Board of Directors Room 31 March 2016 Staff Survey Summary Outcomes National NHS Staff Survey 2015

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1 Board of Directors Room 31 March 2016 Staff Survey Summary Outcomes National NHS Staff Survey Introduction The Trust has participated in the national staff survey for the last 13 years. Overall, during that time there has generally been good feedback. In the last 3 years the Trust has been in the top 20% for its response rate and staff engagement score. The staff survey ranking scores have changed and only score the results across three areas, including worse than average, average and better than average. The best 20% and worst 20% have not been applied within this analysis. This paper provides feedback to the Board of Directors on the outcome of the 2015 National NHS Staff Survey, in which overall the results were very positive. The headline information in relation to the National NHS Staff Survey 2015 is: The Trust s response rate was 55% - this is higher than the average for Mental Health, Learning Disability & Community Trust s in England [44%]. This puts the Trust s response in the better than average ranking. Staff engagement levels have remained the same high level as the previous year, and again the Trust scores in the better than average ranking. A high level of the surveyed staff stated that they would recommend the Trust as a place to work or receive treatment. This scores the Trust in the better than average ranking. 2.0 The NHS National Staff Survey 2015 The NHS National Staff Survey is administered by a range of external contractors approved by NHS England. This was undertaken on behalf of the Trust by Quality Health, and strongly supported within the Trust by the Chief Executive, Executive Team, Staff Side Partners, Managers and the Human Resource / Workforce Information Team. The content of returned survey questionnaires were analysed by the Picker Institute Europe, on behalf of NHS England, who have published the outcome of the survey for the Trust. This is presented in the form of 32 Key Findings [KF s], structured around the four NHS Staff Pledges below, and also two additional themes of Staff Satisfaction and Equality & Diversity. Staff Pledge 1 Staff Pledge 2 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. To provide all staff with personal development, access to appropriate training for their jobs and line management support to succeed. 1

2 Staff Pledge 3 Staff Pledge 4 To provide support and opportunities for staff to maintain their health, wellbeing and safety. 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. The report provides a summary of the key findings, examining the top and bottom ranking scores for the Trust, where the largest changes have occurred since the 2014 survey and a detailed summary by the identified headings. The report also details responses by occupational group, division and different demographics. After lobbying the survey administrators the Trust have now been benchmarked against a combined group of Mental Health, Learning Disability and Community Trusts. In previous years the scoring ranged over 5 categories including worst 20%, worse than average, average, better than average and best 20%. Within this 2015 survey analysis there are 3 ranges, including worse than average, average and better than average. 2.1 Response Rate A random representative sample of 814 staff from the Trust were asked to participate in the survey. There were 451 responses, a 55.4% response rate. This is a 2.5% decrease from the Trust s 2014 survey. This response rate is higher than the national average for Mental Health, Learning Disability & Community Trusts (44%) and puts the Trust response rate in the better than average category of Mental & Health, Learning Disabilities & Community Trusts in England. Figure 1 shows the Trust response rate in relation to the threshold for the above average of Combined Mental Health, Learning Disabilities & Community Trusts and the highest attained score. Trust Response Rate Threshold for above average Highest score attained 55% 47% 55% Figure 1 Trust Reponses Rate The response rate by Division is expressed in figure 2: Trust Response Rate Corporate Forensic Health Partnerships Local Percentage 55% 72% 58% 56% 49% Numbers National Average (Response Rate) 44% 44% 44% 48% 44% Better than average Yes Yes Yes Yes Yes Figure 2 Divisional Response Rate A ranking analysis has been completed on the response rates; The Trust was 18 th (of 230) against all NHS Trusts (excluding Ambulance Trusts and CCG s) 8 th (of 75) against all Mental Health, Learning Disability and Community Trusts and 1 st (of 29) against Combined Mental Health, Learning Disability and Community Trusts (our selected benchmark group). 2

