Organisational Development Ltd
NHS Clinical Team Examples
Paediatrics Department
Crisis containment and team rebuild
(General Hospital within multi-site Trust)
A Paediatrics medical team erupted into conflict: Incident reports weaponised, registrars shouting across wards, toxic emails, and HR triggering four behavioural investigations. One consultant monopolised the rota, another was suspended, and the Clinical Lead was stretched to breaking point.
We conducted one‑on‑one deep-listening sessions, then used our Tri‑Factor Diagnostic to map operational, relational, and cultural fractures in a facilitated workshop. The team aligned on priorities and we executed:
ESCI 360 diagnostics & team workshop; One‑to‑one coaching for the Clinical Lead; Targeted mediation between warring consultants; Governance lead training in “Just & Learning” incident reviews; Rota redesign to break the consultant monopoly; Exit or transition of the most toxic individuals.
Result: Within 90 days, all investigations were closed, communication channels reopened, governance stabilised, and the department returned to focused, collaborative care.
Anaesthetics Department
High Impact Intervention and Reset
Acute Hospital within Regional NHS Trust
An Anaesthetics team had recorded 21 incidents of bullying and abuse in nine months. Junior doctors were off sick, nurses refused to work with certain consultants, emails were sent to the CEO, grievances were weekly, and the Clinical Lead had resigned.
Partnering with HRBP and the CMO, we held a mandatory “Friday Showdown” for all consultants to present the facts judgment‑free—and then listen. After an hour of airing grievances, the CMO held the room to account (including asking a disruptive consultant to leave).
Using the Tri‑Factor Diagnostic, we replayed the feedback and they felt heard. They immediately filled the Clinical Lead role. Two follow‑up workshops addressed relational skills (Non‑Violent Communication) and practical “hygiene” fixes (equipment, layout, shifts).
Result: All complaints ceased, rotas stabilised, and stress levels dropped—delivering a functional, accountable team within one month.
Ophthalmology Department
Repairing Relationships and Restoring Performance
Multi-site Acute and Community Trust
A new Clinical Lead faced entrenched, income‑focused consultants blocking service improvements. Backlogs soared, morale plummeted, and the leadership triumvirate (clinical, ops, nursing) had disbanded. Governance and admin disputes reached the Board.
I coached the Clinical Lead, reactivated the triumvirate with clear roles, then ran a Dialogue Diagnostic across the department to map culture, morale, and operational stressors.
Key actions: Played back findings and co‑designed an all‑staff workshop; Formally challenged and realigned a disruptive consultant’s job plan, ending a three‑year rift; Observed and coached audit meetings, giving direct feedback on hierarchy and communication; Brokered joint action plans between admin and governance leads.
Result: Over 12 months, the department stabilised, backlog reduced, performance improved across all metrics, and key talent was retained.
Trauma & Orthopaedics Dept.
From Standoff to Solutions
Acute and Community NHS Trust
A dispute between senior T&O consultants had escalated into a standoff with executives. Lawyers were poised to step in, and an external review (based on a tiny sample) had branded the entire department “toxic.” Key staff threatened to leave, and the Trust’s reputation was at risk.
I partnered with executives to lead two intensive, two‑hour full‑team dialogic sessions in which every consultant could speak. Their feedback showed the core culture wasn’t toxic—but that mistrust, broken reporting processes, and unanswered questions had fuelled the crisis.
Key actions:
-
Presented and validated consultant concerns without blame, then mapped themes through my Tri‑Factor Diagnostic
-
Rapidly engaged the Executive Management Group to address valid issues, correct misperceptions, and establish clear concern‑raising protocols
-
Provided ongoing one‑to‑one coaching for the DGM to spearhead relationship repair, public reputation recovery, and operational role realignment
Result: Within 90 days, legal threats evaporated, at‑risk consultants stayed, and the department regained stability, trust, and sustained performance.