SUMMARY REPORT (7) TRUST BOARD 28 th April 2016

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1 SUMMARY REPORT (7) TRUST BOARD 28 th April 2016 Subject 2015 Staff Opinion Survey Action Plan Prepared by Approved by Presented by Purpose Ruth Bardell, deputy Director Human Resources and Organisational Development Susan Young, Executive Director Human Resources and Organisational Development Susan Young, Executive Director Human Resources and Organisational Development The objective of this report is to provide the Board with the key priorities of improvement in relation to the 2015 National Staff Opinion Survey and the associated trust wide action plan. Trust Objectives Receive Approve Quality People Partnership Resources Executive Summary The staff survey was taken across the whole Trust in the autumn of 2015, and enables the trust to compare itself with other acute Trusts nationally. Compared with the previous year's results, the Trust has made significant inroads into issues such as staff engagement. Since 2014 the Trust has seen 12 positively statistically significant change, no negatively statistically significant changes, and 10 key findings have remained the same. Over 90 questions are brought together as "Key Findings" for national benchmarking purposes. (Appendices 1 & 2) However, the Trust still compares poorly with other acute Trusts elsewhere in the country, although the percentage of findings in the bottom 20% of acute trust is less than last year. The area where the trust compares least favourably with others includes some of the findings in relation to staff engagement (staff motivation at work, and recognition and value of staff by managers and the organisation) Raising concerns, particularly in relation to confidence that the Trust will deal fairly with concerns, harassment bullying and abuse experienced by our staff and the levels of stress felt by our staff. An initial discussion of the results took place at the People and OD Committee, and, on the basis of that discussion, key activity has been identified and incorporated into a Trust wide action plan (Appendix 3) for the next 12 months. In order to build on the results of this survey, will focus on four key themes: Improving staff engagement using Listening into Action as the key enabler; Giving our staff Freedom to Speak up enabling, encouraging and learning; Improving staff Health and Wellbeing, with a particular focus on Stress Identifying areas where there are spikes in bullying, harassment or abuse from colleagues or service users.

2 Key Recommendations It is recommended that the Trust Board approve the recommendations set out within the main report and endorse the attached action plan for management through the People and Organisational Development Committee. Assurance Framework The report provides information on the key risks and current level of assurance in meeting the Trust s objectives. Next Steps The performance of the Trust in the delivery of this action plan will occur through the People Operational Group with assurance reporting through the People and Organisational Development Committee. CQC Regulations Financial Implications Legal Implications Equality & Diversity Workforce and Staffing Performance Management Communication ACAS HSE HBA CQC NHSI Corporate Impact Assessment Staff satisfaction is linked to both the quality of patient care, experience and outcomes Delivery of improved staff satisfaction will require the deployment of resources in terms of both dedicated staff time and finance. The intention is that this will be managed through the redeployment of the existing Human Resources Budget and via access to funding streams allocated to specific initiatives such as Health and Well Being as part of the 2016/17 budget setting process. The actions proposed are within the legislative framework We will positively act to promote inclusivity in all our action plans Improved engagement of staff is proven to increase productivity and high quality patient outcomes The performance management of the resultant action plans associated with the 2015 staff survey results will take place through the People and Organisational Development Committee A range of engagement plans are proposed as part of the improvement plan Acronyms / Terms used in Report Advisory, Conciliation and Arbitration Service Health and Safety Executive Harassment, Bullying and Abuse Care Quality Commission NHS Improvement Page 2 of 8

3 2015 Staff Opinion Survey Results and Action Plan 1. Introduction 1.1. This paper sets out the Trust position in relation to the 2014 NHS Staff Opinion Survey and proposes key actions for the Trust to focus on in the next 12 months This paper utilises the un-weighted dataset as set out within the Quality Health survey for the purposes of consistency and clarity The staff survey was taken across the whole Trust in the autumn of 2015, and enables the trust to compare itself with other acute Trusts nationally. Compared with the previous year's results, the Trust has made significant inroads into issues such as staff engagement. Over 90 questions are brought together as "Key Findings" for national benchmarking purposes. Appendices 1 & Since 2014 the Trust has seen 12 positive statistically significant changes, many of those in areas which cover staff engagement, such as good communications, staff motivation and the ability to contribute to improvements at work. This aligns well with the results of the Listening into Action Pulse survey, which also shows improvements in areas such as clarity of the Trust's objectives and the ability to contribute There are no negative statistically significant changes in the Trust's national staff survey results, and 10 key findings have remained the same However, the Trust still compares poorly with other acute Trusts elsewhere in the country, although the percentage of findings in the bottom 20% of acute trust is less than last year. The area where the trust compares least favourably with others includes some of the findings in relation to staff engagement (staff motivation at work, and recognition and value of staff by managers and the organisation). Raising concerns, particularly in relation to confidence that the Trust will deal fairly with concerns, harassment bullying and abuse experienced by our staff and the levels of stress felt by our staff are also areas for concern Although there is still a long way to go, it would appear that the Listening into Action Programme is having a positive impact on staff engagement. The People and OD Committee therefore recommended that the LiA programme continues to focus on this area. However, more work needs to be done to make improvements around raising concerns and incident reporting. It is therefore recommended that these are the areas for focus in the corporate improvement plan It is also expected that Divisions will carry out a more detailed analysis of their own results, looking at different professional groups, demographics, etc., and focussing actions on the "hot spot" areas or groups. Page 3 of 8

