NHS Reset: Innovation and leadership post COVID-19: five things your teams want from you

Over the past three months, through the Health Foundation’s Q Community, we have convened conversations with over 700 people working in health and care about what we can learn from the experience of COVID-19. We discussed huge service changes that were put in place almost overnight, and what it would take to embed and build on the beneficial changes. We wanted to understand not just the innovations that took place, but also the positive and sustainable ways of working that helped make such change possible.

From what we heard, here are the top five things people want from their leaders to enable them to build a stronger, more resilient health and care system for the future.

1. Champion structured approaches to learning
One of the most striking aspects of the response to COVID-19 was how people working across health and care established new systems, processes and ways of working at unprecedented speed. Even as people were in the middle of implementing these changes, they understood that there was a huge amount of learning being generated, and there was an urgent need to capture and use that learning to improve services in the long term. Suddenly many people saw how it had always been: every team, every department, every member of staff is an expert in their own subject, and there is so much insight about the systems they work within that they need to unearth and put to use.

In the midst of the pandemic, the task of capturing this learning felt overwhelming for many, but there are tools, approaches and principles that can help teams get started, and do this well. Leaders have an opportunity to champion structured approaches to learning so that it becomes part of the way we work each day.

2. Trust and empower
Between late March and May, when the pandemic was at its peak, we heard many people say they had freedom to make decisions in a way they had never experienced before. Actual and perceived barriers were lifted, and they suddenly felt empowered to make rapid and responsive decisions about care delivery. The key to this seemed to be that people felt trusted: trusted that they would make decisions based on a shared goal, and in the best interests of the population and system at large. 

There is a clear opportunity to build on this recent experience and have meaningful conversations about what COVID-19 can teach us about empowering and enabling teams to deliver improvements to care. Thinking about the psychology of change is a crucial aspect of this conversation and inspiration can be taken from a range of practical examples.

3. Sort out the practical things
It simply shouldn’t have taken a pandemic to ensure that staff had access to basic equipment and resources, such as working laptops or tools to enable video conferencing. But it did! For all sorts of reasons, fixing some of the day-to-day practical issues that prevent people from being efficient and effective became easier during COVID-19.

People want leaders to continue to prioritise this, taking steps to understand the practical issues or niggles that slow teams down, or grind them down.

4. Keep taking action on wellbeing 
Wellbeing has been a primary focus for every employer in the NHS during the pandemic, and this has been a source of pride for many people. From the most basic intervention – such as ensuring staff have a place to eat lunch – through to the more intensive psychological support and counselling, there has been talk and action on wellbeing and wellness.

Leaders cannot, of course, shy away from the challenges yet to come, such as a potential increase in demand for counselling as staff members process the trauma and events of recent months. But there are great examples to learn from that leaders can draw on and steal with pride.

5. Recreate the shared sense of purpose and identity
In one of our workshops, a GP candidly shared her experience of working with local managers during COVID-19. She talked about how they worked with passion and dedication and how, for the first time, it felt like she and they were working towards the same goal. This experience was replicated across the country as, for a short while, people were no longer ‘managers’ or ‘clinicians’ or ‘porters’ or ‘social workers’, they were health and care workers fighting the biggest fight of their career. 

There is an opportunity for the positive legacy of COVID-19 to not only be about service change and innovation, but a fundamentally different way of thinking. What would it take to recreate that shared sense of purpose and identity, with each and every person feeling and acting like they are part of something much bigger than themselves or their organisation? 
Just think what we could achieve together if we nailed that.

Tracy Webb is associate director of collaborative change for the Health Foundation’s Q Community. Follow her and the Q Community on Twitter @TracyWebb007 @theQCommunity

Find out more

As part of the NHS Reset campaign, the NHS Confederation has partnered with the Health Foundation and AHSN Network to explore the best practice and innovation that have emerged over the COVID-19 period.

Join our webinars in September for practical insights on how leaders can embed positive changes and explore how to evaluate and systematise service innovation:

8 September: Positive service shifts accelerated by COVID-19: lessons for leaders (12.30-2pm)
Featuring:

• Hugh McCaughey, National Director of Improvement, NHS England and NHS Improvement
• Zoe Lelliott, Acting Chief Executive, Health Innovation Network
• Niall Dickson, Chief Executive, NHS Confederation

9 September: The race to systematise service innovation: how to make the changes in practice and mindset sustainable (1-2pm)
Featuring:

• Prof Mary Dixon-Woods, Professor of Improvement Studies at Cambridge University and Director of THIS Institute
• Prof Gary Ford, Chief Executive of the Oxford Academic Health Science Network and Professor of Stroke Medicine at Oxford University
• Niall Dickson, Chief Executive, NHS Confederation