East of England Ambulance Service: Shifting culture to create an exceptional place to work and volunteer

East of England Ambulance Service NHS Trust (EEAST) provides 24/7 services to more than six million people, covering a footprint of 7,500+ sq. miles and six mainly rural counties. It employs more than 4,000 staff, operating from 130 sites, and supported by 1,500 volunteers.

The Trust was on a major journey of transformation with the interim Chief Executive Officer and leadership team driving improvements in culture and performance. Get Real Change was asked to support them to empower leaders and managers to drive change, shape the culture and realise the Trust’s vision.

The challenge: Aligning values and behaviours, and empowering leaders and managers

Unstable executive leadership teams had created cycles of unfinished change, and difficulties in progressing and sustaining improvements. The culture was mixed and most staff felt their concerns weren’t listened to. They had become disempowered and disengaged. These difficulties were reflected in the July 2019 Care Quality Commission (CQC) inspection; Though rated ‘outstanding’ for Care, ratings had declined to ‘inadequate’ for Well Led.

EEAST’s board recognised the high levels of staff commitment and care. However, a negative culture had emerged, impacting heavily on wellbeing and individuals and teams performance.

The solution: Shaping a new organisational culture

A more stable executive team led by Dorothy Hosein (CEO) and Marcus Bailey (COO) started making strides towards their vision of making EEAST an exceptional place to work and volunteer. However, they wanted to accelerate progress and open the organisation to new possibilities.

Dorothy and Marcus decided to bring Get Real Change on board to work across the organisation and support the drive for change. They identified that our expertise in collaboration, and practical approach to development could leverage the change process to simultaneously develop leaders, shape culture, empower staff and deliver improvements. That creating an open dialogue across the organisation could empower staff to share experiences, know they were heard, and foster relationships.

The approach: Creating dialogue and sparking ideas for change

We brought more than 300 staff together through 28 workshops, creating a conversation spanning all departments - from IT, and operations to HR and clinicians, and from middle management to executive team level. Through a combination of dialogue, observation and evaluation we:
• Measured current ratings of organisational effectiveness
• Mapped current organisational culture and identified patterns of relating, drawing out inconsistencies between values and behaviours
• Gave staff space to reflect and make their voice heard; empowering people to shift their focus from the past to the future
• Shaped a collective, new vision for workforce development, culture and leadership
• Developed clear sets of expected behaviours from EEAST’s leadership teams
• Identified where systems, processes and practices were not supporting desired behaviours
• Sparked engagement and ignited desire for change, unlocking shared motivation, energy and meaning across teams that often worked in silos
• Generated and prioritised both immediately implementable and longer-term ideas for change

The approach: Dragons Den

We launched a ‘Dragons Den’-style event for frontline managers to pitch ideas for improvement to the executive team.
The event was designed to maintain momentum and take workshop ideas forwards. It was also a lot of fun. It was the first time many managers had developed and presented at executive team level. We coached and supported people to maximise this opportunity to stretch and grow their experience.
All ideas gained support from at least one ‘Dragon’, a huge boost to morale.

The approach: Shared learning and clear focus

The workshops generated rich and complex data. Rather than externally analysing, drawing conclusions and presenting findings, we took the process into the organisation through new workshops.
Staff discovered new insights and together discussed potential consequences and implications. This shared learning and sense-making experience brought clarity and alignment to key goals, and the next steps to achieving them.

Outcomes: What has changed? And what’s next?

The programme enabled wide understanding of the values, behaviours and supporting mechanisms needed to underpin EEASTs future direction. It created a shared basis for change across the organisation and changed the organisational narrative. Leaders feel they own their culture and can shift focus to improving for the future.

Leadership commitments: Collective agreement set ten commitments about how leaders lead, aligned to shared vision and values. Defining these behaviours provided the clear framework to hold themselves and each other to account.

Staff-led strategy: The programme has provided the basis for new Culture, Leadership and Organisational Development strategies and programmes, ensuring the voice of staff is central. It has informed an ambitious new Leadership Development Programme.

CEO Dorothy said:

"We struggled for many years with performance, patient safety and finances. The culture reinforced negative leadership styles and behaviours.
“We engaged Get Real Change to help leaders and managers across the organisation begin to understand and respond to our challenges, explore our organisational values and reflect who we want to be as an organisation. They mapped our culture, encouraged and empowered our leaders and managers to understand it and see why and what we needed to change.
“They’ve started something big. Behaviours and conversations are changing. Get Real Change has made a real difference and been an important part of our journey."

We now look forward to sharing the next stage of the journey as we continue our work with EEAST.

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