Organisational Development Strategy February 2014 update

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1 Organisational Development Strategy February 2014 update Infrastructure Organisational structure SPA Integrated Community Team RAID NE Lincs CAMHS Corporate Technology and clinical systems Clinical systems benefit realisation IT equipment for community staff Rationalisation of bureaucracy Applied technology to improve patient care, support business development and support communication with teams Governance and policies Annual Governance Review Corporate Governance Framework Policy project Processes Admin Review Streamline Corporate Services LEAN Productive series Environment Estate Facilities Mobile working Home working Procurement Improved effectiveness and efficient functioning of the organisation Patient outcome: A clear sense of one organisation, integrated care giving consistency of experience regardless of location and intervention Organisational capability Training and compliance Training Needs Analysis Skills training Mandatory training Evaluation of learning outcomes Effective leadership Leadership offering Qualities and behaviours Visible leaders Empowerment Shadowing and coaching Workforce planning Business plan Service plans Workforce profile Workforce risk Capability and skills mix Skills audit Addressing the skills gap Benchmarking Talent Management Recruitment Induction Appraisals Succession planning Coaching Patient outcome: Increased confidence in the capability of our staff, recognised improved quality standards and patient care Change Management PMO SLM/SLR communication Energy for change Highly skilled, competent staff who have the leadership qualities and behaviours required to deliver better patient care Engagement Employee relations Review of local T&C s investigations performance Making a difference Participation & Involvement Action plans and outcomes Staff survey Cultural barometer Communication Developing infrastructure & channels for two way comms (SHARON, team brief) Specific staff campaigns Patient outcome: A positive experience when interacting with staff Roles and responsibilities Role profiles Accountability Performance Supervision Health and wellbeing Health and wellbeing programme Staff support Managing attendance Stress Reward & recognition Saying thank you Recognition budgets Long service awards Staff Excellence Awards External awards Reward Increased staff engagement and satisfaction. Recommendation of the Trust as an employer and provider of care to friends and family Care Compassion Competence Communication Courage Commitment 1

2 Engagement Employee relations Review of local T&C s investigations performance Making a difference Participation & Involvement Action plans and outcomes Staff survey Cultural barometer Communication Developing infrastructure & channels for two way comms (SHARON, team brief) Specific staff campaigns Patient outcome: A positive experience when interacting with staff Roles and responsibilities Role profiles Accountability Performance Supervision Health and wellbeing Health and wellbeing programme Staff support Managing attendance Stress Reward & recognition Saying thank you Recognition budgets Long service awards Staff Excellence Awards External awards Reward Increased staff engagement and satisfaction. Recommendation of the Trust as an employer and provider of care to friends and family Staff engagement journey 2013/14 New Year 2013 No surprises...? The Trust launched a significant staff engagement exercise during 2012, with the commencement of Making a Difference in autumn The Organisational Strategy identifies three key themes: infrastructure, capability and engagement - the activities to support these themes were refreshed and actions commencing. The 2012 staff survey gave a static picture when compared to Trust comparisons to 2011 comparisons in KFs demonstrated an improvement (positive change) 7 KFs demonstrated a marginal improvement (no significant change 11KFs demonstrated a marginal decline (no significant change) 7KFs were revised and so no comparison to 2011 Staff engagement score demonstrated no change. 2 4 KFs top 20% 23 KFs bottom 20% 4 Staff engagement score bottom 20% The staff results for 2012 were not a surprise, demonstrating the significant challenge required to drive culture and organisational change. Spring 2013 Start as we mean to go on! Upon the publication of the staff survey results, a communication from the Chief Executive was released to all the staff acknowledging the results, the need to improve and to encourage staff to attend forthcoming staff focus groups. A commitment to continue to listen to staff views The Trust embarked on an annual health check (4 March to 13 March 2013) which saw 300 frontline staff in focus groups across the Trust (Chesterfield, Lincoln, Gainsborough, Grantham, Stamford, Skegness, Boston and Spalding). The results of the health check were shared at the Board time-out on 15 April and with all staff. The Trust s first nursing conference took place with the launch of the national 6Cs. The Executive Team (ET) saw c.400 members of staff in one collective day of commitment on 13 March, using the opportunity of the national NHS Change Day. The team visits nearly 50 teams across the county, to raise awareness and briefly discuss with teams the Francis report and their collective roles and responsibilities; as well as demonstrate their support for the 6Cs and continue the effort to develop a culture of openness, transparency and honesty throughout LPFT about matters of concern. Launch of Speak up - a new discreet address for staff to highlight safety concerns. The Making a Difference session on PEOPLE took place from February to April 2013, with 58% of teams taking part. Making a Difference leaders day (1 May 2013) - Joint senior leaders and organisational development group meeting, which looked in detail at the staff survey results by service lines, leadership and the revised performance review process. 85% of managers who attended said they felt better equipped. May 2013 Making a Difference staff survey feedback on service line outcomes.

