CENTRAL MANCHESTER UNIVERSITY HOSPITALS NHS FOUNDATION TRUST

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1 CENTRAL MANCHESTER UNIVERSITY HOSPITALS NHS FOUNDATION TRUST Agenda Item 9.4 Reprt f: Margt Jhnsn Executive Directr f Human & Crprate Resurces Paper prepared by: Helen Parker, Assciate Directr f OD&T Date f paper: 24 th April 2015 Subject: 2014 Staff Survey Results Indicate which by Infrmatin t nte Purpse f Reprt: Supprt Reslutin Apprval Cnsideratin f Risk against Key Pririties: (Impact f reprt n key pririties and risks t give assurance t the Bard that its decisins are effectively delivering the Trust s strategy in a risk aware manner) The staff survey prvides a snapsht f rganisatinal culture at a mment in time. It has a particular emphasis n the levels f staff engagement which impacts directly n the experience f patients and als n the verall prductivity and effectiveness f the rganisatin. Recmmendatins: 1) The Bard f Directrs are requested t nte the strengths, imprvements and areas fr develpment. 2) Agree the gals in sectin 8 and actins in sectin 9. Cntact: Name: Helen Parker Assciate Directr f Organisatinal Develpment Tel: Page

2 1.0 Intrductin 1.1 This reprt utlines the results f the 2014 Natinal NHS Staff Survey, prviding a natinal and reginal cntext fr the results and key messages fr CMFT. It als includes a summary actin plan. 1.2 The survey results are used by the Care Quality Cmmissin (CQC) in their Annual Health Check, as evidence twards cmpliance with Department f Health cre standards. 1.3 There are 29 key findings within the survey plus an verall staff engagement scre. 1.4 It shuld be nted that the data prvided in the Staff Survey Reprt is weighted t take accunt f differing respnse rates frm different staff grups. 1.5 The staff engagement scre remained the same as last year at This is abve the natinal average fr all Trusts and average when cmpared with Acute Trusts. Sustaining this level f engagement in the cntext f the current pressure is an achievement, NHS Staff Survey Results- the natinal cntext (All Trusts) 2.1 NHS Emplyers highlighted the key trends acrss all Trusts frm the 2014 Staff Survey. A cmparisn f hw CMFT cmpares against these is summarised belw: 2.2 A new questin n raising cncerns shws that 68% f staff natinally wuld feel safe t raise a cncern abut unsafe clinical practice and 93% wuld knw hw t d s. 67% f CMFT staff wuld feel safe t d s and 93% wuld knw hw. This will nw be a key measure fr the Trust. 2.3 Staff Engagement The staff engagement scre is used as an indicatr fr the directin f travel n the quality f care being delivered and is made up f the fllwing aspects f staff engagement: Staff perceived ability t cntribute tward imprvements at wrk Staff willingness t recmmend the Trust as a place t wrk and receive treatment (advcacy) Staff mtivatin and engagement at wrk Natinally the verall staff engagement scre fell slightly frm 3.71 t 3.70 due t decreases in staff mtivatin and advcacy scres. Staff ability t cntribute tward imprvements at wrk remained the same By cmparisn CMFT scres reflect: An increase in the number f staff reprting an ability t cntribute twards imprvements in wrk, and An increase in staff mtivatin at wrk, and; A decrease in staff willing t recmmend the Trust as a place t wrk r receive treatment 2 Page