4 2. Executive Summary 2.1. The NHS Staff Opinion Survey is sent to all Trust staff between September and December each year and the Trust has utilised the same survey provider for more than 10 years In 2015, the Trust took the decision, following considerable feedback from the 2014 NHS Staff Opinion Survey to undertake the survey electronically. This enabled 80% staff to be accessed through their preferred electronic mail account and complete their survey on line. An additional 20% of surveys were sent hard copy to staff without addresses or who were considered as not having easy on line access whilst at work Response rates for the 2015 staff survey were lower than the 2014 survey. 4,884 staff were invited to take part in the 2015 NHS Staff Opinion Survey for Royal Cornwall Hospitals Trust. 1,843 usable responses were returned to Quality health for submission into the final report, giving a Trust response rate of 38%. This is below the national average for acute trusts (41%). However, although the trust response rate is lower than the previous year s rate which was 45%, we are advised that this is not a statistically significant change The transition of the Trust from GroupWise to NHS.net as the electronic mail for the Trust may have impacted on Staff completing the survey as they became familiar with the new system. However, it is recommended that engagement with the survey process for 2016 is planned in Qtr. 2. And received by the Operational Workforce Group to ensure optimum engagement for the 2016 survey Quality Health have recommended that the Trust liaise with areas where response rates improved by more than 20% in 2014/15. The plan for the 2016 Survey will incorporate learning from NHS Barnsley CCG (82%); North Staffordshire Combined Healthcare Trust (60%) and Somerset Partnership Trust (49%) in order to ensure that the Trust receives a proportionally representative sample of opinion In addition, the Trust has also participated in quarterly collection of the NHS Staff Friends and Family Test, and has surveyed staff as part of the Listening into Action initiative. The results of these surveys will assist in triangulating some of the findings of the 2015 National Staff Opinion Survey This paper, and its accompanying action plan, will be shared with divisional Boards to ensure aligned action on the four key themes set out below. 3. Key Findings and Recommendations 3.1. Quality Health has provided the Trust with all data collected during the 2015 Staff Opinion Survey. This includes the raw data, a management report benchmarking the Trust against national trusts and a comments report which includes all comments that staff have added in their opportunity to describe how it feels to work at Royal Cornwall Hospitals Trust Key activity has been identified and incorporated into a Trust wide action plan (Appendix 3) for the next 12 months, in order to build on the results of this survey, will focus on four key themes: Improving staff engagement using Listening into Action as the key enabler; Giving our staff Freedom to Speak up enabling, encouraging and learning; Page 4 of 8

5 Improving staff Health and Wellbeing, with a particular focus on Stress Identifying areas where there are spikes in bullying, harassment or abuse from colleagues or service users Improving Staff Engagement The Trust is committed to providing staff with a range of opportunities to feed back on their experience of working in Royal Cornwall Hospitals Trust The Trust re-launched Listening into Action last summer, having previously used the methodology in 2014 to enable and empower staff to make the changes they believe make a difference to both the patients and themselves The feedback received through the 2015 Staff Survey told us that 50% of staff say that they look forward to going to work (compared to 41% last year); 68% staff are enthusiastic about their job (compared to 60% last year); and 45% are satisfied with the recognition they receive for good work (compared to 39% last year). However, all of these questions are still in the bottom 20% when compared to others in the sector Other questions where the Trust performs poorly compared to its peers (in the bottom 20%) include: staff agreeing that they are able to do their job to a standard they are personally pleased with (69%, compared to a national average of 80%); staff satisfied with the extent to which the organisation values their work (29% compared to 40%); staff agreeing that they are able to deliver the patient care they aspire to (54% compared to 66%) The Trust scores at the bottom of the sector on whether staff think that patient / service user care is the organisation's top priority (55% vs. 73%), and whether the organisation acts on concerns raised by patients / service users (55% vs. 71%) However, both of these questions have improved over the last year, as the 104 results were 43% and 45% respectively. The experience of our service users continues to be evaluated very positively with 97% saying that they would recommend the Trust to their friends and family We will also utilise the opportunities we have through the quarterly NHS Staff Friends and Family Test to further explore why staff feel the way they do in relation to the above questions particularly as we see consistently high levels of satisfaction from our service users % of our staff say that they know who senior management are where they work. But only 27% agree that communication between senior management and staff is effective; only 26% say that senior management involve them in important decisions; and only 23% say that senior management act on staff feedback We will continue to embed the Listening into Action methodology and its associated behaviours to facilitate the change in experience for staff that will improve communication between staff and senior managers Recommendations o Strengthen the governance process to assure the Trust of action being taken to change the way it feels to work at RCHT; Page 5 of 8

