Interview with Katherine Fenton OBE, Chief Nurse, University College London Hospitals (UCLH) and pioneer of SBR in the NHS

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1 Interview with Katherine Fenton OBE, Chief Nurse, University College London Hospitals (UCLH) and pioneer of SBR in the NHS

2 We are pleased to share this interview with Katherine Fenton OBE, Chief Nurse at University College London Hospitals NHS Foundation Trust and pioneer of strengths-based recruitment in the UK National Health Service. In December 2014 we asked Katherine 10 questions about the experience of introducing SBR into the NHS. Her answers give a rare and inspiring insight into the thoughts of a Board level person about making a difference, legacies and strengths. As Chief Nurse at University College London Hospitals NHS Foundation Trust (UCLH), Katherine Fenton is responsible for the leadership of 3500 nurses. Aside from her other responsibilities as an Executive Director on the UCLH Board, it is Katherine s role as Chief Nurse to ensure that enough nurses with the right skills are developed properly and deliver high quality care and patient outcomes. UCLH is a member of The Shelford Group 1, which comprises 10 leading NHS multi-specialty academic healthcare organisations. 1. How did you first hear about strengths-based recruitment and what inspired you to take the idea to the 10 Chief Nurses of The Shelford Group for their consideration? In 2013 Nursing in the NHS was under huge external criticism concerning poor quality of patient care this was in the light of the public enquiry into the Mid Staffordshire NHS Foundation Trust. One of the key roles with great potential to influence the quality of patient care in UK Nursing is the Ward Sister. If you have a great Ward Sister in place, you get a happy ward, low staff turnover and, most importantly, great outcomes for patients. We intuitively knew who our best Ward Sisters were and we knew their qualifications and competencies, but we couldn t articulate their strengths, qualities and attributes to be sure we were recruiting the best people for the role. I know Sally Bibb [the founder of Engaging Minds] and she told me about the successes of strengths profiling great baristas in Starbucks and domiciliary care workers in the social-care sector, and how it was possible to select the right people for the job every time by identifying their strengths and recruiting based on those strengths. I began to wonder if we could apply the same principles to our own recruitment 1 The Shelford Group members are University Hospitals Birmingham NHS Foundation Trust, University College London Hospitals NHS Foundation Trust (UCLH), Sheffield Teaching Hospitals NHS Foundation Trust, Oxford University Hospitals NHS Trust (OUH), Newcastle- Upon-Tyne Hospitals NHS Foundation Trust, King s College Hospital NHS Foundation Trust, Imperial College Healthcare NHS Trust, Guy s and St Thomas NHS Foundation Trust, Central Manchester University Hospitals NHS Foundation Trust (CMFT) and Cambridge University Hospitals NHS Foundation Trust (CUH) engagingminds engagingminds.co.uk

3 process. It was a time when circumstance had handed us the freedom to do something new and radical. We were able to try something quite different, to see if we could really make a difference to the quality of patient care. 2. How easy was it for you to sell the idea of SBR to the other 9 Chief Nurses in the Shelford Group, and beyond? My Shelford colleagues are bright, they were facing the same challenges as me. SBR is such common sense that actually it was quite easy. Plus, I ve got a reasonable track record of coming up with ideas that may take a different approach but work in practice, so it wasn t as hard as I thought it might be. If people like doing something then they are more likely to do it well, and if they don t like doing something it stresses them out and they can t be as effective. It s obvious. So, if we can identify what it is that all Great Ward Sisters love doing and do naturally, there s enormous potential to take stress out and put excellence in. That s inevitably going to impact patient care for the better. We all sensed the possibility. Then, when we started working with the relevant Matrons and line managers of the Ward Sisters we found them saying again and again, this has got the potential to transform the NHS!, and we really knew we were on to something. With each person we spoke to about it, the prospect of making a real difference to patient care with SBR grew. 3. How far along is the Shelford Group with the adoption of SBR across its member Trusts and what impact is it having at the front-line? Within my own organisation at UCLH we ve now appointed 12 Ward Sisters out of a possible 50 using the 13 point strengths profile developed by Engaging Minds. We are actually one of the smaller Trusts, so eventually across the Shelford Group we are talking more than 10 times that figure, and the other Trusts are progressing with the approach at their own paces. To be honest it is too early for quantifiable results, but I can say that we have always had some wards that we might describe as worry wards the ones we know we may need to give extra support to and of the 12 wards where we have recruited the Ward Sister using SBR, none of them are worry wards. That, to me, is a great early result. In terms of reaction from the front-line, the Ward Sisters who have been recruited through the SBR process feel thoroughly investigated, that we really know them by the end of the process. They feel we are certain and they are certain they are the right people for the job, which inspires confidence. There was a bit of push back from the recruiters at first because it does take more time to recruit a engagingminds engagingminds.co.uk

