Board: Summary Report
Date of Board meeting:
26th October 2011
Title of report:
Update on the Actions resulting from the NHS National Staff
Survey 2010
Title of director:
Director of Organisation Development and Workforce
Paper number:
WL2166
For decision
X For discussion
X For information
Purpose of the report:
To update the Board on the progress on actions to address the results of the Staff Survey 2010.
Action required:
The Board is asked to note and discuss the content of the report.
Summary of key issues
Some progress has been made on the majority of agreed actions to address the
disengagement of staff, but there are other understandable actions which are likely to have a
negative impact on staff perceptions – changes to terms and conditions. Furthermore, there
remain inconsistencies in management style and practice, so the espoused values are not
yet embedded everywhere.
Relationship with the Assurance Framework (Risks, Controls, and Assurance):
CO1 - To provide a safe and effective service
CO2 - To provide a positive and consistent patient experience
CO5 - To build an engaged and patient focused workforce
Care Quality Commission Registration Regulations:
Regulation 21 - Requirements relating to workers
Regulation 22 - Staffing
Regulation 23 - Supporting workers
Summary of Financial and Legal Implications:
Good workforce utilisation, management and development are a key component of corporate
governance and financial control.
Equality & Diversity and Public & Patient Involvement Implications:
Links to ensuring fairness and equal opportunities for all staff
PROGRESS UPDATE ON AGREED ACTIONS FROM THE 2010 STAFF SURVEY
1.
INTRODUCTION
1.1
This paper provides an update on each of the actions agreed by the Trust Board in May 2011
to address the Staff Survey results. It also highlights other relevant activity that may
contribute to improvements in staff satisfaction, and outlines factors that may adversely affect
staff satisfaction.
1.2
The annual NHS Staff Survey is conducted in October each year so this paper also outlines
the actions that have been taken to improve the response rate and also to improve the
analysis of results.
1.3
The Board are invited to discuss and note the contents.
2.
ACTION UPDATES
2.1
Sharing Information - The staff survey results have been communicated at corporate and
local levels. The Exchange featured the Board report and CSUs were provided with unit
specific information to enable local discussions, suggestions and prioritisation of possible
actions. Team Brief was also used to communicate and feature were included in Mental
Health Matters.
2.2
A Fix It Fund of £50k has been launched to encourage staff engagement and to support the
implementation of good staff ideas. The fund was announced at the Quality Awards in
September and the application form has been placed on the Exchange. This facility was also
featured in Team Brief and one bid is already being worked up. The details are included in
Appendix 1.
2.3
Setting A Clear Direction - The vision, mission, goal/ objectives and IBP were drafted for the
1st August deadline and CSU Directors have subsequently been sharing Trust and CSU
plans. Specialist and Forensic Services has been very open and shared the scale of the
anticipated staff reductions whilst highlighting the opportunities for business growth which
would mitigate the deletion of posts. Similar activity will be repeated at Broadmoor but has
been delayed for the decision on the future of DSPD services, which is still awaited. Local
Services has only recently got a full senior management team and have just received
approval for the project resource required to support the implementation of their ambitious
plans. A commitment to present Trust, CSU and supporting plans has been made by all
Directors and there will be further opportunities to ensure face to face discussions with the roll
out of the Business plans for 2012/13 once the implications of the commissioning intentions
are clear.
2.4
Leadership and Management Development – The QUASIC Programme has been rolled
out for nursing managers across the London services and the Board has agreed to the
extension of the programme to another 200 managers. Some 79 clinical managers have
either completed, or are going through the 6 month programme. Work is also about to
commence on designing a programme for managers graded below Band 7 and aspirant
managers. Hopefully it will be possible to involve some of the QUASIC graduates to deliver
some aspects of the new programme as this could provide them with greater variety, further
development and enhanced job satisfaction. This methodology would also enhance
organisational capability and capacity, but will probably require backfill arrangements to avoid
undermining operational areas. Accordingly a case will be required to obtain the necessary
funding.
The extension of the QUASIC Programme should help to create a common language as well
as promote the desired culture. However, further work is being undertaken to ensure
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effective measurement of its long term impact is in place, and enables ongoing modifications
to ensure continuous improvement and fit given the pace of change.
2.5
Staff and Management Charter – the charter was distributed via the current face to face
channels (Appraisal, PDR and Objective Setting processes) to ensure dialogues about the
content. The charter is given to new entrants at induction as part of the Directors’ welcome
which includes the screening of a video outlining the Trust Values.
