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Header image for the current page Supporting Great Ormond Street Children’s Hospital in its ambition to become an outstanding organisation

Supporting Great Ormond Street Children’s Hospital in its ambition to become an outstanding organisation

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Great Ormond Street Children’s Hospital commissioned an independent well-led review to build upon its newly launched 5-year strategy and support its journey to become an outstanding organisation.

Arden & GEM’s Effective Leadership Solutions team brought together a multidisciplinary group with executive experience, specialist expertise and sector knowledge to undertake a developmental well-led review that has provided insight and recommendations that will help the Trust operate within an increasingly complex and changing NHS landscape.

The challenge

Great Ormond Street Children’s Hospital NHS Foundation Trust (GOSH) is an internationally renowned specialist paediatric centre offering a wide range of health services to children from its site in London. With a reputation for clinical excellence, research and collaboration, the Trust employs more than 4,000 staff and receives over 230,000 outpatient and 43,000 inpatient visits each year.

Building on a current CQC rating of ‘good’ for well-led and a newly launched 5-year strategy, the Board wanted an independent external provider to undertake a well-led review to identify areas of excellence and opportunities for improvement.

In addition to focusing on the key well-led themes of leadership, engagement, culture, governance and assurance, and quality improvement, the review also needed to consider the Trust’s leadership response to the significant changes taking place within the NHS landscape that require GOSH to work across systems and in an increasingly devolved commissioning environment.

Our approach

Arden & GEM’s Effective Leadership Solutions (ELS) team worked in partnership with audit experts, BDO LLP, to deliver the review, bringing the benefits of a dedicated specialist NHS resource together with the support of a major professional services firm.

Team structure
The combined review team was selected to cover all the major components of a well-led review, as well as the specific requirements of a specialist Trust like GOSH. In particular, paediatric expertise was secured by bringing on board clinical peer reviewers and advisors with medical, nursing, leadership and research backgrounds.

By accessing Arden & GEM’s wider multidisciplinary workforce, a specialist advisor for equality, diversity and inclusion also formed part of the team to support review activity focussed on improvement and performance in this area of growing national policy focus. The review was underpinned by robust project management which included a dedicated delivery lead and project manager.

Remote delivery
The delivery team was able to draw upon their recent experience in using technology – including video conferencing, virtual whiteboards and breakout rooms – to undertake the entire review remotely. This approach ensured that the process adhered to the Trust’s COVID-19 protocols while enabling crucial first-hand observations of behaviours and culture to be made.

Review approach
ELS adopted a tried and tested four-step approach to delivery, covering:

  1. Preparation – The team undertook a desktop review of evidence provided by the Trust comprising a self-assessment and evidence pack, the latest CQC report, previous well-led reviews, and a range of policies and papers.
  2. Observation – The review team observed a private and public board meeting as well as committee, operational and management meetings.
  3. Engagement – One-to-one semi-structured interviews were held with key internal staff and external stakeholders. Workshops and focus groups were facilitated with the Council of Governors, staff, patients and parents.
  4. Analysis and reporting – Evidence from the previous three stages was collated, reviewed and quality assured to identify key finding and recommendations against each of the five key focus areas.

Review findings
Following a five-month process, the findings of the final report were fed back to the Trust Board and were unanimously well received, with positive feedback for the review team.

During the review, the team also delivered targeted coaching and development feedback sessions to the Chief Executive and Company Secretary to ensure they were familiar and comfortable with the emerging findings, and to support knowledge transfer.

The outcomes

By bringing together a multidisciplinary review team with executive experience, specialist expertise and sector knowledge, stakeholders were openly and constructively engaged in the process.

The findings have informed the Trust’s development plans and provided insight into and recommendations for the Trust’s future, within a complex and changing NHS landscape, in the following areas: