Development Centre
Programme: Finance
 HR
 Nursing (Nottinghamshire)
2015/16
APPLICATION FORM
Dear Colleagues,
Many thanks for expressing an interest in the 2015/16 Development Centre Programme. This new programme you are applying for
aims to offer those interested in or new to a Director role the opportunity to explore the complexities in preparing for the role in
more depth. You should emerge from the programme with a deeper understanding of the role and greater confidence,
knowledge and skills to be interview ready.
The programme will be based around enhancing your skills and behaviours using the current NHS 360 Healthcare Leadership model to
prepare you for your first step into a Director role:1. Leading with care
2. Connecting the service
3. Sharing the vision
4. Influencing for results
5. Engaging the team
6. Evaluating information
7. Inspiring shared purpose
8. Developing capability
9. Holding to account
Our programme is designed for participants who along with the ambition to become one of the future Directors of within the NHS, you
will also have the following characteristics:
• A passion for delivering high quality services to improve patient care
• Able to communicate across boundaries
• Able to show an interest in the system and want to change their environment for the better
• Show an insight into their own behaviours and authentic self-awareness
• A “can do” positive attitude and enthusiasm
• Able to listen to and build on feedback from others
• Have authenticity, integrity, compassion and humility
• Able to engage others and build commitment
• Able and willing to learn
• Be respected and valued by their colleagues
This application isn’t a traditional application form – we want to find out more about you and what motivates you, as well as the things
that you find frustrating. Authentic, values based leadership is critical for health service leaders of the future and it is important to us
that we understand who you are and what you have achieved in your career.
The application form will be used to select successfully shortlisted candidates to attend a Development Centre on either one of the
following 3 dates, Thursday 3rd March, 6th April or the 16th June 2016. The purpose of the initial Development Centre is to gather
further information around your development needs and to highlight areas for you to focus on going forward on the programme and
within your individual coaching sessions.
Full details of the dates of the programme are listed in the application form and you will need to be able to attend all of the compulsory
dates to be able to apply. For more information please contact the Academy at
eastmidlands.leadershipacademy@nottshc.nhs.uk or telephone 0115 748 4277.
So, good luck and best wishes!
Yours sincerely
Paul O’Neill
Director
East Midlands Leadership Academy
Lyndsay Short
Deputy Director
East Midlands Leadership Academy
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Development Centre Programme
Eligibility
The Development Centre programme is aimed at individuals are recently new to the role of a Director of Finance, HR or Nursing
(Nottinghamshire region only) or who aspire to become a Director of within the next 3 years, and have been or are currently
deputies or heads of for some time and progressed through available personal development programmes and are looking for
their first Board level role.
We are especially interested in ensuring that leaders represent the diverse backgrounds that we serve across the East Midlands and
would warmly welcome applications from underrepresented groups, whose involvement would richly add to the programme; Full or
part-time staff may apply.
Attendance requirements
The duration of this programme is 4 months. If you are successfully accepted onto the programme you will be able to attend one of
the 3 Development Centres and all coaching sessions as agreed with your coach. You will also have the option to access a 2 day
residential programme on preparing for Director roles and at least 1 EMLA Masterclass:
Workshops
Development Centre
Development Centre
Development Centre
Dates
3rd March 2016
th
6 April 2016
th
16 June 2016
st
Duration
Full day
Full day
Full day
Optional – Residential - Preparing for
Director roles
30 & 31 March 2016
Full days
Optional – Residential - Preparing for
Director roles
9th & 10th May 2016
Full days
Optional – Residential - Preparing for
Director roles
18th & 19th July 2016
Full days
4 x Coaching Sessions
To be determined with your Coach
4 x 2 hour sessions
1 x EMLA Masterclasses (TBC based on
needs analysis from group 360 feedback)
TBC
TBC
Sponsors and Line Managers
You will need to identify a sponsor. This could be your Line Manager but doesn’t need to be. Your sponsor is responsible for supporting you
through the programme and mentoring throughout the programme.
Line Managers / sponsors will be required to support your application with a written testimony, and will be required to sign this
application to show that they give authorisation for you to be released from your role on all of these dates and that you have gained
organisational commitment to your development.