3 2.3.4 The change in the measure f staff willing t recmmend the Trust as a place t wrk r receive treatment was a decrease f 0.6 frm 3.71 in 2013 t 3.65 in Whilst this is nt statistically significant and has NOT resulted in a reductin in verall staff satisfactin, it is a bigger decrease than the verall natinal psitin frm 3.64 in 2013 t 3.62 in This has impacted n ur ability t imprve ur engagement scre. Fur questins feed int this key finding. The respnses fr 3 ut f the 4 questins imprved r remained the same in Hwever there was a 4% drp frm 69% in 2013 t 65% in 2014 in staff reprting that care f patients/service users is my rganisatins tp pririty. The average fr acute Trusts was 70% in It is highly likely therefre that this perceptin has had a direct impact n staff recmmending the Trust as a place t wrk r receive treatment and cnsequently ur ability t imprve the staff engagement scre The reasns fr the decreased staff advcacy scre needs t be fully understd and addressed as this clearly has a direct bearing n staff satisfactin and cnsequently, n patient satisfactin The table belw utlines CMFT cmparisn f staff engagement results 2013 and 2014 and ur ranking alngside Acute Trusts. Overall Staff Engagement Staff ability t cntribute tward imprvements at wrk 2013 CMFT 2014 CMFT 2014 Ranking cmpared t All Trusts and Natinal Averages Abve average 67% 69% 68% Abve average 2014 Ranking Cmpared t all Acute Trusts and averages 3.74 Average 68% Average Staff recmmendatin f the Trust as a place t wrk and receive treatment Abve average 3.67 Average Staff mtivatin at wrk Abve average 3.86 Abve average 2.4 Line Manager Supprt The key psitive trend acrss Trusts natinally was the imprvement f indicatrs in the perceptin f supprt frm line managers. The percentage f staff reprting that they were happy with the supprt they get frm their manager rse frm 65% t 68%. At CMFT this rse frm 67% t 70% which is abve the natinal average. 3 Page

4 2.5 Training and Develpment Natinally the number f staff receiving appraisals has remained stable at 83%, at CMFT this figure is 84% which althugh dwn n the previus year (frm 88%), is still abve the natinal average. The percentage f staff wh reprt that they receive a wellstructured appraisal has risen slightly frm t Althugh remaining abve the natinal average the % f CMFT staff reprting well structure appraisals fell frm 43% t 39% Overall the levels f staff training increased acrss mst areas including health and safety and equality and diversity. This is als true fr CMFT. 2.6 Health and Wellbeing Natinally the percentage f staff saying that they had suffered wrk-related stress in the previus 12 mnths rse frm t Hwever the percentage f staff feeling under pressure t wrk when feeling unwell fell frm 27 t 25% At CMFT we saw a decrease in the percentage f staff suffering frm wrk related stress frm 43% t 33% and als a decrease in thse feeling under pressure t wrk when unwell frm 28% t 24% keeping us abve average natinally The percentage f CMFT staff wh believe the Trust takes psitive actin n health and wellbeing has fallen frm 43% t 39% which is belw the natinal average f 43% % f CMFT staff reprted experiencing physical vilence frm patients, their relatives r ther members f the public in the previus 12 mnths, dwn frm 15% in Natinally, this was 15% in 2013, dwn 1% t 14% in There has been a 5% decrease (frm 29% in 2013 t 24% in 2014) in the percentage f CMFT staff reprting that they experienced bullying, harassment and abuse frm patients, their relatives r ther members f the public in the previus 12 mnths. This is belw the natinal average f 28% Althugh natinally there was a small rise ( t 23.68) in staff reprting experiencing bullying and harassment frm staff CMFT staff reprted a fall frm 21% t 19%. 3.0 Prgress against gals identified in The fllwing summary benchmarks CMFT against all Acute Trusts. Gal Achievement Cmments Imprve the staff respnse rate In 2014 CMFT have achieved Overall the natinal average t ensure it is equal t r abve the natinal average. a respnse rate f 44% which is average fr acute Trusts. drpped by 7% frm 49% t 42%. Maintain an abve average fr the staff engagement scre and thse key findings where this was achieved this year The CMFT scre f 3.76 is slightly abve the natinal average fr acute Trusts f When reviewing the indicatrs feeding the staff engagement scre the Trust is abve the natinal average fr jb satisfactin and mtivatin, but belw fr advcacy (recmmending the Trust as an emplyer/care prvider). 4 Page

