7 July - Mental health network webinar

11 July 2022

This week’s special guest was Peter Molyneux, Chair, Sussex Partnership NHS Foundation Trust.

The session began with a presentation from Peter, who spoke about reputation as a significant driving force. He shared definitions in terms of image, identity and reputation and explained how reputation can be managed. He also noted reputation is a board-wide issue, and argued it can be shaped by having a clear purpose, understanding what drives opinion, shaping a compelling narrative, mitigating risk by taking stakeholder concerns into account and forming constructive relationships. This leads to outside-in thinking, with trust as the central goal. A complex concept, which requires to understand the causes and consequences of perception and how it influences behaviour.

“The board has a clear role in terms of direction and control in stakeholder relationships. Sometimes there is too much focus on risk reduction, rather than risk appetite, and there is often a lack of data to understand what is driving stakeholder relationships.”

An example of a context cycle for ongoing stakeholder management was discussed – a key factor of which is recognizing the strategic actions to take to close the gap between image and identity. The group’s approach focused on understanding the link between cause and consequence, understanding who the key stakeholders are and recognizing the actions to be taken and how they can be evidenced. Data from patient, staff and partner surveys was gathered and mapped into causes and consequences and regression analysis was used. Existing data was used to prevent this from being an additional task.

“Dashboards help to gather multiple sources into one place, provides a high- level summary and ensures a common approach across all stakeholders. However, the dashboard is not a replacement for other surveys or investigations into stakeholder groups.”

“Actionable insights and data can support a shift in focus of strategic priorities. It can be shared with internal and external stakeholders and shows a snapshot of stakeholder relationships for any given point in time. It shows trusted and less trusted areas and gives the board a sense of what to focus on.”

Peter noted this work was done for and paid for by Sussex Partnership NHS Foundation Trust and, as such, there is no commercial element.

The group expressed interest in the board’s response.

“The dashboard provides confirmation to support things that were likely already being considered and helps to steer the board’s focus. A key factor is that it does not become an additional workload, but rather is incorporated into the day to day. The data becomes more granular in the second year and allows the board to think about changes to achieve a different outcome.”

Someone pointed out that reputation hinges on changes in regulatory judgement and, as such, the only reputation that really matters in immediate context is the judgment made by the CQC.

The group agreed an understanding of which stakeholders are most powerful is important.

“The patient may be the most important stakeholder, but they are not the most powerful. There is a need to look through a lens of power and legitimacy to understand who the urgent stakeholders are. The dashboard is a good evidence base to showcase a different method of staff and patient engagement to the CQC. Managing partners in this way makes them more forgiving when a mistake is made.”

Some participant referenced the new operational landscape, including horizontal accountability to communities and partners, and how these different relationships are managed.

Someone asked how the dashboard was practically coordinated and how governors featured in the process. Peter confirmed he drove this as chair, alongside the director of communications and with support from an MBA Henley Business School student, although he did not engage governors in the production of the dashboard.

Some participants were impressed by the methodical approach. They spoke of potentially replicating some of this work when measuring external stakeholder attitudes to avoid “reinventing the wheel.”

Others expressed interest in the approach, but felt they would not apply the same approach to their own trust. Indeed, some spoke of the complexities of serving a number of stakeholders in the most effective way.

The complex stakeholder landscape was then discussed, as well as the wider questions it raises: how is this managed? Who are trusts genuinely accountable to? And who do they want to be accountable to?

Many would welcome a wider conversation on who the main stakeholders are and the audience who are most important to providers. The chair of this meeting confirmed this will be taken forward.