Completing This Application Form
The closing date for applications is 5.00pm Monday 8th February 2016. Unfortunately there will be no extension of this deadline
except where there are extreme mitigating circumstances. Please complete all relevant sections and email to
eastmidlands.leadershipacademy@nottshc.nhs.uk, marked Development Centre Application.
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Section 1: Personal Details
All components of this application form need to be completed otherwise your application will be void.
ABOUT YOU
Title:
First Name:
Surname:
Job Title:
Position/Grade/AFC Banding:
Employing Organisation Name
Work Address:
Postcode:
Email Address:
Telephone Number:
Mobile:
ABOUT YOUR LINE MANAGER
Name of Line Manager:
Job Title:
Employing Organisation Name:
Address of Line Manager:
Postcode:
Email Address :
Telephone Number:
ABOUT YOUR SPONSOR (If different to your line manager)
Name of Sponsor
Job Title
Employing Organisation Name
Address of Sponsor
Postcode
Email Address
Telephone Number
EQUALITY MONITORING FORM
This form will not be part of the selection process and will be collated separately for our monitoring of equality and diversity.
ARE YOU (please highlight which applies)
Male
Female
I do not wish to disclose
WHAT IS YOUR AGE GROUP (please highlight which applies)
Under 25
25-29
55-60
Over 60
30-34
35-39
40-44
45-49
50-54
I do not wish to disclose
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ETHNICITY (please highlight which applies)
African
Other Ethnic Group
British White
Other mixed
Bangladeshi
Other White
Caribbean
Pakistani
Chinese
White and Black African mixed
Indian
White and Asian mixed
Irish White
White and Black Caribbean mixed
Other Asian or Asian British
I do not wish to disclose
Other Black or Black British
HOW DO YOU DESCRIBE YOUR RELIGION / BELIEF? (please highlight which applies)
Atheism
Jainism
Buddhism
Judaism
Christianity
Sikhism
Hinduism
Other
Islam
I do not wish to disclose
PLEASE INDICATE WHICH TERM WOULD BEST DESCRIBE YOUR SEXUALITY
Bisexual
Gay
Heterosexual
Lesbian
I do not wish to disclose
DO YOU HAVE A DISABILITY?
No
Yes
If you answered yes, and would like to, please indicate the nature of your disability (please select as many as are applicable)
Dyslexia/ Learning disability
Blind/ Partially sighted
Deaf/ Hearing impairment
Mobility difficulties
Personal care
Mental Health difficulty
Unseen disability
(e.g. diabetes, epilepsy, asthma)
Multiple disabilities
Autistic Spectrum Disorder
(incl Asperger’s Syndrome)
Dietary requirements:
Access required:
Other, please specify
ENGAGEMENT BACKGROUND (please highlight which applies)
Medical
Clinical
Finance / Administration
Management
Other, please specify
I do not wish to disclose
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Section 2: Supporting Evidence
Please Confirm the following:
Yes/ No
Attached an up to date CV
Yes/ No
Completed Appraisal in last 12 months
Yes/ No
Current PDP in Place
Yes/ No
Have you completed a 360 in the last 12 months?
Yes/ No
Support from HRD/OD along with Line Manager/nominator support
Please answer the following questions. Please answer in no more than 2100 characters (approximately 300 words).
1. PLEASE CAN YOU DESCRIBE YOUR MOTIVATIONS FOR APPLYING TO PARTICIPATE ON THE DEVELOPMENT CENTRE
PROGRAMME?
2. PLEASE DESCRIBE THE CHALLENGES YOU ANTICIPATE IN PREPARING FOR YOUR NEXT ROLE / CURRENT ROLE (if recently
appointed as a director):
3. WHAT EXPOSURE IF ANY, HAVE YOU HAD TO YOUR CURRENT BOARD? PLEASE DESCRIBE THE ACTIVITY, THE PURPOSE AND
THE OUTCOME INVOLVED
In framing your response, please think about the following:
• What led up to the situation?
• What was the outcome?
• Who was involved?
• What was, or will be the impact for patients?
• What was your involvement?
• What did you learn from this?