5 Achieve a 30% increase in the number f key findings scring in the 20% f trusts. T achieve imprvements in the 3 areas where staff experience has deterirated These were: Mre staff suffering wrkrelated stress Mre staff experiencing physical vilence frm patients, relatives r the public Mre staff experiencing physical vilence frm staff In 2013, CMFT was in the tp 20% f Trusts fr 8 key findings. This has increased t 11 which is a 37% increase. The Trust appears in the tp 20% f acute trusts acrss all three areas where we had deterirated in Agenda Item 9.4 The Trust has maintained the tp 20% psitin in the key findings relating t: Health and safety training, Harassment frm patients/the public r staff Effective team wrking. Reprting near misses, errrs r incidents CMFT mved int the tp 20% fr : Wrk related stress Staff experiencing physical vilence frm patients and staff Staff having equality and diversity training Supprt frm immediate managers Staff jb satisfactin The Trust has hwever mved ut f the tp 20% f acute trusts fr key findings relating t: Staff wrking extra hurs, Well-structured appraisals, Fairness/effectiveness f incident reprting, and Wrk pressure felt by staff. Fr these indicatrs, the Trust has mved frm belw average t within the tp 20% f trusts Furthermre, CMFT is als in the tp 20% f acute Trusts fr high levels f reprting errrs and incidents and we saw imprvements in equality and diversity indicatrs, supprt frm immediate managers and an in staff jb satisfactin. 4.0 CMFT 2014 Staff Survey Results 4.1 The fllwing is a summary f all key findings fr CMFT benchmarked against all acute Trusts. 4.2 The 2014 survey is brken dwn int 29 key findings. In 2014 Q13 and Q19 were replaced with new questins, because f this Key Finding 12 Percentage f staff saying hand washing materials are always available has been remved. 4.3 Tw new Key Findings have been intrduced based n the new questins, these are percentage f staff agreeing that they wuld feel secure raising cncerns abut unsafe clinical practice and percentage f staff agreeing that feedback frm patients/service users is used t make infrmed decisins in their directrate / department, these scres nw feature as Key Findings 15 and 29 respectively. 5 Page

6 4.4 When cmpared t the 2013 survey, the Trust has imprved in 17 areas, deterirated in 9 areas and remained the same in 1 area. 4.5 This sectin is brken dwn int fur areas key strengths, areas where CMFT is abve average, belw average and areas fr develpment. 4.6 Key Strengths When cmpared t 2013, there has been a statistically significant psitive change in the fllwing Key Findings since the 2013 survey: Percentage f staff experiencing wrk-related stress in the last 12 mnths. experiencing physical vilence frm and patients public experiencing physical vilence frm staff having received E&D training in last 12 mnths There are 11 key indicatrs where CMFT ranks in the tp 20% f acute trusts natinally: Percentage f staff receiving health and safety training in the last 12 mnths Percentage f staff experiencing wrk related stress Percentage f staff reprting errrs, near misses r incidents Percentage f staff experiencing physical vilence frm and patients public Percentage f staff experiencing physical vilence frm staff Percentage f staff experiencing bullying and harassment frm and patients public Percentage f staff experiencing bullying and harassment frm staff Percentage f staff having E&D training in the last 12 mnths Percentage f staff reprting effective team wrking Percentage f staff reprting supprt frm immediate managers Levels f staff jb satisfactin 4.7 Areas Abve Average When reviewing change in key findings since 2013 and ranking cmpared with all acute trusts in 2014, the fllwing 8 areas are identified as abve (better than) average: Percentage staff agreeing that their rle makes a difference t patients Percentage f staff witnessing ptentially harmful errrs, near misses r incidents in the last mnth Fairness and effectiveness f incident reprting prcedures Percentage f staff feeling pressure in last 3 mnths t attend wrk when feeling unwell Percentage f staff reprting gd cmmunicatin between senir managers and staff Levels f staff mtivatin at wrk Percentage f staff experiencing discriminatin at wrk in the last 12 mnths Percentage f staff agreeing feedback frm patients/service users is used t make infrmed decisins in their department 6 Page

