FOI/2025/26/078

Request

How many directorates/divisions do you have? Can you please provide the details.

Five clinical operating divisions aligned to place - (Hertfordshire, Outer North West, North Central, Inner North West and South West)

Can you describe your leadership model for directorates/divisions.

Each operating division is led by a Director of Operations, supported by a Deputy Director of Operations (two in Inner North West division), a Director of Nursing and Therapies, and a Medical Director. The Director of Operations manages Heads of Clinical Service, who lead each of the clinical service units in the division.

Can you please share the structure and banding of your directorate/divisional leadership teams.

As outlined above, each division has a leadership model and across the Trust the structure and banding of operating divisions is as follows:

 

Chief Operating Officer (1WTE – VSM)

Director of Operations (5WTE - B9)

Deputy Director of Ops (6WTE - 8D),

Director of Nursing and Therapies (5WTE - 8D),

Medical Director (4PA-8PA (varies by division))

Heads of Clinical Service (Varies by division - 8C)

Clinical Service manager (Varies by division - 8B)

 

What are the strengths of your model?

This model ensures divisions are operating at place and services are designed and delivered to meet the needs of the local population with local partners

What are the challenges with this model?

There is a challenge with divisions operating at place in partnership with local systems and also aligning with the core CLCH approach

Quality improvement

Do you have a quality improvement offer at your Trust, if so, can you please describe, including methodology or provider you developed with.

At CLCH we use the Model for Improvement as our core Improvement framework. It is the most widely used in healthcare and can be adapted for almost every situation. Based on the scientific method, it is a simple, yet powerful framework for driving improvement where the effectiveness of solutions is unclear. We have a core set of tools and a project structure that underpins the method. We are however, flexible enough to be able to utilise alternative improvement methods (e.g. LEAN, Six Sigma, etc..) and tools, as required, depending on the need.

 

Our approach to Quality Improvement (QI) is to grow independent improvement capacity and capability in support of our Strategic Vision to ensure that everyone is enabled and empowered to Do Things Well, Do Things Better and Do Better Things. We aim to ensure that our improvement efforts are underpinned by the principles, methods, tools and project structures that make our efforts more effective, more efficient and more sustainable.

 

To support improvement capacity and capability development, training is offered using a “dosing approach”; where staff are trained to the level required for their role and to the needs of their service. This approach ensures best use of time, whilst also offering a progression of learning that begins with building general awareness throughout all roles in CLCH and culminates with a smaller proportion of staff who are skilled to coach improvement work. The dosing model has three main levels of improvement capability:

Fundamentals (for all staff to learn the basics of improvement)

Practitioner (for anyone leading improvement work)

Coach (for staff supporting others to implement improvement work).

 

All improvement support is delivered in house, minimising costs for the Trust. The expertise of the QI team enables the service to function as an internal consultancy, able to provide expert guidance on the application of improvement science to our change efforts and management approach. The QI team provide the following services:

Strategic improvement advice: (e.g. development of organisational management systems and processes to optimise improvement efforts)

Quality Improvement training: (structured Quality Improvement training and modular sessions which are incorporated within our wider development programmes – e.g. leaders training)

Improvement Coaching: (Support for teams or individuals who are struggling to apply improvement science in real life contexts)

Facilitation support: (Hands on support on the application of improvement methods, tools or techniques in change projects; Planning, preparation and facilitation support for improvement events and workshops)

Analytics support: (Measurement support for project teams and services, data collection process development, data analytics and presentation support, process automation and app development)

 

Do you have a dedicated team, if so how many WTE is this?

There is a dedicated Quality Improvement Team in CLCH, which is part of the wider Transformation Service. There are 9WTE posts in the QI team.

Can you please share the structure, and banding of roles within this team.

• 1.0WTE Band8B Quality Improvement Programme Manager
• 1.0WTE Band8A Quality Improvement Training Lead
• 1.0WTE Band8A Senior Improvement Facilitator
• 5.0WTE Band7 Improvement Facilitator (Currently we have 1WTE Clinical Improvement Facilitator in post who is a practicing nurse)
• 1.0WTE Band6 Improvement Analyst

 

 

Do you have a dedicated People Participation and/or volunteering team within the Trust, if so how many WTE is this?

 

Yes, 1 WTE band 7. 1 WTE band 6.

 

Can you please share the structure, and banding of roles within this team.

 

Band 7 Head of Volunteering and Participation line manages the Band 6 Volunteering project officer.

 

Do you pay service users or volunteers for their involvement?

 

Yes, if recruited and onboarded as a Patient Representative they are paid on a sliding scale of involvement as per the Trust remuneration policy.

Do you have a dedicated performance team within the Trust, is this centralised or embedded within clinical teams? How many WTE make up your performance team?

The Trust Performance, Planning and Insights team – oversees Trust wide performance and sit within the trust corporate function reporting directly into the Chief Operating Office of Operations. This team is made up of 4WTE permanent staff, 1WTE Director of Partnership, Planning and Insights (B8d), 1WTE Head of Planning and Insights (B8c), 2WTE Analysists (B7).

 

Each operating division also has 1WTE Head of Business, Performance (8d), who manage 1WTE deputy (b8a) and 1WTE/2WTE analysts (B5/6 – varies by division) – and these functions support divisional performance.

 

Can you please share the structure, and banding of roles within this team.

 

As above