Over the past five years, Pro-Noctis has worked with South Tees Hospitals NHS Foundation Trust, navigating a landscape shaped by inspections, reports, partnerships, site expansions, spending cuts, and the unprecedented challenges of a pandemic.

Following a disappointing inspection rating in 2019, the NHS Trust was committed to more effectively empowering its staff and leaders. They wanted to enable their clinicians to drive change and enhance all aspects of the organisation, especially patient care and service delivery.

Through customised programmes for staff, team development days, a seminar on fostering a high-performance culture, and access to one-on-one support, the Pro-Noctis and South Tees work has proven to be transformative.  As a result, South Tees Hospitals NHS Foundation Trust became one of the first acute hospital trusts in England since the pandemic to receive an improved rating from the Care Quality Commission (CQC). The programme has not only shaped the Trust’s approach to leadership, but also the organisational energy and culture.

Now, as the Trust expands with a new model structure, the work is set to continue. Dan Fawkes and Kate Harrison from South Tees Hospitals NHS Foundation Trust’s Leadership and Organisational Development Team reflect on their five-year collaboration with Pro-Noctis, a leadership development consultancy. They discuss key milestones, cultural shifts, and the challenges of integrating a leadership programme within the NHS…

Hi Dan and Kate. How did the partnership between South Tees and Pro-Noctis begin?

Dan Fawkes: We started speaking with Pro-Noctis back in 2020 when we were building a new Leadership Development and Quality Improvement Education Team. The need for leadership development was significant, but our internal resources were limited.

We wanted external expertise to support senior leadership and, crucially, to engage harder-to-reach colleagues who might not initially see the value in an internal programme. I had a few conversations with Phil Kelly from Pro-Noctis and Jennie, our Group Deputy Director of Culture and OD, and we’ve been working with them ever since—nearly five years now.

What have been the most significant milestones in the programme?

Kate Harrison: One of the most significant moments was when we started seeing high levels of engagement from medical staff, particularly those who are sometimes harder to reach. Once word spread about the programme’s impact, we found ourselves with waiting lists, which was a huge milestone. It wasn’t us promoting it; it was staff recommending it to each other.

Dan Fawkes: Another key milestone was the timing. We launched the programme in the middle of the pandemic when our leaders were navigating extreme challenges. The ability to give them tools and space to reflect on their leadership was invaluable.

We started seeing high levels of engagement from staff… Once word spread about the programme’s impact, we found ourselves with waiting lists, which was a huge milestone. It wasn’t us promoting it; it was staff recommending it to each other.

We also saw major structural changes, with many senior leaders moving into new roles. I remember 10 to 12 clinical directors telling me how vital the programme was in helping them step into their roles. One stated:

‘It helped me address challenges in my new clinical director role, recognising that colleagues may need different information before making decisions. All consultants should attend.”

Kate Harrison: We also hosted a High-Performance Cultures event in 2023 with keynote speakers like Professor Michael West and Ed Clancy. The conversations that stemmed from that event are still shaping leadership development today.

What impact has this had on the Trust’s culture?

Kate Harrison: Culture is difficult to measure, but one of the biggest shifts we’ve seen is the golden thread of compassion running through leadership. The coaching element – leading with care and having better conversations – has been transformative.

We’ve also seen Community Services-based colleagues, who can feel more remote from the hospital setting, engage with the programme and adapt their leadership to their environments.”

Dan Fawkes: In 2019, the Care Quality Commission (CQC) rated us as ‘requires improvement.’ When they returned in 2023, we achieved ‘good across the board,’ including in leadership. We were the only NHS Trust in the country to make that jump during the pandemic.

The CQC report also cited work Kate, and I have been involved in—including elements supported by Pro-Noctis—as ‘outstanding.’ That’s a real testament to how leadership development has shaped our culture.

Culture is difficult to measure, but one of the biggest shifts we’ve seen is the golden thread of compassion running through leadership. The coaching element – leading with care and having better conversations – has been transformative.

What challenges have you faced along the way?

Kate Harrison: Getting people to attend can be a challenge, particularly during busy periods like winter when releasing staff is difficult. However, over time, the impact of word-of-mouth has made a huge difference.

Dan Fawkes: I’ve worked with many external providers before, and it can sometimes feel like they’re just there to deliver and move on. But Pro-Noctis has been flexible and responsive.

For example, they originally ran the Human Performance Practitioner (HPP) programme over five days, but they adapted it to a three-day/two-day split, which made it more manageable operationally. That kind of flexibility isn’t something you always get with external providers.

What lessons have you learned from working with Pro-Noctis?

Kate Harrison: Having an external lens has been invaluable. It’s easy to become insular in your thinking, so bringing in different perspectives and engagement techniques has been a big learning curve.

Dan Fawkes: We’ve also learned the importance of sustainability. We’ve built internal capability, with our team now co-facilitating alongside Pro-Noctis. That means we’re getting a return on investment and making the programme more sustainable.

I’ve worked with many external providers before, and it can sometimes feel like they’re just there to deliver and move on. But Pro-Noctis has been flexible and responsive.

What’s next for South Tees and Pro-Noctis?

Kate Harrison: We’re expanding. South Tees is now part of a larger group structure, University Hospitals Tees, which means working alongside colleagues from another Trust much more closely than ever before. The challenge now is creating a consistent leadership culture across multiple sites.

Dan Fawkes: We already have a series of HPP programmes lined up, but we’re also launching Leading Through Change workshops. The NHS is constantly evolving, and this group model will bring even more change.

With increasing financial pressures, leadership has never been more critical. While resources are being reduced, we need our leaders to be more effective than ever. That’s why we’ll be drawing on everything we’ve learned with Pro-Noctis to support our teams through this transition.

At Pro-Noctis, we specialise in helping people get the best out of themselves and their teams. If you would like to find out more about how we can help you improve performance – personally, or professionally – get in touch for a free consultation.