The aim of this report is to provide an independent and theory-based evaluation of CLAHRCs (Collaborations for Leadership in Applied Health Research and Care) as a new form of networked innovation in the health sector.

Health and well-being services, in common with many public services, cannot be delivered by a single organisation. Weight loss, exercise, smoking cessation and other programmes require the co-ordination of services delivered by several organisations in a locality. There is some evidence, mostly from other sectors, that middle managers play pivotal roles in this co-ordination. They have to find ways of co-ordinating services such that organisations are able to meet their own objectives while working together, and issues raised by cultural and other differences can be overcome. In doing so, they have to find ways of explaining what they do, and what they need to get done, to one another. This study focuses on the knowledge creation processes that underpin these activities, in the context of health and well-being services.

The NHS Trust Development Authority, the Care Quality Commission (CQC) and Monitor have committed to developing an aligned framework for making judgements about how well led NHS providers are.

By ‘well led’ we mean that the leadership, management and governance of the organisation assure the delivery of high quality care for patients, support learning and innovation and promote an open and fair culture.

This article outlines their statement of intent.

One of the biggest challenges of improving quality within health care is engaging clinicians in the work. Clinicians have demanding schedules, high stress levels, and pressure from payers and accreditors. How can you engage these busy colleagues to join your improvement work?

Based on current available data, the healthcare science (HCS) workforce is understood to form approximately 5% of the workforce, yet their work is believed to provide input to around 80% of all diagnostic decisions.

But do we the NHS really understand where healthcare scientists are within our organisations, what roles they are undertaking and even how many there actually are?

This case study focuses on how health and well-being managers collectively create knowledge. The objective was to develop a better understanding of the way that knowledge is created within and between healthcare organisations, across different managerial levels, and of the role played by informal networks in those processes.

One of the five questions CQC now asks of all providers is ‘how well-led is this organisation?’. The quality of leadership is one of the most important determinants of the quality and safety of services. This framework outlines the dimensions of leadership that organisations will be assessed on and allows organisations to align themselves with the common expectation of what good looks like.

The Streamlining Programme was a collaboration between Skills for Health, HR for London and NHS Employers, the programme has saved millions of pounds and improved efficiency and quality in three key areas:

• Junior doctors’ rotations
• Employment checks
• Statutory and mandatory training

By working together to benchmark performance and share best practices, the 39 London trusts have increased performance in respect of training compliance, reduced duplication and achieved a dramatic reduction in costs. Simultaneously, the programme has delivered higher quality, improved efficiency and greater productivity.

Case studies, guidance documents and advice from the participating London HR Directors are all available.

Employee engagement is vital to high quality care in the NHS. Evidence shows it is linked to both patient satisfaction and quality of care. Argues that by better engaging with employees, the NHS will be more able to face the significant challenges of the next few years. Research shows that NHS Trusts which effectively engage their employees have higher levels of staff wellbeing and more satisfied patients; they have better clinical outcomes and they are more efficient. It’s increasingly clear that engagement is vital to high quality care in the NHS.

The report is an in-depth investigation of the approaches used to develop staff engagement in these organisations, with the aim of sharing ideas and best practice. The trusts involved range from specialist to acute general hospitals and mental health services and have either been high performers on staff engagement for some time and/or improved significantly in recent years.

These organisations have used a range of different techniques and in some cases have focussed on particular areas. The key elements of their approach are:

• focus on organisational values
• strong support from senior leaders
• line managers have been supported to foster engagement in their role
• recognise the value of “employee voice” through seeking and acting on staff feedback
• they have worked in partnership with staff side organisations.

The Department of Health’s five high impact changes were used by the project team to assess the current practice of each trust and develop a feedback report to identify areas of strength and development. Each trust developed interventions based on the individual needs of their organisation and relevant to the community they served, resulting in an individual evidence-based improvement action plan which – if implemented effectively – could make considerable savings.

The project team identified a significant amount of good, innovative practice, including:

• the identification of health needs of staff
• performance dashboards linking workforce and patient safety data
• effective use of the Electronic Staff Record (ESR) and e-rostering self-service system with close to real-time reporting
• planning and communicating of initiatives to coincide with national public health campaigns.