7 4.8 Areas Belw Average Using the same ratinale used t identify areas abve average, the fllwing 2 areas are identified as belw average: Percentage f staff staff wrking extra hurs Percentage f staff staff appraised in the last 12 mnths Finally, there was ne Key Finding where the Trust has nt nly experienced a negative change since 2013 survey, but als is in the wrst 20% f acute trusts: Percentage f staff staff feeling satisfied with the quality f wrk and patient care they are able t deliver The average fr acute trusts has fallen by 2% against this indicatr frm 79% in 2013 t 77% in CMFT sits at 75% a fall f 5% frm Areas f Develpment This sectin highlights the three Key Findings fr which CMFT cmpares least favurably with ther acute trusts in England. It is suggested that these areas might be seen as the fcus f imprvement plans Staff satisfactin with the quality f wrk and patient care they are able t deliver Wrking extra hurs Number f staff appraised in the last 12 mnths As mentined earlier in this reprt we als saw a decrease in the percentage f staff recmmending the Trust as a place t wrk r receive treatment which has meant we have nt imprved ur staff engagement scre. It is anticipated that fcussing ur effrts n addressing the three key findings abve will have a direct impact n ur ability t imprve ur verall staff engagement scre. 5.0 Staff Friends and Family Test 5.1 The Staff Friends and Family Test was implemented in 2014/15 acrss all staff in quarter 1, with Sdex staff and the Bard in quarter 2 and with staff participating in the sample in quarter 3. Results are detailed belw: Recmmended - Wrk Nt Recmmended - Wrk Recmmended - Care Nt Recmmended - Care Q1: All staff 64% 15% 74% 9% Q2: Chrt 1 Leading fr Excellence 100% 0% *85% 0% Q2: Sdex 50% 35% 74% 11% Q3: Staff Survey 62% 67% *Nt 100% due t net prmter scre calculatin 7 Page

8 5.2 The table shws variatins in advcacy between the different staff grups. The Q3 staff survey results are nt directly cmparable t the ther quarters. 6.0 Cmparisns t Shelfrd Grup and Greater Manchester Acute trusts 6.1 Natinal Benchmarking Shelfrd grup 6.2 The table belw shws hw the Trust cmpares t ur peers in the Shelfrd grup acrss a range f indicatrs including respnse rate, staff engagement scre and the number f key findings in the tp/bttm 20% f acute trusts natinally. The table has been arranged by the highest number f key findings in the tp 20% f acute trusts natinally. Organisatin Respnse Rate Staff Engagement Scre Key Findings in tp 20% f acute trusts natinally Key findings in bttm 20% f acute trusts natinally Newcastle Sheffield CMFT GSTT Birmingham Oxfrd Kings Imperial Cambridge The table shws that CMFT has the secnd highest number f key findings in the tp 20% f Trusts frm the Shelfrd Grup. The respnse rate is wrthy f nte with the Trust having the third highest (fllwing Birmingham and Newcastle). 6.4 Despite achieving 11 key findings in the tp 20% f Trusts ur staff engagement scre is ne f the lwest scres in the Shelfrd Grup. This can be explained by the fact that nne f the11 key findings in the tp 20% include the key findings that make up the staff engagement scre. 6.5 Hwever despite a decline natinally, which is reflected by a decline in the scres f 50% f the Shelfrd grup, CMFT has maintained its staff engagement scre ver the last tw years. This means CMFT is ne f nly 5 Shelfrd Grup members that have nt seen a decline in staff engagement scres meaning CMFT has maintained its year n year imprvement against the mean average Shelfrd Trust staff engagement scre 8 Page

9 6.6 Greater Manchester Acute Trusts The table belw shws hw the Trust cmpares t ur peers in Greater Manchester Acute trusts acrss a range f indicatrs including respnse rate, staff engagement scre and the number f key findings in the tp/bttm 20% f acute trusts natinally. Again, the table has been arranged by the highest number f key findings in the tp 20% f acute trusts natinally. Organisatin Respnse Rate Staff Engagement Scre Key Findings in tp 20% f acute trusts natinally Key findings in bttm 20% f acute trusts natinally Wrightingtn, Wigan and Leigh Salfrd Bltn CMFT Stckprt Suth Manchester East Cheshire Tameside Pennine Acute The table shws the Trust is 4 th when cmpared against lcal trusts fr key findings in the tp 20% and als the 3 rd highest respnse rate in the regin Finally, CMFT is ranking 6 th ut f the 9 GM acute Trusts fr staff engagement despite achieving 11 key findings in the tp 20% f Trusts. This can again can be explained by the fact that nne f the11 key findings in the tp 20% include the key findings that make up the staff engagement scre. 7.0 Establishing the link between staff satisfactin and patient satisfactin 7.1 The Assciatin f UK University Hspitals HR Frum cmmissined a piece f wrk via Trvus t establish whether there was a relatinship between inpatient satisfactin levels and staff mtivatin data (cllected thrugh the staff survey). Mre imprtantly what can be learnt frm the analysis t imprve bth staff mtivatin and therefre psitively impact inpatient satisfactin. 7.2 This wrk is underpinned by research carried ut by Prfessr Michael West which has shwn that Inpatient care and satisfactin is higher when staff perfrmance and mtivatin is high. 7.3 The research fund that there is a causal relatinship between staff mtivatin and inpatient satisfactin. This is significant, because it means that the data relating t these Trusts d align t Prfessr West s principles. Therefre we can g n with cnfidence t lk at the guiding factrs that influence staff mtivatin, which in turn supprt patient satisfactin. 9 Page