6 o The Listening into Action methodology will become the way that managers engage with staff; o The Trust Operational Plan, Organisational Development Strategy, Clinical Strategy and Workforce Strategies will all have the same key priorities which will underpin the appraisal process o We will build on the Trust Partnership Agreement to better engage with our staff side colleagues and involve them in improving outcomes for our patients o We will regularly feedback to staff the results of staff surveys and the feedback that we receive from our service users Giving our staff Freedom to Speak Up At RCHT, colleagues have consistently reported being aware of the Trust s Raising Concerns Policy and 92% of staff in the 2015 survey report that they know how they should go about reporting concerns if they have them However, the latest results suggest colleagues share the reservations of the wider NHS workforce about the implications of raising concerns, with only 58% of respondents agreeing that they would feel secure raising concerns about unsafe practice and 40% of respondents reporting they would be confident that the Trust would address their concern Key findings relating to staff having confidence and security in reporting unsafe clinical practice (calculated using a range of responses and scored out of 5) is Although this does represent a statistically significant increase from the Trust s 2014 score (3.25), the national 2015 average is 3.62 (highest score 3.93) which means the Trust score remains within the lowest 20% when compared to all other acute trusts in In recent months, the Trust has reviewed and refreshed the Raising Concerns Policy. NHS Employers have now released additional guidance and good practice and the HR Team are enduring that this is captured in our most recent Policy. We must now work closely with staff to determine the reasons why our staff do not feel confident about raising their concerns and enable the behaviour and culture change that promotes RCHT as an organisation that will learn from concerns, incidents and near misses wherever they are raised NHS Employers have set out a framework for improving how staff feel about raising concerns and have a recommended process for the appointment of the Trust Guardian. The Trust will utilise this framework to embed best practice in managing concerns as they are raised Recommendations o Ensure that the best practice guidance issued by NHS Employers is reflected in the current Trust Policy; o Develop our Raising Concerns Support Officers; o Appoint a permanent Freedom To Speak Up Guardian; o Implement NHS Employers Draw the Line Campaign; 3.5. Improving staff Health and Wellbeing with a particular focus on Stress Overall, 83% of staff say that the Trust takes positive action on health and well-being against a sector score of 90%. All scores within the Health and wellbeing section of the survey improved. However, these early improvements are fragile and we must maintain momentum to convince staff of the Trust commitment to keep them healthy and well. Page 6 of 8

7 Scores on stress have significantly improved since last year, and are now average when compared to the rest of the sector. For example, 55% of staff report attending work when feeling unwell (a significant improvement from 62% last year); 32% report feeling pressure from their manager to attend work when they were not well enough and 25% report feeling similar pressure from colleagues In the last year the Trust has been working with staff, through the Health and Wellbeing Group to refresh the Management of Stress Policy, deliver a programme of resilience training and offer physical exercise opportunities to improve how our manager identify and deal with staff who may be experiencing stress as well as enabling staff to partake in activity known to reduce the feelings of stress The Health and Safety Executive has indicated that responses from the NHS Staff Opinion Survey can be utilised to analyse the levels of stress in hospitals. The improvements, in year, are incremental and as such we must continue to focus on ensuring that contributory factors increasing the incidence of stress i.e. Working relationships, demands at work and support available to staff continue to enable improvements RCHT has been utilising the HSE Stress Audit Tool to enhance manager s focus on stress and take action to reduce stress in the workplace. We will utilise the findings locally to deter understand the key interventions required at specialty level to review the current activity as part of the refresh of the Health and Wellbeing strategy and overall action plan We will also undertake the NHS Employers Healthy Workplace Toolkit which will support us in implementing the NICE workplace guidance, deliver the changes we have committed to in our Public Health Responsibility Deal pledges and improve the health and wellbeing of our staff Recommendations o Review current HSE Audit results for key trend data o Refresh the Trust Health and Wellbeing Strategy and action plan to align activity with the Trust current position. o Review the Trust Management of Stress Policy in line with NICE Guidance o Implement the NHS Employers Creating Healthy Workplaces Toolkit 3.6. Harassment, Bullying and Abuse Relationships play a key part in how our staff feel whilst working at RCHT and contribute significantly to how our staff engage and the levels of stress they experience whilst at work % of our staff currently report experiences of harassment, bullying or abuse (HBA) from our own staff. The trust remains in the bottom 20% of acute trusts on his question, against a national average of 26% In 2014, the Trust developed Trust Values with staff and underpinned these with a behaviours framework. The Trust uses Values based recruitment methods and the Trust Values are incorporated into the appraisal process. Page 7 of 8

