Inspiration: Building capacity in adult community teams

Inspiration: Building capacity in adult community teams

Back to the map | Contact the project lead

Organisation: Oxleas NHS Foundation Trust


The aim of this project is to use a number of methods to build the capacity of the district nursing workforce in Bexley and Greenwich.

Brief Summary

I have been a Darzi Fellow since September 2014 and have a background in forensic psychiatry.

My project is taking place within the District Nursing workforce in Oxleas NHS FT across the boroughs of Bexley and Greenwich and is broadly entitled “Building Capacity in Adult Community Teams”.

The project has a number of strands including a skills review (a skills gap analysis leading to identification of skills deficits, the introduction of simulation training and strategic skills acquisition for the future), supporting the transformation of processes to become lean and productive, encouraging grassroots quality improvement initiatives and promoting collective leadership throughout the workforce.

My main focus, as the project progressed, has shifted to workforce morale. Morale, I think, is the defining factor in whether one sees potential change as an opportunity or a threat, and will therefore have a huge impact on engagement and therefore the success of any venture. Through working with the whole system the service has been able to provide much better access to information for staff, have provided teams with a dedicated senior executive link and set up a regular program of listening and engagement events, among other initiatives.

What we have started to see as the engagement, listening and acting on concerns/suggestions has progressed, is a positive shift in the conversations that are happening. Confidence is increasing that changes can be made and, whilst it’s early days, the fostering of a collective leadership approach across the whole system is taking shape.

Area of work

In relation to the four foundations of our declaration, this project aims to:

  • Happy staff with the right skills

Advice for others

Have a look on the Internet for materials about Wicked versus Tame problems. Building capacity is certainly a ‘wicked’ problem with so many stakeholders, competing priorities and other wicked problems intertwined. Understanding that what you’re dealing with is a wicked problem can be liberating as you recognise why it’s been so complex, changing and challenging. It also gives you the permission to try, fail, try again and fail better!

When working with nursing teams around morale you need to first listen, learn their stories and see things from their perspective. If you’re moving towards thinking of solutions two questions about value are really useful:

  • what zaps your energy in your work?
  • what adds value to your day and boosts your energy?

Helping nurses to remove some of the energy-zapping obstacles and/or to do more of the things that make them feel energised as a nurse can have a real impact on morale.

Links for more information

I found the following model particularly useful in conceptualising what was going on, how to generate solutions and also on how to ensure the whole system is involved: Total System Power

Comments are closed.