Northern Lincolnshire and Goole NHS Foundation Trust (NLaG) and Hull University Teaching Hospitals NHS Trust (HUTH) have historically been two separate organisations working either side of the river Humber on the east coast. From 1 April 2024 a group structure was put in place which brought the two trusts closer together in a group model called the NHS Humber Health Partnership. However, we have not legally merged so both trusts have maintained their separate sovereignties and, therefore, their responsibilities for Freedom to Speak Up.
The new group manages five main hospitals sites: Hull Royal Infirmary, Grimsby Diana Princess of Wales Hospital, Scunthorpe General Hospital, Castle Hill Hospital and Goole and District Hospital. It also provides a wide range of community services across North and North East Lincolnshire, including district nursing, physiotherapy, psychology, podiatry and specialist dental services.
It employs more than 17,000 staff, has approximately one million patient touchpoints each year and has a budget of c£1.4bn. NHS Humber Health Partnership has a structure of 14 Care Groups (which manage all the clinical work) and corporate directorates, including one for staff, called People.
The move to a group model has been carried out at pace, and as Freedom to Speak Up guardians we both felt passionately about ensuring all workers continued to have a voice which counts when it came to contributing to the organisations’ strategic objectives.
In the absence of national guidelines for guardians working as part of a group we also knew we needed to work together to put into place robust ways of working which were open and transparent for the workers we support. We started talking at the start of the ‘group’ conversations to develop a set of principles which we would both follow. We agreed it was important that we:
- Do not share details of individual cases with each other to ensure that confidentiality and trust in our roles were not impacted
- Provide clarity for staff through our communications of which guardian they need to contact if they want to speak up
- Align our governance and management, including changing to a single Executive Sponsor and line manager within the People directorate.
We recognised early on that although we remain guardians of our separate organisations, we had to be consistent in frequently reinforcing the message that workers across the Group were all being supported to speak up. Our regular communications have been clear to all colleagues in the Care Group or management structure, that NLaG staff contact Liz and HUTH colleagues speak to Fran.
At a higher management level, we have had to adapt our ways of working with senior leaders across the two organisations as there are now shared management structures in place with one Executive team and a Board-in-Common which leads both trusts.
We have also had to harmonise the way we report cases to ensure our shared care groups can be compared in terms of speaking up metrics and information. We have also worked extensively to streamline how we report to the joint Boards-in Common and Committees-in-Common with consistent reports so data can easily be compared and discussed, while still maintaining our roles as separate guardians.
We have achieved a lot in a small amount of time, largely thanks to the foundations of a positive working relationship we forged in the early days and living the Freedom to Speak Up Guardian values. We constantly challenge each other, and have identified, and agreed which areas of practice we want to take forward for the good of the Group and the workers we support.
Our successful working practices have also been formally recognised by the Boards-in-Common, and we have their agreement to develop a Group Freedom to Speak Up Strategy. At Board meetings we have also been praised for how well we have formed a partnership and supported the Group in a short period of time with one Board member commenting: “We are a force to be reckoned with”.
It is also nice to see that word is spreading as we are regularly being contacted by other guardians from across the country where they too are facing working in new or emerging group structures. We are also involved in national discussions with the National Guardian’s Office and NHS England about developing good practice in this fast-moving area of structural change for NHS providers.