8 The Dignity at Work Policy is under review currently and we will ensure that NICE, ACAS and HSE guidance is considered in delivering a best practice policy and associated programme of awareness and training Recommendations o Review Dignity at Work Policy in line with HSE and ACAS guidelines o Utilise the NHS Employers Draw a Line Campaign to facilitate a trust Culture of raising concerns and receiving concerns positively o Strengthen the Dignity at Work element of the Managers Passport to enable all managers to understand the impact that harassment bullying and abuse has on staff wellbeing and patient care o Refresh Zero Tolerance of abuse on our staff media campaign throughout the hospital sites. 4. Conclusions 4.1. The improvements seen in the 2015 scores are encouraging in that they show a number of positive changes heading in the right direction. However, the trust remains in a difficult position in comparison with peer trusts. We must therefore maintain focus on the key issues identified in the survey We know that we will continue to work in challenging operational and financial conditions and this will further increase the need to engage our staff fully in the delivery of the operational and clinical plans. A key priority for this will be the involvement of our staff side colleagues The key actions from the 2015 Staff Opinion Survey build on work already underway. The action plan will be monitored through the Operational Workforce Group and assurance given to the People and Organisational Development Committee. 5. Recommendations 5.1. It is recommended that the Trust Board receive and endorse the attached action plan for delivery Page 8 of 8

9 2015 National NHS staff survey Results from Royal Cornwall Hospitals NHS Trust

10 Table of Contents 1: Introduction to this report 3 2: Overall indicator of staff engagement for Royal Cornwall Hospitals NHS Trust 5 3: Summary of 2015 Key Findings for Royal Cornwall Hospitals NHS Trust 6 4: Full description of 2015 Key Findings for Royal Cornwall Hospitals NHS Trust (including comparisons with the trust s 2014 survey and with other acute trusts) 15 5: Workforce Race Equality Standard (WRES) 24 6: Key Findings by work group characteristics 25 7: Key Findings by demographic groups 34 8: Work and demographic profile of the survey respondents 39 Appendix 1: Key Findings for Royal Cornwall Hospitals NHS Trust benchmarked against other acute trusts Appendix 2: Changes to the Key Findings since the 2013 and 2014 staff surveys (including indication of statistically significant changes) Appendix 3: Data tables: 2015 Key Findings and the responses to all survey questions (including comparisons with other acute trusts in 2015, and with the trust s 2014 survey) Appendix 4: Other NHS staff survey 2015 documentation 60 2

11 1. Introduction to this report This report presents the findings of the 2015 national NHS staff survey conducted in Royal Cornwall Hospitals NHS Trust. In section 2 of this report, we present an overall indicator of staff engagement. Full details of how this indicator was created can be found in the document Making sense of your staff survey data, which can be downloaded from In sections 3, 4, 6 and 7 of this report, the findings of the questionnaire have been summarised and presented in the form of 32 Key Findings. In section 5 of this report, the data required for the Workforce Race Equality Standard (WRES) is presented. These sections of the report have been structured around four of the seven pledges to staff in the NHS Constitution which was published in March 2013 ( plus three additional themes: 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 education and training for their jobs, and line management support to enable them to fulfil their potential. 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 theme: Equality and diversity Additional theme: Errors and incidents Additional theme: Patient experience measures Please note, the questionnaire, key findings and benchmarking groups have all undergone substantial revision since the previous staff survey. For more detail on these changes, please see the Making sense of your staff survey data document. As in previous years, there are two types of Key Finding: - percentage scores, i.e. percentage of staff giving a particular response to one, or a series of, survey questions - scale summary scores, calculated by converting staff responses to particular questions into scores. For each of these scale summary scores, the minimum score is always 1 and the maximum score is 5 Responses to the individual survey questions can be found in Appendix 3 of this report, along with details of which survey questions were used to calculate the Key Findings. 3

12 Your Organisation The scores presented below are un-weighted question level scores for questions Q21a, Q21b, Q21c and Q21d and the un-weighted score for Key Finding 1. The percentages for Q21a Q21d are created by combining the responses for those who Agree and Strongly Agree compared to the total number of staff that responded to the question. Q21a, Q21c and Q21d feed into Key Finding 1 Staff recommendation of the organisation as a place to work or receive treatment. Q21a "Care of patients / service users is my organisation's top priority" Q21b "My organisation acts on concerns raised by patients / service users" Q21c Q21d KF1. "I would recommend my organisation as a place to work" "If a friend or relative needed treatment, I would be happy with the standard of care provided by this organisation" Staff recommendation of the organisation as a place to work or receive treatment (Q21a, 21c-d) Your Trust in 2015 Average (median) for acute trusts Your Trust in % 75% 43% 55% 73% 45% 42% 61% 32% 50% 70% 38%