The Board receives a monthly update on objective setting and appraisal so there is evidence
that aspects of the rights and responsibilities are being enacted though not consistently
across the organisation. The HR Business Partners provide detailed information to their
managers and such matters are picked up in the CSU Quarterly Performance Mtgs.
2.6
Strengthening Appraisal – A 360 degree feedback process was successfully used in the OD
& Workforce Directorate for the 2010/11 appraisals. Accordingly the corporate PDR process
is to be modified to encourage 360 degree feedback to ensure more robust and holistic
discussions of performance. Given the importance of the multi-disciplinary team (clinical and
non clinical, or a mix of both) the Learning and Development team are working with the
Exchange team to incorporate 360 feedback into the appraisal process in 2012.
A sample audit of appraisal records indicates that some appraisals are well documented and
thorough, whilst others are not of an acceptable standard. There clearly are issues of poor
quality which require further attention. Although it is possible that the actual conversations
were meaningful it is still necessary to have robust documentation, especially if there is a
capability issue. Furthermore it is helpful and respectful if the individual receives an accurate
record of the discussion.
As at the end of Sept 63% of staff are recorded as having had an appraisal and given the
annual cycle a higher percentage would have been expected. Clearly there is a need to
increase focus on this important activity. The management restructuring, with the departure
of a number of senior managers, seems to have contributed to lower rates in some areas and
it is therefore more difficult to robustly plug the gap. However, 83% of staff have objectives
which is an encouraging indicator.
2.7
Introducing the NHS London Talent Management process – The Trust has signed up to
the process that NHS London are promoting, which requires conversations about individuals’
aspirations and associated feedback on their realism, plus any development support if
appropriate. 20 Directors and senior managers have attended day long Talent Management
Conversations training and further training will be delivered internally for managers who are
facilitating the sessions, as well as familiarisation sessions for the 120 participants. At the
time of writing 37 participants had attended the internally delivered training. Each directorate
has chosen their initial target population and everyone taking part has received an
introductory letter from the Chief Executive (Appendix 2). The target population includes
Directors and their direct reports, as well as senior clinical managers.
The Executive Team have completed a calibration meeting, facilitated by an experienced
Talent Coach who is funded by the SHA. This meeting helped to ensure a collective view of
‘potential’ and ‘good performance’, to minimise the possibility of mismanaging individuals’
expectations. The web based system has been loaded with our data and two systems
administrators have been trained. Log on details are being distributed to participants who will
complete specially designed forms prior to meeting with their manager to discuss their views
and to receive feedback. Clearly it is hoped that this process will reinforce performance
management messages but also highlight the support that may be needed to enable an
individual to develop and progress their careers. The process is also designed to increase
confidence in having open and honest conversations.
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The information will also inform senior succession planning exercises that were started by the
Department of Health a few years ago. The outcomes will be shared with the Trust’s
Remuneration Committee.
2.8
Leadership Development Strategy Audit1 and was undertaken in April and the findings
were shared with the participants. Work is underway to audit the flexible training expenditure
to enable discussions about how we can best use our limited resources, as well as get the
best return on our spend. Hopefully as part of the business planning process it will be
possible to aggregate needs and develop a Trust wide training plan which fulfils CSU
requirements.
2.9
Improve Communication - The monthly Team Brief content is discussed and finalised by the
Executive Directors. Meeting shortly after the Board it ensure that key decisions can be
conveyed so that everyone knows what issues the Board is dealing with. The aim is to
ensure that the “big picture” is consistently being cascaded throughout the organisation along
with updates on our progress and expressions of appreciation.
Local areas have also taken initiatives to improve communication. Broadmoor for example
has implemented a ‘Back to the Floor’ initiative for senior managers, which came directly from
the comparatively poor rating from Broadmoor respondents regarding the effectiveness of
communication between senior management and staff. “Only 19% of staff at Broadmoor
(27% Trust average) of staff felt that senior managers were here to try to involve staff in
important decisions and only 19% of staff at Broadmoor (23% Trust average) felt that
communications between senior management and staff was effective.” Attendance at the
Broadmoor Staff Open Forum is also being encouraged.