3 2.2 Scoring There are two types of scoring system for the key findings: Percentage scores - percentage of staff responding to a particular response. Scale summary score - calculated by converting staff responses to particular questions into scores [the minimum score is always 1 and the maximum is 5]. For the majority of the key finding scores in the 2015 staff survey, the higher the score the better, however there are some key findings where a high score represents a negative response and for ease of reference these have been asterisked [*]. 2.3 Results The report has identified the key findings where the Trust compares most favourably with other trusts within our staff survey peer group, figure 3 identifies the areas where the Trust is in the better than average of Combined MH, LD & Community Trusts Score 2014 Score 2015 National Average Above / Below average Threshold Best score attained 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 KF4. Staff motivation at work KF5. Recognition and value of staff by managers and the organisation KF7. % able to contribute towards improvements at work KF8. Staff satisfaction with level of responsibility and involvement KF9. Effective team working KF10. Support from immediate managers KF12. Quality of appraisals KF13. Quality of non-mandatory training, learning or development KF14. Staff satisfaction with resourcing and support KF15. % of staff satisfied with the opportunities for flexible working patterns * KF16. % working extra hours * KF17. % suffering work related stress in last 12 mths KF19. Org and mgmt interest in and action on health / wellbeing KF21. % believing the organisation provides equal opportunities for career progression / promotion KF24. % reporting most recent experience of violence KF27. % reporting most recent experience of harassment, bullying or abuse KF30. Fairness and effectiveness of procedures for reporting errors, near misses and incidents KF31. Staff confidence and security in reporting unsafe clinical practice KF32. Effective use of patient / service user feedback Figure 3 Key Findings in better than average of Combined MH, LD & Community Trusts. Finally there are 5 areas where the Trust is compared as average within the staff survey to other Combined MH, LD & Community Trusts, these include: % appraisal in last 12 months [KF11] % feeling pressure in last 3 months to attend work when feeling unwell [KF18]; % experiencing harassment, bullying or abuse from staff in the last 12 months [KF26] % reporting good communication between senior management and staff [KF6] % witnessing potentially harmful errors, near misses or incidents in last the last month [KF28] Findings for all the Trust s results are summarised in Appendix 1. 3

4 2.4 Movements from the 2013 Staff Survey The chart below shows where movements from the 2014 survey have occurred; this shows the change compared with our 2015 staff survey results. The most significant movements are noted on KF25 - % experiencing harassment, bullying or abuse from patients, relatives or the public in last 12 months where the figure has deteriorated. Please note that within this indicator a high or positive score indicates a negative finding. Figure 4 Changes since

5 2.5 Summary of Comparisons with all MH, LD & Community Trusts in 2015 The chart below shows the Trusts responses compared to all Mental Health, Learning Disability and Community Trusts. The chart highlights where we have scored in the better than average, average or worse than average categories. Please note that for some scores a high / positive score indicates a negative finding, these are marked with an asterisk (*). Figure 5 Comparisons with MH/LD & Community Trusts. 3.0 Staff Engagement The overall staff engagement score has been calculated for the Trust. This shows how engaged staff feel they are within the organisation. Possible scores range from 1 to 5, with 1 indicating poor engagement and 5 indicating high engagement. The overall engagement scores are calculated from the questions that make up key findings 1, 4 & 7. These are staff recommendation of the organisation as a place to work or receive treatment, staff motivation at work and % able to contribute towards improvements at work. 5

6 The score for Nottinghamshire Healthcare is When compared to the National 2015 average for Combined Mental Health & Learning Disabilities Trusts [3.81] the Trust is ranked in the better than average category. Figure 6 Staff engagement scores The divisional engagement scores are detailed in the table below: Trust Engagement Score Corporate Forensic Health Partnerships Local Numbers Average Engagement Score Figure 7 Divisional staff engagement scores The Trust s staff engagement scores have been above the national average and in the upper quartile of mental health, learning disability and community trusts over the last 3 years. This is expressed in figure Trust Engagement Score National Average Figure 8 Annual staff engagement scores 6

