January 2012 - Sandwell & West Birmingham Hospitals

SWBTB (1/12) 283 (a)
Sandwell Community Adult Health
5.2 Corporate functions such as finance, HR, estates, IM&T and governance are apportioned
to divisions. The different divisions are at varying levels of maturity relating to capability and
capacity to performance manage and have delegated autonomy and decision rights. The aim
is to bring all management teams up to the same level through development and training.
Clarity about what leaders are expected to do in their roles is a vital part of their leadership
development and needs constant reinforcement through actions of the Trust executive
team.
5.3 There is a level of understanding between divisions, clinical directorates, the people who
work in them and the clinical areas such as wards and outpatients that are relevant to each
directorate. A comprehensive knowledge will take quite some time to evolve, but provided
staff are supported to develop skills and competencies, this can be achieved.
5.4 The Divisions do not all replicate the same management structure. The larger divisions,
such as The Medicine Division have a triumvirate structure of Divisional Director, Divisional
Manager and Head of Nursing. Other divisions have a version of this and recruitment of
suitable people to these critical posts is essential to work towards effective cultural change.
5.5 All Directorates have Clinical Directors in post and allocated General Managers &
Matrons although their time is not exclusive to single directorates. Clear definition and
understanding of the level of support , both management and administrative, is required to
be able to meet leadership teams’ needs to be able to implement SLM fully. The SLM
Steering Group needs to undertake work to establish agreed terms of reference, decision
rights, and a process for “earned autonomy” for the divisions and directorates.
5.6 A change in structure alone will not get people to work differently. Cultural change is
required to shift the culture from one of compliance to one of commitment and
engagement. Inherent in this is also the need to develop service improvement, and
leadership and management capability across the organisation.
5.7 For the division and directorate teams to be successful in leadership and management,
many will need to increase their skills and capabilities. The Learning & Development Team
are working on a framework, based on the national The Management and Leadership
Development Framework to support staff to perform better in their roles. The role out of
development programmes at all levels in the Trust will support SLM.
4