13 2. Overall indicator of staff engagement for Royal Cornwall Hospitals NHS Trust The figure below shows how Royal Cornwall Hospitals NHS Trust compares with other acute trusts on an overall indicator of staff engagement. Possible scores range from 1 to 5, with 1 indicating that staff are poorly engaged (with their work, their team and their trust) and 5 indicating that staff are highly engaged. The trust's score of 3.54 was in the lowest (worst) 20% when compared with trusts of a similar type. OVERALL STAFF ENGAGEMENT This overall indicator of staff engagement has been calculated using the questions that make up Key Findings 1, 4 and 7. These Key Findings relate to the following aspects of staff engagement: staff members perceived ability to contribute to improvements at work (Key Finding 7); their willingness to recommend the trust as a place to work or receive treatment (Key Finding 1); and the extent to which they feel motivated and engaged with their work (Key Finding 4). The table below shows how Royal Cornwall Hospitals NHS Trust compares with other acute trusts on each of the sub-dimensions of staff engagement, and whether there has been a change since the 2014 survey. Change since 2014 survey Ranking, compared with all acute trusts OVERALL STAFF ENGAGEMENT Increase (better than 14)! Lowest (worst) 20% KF1. Staff recommendation of the trust as a place to work or receive treatment (the extent to which staff think care of patients/service users is the trust s top priority, would recommend their trust to others as a place to work, and would be happy with the standard of care provided by the trust if a friend or relative needed treatment.) KF4. Staff motivation at work (the extent to which they look forward to going to work, and are enthusiastic about and absorbed in their jobs.) KF7. Staff ability to contribute towards improvements at work (the extent to which staff are able to make suggestions to improve the work of their team, have frequent opportunities to show initiative in their role, and are able to make improvements at work.) Increase (better than 14)! Lowest (worst) 20% Increase (better than 14)! Lowest (worst) 20% Increase (better than 14)! Lowest (worst) 20% Full details of how the overall indicator of staff engagement was created can be found in the document Making sense of your staff survey data. 5

14 3. Summary of 2015 Key Findings for Royal Cornwall Hospitals NHS Trust 3.1 Top and Bottom Ranking Scores This page highlights the five Key Findings for which Royal Cornwall Hospitals NHS Trust compares most favourably with other acute trusts in England. TOP FIVE RANKING SCORES KF24. Percentage of staff / colleagues reporting most recent experience of violence KF18. Percentage of staff feeling pressure in the last 3 months to attend work when feeling unwell KF20. Percentage of staff experiencing discrimination at work in last 12 months KF23. Percentage of staff experiencing physical violence from staff in last 12 months KF27. Percentage of staff / colleagues reporting most recent experience of harassment, bullying or abuse For each of the 32 Key Findings, the acute trusts in England were placed in order from 1 (the top ranking score) to 99 (the bottom ranking score). Royal Cornwall Hospitals NHS Trust s five highest ranking scores are presented here, i.e. those for which the trust s Key Finding score is ranked closest to 1. Further details about this can be found in the document Making sense of your staff survey data. 6

15 This page highlights the five Key Findings for which Royal Cornwall Hospitals NHS Trust compares least favourably with other acute trusts in England. It is suggested that these areas might be seen as a starting point for local action to improve as an employer. BOTTOM FIVE RANKING SCORES! KF2. Staff satisfaction with the quality of work and patient care they are able to deliver! KF4. Staff motivation at work! KF31. Staff confidence and security in reporting unsafe clinical practice! KF30. Fairness and effectiveness of procedures for reporting errors, near misses and incidents! KF5. Recognition and value of staff by managers and the organisation 7

16 3.2 Largest Local Changes since the 2014 Survey This page highlights the five Key Findings where staff experiences have improved at Royal Cornwall Hospitals NHS Trust since the 2014 survey. (This is a positive local result. However, please note that, as shown in section 3.3, when compared with other acute trusts in England, the scores for Key findings KF1, and KF4 are worse than average). KF4. Staff motivation at work WHERE STAFF EXPERIENCE HAS IMPROVED KF23. Percentage of staff experiencing physical violence from staff in last 12 months KF1. Staff recommendation of the organisation as a place to work or receive treatment KF18. Percentage of staff feeling pressure in the last 3 months to attend work when feeling unwell 8

17 KF8. Staff satisfaction with level of responsibility and involvement 9

18 3.2. Summary of all Key Findings for Royal Cornwall Hospitals NHS Trust KEY Green = Positive finding, e.g. there has been a statistically significant positive change in the Key Finding since the 2014 survey. Red = Negative finding, e.g. there has been a statistically significant negative change in the Key Finding since the 2014 survey. Grey = No change, e.g. there has been no statistically significant change in this Key Finding since the 2014 survey. For most of the Key Finding scores in this table, the higher the score the better. However, there are some scores for which a high score would represent a negative finding. For these scores, which are marked with an asterisk and in italics, the lower the score the better. Change since 2014 survey 10

19 3.2. Summary of all Key Findings for Royal Cornwall Hospitals NHS Trust KEY Green = Positive finding, e.g. better than average. If a is shown the score is in the best 20% of acute trusts Red = Negative finding, e.g. worse than average. If a! is shown the score is in the worst 20% of acute trusts. Grey = Average. For most of the Key Finding scores in this table, the higher the score the better. However, there are some scores for which a high score would represent a negative finding. For these scores, which are marked with an asterisk and in italics, the lower the score the better. Comparison with all acute trusts in

20 3.2. Summary of all Key Findings for Royal Cornwall Hospitals NHS Trust KEY Green = Positive finding, e.g. better than average. If a is shown the score is in the best 20% of acute trusts Red = Negative finding, e.g. worse than average. If a! is shown the score is in the worst 20% of acute trusts. Grey = Average. For most of the Key Finding scores in this table, the higher the score the better. However, there are some scores for which a high score would represent a negative finding. For these scores, which are marked with an asterisk and in italics, the lower the score the better. Comparison with all acute trusts in 2015 (cont) 12

