Challenge

Two NHS Trusts were stuck. They’d formed a partnership to merge two existing services, improve care and expand capacity to treat the most at risk of babies, but it wasn’t progressing.

Liverpool Women’s NHS Foundation Trust and Alder Hey Children’s NHS Foundation Trust formed their partnership after a review identified that to improve outcomes, their Neonatatal units should merge into a larger single specialist service across the two hospitals.

Both Trust Boards had publicly committed to the partnership and were frustrated at the lack of progress.

Approach – integrating activity

We identified the solution as integrating activities across the two Trusts. Through engaging lots of stakeholders, we worked to clarify what a merged service would look like and revitalised the positive and emotive benefits of this. This work brought the leadership closer together, and they agreed a prioritised roadmap to achieve this vision inside four years. A cornerstone of the next step.

This single integrated service, along with the enhanced estate and facilities would ultimately lead far fewer babies needed to be transported between the units and a far safer service.
 
We co-created a framework with clinical staff and operational managers that would aid joint activities, unleashing positive energy across the partnership. Working groups were established, with clear roles and responsibilities. These groups used an iterative process that, despite the organisational complexities meant small steps were taken and rapidly reviewed before moving to the next stage.

Outcome – what happened?

As the vision and roadmap became clearer, decisions and the small steps started happening organically. People took the initiative, confident that it was consistent with the direction of travel.

Very quickly the organic changes brought real progress. Positive stories emerged, for example, how standards from one service had been adopted in another to great benefit improving quality and productivity. Both Trusts began to see benefits from the small-scale changes. This led to slightly bigger planned steps in change being delivered successfully, for example joint medical rotas, nursing staff rotation, and consistent use of separate IT systems.

Staff opinion started to shift – and as successful change became visible and collaborative, positivity increased and more staff wanted to be involved.

Very quickly we reached a point where they no longer needed hands-on support. The approach and framework we’d co-designed was adopted and we could step back.

A year later and working practices are much more integrated and joint working embedded. Plans for the expansion of the Alder Hey unit are progressing with the unit due to open in 2022 and work on the refurbishment of the Liverpool Women’s unit is on track to complete in the very near future.


Jeff Johnson, Chief Operating Officer at Liverpool Women's NHS Foundation Trust, said of the work:

Working with another organisation in partnership to merge two critical services. Both organisations were committed to the change, but required strong independent engagement and leadership to bring the teams closer and agree clear objectives. Although only involved for a short time, Steve engaged people and provided shape to the work, resulting in greater energy and pace. We made a big step forward in a short timescale.