In the two most recent staff surveys for the NHS in England, Guy’s and St Thomas’ had the highest overall staff engagement score of all trusts.
This case study discusses how organisational values have been identified and embedded at Guy’s and St Thomas’ NHS Foundation Trust, and how, over ten years, Appreciative Inquiry (AI) has been the organising principle for a range of interventions. The result has been a shift in culture leading to high levels of staff engagement and to high quality, safe and efficient services for our patients.
Guy’s and St Thomas’ is among the UK’s busiest NHS foundation trusts. We provide a full range of hospital and community services for people in Lambeth, Southwark and Lewisham, as well as specialist services such as cancer, renal and cardiovascular for patients from further afield.
Evelina London Children’s Hospital is part of Guy’s and St Thomas’. It provides many specialist services, including treatment for complex heart conditions, general services for local children, and children’s community services in Lambeth and Southwark.
St Thomas’ Hospital has one of the largest critical care units in the UK and one of the busiest A&E departments in London. Guy’s Hospital is home to the largest dental school in Europe and a new £160 million Cancer Centre. Our adult community services teams are at the heart of our local communities, working closely with other healthcare organisations, GPs, local authorities and voluntary and community groups. They provide a range of services across Lambeth and Southwark in many locations including in GP surgeries, clinics and health centres and in patients’ homes.
In 2006, our NHS Staff Survey results showed that the Trust’s staff were disaffected. Only 54% of respondents said they believed that the care of patients was the Trust’s top priority and only half said they would be happy for a friend or relative to be treated by the organisation. This was very much at odds with the kind of organisation that Guy’s and St Thomas’ wanted to be, or felt it was.
At the same time, the Trust was financially very challenged. As part of our response to this, it was agreed that the Trust should identify its values. In his book Good to Great, Jim Collins identified that the long-term success of an organisation requires clarity on core values.
Rather than inventing a set of aspirational values, the Trust “discovered” them through a process of engaging with staff, patients, members, union representatives and others to identify what values the organisation already held.