3 as part of the planning round for 2014/15. Crucial to the refresh of strategy are Transforming Mental Health Services issues, which required sign off to allow the Trust to move forward on transforming clinical services. Including a solution for Sycamore Assessment Unit in Grantham. Following a recent meeting of the Health Scrutiny Committee, the committee were happy with progress made with phase one of this major project and the Trust and South West Lincolnshire Clinical Commissioning Group will now proceed with a series of engagement events to involve and inform the full range of stakeholders and conclude phase one of the clinical strategy. The Committee also supported the permanent closure of Sycamore Assessment Unit for the final part of the consultative processes to be concluded. Read the full clinical strategy update by clicking this link Briefing point: Single Point of Access now available in Lincolnshire East As of 1 October our Single Point of Access (SPA) is now available in the east of the county, with the final Clinical Commissioning Group Lincolnshire West due for launch on 2 January Summer 2013 Do as we say we do! June 2013 saw the launch of the pilot e-cultural barometer launched with DART, Witham Court, Crisis teams and organisational development. A 40% return rate was achieved. The results indicated an improved picture. Trust cultural barometer headline results (Sept 13) I am proud to work for LPFT 64% Making a Difference PATIENT session took place from June to August 2013, focusing on the Francis report, Duty of Candour and how teams could contribute to improved patient care. 70% of teams took part. The cultural barometer was launched across the Trust in August and September 2013 and the Trust received a 40% return rate. Like the pilot the results indicated an improving picture, but that there were still concerns around communication and morale. July saw the launch of the formal monthly team briefing, as well as additional communication activities. Team briefed: Date of briefing: October 2013 Core briefing notes Briefing point: Payment by Results The Trust is now reporting that 46% of our patients have an in date cluster recorded. Recent media speculation on PbR has been unclear and we want to clarify that clustering our patients remains a high priority for clinical teams. The Trust has a target of 100% of patients clustered by the end of the year and a CQUIN target with commissioners for 2013/14, which will affect the Trust financially if we do not meet this. The Trust is already behind with this piece of work and it is extremely important that we do all we can to clinically code as soon as possible. PbR will help us understand what our costs are as an organisation, as well as our demand for services and affects how we will be paid in the future. If you would like help and assistance with anything around Payment by Results please contact Chris Ashwell on Briefing point: Sustainable Services Review Significant progress on the first phase of the Lincolnshire Sustainable Services Review has been made with our provider and commissioner colleagues. An analysis of the current health and care position is now complete and it has identified a number of key issues and opportunities which provide evidence for the second phase of work the design of future services. Care Design Groups (CDGs) have taken place in the following areas: urgent care, planned care, women and children and early intervention and long term care. A Lincolnshire Health and Care Summit will also take place this month with representatives from health and care professions, patients, service users and the wider community to look at initial design options. After this summit a blueprint for the future will be developed. More information is available in the second staff briefing available on SHARON. Briefing point: Director portfolio changes Following a recent review by the Executive Team of director portfolios, the team have agreed that some changes will be made with effect from 1 October to the director responsible for information and technology (IM&T). In many organisations these areas sit with the Director of Finance, and now Karen Berry is fully up to speed with the role since her appointment in February, she will now oversee these areas and drive the Trust s future ICT strategy, implementation of PbR, Service Line Reporting and clinical systems review. Briefing point: Clinical Strategy The Trust has made significant progress on implementing the clinical strategy, which is due to be refreshed I would recommended the Trust as a place for my family and friends to receive treatment 62% My area is good place to work 66% Morale in my area is high 65% Communication in my area is effective 51% The leadership in my area is visible and supportive 62% Behaviours of staff in my area support the Trust value of Respect 72% I receive regular feedback about my performance 65% I feel able to report safety concerns 77% Green = majority responded positively Red = majority responded negatively The Chief Executive roadshows, supported by the Executive Directors, took place in August, September and October Many staff indicated they had seen some positive improvements, but with an acknowledgement that there was still more to do. The roadshows were purposefully aimed at smaller groups of staff, to encourage more open conversations about the Trust, where we were going and what staff need to support them in delivering high quality and safe patient care. The Chief Executive saw nearly 300 members of staff during the roadshows. Generally feedback has been positive from those service users and GPs who have used SPA. The SPA team continue to refine and improve processes as the roll out continues and encourage teams where it is already available to feedback on areas for improvement or issues they are experiencing, so these can be resolved in the future. Contact Lynn Bourne on or Read more about SPA by using this link. 3

