WINNER 2008: Heart of England NHS Foundation Trust

In 2007, Heart of England Trust acquired a neighbouring, poor performing trust, Good Hope, in what was a first in the NHS. The groundbreaking acquisition was subject to intense national and local scrutiny and was intended to bring a number of strategic benefits to Heart of England. These included a growth in market share of patients across north, east and south Birmingham; financial efficiencies; clinical innovation and succession planning.

The HR team was closely involved from the start and built a strong business case to demonstrate that the key to a successful acquisition and continued success was in bringing the staff together and developing the culture of the organisation. Particularly crucial was the learning from a previous merger with Solihull Trust 10 years previously - a lack of people focus at that time resulted in continuing integration challenges 10 years on.

Crucially, the trust needed to improve the financial stability of Good Hope and its reputation with local people. At the same time, trust wide performance on local and national targets could not be affected.

To ensure the acquisition was a success a ‘Moving forward Together' programme was developed focusing on both the business and employee needs. This included the creation of the cultural integration group to oversee organisational development activity appropriately; the development of leadership capability to manage the human dynamics of organisational change, particularly clinical leadership; the collation of key data from a local staff survey to measure employee views and inform the future people strategy; and an effective two way communication with thousands of employees.

A key milestone was the early development of the trust values, developed by the executive team and discussed at a number of forums to gain a wider stakeholder view. These values are now the foundation of all organisational development activity and have begun to create the culture of HEFT as a world class organisation.

The trust was clear that strong and effective leadership, from both doctors and managers, was crucial to achieving the benefits of the acquisition. Historically, clinical directors and senior managers from the two Trusts received limited formal management and leadership development. Senior doctors, in particular, had virtually no leadership development yet were responsible for large departments, workforce and budgets. A Leaders for Excellence in Business programme was launched, with senior leaders from both Trusts taking part and a third of participants from Good Hope.

Key to the success of the programme was early engagement of clinicians. The trust chief executive is a former surgeon and championed the programme along with the medical directors.

Heart of England is the only NHS trust in the country that undertakes its own staff survey. It has significantly improved some key areas of concern, such as ‘blame for making a mistake' and the ‘ability to speak up and challenge'. Staff at Good Hope are no longer fearful about the future of their hospital. The results show the trust's overall rating in 2007 for engagement was 68% and for leadership was 66%.

Heart of England is now one of the largest trusts in the country with a workforce of 10,000 and an annual budget of nearly half a billion pounds.

A key benefit of the acquisition was financial efficiencies, particularly in ‘back office' areas such as finance, IT and HR. The trust estimated that up to 50 people could be redundant at a cost of £1.8million in order to achieve our efficiency target for 2007/08 of £3million.

HR set up the Jobs unit to support the merger of Heart of England Foundation Trust and Good Hope Hospital and the subsequent restructuring of departments. The unit was set up as an independent body and has supported 600 employees during the transition. As a result of its work, only six people have been made redundant to date and the estimated cost of redundancy has fallen, saving the trust £750,000.

As a direct result of this programme the Trust has: Successfully managed and implemented the change and brought together two large organisations, developed a cadre of capable leaders who are taking forward clinical service improvements to benefit patients, achieved efficiency savings of £3million in back office areas with a limited number of redundancies and a saving of £750,000 on redundancy costs, maintained positive employee morale and employee relations during a time of significant change with no major impact on staff turnover or sickness rates , spotted and promoted talent, including a number of Good Hope staff promoted to senior posts, significantly improved the stability and reputation of Good Hope hospital with its local community and maintained Trust performance on key national and local indicators and in most areas continued to improve.

The trust has integrated 2,600 Good Hope staff into a 10,000 workforce with no adverse affects on patient care, sickness or staff turnover. It has continued to improve performance and delivered on all key targets and been able to identify and promote talented staff and communicate and engage with staff at all levels.

If any more were needed to show why this achieved an HR Excellence award, then the fact that the trust is now using its learning to support other NHS organisations going through similar merger and acquisition issues should prove it.

To enter the HR Excellence Awards 2009, click HERE