NHS: Royal Berkshire

Developing leaders to align power with purpose and patient care


Royal Berkshire NHS Foundation Trust is one of the largest general hospital trusts in the UK. Providing acute medical and surgical services to Reading, Wokingham and West Berkshire in specialist services such as cancer, dialysis and ophthalmology.

The Trust was struggling to deliver its efficiency targets. But creating strategies was a challenge because an embedded hierarchical culture stopped people on the ground from offering their ideas. Over time, power was determined by professional status rather than patient care; a way of working that blurred business and medical issues.


We designed and delivered a two-fold intervention that challenged the way the Trust’s leaders and their managers were thinking and acting:

  • Firstly, we helped the CEO and directors to speak and act in alignment with the values and vision of the Trust
  • Secondly, we worked with the management community to drive a meaningful and credible culture change throughout different disciplines and levels within the Trust


  • Within six months the Trust achieved £7 million savings whilst maintaining service levels
  • Within a year average patient waiting times were reduced from 16 to 2 weeks
  • Permission was granted to proceed with formulating future strategies
  • Transformed the culture and developed 7,500 people, over 3 years
  • Service levels maintained (short term) and enhanced (long term)
"Our culture was constrained and rule bound. Achieve Breakthrough supported and coached us as leaders in harnessing the power of all staff to shift the organisation from a culture centred around professions and hierarchies to one focused on the patient and the patient care process" Former CEO