2.10
Strengthen Selection Processes so that aptitude and attitudes are tested as part of the
process and that development needs identified are discussed with successful candidate and
built into PDRs from the outset. A Values questionnaire has been introduced and managers
are free to include various means to assess relevant competencies and qualities including
literacy, numeracy and typing tests; presentations; stakeholder interactions; a basket of tasks
which might include writing a synopsis, and other selection methods.
2.11
Genuine Consultation – The quality of consultation documentation and processes has
improved but there has been occasionally been a lack of consistency. However, the Trust
has demonstrated its listening skills and a poor consultation in Local Services was stopped,
and quickly followed by the Director visiting concerned staff to get the process back on track.
2.12
Ward Managers Job Descriptions – Some work has been done through the restructuring
exercises. The QUASIC programme helps to clarify expectations and role requirements but it
is likely that more effort is required to strip out work that can be pushed down to team leaders
and to focus on value added activity. The future introduction of e-rostering should release
Ward Managers’ time and examining these pivotal roles would be worthwhile and needs to be
programmed.
3.
STILL TO PROGRESS
The items below have not been taken forward as yet
o As resource permits, introduce development and assessment centres for aspirant
managers.
o Provide middle managers with absolute clarity about their roles and the difference
between managing managers, as opposed to individual contributors. The QUASIC
programme will address this in part.
1
This Audit was conducted in April and feedback received by Executive Directors in May ll
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4.
OTHER RELEVANT ACTIVITY
4.1
Health Promotion - The Health and Wellbeing team have run 5 Health promotion days for
staff focussed on alcohol awareness; cholesterol testing; glucose and blood pressure, as well
as including stands on managing stress and building emotional resilience at work. This year
the travel co-ordinator and gym services joined the days, encouraging staff to increase their
physical activity levels. Over 400 staff have attended the various days.
The psychiatrist and counsellors have delivered two sessions of training to managers on
managing staff with mental health problems. This training was run as part of the gatehouse
training for new managers.
The Mi Wellbeing Pilot is an on-line well being tool to promote staff emotional and physical
well being. The on-line tool, accompanied by coaching from the Health at Work team,
encourages individuals to improve their own well being at home and at work. The pilot is
aimed at building emotional resilience, particularly with staff with high absence levels, stress.
An on-line referral system for counselling is being developed to enable staff to self refer
electronically for a counselling appointment and/or request training from the health at work
team. The system will go live by the end of the year.
4.2
Recognition – The Trust continues to run the popular Employee of the Month and the Annual
Quality Awards which recognise exceptional individuals. There is also an Annual Staff
Awards ceremony to celebrate all those staff who gained a qualification in the preceding year.
This year there were 94 successful colleagues who enjoyed lunch together as they received
certificates of achievement.
4.3
Policy Changes – The Trust has revised the guidance for staff and managers on dealing with
bullying and harassment by developing a Dignity at Work policy and its implementation will be
supported by training. Furthermore, investigations are being supported by a specially trained
HR Manager. The Capability policy is fully operational and the expected reduction in formal
disciplinary processes has materialised.
5.
NEXT STAFF SURVEY
5.1
The 2011 Staff Survey is just being distributed and in order to encourage responses vouchers
are being offered to randomly selected participants who will be drawn by Quality Health, our
survey provider, to maintain confidentiality. Furthermore, CSUs are encouraging staff to
complete the lengthy questionnaire.
Broadmoor for example have recruited Survey
Champions and will provide time for survey completion.
5.2
It is worth noting some of the things that are likely to affect staff perceptions and doubtless
influence the rating they ascribe to particular survey questions. In the current environment job
security remains a concern and the Trust has been very open and honest about the need to
improve productivity and adopt new ways of working. The prospective TUPE transfer for
Estates and Facilities staff doubtless raises anxieties and in order to maintain a competitive
position in the market the Trust has made changes to terms and conditions (e.g. cessation of
overtime at Broadmoor, planned removal of mufti allowance) and will need to continue to
mirror the terms and conditions offered by other Trusts (reduction of pay protection;
standardisation of on call allowances; increase and introduction of car parking charges).
5.3
The 2011 survey responses will be cut by CSU. The larger corporate directorates, such as
OD & Workforce, and Finance & Information, will get specific directorate feedback for the first
time. This should hopefully facilitate more useful dialogues.
The Board is asked to note and discuss the progress update on the 2010 Staff Survey
Action plan.
Ruth Lewis
Director of Organisation Development and Workforce
Oct 2011
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