• What behaviours did you demonstrate?
4. PLEASE IDENTIFY 3 OBJECTIVES THAT YOU HOPE TO ACHIEVE BY GOING ON THIS PROGRAMME:
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5. HOW WILL YOUR ATTENDANCE ON THIS PROGRAMME BENEFIT:
(a) your team
(b) your line manager
(c) your organisation
(d) patients, careers and service users
6. PLEASE PROVIDE TWO EXAMPLES OF DELIVERY SUCCESS IN YOUR ROLE IN THE PAST TWO YEARS.
You should include your personal involvement, the role you played and how you influenced others.
In framing your response, please think about the following:
• What led up to the situation?
• What was the outcome?
• Who was involved?
• What was, or will be the impact for patients?
• What was your involvement?
• What did you learn from this?
• What behaviours did you demonstrate?
7. PLEASE DESCRIBE AN OCCASION WHEN YOU WERE FRUSTRATED BY SOMETHING, WHAT YOU DID, AND WHAT THE RESULT WAS.
In framing your response, please think about the following:
• What led up to the situation?
• What was the outcome?
• Who was involved?
• What was, or will be the impact for patients?
• What was your involvement?
• What did you learn from this?
• What behaviours did you demonstrate?
8. WHEN DO YOU THINK YOU WILL BE READY TO TAKE ON THE ROLE OF DIRECTOR?
6 MONTHS
12 MONTHS
18 MONTHS 2 YEARS
3 YEARS
9. PLEASE INDICATE BELOW YOUR ORDER OF PREFERENCE FOR ATTENDING ONE OF THE THREE DEVELOPMENT CENTRES
AVAILABLE:
3RD MARCH 2016
6TH APRIL 2016
16TH JUNE 2016
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LINE MANAGER/ SPONSOR PLEASE COMPLETE THE FOLLOWING QUESTIONS:
PLEASE SUMMARISE WHY YOU FEEL THAT THIS PARTICIPANT IS SUITABLE FOR THE DEVELOPMENT CENTRE PROGRAMME?
PLEASE IDENTIFY THREE KEY CHALLENGES THAT THE PARTICIPANT COULD FACE IN THEIR NEXT ROLE (OR NEW ROLE IF
RECENTLY APPOINTED TO DIRECTOR)?
PLEASE OUTLINE WAYS THAT THIS PARTICIPANT WILL BENEFIT FROM THIS PROGRAMME BY IDENTIFYING THREE
DEVELOPMENT AREAS THAT YOU WOULD LIKE TO SEE THEM PROGRESS IN
PLEASE IDENTIFY TWO KEY STRENGTHS THAT YOU REALLY VALUE IN THE PARTICIPANT
AS A LINE MANAGER / SPONSOR HOW WOULD YOU LIKE TO SEE THIS PROGRAMME BENEFIT YOUR ORGANISATION AND
HOW WOULD YOU MEASURE SUCCESS?
AS A LINE MANAGER / SPONSOR USING THE 9 BOX GRID ON THE FOLLOWING PAGE – WITH THE APPLICANT PLEASE INDICATE
WHERE YOU BOTH FEEL THAT THE INDIVIDUAL SITS WITHIN THE GRID.
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Talent Grid - 9 Box
This is the ‘standard’ 9 box grid used to assess both performance and potential.
The tool can be used to help you map / assess individuals within your organisation and give you an idea of the current status of
performance and potential by plotting all employees on an organisational talent grid.
You can use outcomes of the assessment to help identify the areas to focus your talent development work, and also link these
outcomes to inform your succession planning.
Measures of Performance include:
1. Consistent achievement of goals over time
2. Delivery or participation in projects
3. Appraisal results
Meeting Expectations
Exceeds
Expectations
Measures of Potential include:
 Ability to inspire others
 Acts as a role model to others
 Communicates vision
 Engages with a broad range of stakeholders
 Lives the NHS values
 Able to handle complex organisational challenges
SPECIALIST IN FIELD
High Performance, Low Potential
1. Very competent in own field,
potentially reached ‘expert’
stage of their potential
2. Far exceeds performance
expectations
3. Potentially capable of
assuming a new role within
their specialist field
4. Acts as role model for
organisational behaviours and
values
EMERGING POTENTIAL
High Performance, Medium Potential
1. Far Exceeds Performance
Expectations
2. Capable of growing into a more
complex role
3. Could advance to the next level
4. Very competent and flexible
5. Acts as role model for
organizational behaviours and
values
ROLE MODEL – TOP TALENT
High Performance, High Potential
1. Far exceeds performance
2. High potential to grow into a role
with broader responsibility.
