NHS Lothian – Scotlands largest NHS organisation, employs 24,000 staff providing health services to the second largest residential population in Scotland. NHS Lothian faces the usual stresses of providing frontline support to people facing illness and trauma – and recently, this was also in the context of a need to modernise its service delivery. The Board found a significant proportion of its HR, management and staff time was spent on managing issues arising under ‘people management’ policies, many rooted in a lack of open, honest dialogue in the early stages of conflict. Problems were being stored up and then expressed inappropriately.

NHS Lothian wanted to create a different model for handling all types of conflict – from straightforward differences of opinion and perspective, different working practices to clashes of personality – with a new ‘clear air’ culture. New channels and platforms were needed to deal with issues more quickly – and at lower levels of management, supported by a culture where all staff had trust in the systems, their managers, and being able to be open about difficulties and vulnerabilities.

The experts at CMP Resolutions were called upon to establish an in-house mediation service by upskilling managerial staff in handling difficult conversations and training key staff as internal mediators. The Board also used CMP’s experience to advise on the infrastructure and materials required to manage, monitor and evaluate the service, and as the source of external conflict resolution partners to bring in for particularly complex or sensitive cases.

CMP’s ‘Courage to Manage’ e-learning programme and one-day ‘Difficult Conversations’ classroom training were run as a pilot involving 65 managers. Learners reported gaining significant skills from the learning, which they also enjoyed and believed to be a good use of their time. The pilot was so successful that managers elsewhere in NHS Lothian commissioned more than 20 additional delivery days for the course. The training is now part of their management development pathways as an essential module of management training, and they now have more than 300 managers trained.

CMP helped with the process of selecting the most appropriate members of staff to be trained as mediators, and in getting the internal services up and running – supporting the marketing of the service internally, advising on the service structure and resourcing. 16 mediators were trained to an accredited standard, on the 6 day ILM Endorsed Professional Workplace Mediator training.

In the two years following the end of the initial programme, NHS Lothian has seen a referral rate of at least two or more mediations each month. Of those referrals which reach the joint meeting stage, 94% have resulted in an agreement between the parties – more than fifty issues resolved which might have led to more serious and formal interventions or tribunals. There have been falls in the number and length of sickness absences, and for time needed for managing conflict situations, both formal and informal: estimated at a saving of over 100 days in the first 16 months. Across the organisation managers report feeling more confident and able to have effective conversations earlier.

In terms of a tangible Return on Investment, the Board undertook the CMP Resolutions Conflict Profile Audit at the start of the project and then again after 18 months. Combining this data with data gathered through the Courage to Manage pilots and other data sets, the analysis indicated that the financial return on investment could be as much as £2.32 for every £1 spent, a potential return of 232% in the first year alone.

www.cmpresolutions.co.uk

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