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Steve Onyett.
Introduction to team effectiveness
Steve Onyett.
Our Health Our Care Our Say
“By 2008 we expect all PCTs and local authorities to have established joint health and social care managed networks and/or teams to support those people with long-term conditions who have the most complex needs”.
Steve Onyett.
The Challenge of Commissioning- Promoting using practice based commissioning creatively,
so that practice teams can work with patients, families and carers to design care packages better suited to their needs.
How radical is this new approach to teamworking?
Models for this can already be seen in mental health and intermediate care teams.
BUT HAVE WE LEARNED THE LESSONS?.
Steve Onyett.
What is a Team?What is a Team?
A group of people who depend on each other to get a specific job done well.
Steve Onyett.
Benefits of Effective Team WorkingBenefits of Effective Team Working
PerformanceStaff well-being
Steve Onyett.
The 2006 NHS National Staff Survey
89% responded positively when asked: “Do you work in a team?”
However this shrunk to 41% when the survey explored whether the team in question fulfilled criteria for a well structured team
Findings consistent since 2003!
Steve Onyett.
Real teams Shared objectives Members who work closely together to achieve the
objectives of the team Members who have different and defined roles within the
team Less than 7-8 members Opportunities to review the performance of the team and
how it could be improved A team identity, in that others can recognise it as a team
Steve Onyett.
Effective teams have….. Clear and shared objectives – but when
combining hierarchies also need to be clear about where NOT collaborating
The means to deliver in terms of resources, authority and autonomy
The minimum number of team members required to get the job done.
Clear, differentiated, and diverse roles
Steve Onyett.
Effective teams have….. A need among members to work together to
achieve team objectives Participation in decision making Norms for excellence Rhetorical and practical and support for
innovation Defended time out to review what it is trying to
achieve, how it is going about it and what needs to change
Steve Onyett.
The evidence on CMHT effectivenessBorrill et al, (2000) examined 113 CMHTsExternal ratings of innovation and
effectiveness associated with • team clarity of and commitment to objectives, • higher levels of participation, • a stronger commitment to quality, and • practical support for innovation.
Steve Onyett.
Vision that isbased on explicit and shared valuesclear, negotiated, shared, motivating and attainable
Steve Onyett.
Participative safety A climate in which team members feel free to
participate and share ideas, even if those ideas are a little “half-baked”.
Associated with • Less resistance to change and a greater likelihood
of innovation• Constructive controversy in pursuit of excellence. • A collaborative, and participative leadership style. • Appropriate exchange of information for collective
decision-making and as a way of achieving good decisions and role clarity.
Steve Onyett.
Climate for excellenceTeam commitment to achieving excellent
performance through modifying practices and implementing improved methods of working.
Look for commitment to giving users real power in shaping practices, openness to critical evaluation, and time and resources devoted to planning and implementing evaluation.
Steve Onyett.
Support for innovation
The teams expectation, approval and support of attempts to introduce new and improved way of doing things.
May be verbal approval or offers of co‑operation, time and resources.
Support needs to be demonstrated in practice.
Steve Onyett.
A typical effective CMHT had
few part-time workers, relatively low stress levels.
clear leadership
Steve Onyett.
Poor functioningUnclear team objectives were the
biggest contributor to poor functioning. This was associated with the absence
of a clear team leader or co-ordinator or where there was conflict about leadership.
Steve Onyett.
The mental health of team members
Those working in teams have much better mental health than those working in looser groups or working individually.
Steve Onyett.
Mental Health
The benefits appear to be due to: • greater role clarity• better peer support
Those working in teams are also buffered from the negative effects of organisational climate and conflict.
Steve Onyett.
The better the functioning of teams the better the mental health of team members across all domains of health care.
Steve Onyett.
Communication and regular meetings• are associated with higher levels
of effectiveness and innovation in Primary Health Care and CMHTs
• yet the quality of meetings is often poor
Steve Onyett.
Barriers to effective teamworking1. Teams without tasks 2. Teams without freedom and responsibility3. Unwieldy teams with the wrong members4. Organisations deeply structured around
individual work5. Team processes are neglected rather than
developed 6. Strong teams in conflict
Steve Onyett.
Obstacles to Effective TeamworkObstacles to Effective Teamwork
Professional divisions, exacerbated by gender issues
Team members belong to different organisations
The lack of professional mutual role understanding and respect
Steve Onyett.
Obstacles to Effective TeamworkObstacles to Effective Teamwork Lack of understanding of organisational context Lack of pre-qualification team working training Lack of clear team objectives and feedback on
performance Poor or non-existent team meetings, and team
reviews of strategies, processes and objectives The unmet need to base practice and teamwork on
the assessed needs of local populations
Steve Onyett.
Organisational Supports for TeamsOrganisational Supports for Teams
Clear goalsResourcesCommunication and information systemsEducation and training systemsFeedback systemsLiaison and integration with other parts
of the system
Steve Onyett.
Organisational Supports for TeamsOrganisational Supports for Teams
Support with the process of teamworking
Reward systemsAppraisal processesRecruitment and selection policies