Effective teambuilding strategies

1. Teams, Teamwork and Team
Building in The NHS
Presented by Soji Abode-Mark MPharm MBA Cert
06/09/2017By Soji Abode-Mark1

2. Aim
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 To inform, inspire and stimulate ideas and
interventions to use to develop and promote good
teamwork within the National Health Service (NHS)

3. Agenda
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1. Background
2. Key policy documents
3. Teams
4. Teamwork
5. Teambuilding
6. Summary

4. Background
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 Micheal West and Jeremy Dawson (2002)
 NHS teamwork is critical to patient outcomes.
 The report demonstrates how “good team management of NHS
employees leads to higher quality of care, more satisfied
patients and lower patient mortality.”
 Belbin’s Team Roles (1970s)
 Meredith Belbin identified nine “roles” that people within teams
tend to assume. Each role has different characteristics and ways
of working; Belbin suggested that an effective team needs a good
balance of all these roles. Managers can apply this theory to
understand the ways individuals in the team prefer to work, as well
as using the theory to ensure there is a good balance of roles
across the team. (www.Belbin.com)

5. Underpinning Policy documents
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 Working for Patients (DoH 1989)
 Two main objectives of paper
 To give patients better care and greater choice
 To empower NHS to successfully respond to local needs
 Healthcare professionals in the community must
form effective teams (Dowrick 1992)
 Healthcare in the UK is changing in two complementary
directions
 It is moving from hospital focus to a community orientation
 It is shifting from a doctor-centred approach to one based on
collaboration and multidisciplinary team-work
 Towards a Primary Care led NHS (1995)

6. Graphic Complexity of NHS (The Kings Fund-NHS)
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7. Complexity of The NHS
 The NHS in particular is a very large and complex
organisation
 There are multiple stakeholders
 The NHS is predominantly human resource intensive
 Policy implementation is very important
 There are internal and external systems and boundaries
 There is primary and secondary care and patients move
constantly between the two
 There is also the interface between primary and
secondary care to consider
 Source: The Kings Fund
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8. Current situation I of II
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 Research findings:
 About 90 per cent of NHS staff say that they work in
teams but actually the figure is nearer 40 per cent
 The reality is that around half NHS staff are working not in
well-structured teams but in pseudo-teams
 NHS teams have not demonstrated the three simple
elements fundamental to any team:
 The team has a clear objective
 The team working closely together to meet those
objectives
 The team meet regularly to review performance and how
it could be improved
 Source: West and
Dawson

9. Current situation II of II
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 Team tensions
 Team dynamics are not always easily managed, and
status issues can be particularly problematic. There is
tension relating both to diversity of disciplinary
background and to status inconsistencies in teams. There
is a high power imbalance within healthcare teams.
 Cultural change
 The current emphasis on cuts is causing managers to
focus on productivity at the expense of innovation.
 Source: West and Dawson

10. Teams
 Definition
 Any group of people organized to work together
interdependently and cooperatively to meet the needs of
their clients by accomplishing a purpose and goals.
 Teams are created for both long term and short term
goals, examples
 A policy review team, an executive leadership team, and
a departmental team are long lasting planning and
operational groups.
 Short term teams might include a team to develop
process guidelines, a team to plan the annual
departmental party, or a team to respond to a specific
patient problem or complaint.
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11. Types of teams in NHS
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 Departmental teams:
 Groups of people from the same work area or department
who meet on a regular basis to analyse patients needs,
discuss SOPs, solve problems, provide members with
support, promote CPD and share information.
 Cross-functional teams:
 Groups of people who are pulled together from across
departments or job functions to deal with specific patients,
issue, identify problems, or to improve a particular
process.
 Self-managing teams:
 Groups of people who gradually assume responsibility for
self-direction in all aspects of work.

12. Example: core primary care team
GP
Practice
Nurse
District
Nurse
Health
visitor
Manager Receptionist
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13. GP external teams and networks
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 Specialist nurse
 Diabetic
 Asthma
 Macmillan
 Midwife
 Psychiatric
 Continence
 Dietitian
 Stoma
 Dentist
 Pharmacist
 Optometrist
 Audiologist
 Chiropodist
 Psychotherapist
 Social worker
 Secondary care

14. The importance of effective teamwork
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 Patient expectations
 Patients can receive more efficient holistic care
 High quality of healthcare regardless of free at point of need
 Clinical governance
 Teamwork minimizes the liabilities
 Healthcare is not free and tax payer is paying for it and
someone must be accountable when risk occurs
 Healthcare Professionals
 It is difficult for one profession to embody all aspects of care
 The care given by the team can be greater than the sum of
individual episodes
 Continuity of care between professionals is encouraged
 Peer influence and informal learning within the team can raise
the standard of care