21 3.3. Summary of all Key Findings for Royal Cornwall Hospitals NHS Trust KEY Green = Positive finding, e.g. in the best 20% of acute trusts, better than average, better than 2014.! Red = Negative finding, e.g. in the worst 20% of acute trusts, worse than average, worse than 'Change since 2014 survey' indicates whether there has been a statistically significant change in the Key Finding since the 2014 survey. -- Because of changes to the format of the survey questions this year, comparisons with the 2014 score are not possible. * For most of the Key Finding scores in this table, the higher the score the better. However, there are some scores for which a high score would represent a negative finding. For these scores, which are marked with an asterisk and in italics, the lower the score the better. Change since 2014 survey STAFF PLEDGE 1: To provide all staff with clear roles, responsibilities and rewarding jobs. KF1. Staff recommendation of the organisation as a place to work or receive treatment KF2. Staff satisfaction with the quality of work and patient care they are able to deliver KF3. % agreeing that their role makes a difference to patients / service users Ranking, compared with all acute trusts in 2015 Increase (better than 14)! Lowest (worst) 20% --! Lowest (worst) 20% --! Lowest (worst) 20% KF4. Staff motivation at work Increase (better than 14)! Lowest (worst) 20% KF5. Recognition and value of staff by managers and the organisation KF8. Staff satisfaction with level of responsibility and involvement --! Lowest (worst) 20% Increase (better than 14)! Lowest (worst) 20% KF9. Effective team working --! Lowest (worst) 20% KF14. Staff satisfaction with resourcing and support --! Lowest (worst) 20% STAFF PLEDGE 2: To provide all staff with personal development, access to appropriate education and training for their jobs, and line management support to enable them to fulfil their potential. KF10. Support from immediate managers Increase (better than 14)! Lowest (worst) 20% KF11. % appraised in last 12 mths No change! Lowest (worst) 20% KF12. Quality of appraisals --! Lowest (worst) 20% KF13. Quality of non-mandatory training, learning or development --! Lowest (worst) 20% STAFF PLEDGE 3: To provide support and opportunities for staff to maintain their health, well-being and safety. Health and well-being KF15. % of staff satisfied with the opportunities for flexible working patterns --! Lowest (worst) 20% * KF16. % working extra hours No change! Above (worse than) average * KF17. % suffering work related stress in last 12 mths Decrease (better than 14)! Highest (worst) 20% * KF18. % feeling pressure in last 3 mths to attend work when feeling unwell Decrease (better than 14) Below (better than) average KF19. Org and mgmt interest in and action on health / wellbeing --! Lowest (worst) 20% 13

22 3.3. Summary of all Key Findings for Royal Cornwall Hospitals NHS Trust (cont) Violence and harassment * KF22. % experiencing physical violence from patients, relatives or the public in last 12 mths * KF23. % experiencing physical violence from staff in last 12 mths Change since 2014 survey No change Decrease (better than 14) Ranking, compared with all acute trusts in 2015! Above (worse than) average Average KF24. % reporting most recent experience of violence No change Highest (best) 20% * KF25. % experiencing harassment, bullying or abuse from patients, relatives or the public in last 12 mths * KF26. % experiencing harassment, bullying or abuse from staff in last 12 mths KF27. % reporting most recent experience of harassment, bullying or abuse No change Average No change! Highest (worst) 20% No change Average STAFF PLEDGE 4: To engage staff in decisions that affect them, the services they provide and empower them to put forward ways to deliver better and safer services. KF6. % reporting good communication between senior management and staff KF7. % able to contribute towards improvements at work ADDITIONAL THEME: Equality and diversity * KF20. % experiencing discrimination at work in last 12 mths KF21. % believing the organisation provides equal opportunities for career progression / promotion ADDITIONAL THEME: Errors and incidents * KF28. % witnessing potentially harmful errors, near misses or incidents in last mth KF29. % reporting errors, near misses or incidents witnessed in the last mth KF30. Fairness and effectiveness of procedures for reporting errors, near misses and incidents KF31. Staff confidence and security in reporting unsafe clinical practice ADDITIONAL THEME: Patient experience measures Increase (better than 14)! Lowest (worst) 20% Increase (better than 14)! Lowest (worst) 20% No change Below (better than) average No change! Lowest (worst) 20% Decrease (better than 14)! Highest (worst) 20% No change! Below (worse than) average --! Lowest (worst) 20% Increase (better than 14)! Lowest (worst) 20% KF32. Effective use of patient / service user feedback Increase (better than 14)! Lowest (worst) 20% 14