4 Autumn 2013 Inspirational leadership Making a Difference Cultural barometer session commenced in October 2013 to December 2013, with a 70% return rate and good feedback from teams for the teams to work on. Funded team away days and time aside/ forums to discuss issues. The autumn saw the continued focus on developing our leaders with the Making it happen through leadership programme commencing with an ODG/SLT session on change and leadership. The Trust s new Inspirational Leadership Programme (ILP) also launched in December. Over 80% of the 100 leaders who attended said they felt inspired. The Leadership Prospectus was developed and distributed during December. The Trust had three shortlisted finalists in the East Midlands Leadership Academy Recognition Awards. Paul Jackman won NHS Community Leader of the Year and Steve Wyatt won NHS Patient Inclusivity Leader of the Year. Emma Britchford was also shortlisted in NHS Emerging Leader of the Year. Both Paul and Steve go forward to the national awards on 24th February IAPT team to reconsider the amount of clinical contacts for clinical staff Improve communication between community and ward based staff - agree method of communicating recommendations and reviewing cases with staff that have limited access to Silverlink. Not all of the Trust are engaged yet and all staff/ services need to get on board with Making a Difference Everyone is reminded that their views and opinions are valued, needed and important Better attitudes from higher - blame culture persists Strategy Culture We need a solution based approach - there is an opportunity in team meetings to raise issues. Commence planning 2014 development day - ask staff for suggestions of what they would like to see on agenda Team are proud to work for LPFT but feel more work to do in corporate and local understanding and working together More recognition of good work done by teams. Meaningful training for all grades and an opportunity to undertake and enhance existing skills - not just mandatory training For issues that need actioning, that s are sent in a timely fashion - too many arrive with short timescales for action to be completed Greater access to managers and understanding what they do and where they are - access to all staff and managers calendars Investment in admin and clerical support. Keep staff up to date with changes and trustwide activities Maximise timely communication, including actions needed by staff to enable prompt delivery of nonclinical objectives and minimise conflict with clinical work Commit to ensuring the operational managers meeting takes place consistently, as there is a tendency to deprioritise it Structure Review skill mix, as it has been identified that another band 2 would be beneficial to the team to keep up with data inputting Achieving Anonymous Making a Difference suggestion box for staff which will lead into a you said, we did board Investment in technology so that clinical staff have more time to see patients and meet caseload demands. Making a difference.. Focus on patients Integrity IAPT staff need to feel more valued for the hard work they do, rather than focus on CQUINs Ensure that teams have a minimum number of monthly staff meetings so that thoughts, ideas, activity and actions can be shared internally and from the Trust Upgrade wifi so silverlink can be accessed more widely in community teams. More work can then be done on the move. Leadership Development Prospectus 2013/14 Personal responsibility Making it happen Staff survey results 2013 The following section highlights the five key findings for which LPFT compares most favourably/least favourably with other mental health/learning disability trusts in England. Top five ranking scores Question 2013 Staff experiencing harassment, bullying or abuse from patients, relatives or the public in last 12 months 25% 30% Staff having equality and diversity training in last 12 months 77% 67% Staff reporting good communication between senior and staff 34% 31% Staff receiving health and safety training in last 12 months 79% 75% Staff believing the trust provides equal opportunities for career progression or promotion Bottom five ranking scores Question % 89% Staff agreeing that their role makes a difference to patients 88% 90% Staff reporting errors, near misses or incidents witnessed in the last month 89% 92% Effective team working Staff working extra hours 76% 71% Staff suffering work-related stress in last 12 months 47% 43%

