Background On their journey towards excellence, this national healthcare provider for the elderly had reached a stage some years ago they had introduced the EFQM model, the feedback from the assessments, and integrating this comprehensive approach into their strategy and daily operations had helped them take the first steps on to becoming a leading competence centre for geriatric medicine and care. The services comprised of inpatient, day-patient and, increasingly, outpatient care, and range from short visits to multi-year stays. The hospital contains 325 beds with specialisations in internal medicine, neurology and medical geriatrics, with a hospice also located at the clinic. In addition, there are four nursing homes with around 100 beds each, and two-day care centres that complement the nursing homes’ services. Finally, there are 45 assisted-living flats, with 100 new specialist assisted living flats to be opened later this year. The organisation employs circa FTE 1800 people with a team of 5 Directors and 4 Senior Managers leading a team of 24 managers of services. The next stage was to develop and leadership development process to drive the organisation forward in a competing marketplace. It had become apparent there was a cultural disconnect between the Board of Directors and the Managers that was stifling innovation. It was seen that there needed to be a behavioural shift in the way teams were managed and a way of working with the board to develop services. We were invited to co-design and deliver an action learning programme intervention with the organisation s HR team and a local company who specialises in innovation which would address these challenges. Programme design. Materials and handbooks To facilitate the programme and leave a lasting legacy we developed a range of materials and resources to support the programme. Written in German and English they were tailored to each profession in the hospital to meet professional standards whilst retaining the core programme requirements. Scoping and design – month 1 The first 4 weeks of the project were key to establishing the relationship of co working and co-design. This was a challenge culturally as we ended to understand the healthcare systems in another culture, and we were working with people whose second language was English. The first week was spent working along side Directors , Senior Managers and Managers in the business as observers and then meeting staff and community organisations at all levels. We also were learning to work with another consultancy team and the internal team, build trust and rapport quickly. Part of the scoping exercise included identifying and agreeing how and what we would use to evaluate the success of the programme – see below for target and results. The invitations went out for 24 managers from a variety of roles, departments and specialisms, all of whom agreed to take part. A handbook and launch events were co designed with the HR Director and lead consultant from the other partner in the project who we subsequently met monthly to review progress. Directors Launch – Month 2 The Directors and Senior managers who constitute the board (9) were invited to take part in a full day together to explore the purpose and to develop a shared understanding of the programme and desired outcomes. This involved some futures thinking and identifying key organisational projects as a way of achieving goals – both in terms of individual and organisational success. Part of the day also included exploring and completing the Competing Values Framework (CVF)ready for a comparison with managers. Participants Launch – Month 3 The purpose of the launch was to create a shared understanding of the purpose of the programme , the methodology to be used i.e. action learning., the place of the projects and the facilitator. This group also explored and completed the Competing Values Framework (CVF) Competing Values framework analysis and presentation Month 4 The next stage was for Directors and Senior Managers and Managers to explore the results of the CVF. The morning was spent with each group separately as they looked at the results and the second half of the day the two groups joined together to explore the results and the impact on the way they worked and behaved Action Learning sets Months 5 – 10 Action learning sets were formed each comprising of a Director, Senior Manager and Managers not in a reporting line from different work areas. The sets met 4 times over 5-month period to address an area of commercial development. Masterclasses Months 5 – 10 During the overall programme the facilitators collected common areas of interest and arranged master classes for 2 hours using internal resources were appropriate .E.G – Financial awareness and cost control was delivered by the Head of Finance and Strengths based team work delivered by one of the facilitation team Final Event – Month 11 The final event was co-designed by Directors Senior Managers and Managers to evaluate the outcomes in terms of action and learning, and to celebrate success. Subsequent additions to the design Throughout the programme we consistently review the programme and from the feedback obtained we provided 3-day ILM Foundation Programme in Action Learning Facilitation was delivered to build internal capacity or future development programmes with ongoing support Evaluation A summative evaluation against the targets identified in the pre-programme stage took place at the end of the programme and the data shared in the form of a report. The evaluation was conducted by an independent consultant. The second part of the evaluation to look at longer-term impact will be carried out this autumn – 2 years after the programme delivery. End of programme Evaluation – Month 13 Target 1. – To identify the blocks to innovation and change. The Competing Value Framework identified the disconnect between the senior team and their outward facing roles in both the development and securement of the future of services and the managers who were concerned with the day to day challenges of the organisational management and leadership of services. This led to miscommunication and a lack of trust between the groups. Target 2 – To establish a learning culture where managers took responsibility for their own development. All 6 action learning sets established continue in a self-facilitated way and through the use of the behavioural framework have linked the action learning sets to their professional development Target 3. – To support managers to understand the commercial environment and develop intrapreneurial behaviours. Each of the action learning sets addressed different service development opportunities that had been identified by the Board and produced the business case together with operational plans. All have been realised and implemented. The sets are now evaluating the projects. Target 4. – To build a behavioral framework for managers at all levels in the organisation. A behavioural framework has been developed by the external facilitators from the observations and organisational learning harvested from the programme. The framework was co designed with participants and now is being rolled out across the organisation.