23 4. Key Findings for Royal Cornwall Hospitals NHS Trust 1843 staff at Royal Cornwall Hospitals NHS Trust took part in this survey. This is a response rate of 38% 1 which is below average for acute trusts in England, and compares with a response rate of 45% in this trust in the 2014 survey. This section presents each of the 32 Key Findings, using data from the trust's 2015 survey, and compares these to other acute trusts in England and to the trust's performance in the 2014 survey. The findings are arranged under seven headings the four staff pledges from the NHS Constitution, and the three additional themes of equality and diversity, errors and incidents, and patient experience measures. Positive findings are indicated with a green arrow (e.g. where the trust is in the best 20% of trusts, or where the score has improved since 2014). Negative findings are highlighted with a red arrow (e.g. where the trust s score is in the worst 20% of trusts, or where the score is not as good as 2014). An equals sign indicates that there has been no change. STAFF PLEDGE 1: To provide all staff with clear roles, responsibilities and rewarding jobs. KEY FINDING 1. Staff recommendation of the organisation as a place to work or receive treatment KEY FINDING 2. Staff satisfaction with the quality of work and patient care they are able to deliver 1 Questionnaires were sent to all 4811 staff eligible to receive the survey. This includes only staff employed directly by the trust (i.e. excluding staff working for external contractors). It excludes bank staff unless they are also employed directly elsewhere in the trust. When calculating the response rate, questionnaires could only be counted if they were received with their ID number intact, by the closing date. 15

24 KEY FINDING 3. Percentage of staff agreeing that their role makes a difference to patients / service users KEY FINDING 4. Staff motivation at work KEY FINDING 5. Recognition and value of staff by managers and the organisation KEY FINDING 8. Staff satisfaction with level of responsibility and involvement 16

25 KEY FINDING 9. Effective team working KEY FINDING 14. Staff satisfaction with resourcing and support STAFF PLEDGE 2: To provide all staff with personal development, access to appropriate education and training for their jobs, and line management support to enable them to fulfil their potential. KEY FINDING 10. Support from immediate managers KEY FINDING 11. Percentage of staff appraised in last 12 months 17

26 KEY FINDING 12. Quality of appraisals KEY FINDING 13. Quality of non-mandatory training, learning or development STAFF PLEDGE 3: To provide support and opportunities for staff to maintain their health, well-being and safety. Health and well-being KEY FINDING 15. Percentage of staff satisfied with the opportunities for flexible working patterns KEY FINDING 16. Percentage of staff working extra hours 18

27 KEY FINDING 17. Percentage of staff suffering work related stress in last 12 months KEY FINDING 18. Percentage of staff feeling pressure in the last 3 months to attend work when feeling unwell KEY FINDING 19. Organisation and management interest in and action on health and wellbeing Violence and harassment KEY FINDING 22. Percentage of staff experiencing physical violence from patients, relatives or the public in last 12 months 19

28 KEY FINDING 23. Percentage of staff experiencing physical violence from staff in last 12 months KEY FINDING 24. Percentage of staff / colleagues reporting most recent experience of violence KEY FINDING 25. Percentage of staff experiencing harassment, bullying or abuse from patients, relatives or the public in last 12 months KEY FINDING 26. Percentage of staff experiencing harassment, bullying or abuse from staff in last 12 months 20

29 KEY FINDING 27. Percentage of staff / colleagues reporting most recent experience of harassment, bullying or abuse STAFF PLEDGE 4: To engage staff in decisions that affect them, the services they provide and empower them to put forward ways to deliver better and safer services. KEY FINDING 6. Percentage of staff reporting good communication between senior management and staff KEY FINDING 7. Percentage of staff able to contribute towards improvements at work ADDITIONAL THEME: Equality and diversity KEY FINDING 20. Percentage of staff experiencing discrimination at work in last 12 months 21

30 KEY FINDING 21. Percentage of staff believing that the organisation provides equal opportunities for career progression or promotion ADDITIONAL THEME: Errors and incidents KEY FINDING 28. Percentage of staff witnessing potentially harmful errors, near misses or incidents in last month KEY FINDING 29. Percentage of staff reporting errors, near misses or incidents witnessed in the last month KEY FINDING 30. Fairness and effectiveness of procedures for reporting errors, near misses and incidents 22

31 KEY FINDING 31. Staff confidence and security in reporting unsafe clinical practice ADDITIONAL THEME: Patient experience measures KEY FINDING 32. Effective use of patient / service user feedback 23

32 5. Workforce Race Equality Standard (WRES) The scores presented below are the un-weighted question level score for question Q17b and un-weighted scores for Key Findings 25, 26, and 21, split between White and Black and Minority Ethnic (BME) staff, as required for the Workforce Race Equality Standard. Note that for question 17b, the percentage featured is that of Yes responses to the question. Key Finding and question numbers have changed since In order to preserve the anonymity of individual staff, a score is replaced with a dash if the staff group in question contributed fewer than 11 responses to that score. KF25 KF26 KF21 Q17b Percentage of staff experiencing harassment, bullying or abuse from patients, relatives or the public in last 12 months Percentage of staff experiencing harassment, bullying or abuse from staff in last 12 months Percentage of staff believing that the organisation provides equal opportunities for career progression or promotion In the 12 last months have you personally experienced discrimination at work from manager/team leader or other colleagues? Your Trust in 2015 Average (median) for acute trusts Your Trust in 2014 White 28% 28% 29% BME 32% 28% 40% White 32% 25% 30% BME 28% 28% 45% White 83% 89% 82% BME 69% 75% 62% White 7% 6% 8% BME 15% 13% 24% 24