4 person using SBR, but my view is that it takes far more time and energy to remove someone later who has turned out not to be a good fit. It is essential to train the recruiters properly so that they truly buy into the whole process and believe in it. You can t just have a go at recruiting on strengths, you need to be trained to do it by experts. Then your people will get it and the process will work. 4. I understand that strengths profiling of Staff Nurses and Nursing Assistants is now underway, what are your hopes for that? Ultimately I hope it s going to mean better outcomes and experience for patients. In terms of Nursing Assistants, I think it will reduce the number of applications we get because the new wording of the job description will enable people to easily recognise themselves as potentially good candidates or not but that the people who we do recruit will absolutely know what they are coming into, so we will get lower drop-out rates. We won t waste resources training people who aren t right and eventually leave us. I think we ll end up with happier people on the wards, and though that might be challenging to hear, it s what we need to ensure the best possible experiences for patients, and it is what inevitably comes from having people working on the wards who innately love the job. With respect to Staff Nurses, I think it will mean that we get the right candidates into the Staff Nurse training programme and into the profession. Overall, it s the potential to get the right people in place at every level of Nursing that s the starting point for delivering the highest quality patient care. That s the goal. In the NHS, the end point of the SBR process is going to be improvement of the patient s experience and outcome, that s why we considered SBR in the first place and that will be the ultimate improvement we want from it. 5. Why do you think SBR works so well? I think the Engaging Minds SBR method works because to create the strengths profile for a role, it forensically looks at the people we have already identified as being outstanding. The resulting profile is not a composite of the strengths displayed by the group of outstanding people overall, but it is derived uniquely from the innate qualities/attributes and strengths that our outstanding people possess. And my view is that for SBR to work, once you have the strengths profile and you are recruiting against it, there can be no compromise, because the strengths cannot be taught or learned, you either have them or you don t. In conversations about the fact that someone possesses 12 out of 13 of the strengths, I would have to say, Well, do you want a Great Ward Sister or just an OK one? engagingminds engagingminds.co.uk

5 6. Are there any downsides to SBR as far as you re concerned? One concern follows on from what I ve just said, as you can perhaps imagine. For example, if we ve got 50 Ward Sisters in post and we ve got 13 strengths that we know they must have if they are to be Great Ward Sisters, what do we do about the people currently in post who don t exhibit all 13 of the strengths? It s different with the recruitment of Nursing Assistants or students because we re starting at the beginning there, getting the right people in post from the outset. But where existing staff are concerned, there s a potential challenge to face in moving people into jobs that they are better suited for. That requires strong leadership and honest conversations. On the upside, we ve seen that where a Ward Sister has been performing poorly in post, it has really helped them to see the list of the 13 strengths and realise that they are not inadequate people, they are just not suited to the job; it has made them feel better about themselves and it has been easier for them to move on into a position where they can be a round peg in a round hole, which will inevitably be less stressful and more successful for them. Secondly, for some leaders, there might be an initial concern that you may not find enough people, with the right strengths profile, to fill the available positions; in our case, as we face challenges in recruiting junior nurses, it could feel risky in that context to adopt a new uncompromising approach. 7. What advice would you give to other senior leaders who are thinking of implementing SBR? I d say don t try to take short cuts, do it properly. Take the time to understand SBR and the Engaging Minds method of strengths-profiling, because once you understand it, you get it and you can convey the concept to your people so that they get it too. I d also say it s essential to train your own trainers thoroughly, again no short cuts, because once Engaging Minds leave and you are on your own you need to know that you ve trained your staff so that they can train the next group of staff. It s easy in a sense because you find that the Engaging Minds training leaves the first group fired up and highly motivated to train the next group, but you absolutely need to do that train the trainer because you need to make sure the process is sustainable. 8. Why did the NHS appoint Engaging Minds as partners? In the beginning for the Ward Sister SBR project we partnered with Engaging Minds because we knew they d done something similar in the social-care sector and we didn t know of anyone other than Engaging Minds doing the work with the depth of experience and approach that we wanted. We engagingminds engagingminds.co.uk

6 had the freedom to give it a once-off try with them. After the Ward Sister project, when we wanted to embark on the profiling of Staff Nurses and Nursing Assistants, we moved to a full NHS procurement process. Engaging Minds tendered for the work, along with others, and they won. I think the critical difference between them and others in the marketplace is that there is nothing off the shelf about their approach, it is context specific and not based on a pre-written database of strengths. They come fresh to each role they are to profile and they build the profile based on thorough investigation and observation, no corners are cut. You can be confident the resulting strengths profile is unique to the people you want to recruit. It s not a cookie-cutter approach, it s bespoke for your people. 9. What opportunity would you say SBR presents for the NHS? I think SBR could transform how we run the NHS, because it really has got the potential to make sure that every single patient gets a great experience. But, for the NHS to fully benefit from it, future NHS leaders who follow me will need to buy into it, have enthusiasm for it and be willing to drive it through fully. Over the months before I retire in April 2015, I d like to see it gain supporters and momentum so it has a real chance to embed and last. When I ve retired and can only influence from the sidelines, I hope that others will carry the flag for SBR and see it through. 10. What legacy would you like to leave when you retire and how might your pioneering work with SBR play a part in that? The thing I am most proud of in my career is that all of my deputies I think there are 22 of them out there now have become Chief Nurses themselves. I m proud of the part I ve played in their development and that they are now all working as credible and effective nurse leaders within the UK NHS. I guess where my introducing SBR to the NHS fits in with that is that it would be wonderful if it could help us recruit the right people for all nursing roles from the start. If we knew we were choosing the best people to be student nurses every single time it would be amazing. The overall resulting impact on patient care, experience and outcome would be a tremendous legacy to leave. Please call us on +44 (0) or to find out more. This interview was first published in our monthly Topical Updates newsletter. If you would like to receive future Topical Updates from us, please complete our signup form at or drop us an at and we ll be very pleased to add you to our list of valued contacts. Thank you engagingminds engagingminds.co.uk

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