – who use it not so much to unburden themselves as to work through particularly knotty problems affecting their efficiency. Datema talks about a staff member who used the service to unpick the barriers preventing her from working a shorter week. Others like to concentrate on improving patient outcomes.
“We see a lot of people who want to improve the care they give. They use the coaching time to think things through. People soon find they can be open with one another. They can talk about how they really feel about stuff.
“Staff who volunteer as coaches say it’s the best part of their job because they’ve empowered and helped a colleague. And that soon spreads.”
More than 600 employees have accessed a coach or mentor (200 are doing so at present), averaging more than six sessions each. Despite being put together on a shoestring L&D budget, the programme has yielded 83 registered coaches and 114 mentors, as well as 248 completed mentoring relationships. Such is the way coaching has entered the lexicon, it has also directly benefited patients, as part of the tools that help new mothers cope with postnatal depression.
Even so, the team has needed to think fast to deal with the realities of fitting time to talk into the frenetic life of a hospital. Coaches and mentors have needed to be flexible and innovative ideas have come to the fore: in particular, a suggestion of ‘pop-up coaching’ has led to regular two-hour sessions where anyone can drop in for a quick chat.
Within four years, Guy’s and St Thomas’ work has led to the largest coaching and mentoring network in the NHS. But Datema also wanted to create something truly self-sustaining and, over the past two years, working with consultants Elaine Patterson and Karyn Prentice of PattersonPrentice Designs, has pioneered a supervision programme to offer the most dedicated coaches enhanced skills. The year-long initiative sees them incorporate elements of reflective practice and undertake research to hone their coaching techniques, learning creative approaches from Magic Box coaching to Three Chairs. Fourteen individuals took part in the first year and supervised up to five other coaches apiece. The aim is to create a pipeline of experienced supervisors.
Here too, though, the trust has had to be flexible. Datema says the six days away from the frontline that was required of the first cohort was simply too logistically difficult, so the commitment has been spread over a longer period this time round. Similarly, Skype and telephone consultations have been used to continue the learning process when face-to-face opportunities are limited.
Julie Screaton, the trust’s director of workforce and organisational development, is in no doubt that coaching and mentoring is delivering. “It has been proven to bring about a positive impact on personal, professional and organisational development,” she says. “And it works within our wider workforce strategy, supporting staff with leadership development and career management.”
In all, 96 per cent of the employees who have been through the programmes would recommend their coach or mentor to others. The key, says Datema, has been to identify organisational champions who can enthuse others about the programme. Even so, she adds, it’s been far from plain sailing: “I’ve felt really supported to have a go at ideas like this. But there were certainly times when I thought ‘this just isn’t going to take off’.
“But it comes down to caring for each other. We care about the patients and we demonstrate that so frequently that the next step is to care for our colleagues and be genuinely interested in their wellbeing.”