33 6. Key Findings by work group characteristics Tables 6.1 to 6.4 show the Key Findings at Royal Cornwall Hospitals NHS Trust broken down by work group characteristics: occupational groups, staff groups, directorates and full time/part time staff. Technical notes: As in previous years, there are two types of Key Finding: - percentage scores, i.e. percentage of staff giving a particular response to one, or a series of, survey questions - scale summary scores, calculated by converting staff responses to particular questions into scores. For each of these scale summary scores, the minimum score is always 1 and the maximum score is 5 For most of the Key Findings presented in tables 6.1 to 6.4, the higher the score the better. However, there are some Key Findings for which a high score would represent a negative result. For these Key Findings, marked with an asterisk and shown in italics, the lower the score the better. Care should be taken not to over interpret the findings if scores differ slightly. For example, if for 'KF11. % appraised in the last 12 months' staff in Group A score 45%, and staff in Group B score 40%, it may appear that a higher proportion of staff in Group A have had appraisals than staff in Group B. However, because of small numbers in these sub-groups, it is probably not statistically significant. A more sensible interpretation would be that, on average, similar proportions of staff in Group A and B have had appraisals. Please note that, unlike the overall trust scores, data in this section are not weighted. Please also note that all percentage scores are shown to the nearest 1%. This means scores of less than 0.5% are displayed as 0%. In order to preserve anonymity of individual staff, a score is replaced with a dash if the staff group in question contributed fewer than 11 responses to that score. 25

34 Table 6.1: Key Findings for different occupational groups STAFF PLEDGE 1: To provide all staff with clear roles, responsibilities and rewarding jobs. KF1. Staff recommendation of the organisation as a place to work or receive treatment KF2. Staff satisfaction with the quality of work and patient care they are able to deliver KF3. % agreeing that their role makes a difference to patients / service users KF4. Staff motivation at work KF5. Recognition and value of staff by managers and the organisation KF8. Staff satisfaction with level of responsibility and involvement KF9. Effective team working KF14. Staff satisfaction with resourcing and support STAFF PLEDGE 2: To provide all staff with personal development, access to appropriate education and training for their jobs, and line management support to enable them to fulfil their potential. KF10. Support from immediate managers KF11. % appraised in last 12 mths KF12. Quality of appraisals KF13. Quality of non-mandatory training, learning or development STAFF PLEDGE 3: To provide support and opportunities for staff to maintain their health, well-being and safety. Health and well-being KF15. % of staff satisfied with the opportunities for flexible working patterns * KF16. % working extra hours * KF17. % suffering work related stress in last 12 mths * KF18. % feeling pressure in last 3 mths to attend work when feeling unwell KF19. Org and mgmt interest in and action on health / wellbeing Number of respondents Due to low numbers of respondents, no scores are shown for the following occupational groups: Mental Health Nurses, Public Health / Health Improvement, Commissioning Staff and Patient Transport Service. Due to an error in the 2014 calculation, data for the following occupational groups in table 6.1 are not comparable to those in the equivalent table (5.1) in the 2014 reports: Other Allied Health Professionals, Other Scientific and Technical. 26

35 Table 6.1: Key Findings for different occupational groups (cont) Violence and harassment * KF22. % experiencing physical violence from patients, relatives or the public in last 12 mths * KF23. % experiencing physical violence from staff in last 12 mths KF24. % reporting most recent experience of violence * KF25. % experiencing harassment, bullying or abuse from patients, relatives or the public in last 12 mths * KF26. % experiencing harassment, bullying or abuse from staff in last 12 mths KF27. % reporting most recent experience of harassment, bullying or abuse STAFF PLEDGE 4: To engage staff in decisions that affect them, the services they provide and empower them to put forward ways to deliver better and safer services. KF6. % reporting good communication between senior management and staff KF7. % able to contribute towards improvements at work ADDITIONAL THEME: Equality and diversity * KF20. % experiencing discrimination at work in last 12 mths KF21. % believing the organisation provides equal opportunities for career progression / promotion ADDITIONAL THEME: Errors and incidents * KF28. % witnessing potentially harmful errors, near misses or incidents in last mth KF29. % reporting errors, near misses or incidents witnessed in the last mth KF30. Fairness and effectiveness of procedures for reporting errors, near misses and incidents KF31. Staff confidence and security in reporting unsafe clinical practice ADDITIONAL THEME: Patient experience measures KF32. Effective use of patient / service user feedback Overall staff engagement Number of respondents Due to low numbers of respondents, no scores are shown for the following occupational groups: Mental Health Nurses, Public Health / Health Improvement, Commissioning Staff and Patient Transport Service. Due to an error in the 2014 calculation, data for the following occupational groups in table 6.1 are not comparable to those in the equivalent table (5.1) in the 2014 reports: Other Allied Health Professionals, Other Scientific and Technical. 27

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