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Closure, careers and care: Mentoring at NHS Direct

Simon Gosney

NHS Direct call centre

When they heard that NHS Direct would be downsizing, management didn’t simply rest on their laurels – they worked to keep staff engaged and keep producing an excellent service. Simon Gosney from NHS Direct shares how they created a blueprint for change

In the spring of 2012, it was announced that NHS Direct would be downsizing. We didn’t realise it then, but the whole organisation would eventually close a little over two years later. Over 3,000 people, mainly health advisors and clinicians, were affected.

Whatever their role in the organisation, there was a lot of pride at stake for our people: NHS Direct had grown to be a valued and trusted provider of virtual healthcare since its inception in 1998. The immense change and uncertainty of downsizing inevitably caused a great deal of emotional upheaval. I wouldn’t want to underestimate the strain it put people under, at a time when they needed to remain focused on providing the best possible public service for ill and worried patients. It was to their enormous credit that the public satisfaction scores for NHS Direct never wavered through a difficult period.

This rapidly changing landscape presented us with a steep learning curve. None of us in the team had any experience of supporting colleagues affected by an organisation in the process of closing down. One major challenge was how to advise people and allocate consistent but finite resource over 30 sites, while taking account of shift patterns. The timing of support was also difficult to judge. For example, a colleague might not attend a career transition course, thinking they were staying put, only to realise some time later that they would need career advice after all. 

Assessing people’s needs

As well as this, people had very different needs and expectations. Some managers did not want their staff taken away from their duties too soon in the process, as their most important focus was still the best possible standard of care for patients. Initially, the downsizing programme felt to some like a departure from that ethos, in that as a result of their participation, talented staff could end up leaving the organisation sooner than planned. We therefore needed to find the right balance between providing practical support to our colleagues, while ensuring that patient safety was never compromised. 

We decided to train our own people to be colleague support advisors with the help of 10Eighty, the career management consultancy. They were hugely influential in shaping our approach and it was after talking with them that we decided that an ‘in-house with access to external specialists’ model was the best fit for us. We felt that this would give us the right blend of expertise and credibility, but it still required a bit of a leap of faith from those who stepped forward to be trained up. There were no guarantees that they would be available when we needed them, or that they would be flexible and agile enough to step in and run workshops for us elsewhere in the country. Our programme also evolved as needs changed, moving from a more group-based programme and webinar to a much more personalised approach based on a needs analysis.

Evolving the offer

The use of outside expertise brought challenge and stimulus to our senior colleagues in particular – they really helped us to deal with potential barriers and brought credibility and fresh ideas to keep seeding and re-invigorating the programme. This allowed us to evolve the offer over the 2 years, rather than everyone quickly learning what it was and then getting bored of it. They were also able to connect our people to others with whom they were networked, which was really beneficial.

At the end of the process, we were very pleased with all that we achieved. Our patients still rated NHS Direct with satisfaction scores in excess of 90% and all our colleagues, a third of whom transferred to the new service, had had access to diverse and high-quality career advice. Many have taken up the challenge of new careers but a good proportion of clinical staff ended up being retained within the NHS.

Pleasingly, we had inspiring feedback about the programme and employee engagement remained strong, even during a very challenging period of intense change. We felt sure that this was in no small part due to the very tangible investment we made in our people. We believe we left a good legacy and an admirable case study to guide others in the future.

Simon Gosney was Head of Learning and Development at NHS Direct. He has since been appointed Head of Learning and Development at Dimensions, a national not-for-profit organisation which supports people with learning disabilities and autism.

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