Making the Most of Leadership At Every Level
Emma Louise Sinnott, Highly Specialist Speech and Language Therapist, Aneurin Bevan University Health Board
Introduction
The Early Supported Stroke Discharge (ESD) Team and Brain Injury Team were established in Gwent in 2016 as part of the Community Neuro Rehabilitation Service (CNRS) to address the lack of specialist stroke rehabilitation and moderate brain injury support in community settings.
Utilising data from various programs and guidelines, it became evident that patients benefited more from rehabilitation at home once medically stabilised. Feedback from Patient reported Experience Measures (PREMs) data and staff stories emphasised the need for patient involvement and services that truly met patient needs.
The pandemic in 2020 prompted a shift in working methods, with leadership seizing the opportunity to adopt dynamic approaches that catered to service users, peers, and staff, fostering more leadership opportunities within the team.
Methods
Following Care Aims training, a person-centred approach was adopted, enhancing service user and staff empowerment and engagement with evidence-based practices.
Core aims for CNRS were established with input from staff (focus groups, away days, ad hoc feedback) , peer-partners [PP] (focus groups, away days, ad hoc feedback), and service users (Patient Reported Experience Measures). Leadership opportunities were offered across staff groups and peer partners to begin service development.
Outcomes
- Supportive, collaborative relationships within and across services.
- Team culture fosters leadership at all levels.
- High engagement, commitment, and creative freedom among team members.
- Positive feedback from staff Co-production with peer partners enhances interventions and community projects
- Adoption of a prudent and value-based healthcare model
- Five interlinked workstreams provide a holistic service
- High staff retention (8% turnover in 2023) and low sickness (5%) due to a nurturing work environment
Learnings
- Putting the ‘why’ before the ‘how’ and ‘what’. Take time to develop clear outcomes focused on intended results, using Care Aims to prioritise outcomes over inputs and outputs.
- Utilising a full range of resources, valuing contributions from all team members and peer partners.
- Empower staff to become leaders, integrating them into service development in manageable, day-to-day ways.
- Maintain an openness to learning and new perspectives.
What next?
- Transform delivery model, led by Band 6-7 staff.
- Explore Care Aims Framework's impact on wellbeing, resource use, and person-centred value-based healthcare.
- Evaluate social and wellbeing impacts using the Most Significant Change method
- Expand Recovery College to other neurological conditions and collaborate with other health boards.
- Develop Peer Partnership relationships
