GLOUCESTERSHIRE HOSPITALS NHS FOUNDATION TRUST

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1 GLOUCESTERSHIRE HOSPITALS NHS FOUNDATION TRUST MAIN BOARD FEBRUARY STAFF SURVEY RESULTS 1. Aim 1.1 To present to the Trust Board the key findings from the 2014 staff survey results and to outline the process by which results will be shared with staff and the rolling action plan from previous years updated and amended to effect the required improvements. 2. Background 2.1 Between October and December 2014, the national NHS staff survey was undertaken, inviting staff to share their experiences of working in Gloucestershire Hospitals Foundation Trust (GHFT). As in 2013, the Board opted to undertake a full census of all staff across the Trust recognising that the link between employee engagement and patient experience is so fundamental that it is vital to give the opportunity for all of our workforce to have their say. Our response rate in the 2014 survey unfortunately dropped to 54% in comparison to 63% last year. This was a national trend, possibly attributable to the amount of surveys being requested and we remain in the highest 20% of response rates for acute trusts in England. 3. Context Staff Survey Results 3.1 Before looking at the results from the current survey, it is important to provide some context from the previous year. The bottom five ranking scores for our Trust in 2013 are outlined below. The number of staff feeling satisfied with the quality of work and patient care that they are able to deliver The number of staff receiving job-relevant training, learning and development in the last 12 months Staff recommending our trust as a place to work or receive treatment Staff motivation at work The number of staff experiencing physical violence from patients, relatives or the public in the last 12 months It is important to note that for first three of these areas we have moved forward and these are now no longer in the bottom five. It is particularly pleasing that we have improved on staff feeling satisfied with the quality of work and patient care they are able to deliver and the numbers recommending us as a place to work or receive treatment as these were aspirations outlined in the June 2014 Board paper. 3.2 As a response to the sharing of results from last year s survey and in addition to the rolling action plans owned by the Divisions, there were organisation-wide issues with agreed corporate actions: To improve the perception of staff in terms of learning and development opportunities beyond mandatory training. To understand the reason behind the increasing numbers of staff reporting violent incidents from patients/members of the public. To examine the issue of violence against staff by other staff To understand the reasons why disabled staff report a worse employment experience To improve medical engagement To reduce incidences of stress felt by staff To improve the focus on health and well being 2014 Staff Survey Report Page 1 of 9

2 To improve the perception that patient care is not our top priority It was pleasing to see that all of the above areas show signs of improvement, albeit marginal in some cases and not all at the pace we would wish for Staff Survey Results 4.1 The results of the survey are received by the Trust in two ways. The main survey provider (Quality Health) provides the raw data scores for every single question, providing a comparison with the average score for other Trusts as well as progress over the prior year. The scores are broken down into 5 main areas Your Job, Your Personal Development, Your Managers, Your Organisation and Your Health, Wellbeing and Safety at work. This report does not however break the score down into staff groups or divisions and as a consequence allows for general conclusions rather than targeted actions. The main published report sees the findings of the questionnaires summarised by the national survey centre PickerEurope on behalf of the Department of Health and presented in the form of 29 key findings (KF) categorised to echo the four NHS Constitution pledges to staff. Staff Pledge 1: To provide all staff with clear roles and responsibilities and rewarding jobs for teams and individuals that make a difference to patients, their families and carers and communities. Staff Pledge 2: To provide all staff with personal development, access to appropriate training for their jobs and line management support to succeed. Staff Pledge 3: To provide support and opportunities for staff to maintain their health, well-being and safety. Staff Pledge 4: To engage staff in decisions that affect them and the services they provide, individually, through representative organisations and through local partnership working arrangements. All staff will be empowered to put forward ways to deliver better and safer services for patients and their families. Additional themes: Staff job satisfaction, Equality and diversity and Patient experience measures (the latter being a new key finding for this year). 4.2 There are some inconsistencies between the presentation of the scores given by Quality Health compared to Picker, given their distinct categorisation of themes. In terms of the raw data scores provided by Quality Health, out of 87 individual questions, the Trust improved scores on 64, reduced scores on 10 and witnessed no change on 13. This shows a marked improvement over last year. Of greater significance was the narrowing of the gap between ourselves and other Trusts. Clearly, whilst recognising the need to make progress on our own issues, the relative position of GHFT to other Trusts is an important consideration. Within the Picker consolidated findings where the questions are compressed into 29 key findings, our progress is demonstrated with 11 statistically significant improvements (those with a change of 3% or more), 12 show small improvements and 4 show no change with 2 that are entirely new. 5. Key Findings in the GHFT 2014 Survey 5.1 As mentioned in previous reports, the experiences of staff working in GHFT and the results of the survey are set in the context of ongoing challenges both local and national. This year s survey results suggest that the many targeted work streams being undertaken throughout the Trust are leading to improvements, which in many areas are gratifying. There is, however, still significant work to be done in maintaining and accelerating progress and this will require sustained energy and commitment over several more years yet. Appendix 1, provides a full breakdown of Trust scores, however summarised scores are presented below in the following way; 2014 Staff Survey Report Page 2 of 9