5 Staff survey results 2013 comparisons to MH Trusts 2012 comparison to MH Trusts 2013 Trust comparisons to 2012 results 4 KFs top 20% 2 KFs top 20% 5 KFs significantly improved (rated green) 23 KFs bottom 20% 6 KFs better than 16 KFs improved (rated amber) 4 KFs 6 KFs national 7 KFs declined (rated amber) Staff engagement score rated bottom 20% 9 KFs below Staff engagement score significantly improved (rated green) Key findings and staff engagement score KEY 5 KFs bottom 20% Staff engagement score rated national DH rating +/- change since 2012 survey Improvement No change Deterioration + Better score than Worse score than 2012 Ranking compared to all MH Trusts Top 20% Above Average Below Bottom 20% + Better score than Worse score than 2012 Key finding Best MH score +/- change since 2012 survey Ranking 1. Staff feel satisfied with the quality of work and patient care they are able to deliver Staff agree that their role makes a difference patients No change 3. Work pressures felt by staff (lower scores better) Effective team working No change 5. Staff work extra hours (lower scores better) No change 6. Staff received job-relevant training, learning or development in last 12 months Staff appraised in last 12 months Staff had well-structured appraisals in last 12 months Scale 1-5 Scale 1-5 Scale 1-5 Scale Support from immediate managers

6 Key findings and staff engagement score Key finding Best MH score +/- change since 2012 survey 10. Staff had health and safety training in last 12 months Ranking 11. Staff suffered work-related stress in last 12 months (lower scores better) No change 12. Staff say hand washing materials are always available Staff witnessed potentially harmful errors, near misses or incidents in last month (lower scores better) Staff reported potentially harmful errors, near misses or incidents in last month No change Scale 1-5 Scale 1-5 Scale 1-5 Scale Fairness and effectiveness for reporting potentially harmful errors, near misses or incidents Staff experienced physical violence from patients/relatives in last 12 months* Staff experienced physical violence from staff in last 12 months* Staff experienced harassment, bullying or abuse from patients/relatives in last 12 months* Staff experienced harassment, bullying or abuse from staff in last 12 months* Staff felt pressure in last 3 months to attend work when feeling unwell (lower scores better) Staff report good communication between senior and staff Staff able to contribute towards improvements at work Scale 1-5 Scale 1-5 Scale 1-5 Scale Staff job satisfaction Staff recommendation of the Trust as a place to work or receive treatment Staff motivation at work Staff had equality and diversity training in last 12 months No change 27. Staff believe that Trust provides equal opportunities for career progression or promotion Staff experienced discrimination at work in last 12 months (service users/relatives/staff/ public) (lower scores better) Overall staff engagement (this indicator taken from a range of questions in different areas)

7 Organisational Development metrics Jan 2013 Dec 2013 Jan 2014 Benchmark Staff turnover 10.34% Regularly review hot spot areas 11.20% 11.25% 9.2%* Figures from NHS East Midlands NHS Organisations Mandatory training 95.49% Continued focus and improved access 91.86% 92.8% 75.4%* Figures from NHS Mental Health Trusts (England) Appraisal compliance 77.73% Fortnightly reports to leaders 74.88% 79.32% 72.6%* Figures from NHS Mental Health Trusts (England) Sickness absence 5.86% Jan % rolling 12 month Leaders receive monthly alerts. 5.25% 4.61% rolling 12 month 4.58% 4.50% rolling 12 month 4.94% Figures from NHS Mental Health Trusts (England) Actual Vacancy 4.66% Recruitment process review 3.81% 3.31% Variance from funded establishment 6.09% Improved vacancy process 3.67% 3.34% *all above figures as of 31/03/2013 7

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