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Leading in healthcare: Cambridge University Hospitals

Rosie Maternity Hospital

In 2015, Cambridge University Hospitals (CUH) NHS Foundation Trust – Addenbrooke's and The Rosie Hospitals – faced a series of leadership and operational challenges. The internationally renowned teaching hospital was rated 'inadequate' by the Care Quality Commission (CQC) and put in 'special measures' by the NHS's hospital regulator. While the inspection team acknowledged CUH's leading position in several areas and the dedication of its staff, it also found 'serious failures in quality of care' with 'concerns that existing management cannot make the necessary improvements without support'. In addition, the hospital was experiencing many of the common challenges found in the health sector; stretched resources, low morale and fatigue around improvement initiatives.

The new leadership team at CUH was able to make rapid changes that led to the improvement of the CQC rating from 'inadequate' to 'good' in under two years and increased staff engagement as measured by the NHS national staff survey. However, the new team wanted to go further to achieve national excellence. CUH has a vision to work with staff and partners to improve people's quality of life through innovative and sustainable healthcare, across care quality, finance, teaching, research and workforce. To build on its position at the heart of the Cambridge Biomedical Campus. To maximise the benefits for patients, staff and the UK economy.

Roadmap to success

To achieve their vision, the leadership team at CUH identified four key areas of improvement: improving patient journeys, working with communities, strengthening the organisation, and contributing nationally and internationally. Improving culture, climate, leadership and engagement was a key focus on strengthening the organisation and work was undertaken to diagnose the current state and a considered and planned approach to leadership development was created.

In 2017 CUH commissioned Cambridge Judge Business School Executive Education (CJBS) and Cambridge University Health Partners (CUHP), along with The King's Fund, to develop and deliver a Senior Leadership Programme to a group of 150 most senior leaders across clinical and managerial functions, to support the hospital's ambitions and values of Together – Safe | Kind | Excellent.

Leading in a healthcare setting

Working with Cambridge University Health Partners (CUHP), Cambridge Judge Business School has developed a bespoke approach for CUH and delivers three main components of the programme to 150 of the most senior leaders including clinicians, nurses, doctors, operational managers and corporate staff.

First, eight highly interactive 'MBA' style masterclasses are held bi-monthly over a period of 18 months. The purpose of these masterclasses is to develop a common language and joint understanding of the leadership challenges in the hospital. They include classes on hospital finances, the use of routinely collected data to drive change, the cascading of hospital strategy to divisional and ward level, and the building and leading of high-performing multi-functional teams.

Second, CJBS faculty and senior industry leaders, including former CEOs of NHS hospitals, work closely with multi-functional teams in the hospital to address clearly identified challenges. This training on the job solidifies the understanding developed in the masterclasses and creates a momentum of change in the hospital.

Third, the programme will be supported by a 'Virtual Learning Environment' (VLE) which offers the participants and CJBS faculty an online community and communication tool to enhance their learning and provides a forum in which debate and knowledge-sharing continues outside of the classroom.

This combination of MBA-style interactive classroom teaching, on-the-ground supervised workshops, and online learning offers an innovative way to address the challenges of transforming a hospital "on the fly". It integrates the expertise of business school faculty and senior industry mentors with the specific context knowledge of the programme participants and develops a momentum for change in the organisation.

Equipped for the future

The Senior Leaders Programme at CUH supports individual's leadership capability, through personal reflection, challenge and learning, helping them to achieve their full potential as leaders. It will also help support the Trust's ambition to have a culture of continuous quality improvement and embed a new way of working. The online learning platform that faculty and participants develop together during the course of the programme is an important element for the sustainability of the advances made during the programme.

Ultimately, the programme will foster a culture that delivers cross-functional working to achieve the Trust's vision.

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