A better culture for better healthcare

Royal Berkshire NHS Foundation Trust

Royal Berkshire NHS Foundation Trust is one of the largest in the UK, providing acute medical, surgical and specialist services across the Berkshire area.


Reduction in absences due to staff sickness


Reduction in staff turnover

From 87% to 100%

Completion rate of staff appraisals


Royal Berkshire NHS Foundation Trust




In the context of the Francis Report, published in 2013, which highlighted improvements necessary across the NHS, the Trust prioritised a number of key areas, including culture, behaviour and values.

Thus, in the summer of 2014, The Pacific Institute® was brought in to assist with this endeavour. Several   staff   members   were   trained   up as Investment In Excellence® (IIE®) Facilitators, with the aim of rolling the programme out across the organisation. Rather than focusing solely on senior management, the programme has been offered to all levels of employees.

To date, 215 staff members have been through the programme, with the 15th cohort having completed at the end of 2016. Further cohorts are scheduled throughout 2017.


Marsh Maternity Ward:

Two years on, the hospital is now starting to see the results of this investment.  The Trust’s maternity directorate has been the biggest advocate of IIE® to date, with representatives from the department attending each of the programmes run thus far. In many cases, maternity staff have even formed the majority of the group. Indeed, Marsh Ward, one of several maternity wards at the Trust, is leading the way, demonstrating what an impact IIE® can have on this sector.

Although only a third of the staff on the ward have experienced the programme thus far, they have transformed the culture and working environment for all, with their enthusiasm rubbing off on their fellow colleagues. More programmes are planned for 2017.


Staff on the ward have gone on to implement several measures to make the ward a more positive place to work. This has involved the introduction of positive team evenings, which provide focus, clear objectives and a sense of belonging. Emphasis was placed not only on teamwork, but also on the individual to ensure that the whole group bought in to the changes. This is exemplified by the group’s decision to name themselves ‘MARSHIANS’ (Motivated, Assertive, Reliable, Supportive, Hardworking, Inspiring, Amazing, Nurturing, Strong), demonstrating their pride in their reinvigorated team. Posters have been placed strategically across the ward, spelling out the dual-meaning of this aspirational acronym. It is clear that these transformational changes have been instigated by junior staff members, such as health care assistants, with senior managers then buying into the process. It was spearheaded from the bottom up, ensuring the team’s genuine and complete ultimate buy-in.


The dramatic improvements to the culture of Marsh Ward has not just been felt by the staff, but is also evident from the statistical data measured annually. Comparing the results of annual data collected in 2015 to that of 2016, the improvements identified are staggering and clearly reflect the transformational and tangible effect that that the programme has had on the ward’s performance.


Indeed, these changes have also translated to patient care, with improved feedback noted. One patient even compared the ward to an all-inclusive holiday, demonstrating the high levels of patient satisfaction.

With Marsh Ward the envy of the other maternity wards and departments across the Trust, many senior managers are now looking to replicate this model, aspiring to achieve similar levels of success. As more staff from across the Trust experience the programme, it is anticipated that similar improvements will be measured across the board.

Moreover, recognition of the positive impact of this initiative has also come at a national level, with the Trust having recently won the ‘Chamberlain Dunn Learning Award for Education, Learning and Development’ at the 2017 HPMA Excellence in HRM Awards. This award recognises organisational cultures within healthcare organisations that promote an open, constructive and innovative approach to learning, talent and performance, whilst also linking learning and development strategies with key organisational goals.