7 A ranking analysis has been completed on the staff engagement levels; the Trust was 29 th (of 230) against all NHS Trusts (excluding Ambulance Trusts and CCG s) 6 th (of 75) against all Mental Health, Learning Disability and Community Trusts and 3 rd (of 29) against Combined Mental Health, Learning Disability and Community Trusts (our selected benchmark group). 4.0 National Rankings NHS Improvement has published a Learning by Mistakes League which draws on data within the national staff opinion survey, national reporting and learning systems to identify NHS providers that have excellent levels of openness and transparency. The Learning by Mistakes League ranks all NHS organisations in a league table and ranks these over four categories, outstanding, good, significant concerns about openness and transparency or a poor reporting culture. Nottinghamshire Healthcare NHS Foundation Trust was ranked 12 (out of 230 NHS organisations) and was given an outstanding rating for openness and transparency. Figure 9 identifies all the Trust who were ranked as outstanding. Trust Category Staff survey Rank measure Northumbria Healthcare NHS Coundation Trust Outstanding Oxleas NHS Coundation Trust Outstanding The Royal aarsden NHS Coundation Trust Outstanding Tees, Esk and Wear Valleys NHS Coundation Trust Outstanding Salisbury NHS Coundation Trust Outstanding Wrightington, Wigan and Leigh NHS Coundation Trust Outstanding Birmingham Children's Hospital NHS Coundation Trust Outstanding Tameside Hospital NHS Coundation Trust Outstanding Guy's and St Thomas' NHS Coundation Trust Outstanding Sussex Community NHS Trust Outstanding Liverpool Heart and Chest Hospital NHS Coundation Trust Outstanding Nottinghamshire Healthcare NHS Coundation Trust Outstanding Great Western Hospitals NHS Coundation Trust Outstanding Cambridgeshire Community NHS Trust Outstanding Bradford District Care NHS Coundation Trust Outstanding The Walton Centre NHS Coundation Trust Outstanding Surrey and Borders tartnership NHS Coundation Trust Outstanding Central London Community Healthcare NHS Trust Outstanding Figure 9 Openness & transparency outstanding areas 5.0 Last Year s Findings and Actions The previous survey identified 3 areas where we required focused actions; these were identified from our worst ranked scores. Over the last year some of the survey questions have changed or have been replaced, so some of the areas we identified last year we cannot make a direct comparison on from this year s survey. The table below expresses these: 7

8 Survey Area KF29. % reporting errors, near misses or incidents witnessed in the last month 2014 Staff Survey Measure 2015 Staff Survey Measure 90% 89% KF12. Quality of appraisals 49% 3.25 % having equality and diversity training in the last 12 months [KF26] Figure 10 Last year s findings 66% - Comments This factor has remained at a constant level over the last 2 years and in both periods is below the national average. Within the survey, the scoring criteria was changed from a % score to a scale summary score, so no direct comparison is available. However our ranking in the survey for this key finding have moved from average to above average showing improvements has been made. It is noted that this level sits slightly above the median. This question was removed within the 2015 survey, however our internal equality & diversity training is recorded as 93%. 6.0 Areas for Focussed Action The survey data has been extracted and analysed to understand any particular divisional or Trust wide themes. Generally the areas identified for action are the same within the Divisions as they are for the rest of the Trust, however where there is a particular theme the Divisions will be responding to this. The key areas from the survey which suggest a need for improvement are: * KF23. % experiencing physical violence from staff in last 12 months. * KF25. % experiencing harassment, bullying or abuse from patients, relatives or the public in last 12 months. KF29. % reporting errors, near misses or incidents witnessed in the last month. * KF22. % experiencing physical violence from patients, relatives or the public in last 12 months. * KF20. % experiencing discrimination at work in last 12 months. Our bottom ranked scores are shown in figure 11. 8