3. Could advance one level now
4. Highly competent in current role
5. Acts as role model for
organisational behaviours and
values
EMERGING SPECIALIST
Medium Performance, Low Potential
1. Reliably meets performance
expectations
2. Behaves in line with
organisational values
3. Capable of assuming positions at
the same level of complexity
4. Competent in current role and
specialist area
VALUED CORE CONTRIBUTOR
Medium Performance, Medium Potential
1. Reliably meets performance
expectations
2. Capable of growing into a more
complex role in time
3. Behaves in line with organisational
values
4. Competent in current role, but
flexible into others
5. Core to the business, consistent
performance results
HIGH POTENTIAL
Medium Performance, High Potential
1. Reliably meets performance
expectations
2. Potential to grow into a role with
much broader responsibilities at least
one level
3. Behaves in line with organisational
values
4. Competent in role and can flex into
others
5. Core to the business, consistent
performance results
POSSIBLE ROLE MISMATCH
Low Performance, Low Potential
1. Below performance expectations
2. Lacks competence in current role
and displays behaviour not
congruent with organizational
values
3. If no improvement displayed,
leaving the organisation may be
appropriate
DEVELOPING CONTRIBUTOR
Low Performance, Medium Potential
1. Below performance expectations
2. Inconsistent performance and still
aligning behaviours to values
3. Lacks competence in current role
4. May still be new to position, and
need some time to develop
5. Improved performance is necessary
NEW TO ROLE
Low Performance, High Potential
1. Understanding / adapting to a new
role
2. Too early to assess performance
3. Understanding behaviours expected
4. Could take on greater responsibilities
5. Possible successful results once this
person matures in their new role
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Section 3: Declarations
Attendance of all aspects of the programme is paramount and below we are looking for your commitment to this.
All components of this section need to be completed otherwise your application will be void.
1. DEVELOPMENT CENTRE DATE
If your application is successful, you will need to be able to take part in one of the three available Development Centres. Please
highlight to indicate your availability and enter this date in your diary until you are notified of the outcome of your application:
Yes
No
2. PROGRAMME DATES
If your application is successful, you will be required to attend all the compulsory dates of the programme and also commit to
filling in evaluation surveys for the programme.
Are you available to attend all of the compulsory dates listed at the front of this document?
Yes
No
THE APPLICANT
I have read and fully commit to participating in the Development centre programme if my application is successful. I realise the
importance of full attendance and I am available for all the dates listed.
Yes
No
Signature
Date
THE LINE MANAGER/SPONSOR
I have read and fully understand the commitment that is required of the applicant and I am prepared to support them
throughout the programme.
Yes
No
Signature
Date
Actual or electronic signatures are required. Please email your completed form to
eastmidlands.leadershipacademy@nottshc.nhs.uk. The closing date for submissions is 5.00pm Monday 8th February 2016.
Unfortunately, there will be no extension of this deadline except where there are extreme mitigating circumstances. An email
will be sent to you as receipt of your application within 48 hours.
If you have any questions please email eastmidlands.leadershipacademy@nottshc.nhs.uk or telephone 0115 748 4277.
For subscribing member organisations there is no charge to attend this programme. For Pay As You Go members the cost per
place is £4,500.
Please also read our full cancellation policy for EMLA programme which is available –
EMLA Cancellation
Policy.docx
East Midlands Leadership Academy
Floor C . Institute of Mental Health . University of Nottingham Innovation Park (UNIP)
Triumph Road . Nottingham . NG7 2TU
Tel: 0115 748 4277 Email: eastmidlands.leadershipacademy@nottshc.nhs.uk
www.leadershipeastmidlands.nhs.uk
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