3 Staff Engagement Top and Bottom Ranking Scores Improvements and deterioration since last year Selected other scores 5.2 Staff Engagement The overall indicator of staff engagement has been calculated using the questions that make up KFs 22, 24 and 25, relating to the following aspects of staff engagement: Staff members perceived ability to contribute to improvements at work (KF 22); Their willingness to recommend the trust as a place to work/receive treatment (KF 24); The extent to which they feel motivated and engaged with their work (KF 25). The table below shows the progress made by our Trust in terms of employee engagement over the last 3 years with an increase in 2 of the 3 scores making up the staff engagement index, with KF24 being one of our statistically significant improvement scores. The average for acute trusts is 3.74 so whilst we have narrowed the margin to 0.08, we are still not quite there. Therefore, it is vital that we continue to improve our engagement scores at a faster rate than the national average, which in 2014 improved by Staff Engagement Overall Staff Engagement KF22 Staff ability to contribute towards 64% 65% 66% improvements at work KF24 Staff recommendation of the Trust as a place to work or receive treatment KF25 Staff motivation at work Top and Bottom Ranking Scores Top Five Ranking Scores This highlights the five key areas in which the Trust compares favourably with other acute trusts in England Staff Survey Report Page 3 of 9

4 Four of these key findings are as described in the 2013 survey. The new strength for us is the percentage of staff believing our trust provides equal opportunities for career progression or promotion which is positive in respect of our Equality and Diversity agenda. In addition to being our top five key findings, we score better than the national average in all Staff Survey Report Page 4 of 9

5 5.3.2 Bottom Ranking Scores These are the five Key Findings for which GHFT compares least favourably with other acute trusts in England. It should be noted that, whilst KF16 and KF25 remain in our bottom five ranking scores, KF16 has improved over last year and KF25 is the same. KF22 is new to our bottom five scores but has still improved over last year. KF15 and KF29 are new key findings in this year s staff survey and therefore we do not have comparator data. Clearly significant focus will need to be put into addressing KF15 (staff feeling secure in raising concerns about unsafe clinical practice) however our Raising Concerns policy was launched in the Autumn as well as the launch of a new confidential, externally hosted system ( Speak in Confidence ) which not only allows concerns to be raised anonymously, but enables ongoing dialogue between the individual who raised the issue and an appropriate manager, whilst continuing to protect the anonymity of the individual. Clearly there is more work to be done in 2014 Staff Survey Report Page 5 of 9

6 promoting these changes and the Post Implementation Steering Group, chaired by Non-Executive Director Helen Munro will be heavily involved in doing this Improvements and deteriorations since last year The information below depicts the Key Findings where staff experiences have improved: The survey did not highlight any areas where the staff experience had deteriorated Staff Survey Report Page 6 of 9

