The role of 360° leadership feedback in NHS patient care
All-round performance assessments can have a profound impact on self-awareness and provide insights that develop and strengthen teams and organisations as well as individuals, even during a pandemic.
Getting leadership right in the NHS is fundamental to providing the best possible patient care, with numerous examples and evidence to support this. Some showcase outstanding leadership, others demonstrate the adverse and sometimes tragic consequences of inadequate leadership.
The role of the NHS Leadership Academy is to ensure outstanding patient care through building and strengthening leadership competencies and working with partners to deliver excellence. One such partner is PSI Services, a global assessment and talent management company. It works with the NHS Leadership Academy to provide 360° insight and feedback for leadership development and coaching.
Designed to evaluate behaviours related to nine essential NHS leadership qualities, the 360° assessment tool enables appraisal of leadership performance at individual and group level, helping to pinpoint areas where extra support is required. To date, PSI assessments have been completed by 59,000 staff and have achieved measurable improvements across the whole organisation.
PSI Services was given the role of developing a 360° questionnaire to support the competencies highlighted in the Healthcare Leadership Model (HLM360). Surrounding these competencies are desired behaviours integral to effective leadership and team-working that are measurable against HLM360.
Designed to provide feedback from several team members, assessments are completed by the individual, line managers, peers, direct reports and any other personnel that work with the individual. The resulting feedback provides a cross-section of views from which to form an analysis of performance against key competencies.
Those completing the 360° assessments are taken through a questionnaire. The answers are compiled into a performance report for the individual. The report compares the self-evaluation and evaluations from team members and aims to highlight strengths and weaknesses against the Healthcare Leadership Model.
Figure 1: Sample performance report
The report forms part of a performance management review, designed to create a balance between self-awareness and the experience of others, so the individual gains a greater understanding of their strengths, weaknesses, and inconsistencies.
Increased awareness of “blind spots”
Gary Tolometti, Learning and Leadership Programmes Manager at the Royal Free London NHS Foundation Trust, says: “The impact that the 360° reports have can be profound. We have many instances where an individual has become more aware of their blind spots and has improved dramatically as a result. Surprisingly, we often come across people who were not aware of how good they were and just needed that positive feedback to give them the extra boost and confidence to do even better. The overall impact is undoubtedly providing outstanding care for our patients.”
As the 360° assessment tool is implemented across the NHS, it becomes possible to analyse data further to provide meaningful group assessments and feedback. Delivered by group facilitators, all of whom have completed training by PSI Services, the strengths and weaknesses of a group are identified to determine any additional training and coaching requirements. This information has been useful for assessing groups by NHS trust, clinical team and role.
The benefits of this 360° approach became particularly evident during the Covid-19 pandemic. The self-awareness, as individuals and as a group, allowed teams to hone their strengths to get through a period of considerable change and pressure. Operating as a fully functioning team was essential for staff wellbeing, resilience and care for patients.
Time to reflect on crisis leadership
Mandi Sherlock-Storey is Head of Leadership for NHS North East and Yorkshire Leadership Academy. During the pandemic, like many other services, she had to adapt services for NHS leadership colleagues. She says: “While a number of leadership programmes were stood down, the requirement for HLM360 feedback has persisted throughout. We are now delivering feedback sessions virtually and the process has transferred very well. Participants have consistently reported value in the opportunity to review their leadership, taking some time and space to reflect and recalibrate for crisis and recovery leadership.”
A key element of the project was to enable facilitators to work with individuals to interpret and apply results from the feedback tool. PSI has trained almost 3,000 facilitators to perform this role, with consistently positive feedback; training was rated as excellent or good by 96 per cent of delegates.
Since the roll-out of HLM360, more than 25,000 feedback sessions have been completed, providing individuals with valuable insight into other people’s perceptions of their leadership abilities and behaviour. This initiative has improved self-awareness and emotional intelligence, allowing individuals to identify their strengths and how best to apply them, as well as to recognise areas for continued professional development.
The assessment is available to everyone at all levels, not just those in official leadership positions, helping employees understand their own strengths and encouraging the essential behaviours required for the NHS. This in turn helps embed a culture of learning and development, with the aim of self-driven personal growth becoming the norm.
Data to gauge training needs
Data from the assessments has also been extended to evaluate the impact of leadership development on subgroups, including different roles, regions, gender and ethnicity, demonstrating the power of 360° feedback not only for individual performance but to provide the data to better inform strategic decisions and accurately forecast training and development needs.
HLM360 has become the benchmark for ongoing performance management and PSI’s research shows a statistically significant improvement in overall leadership performance, with a notably positive impact on direct reports’ level of engagement.
For many, it has been a launch pad from which to improve and progress their leadership skills. David Chao, Consultant Oncologist at the Royal Free London NHS Foundation Trust, says: “This has been the most valuable and educational feedback in terms of self-development I have had in many years and possibly in my entire consultant career. All consultants and healthcare professionals should go through this exercise at regular intervals in their career.”