Why we support a Shared Governance approach at NUH
The Shared Governance model of leadership encourages personal and professional development whilst focussing on improving patient safety, patient experience and staff experience.
You can read more about our Shared Governance journey by reading the articles below:
- How we’re helping to release the capabilities of frontline staff
'Creating a culture of innovation and engagement through Shared Governance'- a presentation from Rachel Houghton (Practice Development Lead for Quality, Professional Regulation and Shared Governance), for the RUBIS.QI 'Innovating for Improvement' webinar (see minute 41:00)
Shared Governance forms a key part of NUH’s journey to care excellence and obtaining ANCC Magnet® Accreditation. Find out more about Magnet® Accreditation and how the Shared Governance Councils structure and the improvement projects are vital to this journey in this presentation:
NUH acknowledge that our frontline staff are the experts within their clinical areas and are in the prime position to know what our staff and patients want and need. By empowering our frontline staff we support the quality of care we are providing through frontline leadership. Staff that are engaged and satisfied:
- Feel invested in, listened to and part of Team NUH
- Provide better patient care
- Are more likely to stay within the Trust
- Are being talent managed to support succession planning
- Create a confident workforce that are empowered to challenge poor or unsafe practice
- Create innovation on the frontline
- Have an understanding of the corporate function of a hospital
- Are involved in local or national professional debate that will impact on their practice and patient care
What is Shared Governance at NUH?
“Staff having collective ownership to develop and improve practice; ensuring patients receive caring, safe and confident care. It places staff at the centre of the decision making process and sees managers having a facilitative leadership role”.
There are 3 different types of council within the NUH council model:
1) Unit Practice Councils
Unit Practice Councils include one ward/clinical area only. They are our most common form of councils at NUH. These councils meet monthly and tend to have an average of 4-6 members of staff across Bands 2-6 sitting on the council. They focus on improvement using measurable outcomes to evaluate improvement. They also engage in sharing professional decision making alongside senior nursing/midwifery leaders that is meaningful to patients and staff within their clinical areas.
2) Speciality Councils
A speciality council sits across wards/clinical areas that are still within the same speciality. One example of this is our Trauma and Orthopaedic council which sits across Wards F18, F19 and F20. This council sits monthly and will have 2-3 members of staff per ward representing their area on the council. Focus is on improvement using measurable outcomes to evaluate improvement. They also engage in sharing professional decision making alongside senior nursing/midwifery leaders that is meaningful to patients and staff within their clinical areas.
3) Themed Forums
These councils do not sit across one specific clinical area but sit within our Trust as a whole. They represent a group of staff or particular topic/theme using Shared Governance principles to formulate discussions and actions. They discuss topics such as: the evidence-based practice agenda and the BAME council (Twitter: @BAMEsharedgove1) which supports equality and diversity within the Trust.
4) Leadership Council - chaired by the Chief Nurse, Professor Mandie Sunderland
The Leadership Council exists to support the frontline staff councils described above, to develop and push forward their agendas.
All the chairs of our councils attend Leadership Council to report back on their work and take part in strategic discussion and decision making for the Trust.
- Completed initiatives to be celebrated
- Shared decision making around professional issues relating to nursing alongside the chief nurse
- Important messages for councils attention
5) Coordinating council
Coordinating councils are now being established at NUH and this is an essential part of our development. These will be established at Divisional level and then representatives from each divisional council will attend co-ordinating council every 3 months. These meetings will also be attended by the divisional lead and evidence based practice council representative. This provides an opportunity to ask:
- What are you working on?
- What do you need help with?
- What is going well?
- Priorities for the division
- Shared decision making around professional issues relating to nursing that are relevant to the strategic aims of the divisions.
How Shared Governance is supported at NUH
The NUH Nursing and Midwifery strategy has Shared Governance embedded within it to support delivery and culture change towards a more linear model.
So far we have implemented Shared Governance at NUH in two ways:
- Promoting and fostering a distributed rather than directive leadership approach in our teams
- Using councils as a vehicle to implement Shared Governance principles
Shared governance is supported by a team of facilitators that train and coach councils in the skills required for them to be successful. There is an executive level agreement and support for the development of Shared Governance within NUH that enable time out of the clinical care delivery to meet and work on their actions.
Councils have an executive stakeholder in Mandie Sunderland who meets them once a month at Leadership council. This is an opportunity to discuss their work and debate on professional issues within the Trust and nationally to ensure the staff voice is included in any strategic changes.
To support communication and relationships within Divisions we are also developing co-ordinating councils that provide an opportunity to discuss successes and more local changes and priorities for staff to get involved in.
Tel: 0115 969 1169