7 5.34 There is a general positive movement with respect to our key findings when compared with other acute trusts as depicted in the table below. We no longer have any key findings in the Highest (worst) 20% of acute trusts. Changes in Key Findings compared to other acute trusts GHFT 2014 GHFT 2013 Highest (best) 20% Lowest (best) 20% Above (better than) average Below (better than) average Average Below (worse than) average Above (worse than) average Highest (worse) than average Lowest (worst) 20% 3 5 Highest (worst) 20% Some Key data indicating improvements with respect to our actions from the 2013 staff survey results Your training and personal development All Trusts 1f How to deliver a good patient / service user experience 60% 63% 64% 55% 2a My training, learning and development has helped me to do my job more effectively 57% 63% 64% 65% 2c My training, learning and development has helped me deliver a better patient/service user experience 52% 59% 62% 62% Your Job 5b I am enthusiastic about my job 62% 66% 67% 68% 6d I am able to do my job to a standard I am personally pleased with 72% 75% 77% 78% 7e I am unable to meet all the conflicting demands on my time at work 41% 44% 44% 44% Senior Managers 11b Communication between senior management and staff is effective 24% 30% 35% 35% 11c Senior managers here try to involve staff in important decisions 22% 27% 30% 29% 11d Senior managers act on staff feedback 22% 26% 29% 27% 11e Senior managers are committed to patient care 40% 43% 50% 52% Your organisation 12a Care of patients/ service users is my organisations top priority 47% 54% 63% 67% 12c I would recommend my organisation as a place to work 43% 50% 55% 55% 2014 Staff Survey Report Page 7 of 9

8 12d 14c 16 20a If a friend or relative needed treatment I would be happy with the standard of care provided by this organisation Your Health, Well-being and Safety at Work My organisation takes positive action on health and wellbeing During the last 12 months have you felt unwell as a result of work related stress? In the last 12 months how many times have you personally experienced physical violence at work from patients /service users, their relatives or other members of the public? 54% 56% 62% 63% 34% 38% 39% 41% 38% 38% 36% 38% 14% 18% 17% 15% 6. Conclusions and Next steps 6.1 Whilst it is clear that significant progress has been made, it is ever more important that traction is maintained on the areas of improvement, with areas of concern requiring even more effort. As previously stated it is not the aspiration of this Board to reach the average standard of engagement achieved by other Trusts, but to set its stall to be amongst the best. The argument setting out the link between highly engaged staff and improved patient experience has long been accepted by our Board and is increasingly recognised and owned by our Divisional Boards and engagement groups. 6.2 There are a number of work streams in progress and the intention is to continue with those programmes. The staff survey results provide a checkpoint to progress and before presenting a consolidated plan to the Board, it is vital that these results are shared with key stakeholders to obtain their perspectives. These will include; Divisional Steering Group Divisional Engagement groups Divisional Boards Trust Management Team 100 Leaders Culture Change Group Employee Representatives (JSCC) Senior Staff Groups (e.g. Senior Nurse Committee, Medical Staffing Committee) Council of Governors Health and Safety Committee Involve/open staff sessions A number of these groups have been heavily involved in designing and participating in the current work plans and will feel a sense of ownership of the progress made and of work still to be done. It is also proposed to invite members of the Divisional Engagement groups to talk to the Board in April 2015 and to hear the comments from these (and others) before finalising a response and action plan. The data is broadly described however it will be important for different staff groups and divisions to analyse and localise these results, where applicable. This process will be aided through the production of an infographic of our key results for dissemination. It will also be important that these groups are encouraged by the positive progress being made and the fact that their efforts are beginning to bear fruit. Maintaining our flywheel approach of rolling action plans which are augmented by additional insights and activities each year remains the most likely way of embedding engagement as something that happens daily and is not just talked about. This is reflected in the increased engagement scores for each of our Divisions. 6.3 We will imminently be issuing our Quarter 4 Staff Friends and Family Test and will be using the results of the 2014 survey KF24 staff recommendation of our trust as a place 2014 Staff Survey Report Page 8 of 9

9 to work or receive treatment to target our approach in order to better understand where we need work together with specific groups to improve and overcome challenges. 7. Recommendations The Board is asked to note the results from the 2014 staff survey. The Board is asked to agree to receive feedback from the Divisional Engagement groups at the April 2015 Board Authors: Jamie Parker, Becky Wheeler and David Smith Presenting Director; David Smith, HR and OD Director, February Staff Survey Report Page 9 of 9

10 Full breakdown of Trust scores Appendix Staff Survey Report Page 1 of 2

11 2014 Staff Survey Report Page 2 of 2

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