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Public Sector Health: ​Organization Effectiveness Development

Reproduced from the Daily Telegraph  – ‘Healthy Development’

In October 2008, NHS Cornwall and Isles of Scilly embarked on a World Class Commissioning (WCC) programme — intended to transform the commissioning of health services to deliver improved health outcomes.  The initial consulting work had two strands:

  • Rapidly to create a skeleton organization and performance development plan to answer WCC questions.

  • Conduct deeper analysis and engage all parts of the Trust to shape an holistic, integrated plan to lead the planning, commissioning and delivery of the most efficient and effective health services for the people of Cornwall.


First, the team facilitated and integrated discussions —an ‘Appreciation’ (mission-focused decision-making)— which answered a sequence of questions:

  1. ‘Mission analysis’ —clarifying future requirements, service levels, desired effects on ‘stakeholders’ and so on.

  2. ‘Factors affecting success’ — leading to deductions and identification of tasks.

  3. ‘Comparison of options open’ — leading to a decision on which course of action to pursue and develop into a detailed plan to brief to staff and partners


This approach focussed discussion in a logical and time-effective way, while simultaneously engaging people and aligning different interests.  An ‘80%’ plan was quickly produced and because of the dynamic, iterative process behind it, further information and amendments could easily be added later.

Steve Moore, Director of Commissioning and Strategic Development (and currently acting CEO), said: “Once we had engaged support, the project quickly built credibility with the management team.  We needed to develop our organization rapidly and we could all see the value Jeremy Tozer's approach would bring.”

Soon after, the team conducted an 'ACE Insights' survey to prioritise development areas which could make the most impact, and identify where `quick wins could be achieved.  Moore says: “The impact on staff was almost immediate. Following the ACE workshops, ideas and solutions were put in place straight away and it was clear to see the positive effect this was having on our staff.”

Other highly desirable outcomes were the major improvement achieved in the Department of Health Staff Survey, particularly in ‘Staff Sense of Value’, the Trust being placed in the top quartile of PCTs, and nomination for the Health Service Journal’s ‘Primary Care Organization of the Year’ this year.  Moore adds: “When you think where we were as an organization only a few years ago, to be nominated this year for the HSJ’s top award; it’s quite incredible. Our work with Jeremy Tozer and his colleagues has undoubtedly contributed to that.”

A key task now is Talent Management and Development, and the Trust has parented an exciting new initiative “Cornwall Leads” with Jeremy Tozer's assistance. Common interests and the advantages of wider local NHS co-operation quickly became clear and support was swiftly secured from other Trusts; an approach to Cornwall Council produced enthusiasm to share elements of Cornwall Leads.

The vision for Cornwall Leads is to create joint ownership and access to a common Talent Pool and development programme across the public sector; in order to share, develop and retain Talent within the County.

Cornwall Leads starts from agreed definitions of Talent and Talent Management, and cataloguing common interests and opportunities. Each organization will maintain its own system for identifying Talent and the project will establish a consistent approach to matching people to development opportunities and will facilitate joint commissioning for collective leadership and management development.

Moore concludes: “The Trust has come on leaps and bounds, but it doesn’t stop here. We will continue to work with Jeremy and his colleagues in order to engage and enthuse our staff, develop our talent and build a truly world class organization.”

The Trust is now conducting another ACE survey to assess progress and to refresh the OD plan —a dynamic living document and the basis for aligning thought and action!

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