9 Figure 11 Bottom ranked scores The percentage of staff experiencing physical violence from staff in the last 12 months (KF23) has seen an increase from the previous survey and has moved from 2% in 2014 to 4% in 2015, additionally our Trust figures sits above our benchmark average (2%). The percentage of staff experiencing physical violence from patients, relatives or the public in the last 12 months (KF22) has increase from the 2014 survey (17%) to 21% and again is above the comparator group average (15%). Increases are also noted in the percentage of staff experiencing harassment, bullying or abuse from patients, relatives or the public in the last 12 months (KF25), our figures have seen an increase from 27% in 2014 to 34% in 2015 and are above the comparator group average (28%). The percentage of staff reporting errors, near misses or incidents witnessed in the last month (KF29) has shown a slight deterioration from the last survey moving from 90% in 2014 to 89% in 2015; additionally our 2015 response is below our comparator group average (92%). 9

10 Finally the percentage of staff experiencing discrimination at work in the last 12 months (KF20) has seen an increase in the 2015 findings, from 11% in 2014 to 14% in 2015 and sits above the comparator group average (10%). Key work has been undertaken during 2015 around the Sign up to Safety agenda and a formal programme of work has commenced. Six workstreams have been developed, with one of these work streams being assault reduction / prevention. The key factors relating to; staff experiencing physical violence from staff / patients, relatives or the public, the percentage of staff experiencing harassment, bullying or abuse from patients, relatives or the public in the last 12 months and staff reporting errors, near misses or incidents witness in the last month have all been aligned to this work stream. It is recognised that the planned work around improving data quality, clinical risk assessments and clinical risk management, training and development, creating safe working environments, the clinical management of violence and post incident support and management will support key changes to the survey findings. Key actions have been noted within the assault reduction action plan and we will monitor changes to this in future surveys. The percentage of staff experiencing discrimination at work in the last 12 months has also been noted within the Workforce Race Equality Standard (2015). As agreed within the Workforce, Equality and Diversity Sub Committee we are focusing on this indicator / key findings and are progressing relevant actions. The staff survey results for this year and the previous three years have been very positive. These findings are also corroborated by our own internal staff surveys, the Stonewall Index and Investors in People Assessments. An overarching objective for the Trust is to ensure that we continue to achieve high levels of staff engagement. The reasons for this are well documented and evidenced, particularly through the work of Michael West and colleagues. Engaged staff think and act in a positive way about the work they do, the people they work with and the organisation that they work in. Research has identified that high staff engagement is underpinned by the following key themes: Delivering great management and leadership Enabling the involvement of staff in decision making Supporting personal development and training Ensuring every role counts Promoting a healthy and a safe working environment Fundamental to all of this is effective communication and relationships, particularly between staff and line managers and within teams. Within the Trust we have already commenced work to further support; management and leadership development, workforce health and wellbeing, enabling staff voice, staff recognition and benefits, staff engagement and a culture where staff feel able to raise concerns and that is free from harassment. Moving forward we will look at the survey results to inform the refresh of our Workforce Strategy. 7.0 Summary The results from the 2015 staff survey are a very positive. They show an improvement and positive movements from the 2014 survey in the majority of the key findings, and we benchmark well nationally. We have consistently achieved this in recent years, which is encouraging. We understand however, that there is work for us to do to continually improve and we are committed to doing this. Detailed analysis of this survey will be reviewed by the Workforce Equality and Diversity Sub Committee. This detailed analysis will include analysis by Diversity strand. 10

11 We will use this data along with data and learning from other organisations to inform the refresh of our Workforce Strategy. We will test out the things we are already doing to evaluate their impact and determine where our focus should be. We know that where staff feel engaged and able to be who they are, they perform well and this leads to better outcomes for patients. We will continually strive to achieve these overarching objectives for our workforce, and will monitor progress through the Workforce Equality and Diversity Sub Committee. 8.0 Recommendations The Board of Directors is asked to note the contents of this report. Clare Teeney Director of Human Resources March

12 Appendix 1 Trust Median Score Lower Threshold Upper Threshold Corporate Forensic Health Partnerships 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 ediucation and training for their jobs and line management support to ebaled 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 & Wellbeing 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 Violence & 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 affectthem, the service 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 & 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 Staff Engagement Response Rate Response Rate (%) Local 12