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Making the Invisible, Visible:
Executive and Wellbeing Coaching in the National Health Service

For the past 18 months The Maria Paviour Company has been privileged to work closely with senior leaders from BSUH to support an ambitious programme of operational and cultural change.

The Maria Paviour Company has been involved with NHS England in supporting culture change. As a result of the positive reputation, trust, and confidence that we have established, we were contracted to work alongside the Executive Board at BSUH to implement culture change initiatives as the Trust had been put into special measures following its CQC inspection report in 2016.


NHS Improvement provided funding directly to BSUH on the basis that MPC would survey the entire workforce of over 8,000 employees using MPC’s proprietary Care and Resilience Index (CARI™) psychometric tool.

The immediate aim of our intervention was to support the Executive Board to significantly improve the attrition and sickness rates of employees by predicting and preventing these through targeted early interventions for individuals.

The Maria Paviour Company combined its knowledge of neuroscience and psychology that generates high performing and successful teams with an award winning community of professional expertise, to create ‘The Route to Rise’ framework that supports BSUH in the delivery of its ambitions.

We offered a way forward that was realistic, systematic and pragmatic, with the aspiration of creating a working culture whereby every employee could flourish and achieve their full potential for the benefit of its patients. The health and wellbeing of employees was put at the heart of this long-term ambition.

The Challenge

The findings of the CQC’s report of August 2016 into the operation of BSUH stated:

Staff from BME backgrounds and other groups with protected characteristics reported that bullying, harassment and discrimination were rife in the organisation.

The aggregated results we have obtained to date using the CARI™ tool have been triangulated with BSUH’s staff survey results and the CQC report. Our data showed, with 99% reliability, that 70% of staff exist at a level that is below effective functioning. There is good evidence from the organization CARI™ report, and from the anecdotal feedback identified from coaching that many staff continue to experience difficult working conditions. Furthermore, our findings identified that the majority of staff are in a mental state that undermines their ability to change, make good decisions, problem solve or work co-operatively.

In response to this challenge, the Executive Board identified three inter-related drivers to support the transformation and improvement of BSUH and the working lives of its employees: Patients First; Wellbeing; and Diversity. To date, the primary focus of MPC has been in driving forward on the wellbeing agenda.

We supported the launch of CARI™ to every BSUH employee in October 2017, featured in a BBC  news report 

We have since delivered a range of coaching support, workshops and focus group sessions to engage, involve and enhance the health, wellbeing and performance of individuals and teams across the Trust. The green shoots of reconnecting the Trust with its employees and the patients they support has begun to emerge.

The results are personal to each individual and highlight areas where we can take better care of ourselves or need to ask for help…All 8,000 staff across the Trust have access to the CARI survey, enabling them to develop their own personal wellbeing profile and access support to improve individual wellbeing


Delivering Individual Support for Employee Wellbeing

To date, through positive employee engagement and the power of ‘word of mouth’ in the workplace, we have supported over 60%, or 4,800 staff members, of the 8,000 plus employee community. This has enabled us to establish a clear understanding of the challenges that employees are experiencing on a day to day basis and the impact this has on absence, attrition and accidents and the associated performance and patient care.

For example, through the effective implementation of CARI™, we have targeted over 300 employees with resilience interventions that provide tools for altering personal biochemistry immediately. We have also supported a further 200 employees who were in need of intensive coaching support – positively assisting the proactive approach to improving attrition through tackling wellbeing proactively whilst operating within the workplace

Feedback from these interventions has been overwhelmingly positive, with 80% saying that the personal report they received having completed the CARI™ questionnaire was ‘spot on’.
This is a long-term programme that requires on going investment of time, commitment and resources from the Trust if the desired cultural change and the associated shift to high performing, and positively engaged employees and teams, are to be successfully realised. This shift, both in terms of cultural behaviour and day to day performance, is required if the Trust is to succeed in delivering a consistently positive patient experience.

The anonymised survey results offer a snapshot of wellbeing levels from across the Trust and the collective results will be shared with the Executive Team to help them determine where and what improvements are needed to make a difference to the wellbeing of our staff in the workplace


What we have achieved in a relatively short period of time, over a large and diverse organisation, is clarity about the mental health and emotional wellbeing of the workforce, enabling targeted support that is more beneficial for the employees and also results in a more effective return on investment for the Trust.

What I love about CARI is that it gives something back to every employee and it helps us to drive more ROI, because its proactive and preventative. It has allowed us to empower our staff and help them target the support they need and best suits them from our broad range of existing wellbeing investments including our EAP.

MPC was approached by the Learning and Development team to train the internal team in NeuChem coaching techniques and how to deliver the CARI™ questionnaire. The internal team will be tutored through MPC’s School of NeuChem Coaching and once qualified will be skilled and confident to be able to monitor and provide wellbeing coaching with the aim of transforming the health and resilience of the people and organisation in a cost effective and sustainable way.

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