15. Teamwork
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 Superior staff morale and patient care
 There is a relationship between patient satisfaction and
staff experience
 If staff report high work pressure, patients then report they
are being treated insensitively.
 If staff say there are lots of errors and near misses,
patients report insufficient support, information, privacy
and respect.
 When staff say they have got poor health and wellbeing
and work-related stress, that then translates into lower
levels of patient satisfaction.“ (West and Dawson)

16. Teamwork in NHS
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 Teamwork is key to working successfully as a
member of the wider multi-disciplinary team, and
with patients/clients and carers
 Working in teams is essential for the provision of
safe, effective and person-centred care
 NHS teams are complex and some people may feel
confident working in a team within a department or
immediate work colleagues, but not in teams with
other disciplines or agencies or cultures

17. Teamwork Models
 Multidisciplinary teamwork
 Andrews (1987) describes the multidisciplinary team as a
group of professionals who each provide their own
expertise irrespective of the techniques used or the goals
set by other team members.
 Interdisciplinary teamwork (McGrath & Davies 1992)
 This is a more sophisticated model capable of delivering
true integration between professions
 Team members operate with a high degree of
interdependence
 share authority and responsibility for self-management
 are accountable for the collective performance
 work toward a common goal and shared rewards:
addressing patient problems
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18. Challenges to teambuilding
 Work environment tends to favour individual
professional working on personal goals for personal
gains
 Typically reward, recognitions and pay systems
single out the achievement of individual professional.
 Appraisal, performance management and goal
setting systems most frequently focus on individual
goals and progress, and not on team building
 Promotions and additional authority are bestowed on
individuals
 Given all these factors, any wonder why teams and
team work are an uphill task in the NHS
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19. Effective Teambuilding
 Recommendations
 Leadership
 The right environment
 Employee involvement
 Employee empowerment
 Team building sessions
 Job design
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20. Leadership
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 Action items
 Effective leadership should springs from individual
qualities rather than from the profession
 Team leadership should be flexible and open to any
member of the team and it should be democratic
 Hierarchy is played down for the benefit of the team and
leadership can be collective rather than individual
 Team leadership is not about control but effective team
dynamics
 Leadership begins with a vision of job shift naturally from
producing results to encouraging the growth of people
who produce results

21. The Right Environment
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 Action items
 Teams flourish in the right environment and one that
promotes
 Relax friendly atmosphere
 Everyone in the team participates
 There is a clearly stated and agreed objectives
 Ideas are encouraged, listened to, and discussed
 Disagreements are faced and discussed
 Team decisions are accepted by the individuals
 Criticism is open, helpful and positive
 Expression of feelings and emotions is acceptable
 Source: Hallmarks of effective teams

22. Employee involvement
 Action items
 Everyone in the team participates
 Low profile team members are challenged
 Professional groups with different strengths must work
together
 Clinical strength must balance the weakness of others in
the team and vis verse
 All healthcare professionals must be grateful for each
other in the team and hierarchy is played down
 With combined strength the team must achieve the goals
of high quality healthcare for the benefit of all patients
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23. Employee empowerment
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 Action items
 Empowerment is not just a business fad (Pascale)
 It is fundamental to business transformation that is now
taking place and goes hand in hand with technological
advancement and what the needs of the environment
require in terms of waiting times and response times
 It is necessary to radically change the current healthcare
delivery systems: in terms of empowering both internal
and external team members
 Hierarchies are flattened, jobs changed and new
empowered roles created, relating to prescribing and
clinical reviews within the primary care led NHS.
 Source: managing in the next millennium

24. Job design
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 Action items
 Jobs are redesigned to overcome the challenges to
teambuilding
 Team performance is appraised not individual or
professional roles
 Ways to improve collective results, methods or
relationships are sought
 Individuals know what is expected of them, the value of
their work and where it fits into the overall purpose and
objectives of the team

25. Further Teambuilding strategies
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 Socialisation of teams
 Create development centres
 Promote get-together activities
 Inspire brain-storming sessions
 Physical integration of offices
 Dismantling barriers – its amazing what the human spirit
can do without barriers
 Professional groups once separated by high brick walls
are now integrated into low partition areas.
 Re-education of team executives
 Application of Belbin’s theory of team roles to identify how
individuals prefer to perform in teams
 Invite discussions for best practice

26. Summary
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 This presentation has demonstrated why team
development and good practice in leadership and
teamwork are important for successful delivery of
positive outcomes in the NHS
 I have sourced articles, case studies and examples
to show why investing in teamwork is vitally
important to improving services, better care, greater
choice for patients and superior job satisfaction for
NHS staff.