10 7.4 The research brke the Assciatin f UK University Hspitals member Trusts int fur grups as fllws: 1. Staff and Patient Strnger Perfrmers (Staff Mtivatin is high / Patient Satisfactin is high) 2. Staff and Patient Weaker Perfrmers (Staff Mtivatin is lw / Patient Satisfactin is lw) 3. Patient Strnger Perfrmers (Staff Mtivatin is lw / Patient Satisfactin is high) 4. Staff Strnger Perfrmers (Staff Mtivatin is high / Patient Satisfactin is lw) 7.5 CMFT falls int grup 4 and the OD&T team are wrking clsely with the Crprate Nursing Team and Service Imprvement Teams t understand this in mre detail and include findings int actins mving frward. 8.0 Cnclusin 8.1 As a cnsequence f develping a high level cllabrative apprach between HR and divisinal staff, with fcus being applied in the areas f develpment identified in last year s survey, the Trust has achieved a respnse rate higher than the natinal average and had and an verall increase f 38% in Key Findings achieved in the tp 20% f acute Trusts. 8.2 A significant achievement is the imprvement made t the findings relating t staff experiencing physical vilence frm ther staff and frm patients and staff where we have mved frm the bttm 20% f acute Trusts t the tp 20%. 8.3 We have als achieved a reductin f 66% (3 t 1 indicatrs) fr findings in the bttm 20% f acute trusts natinally. 8.4 Hwever despite maintaining an average (as cmpared t Acute Trusts) verall staff engagement scre we were nt able t make imprvements. This is primarily due t a decrease in staff advcacy scres i.e. staff recmmending CMFT as a place t receive treatment r care; in particular the staff respnse t the questin care f patients/service users is my rganisatins tp pririty. CMFT is als in the bttm 20% f Acute Trusts fr staff feeling satisfied with the quality f wrk and patient care they are able t deliver. 8.5 There has als been deteriratin in the numbers f staff reprting they have received an appraisal in the last 12 mnths with mre staff reprting that they are wrking extra hurs. 8.6 The fcus f imprvement plans will therefre need t be n addressing these key areas. 8.7 Fr the 2015 Staff Survey ur gals are t: Cntinue t imprve the staff respnse rate t ensure it is either equal t r abve the natinal average. Imprve the staff engagement scre t within the threshld fr the highest 20% (3.82) and thse key findings where this was achieved this year. Imprve advcacy rates t at least an average f acute Trusts 10 Page

11 Achieve tp 20% f Trusts fr the new raising cncerns measure intrduced this year. Cntinue t increase the number f key findings scring in the 20% f trusts by a minimum f 10% T have n key findings in the bttm 20% f acute trusts. T achieve imprvements in the areas where staff experience has deterirated. 8.8 These gals will be achieved thrugh the delivery f the actins utlined belw Actins and Next Steps Cntinue t wrk with divisins t develp plans t build n strengths and address areas f cncern Embed the Trust Values and Behaviurs framewrk which defines the behaviurs and attitudes we expect f each ther. This includes: Delivery f Living the Values sessins acrss the rganisatin Rllut f a revised appraisal frm, plicy and develpment prgramme Sharing f staff recgnitin stries as identified by the We re Prud f Yu Awards widely acrss the rganisatin Cntinue t build n the staff engagement prgramme by intrducing a new medical engagement framewrk, sustaining the Visin2Actin and Transfrmatin prgrammes. Further develp and sustain high levels f leadership and management develpment Mdify the staff friends and family test t allw a cultural diagnstic f key areas. Implement the Wrkfrce Recvery Plan t: Reducing staff sickness t NHS average and belw All managers are achieving cmpliance with wrkfrce standards Ensure all staff are in receipt f crprate and clinical mandatry training Ensure all staff are in receipt f an appraisal Intrduce a cnsistent staff pulse check t measure and mnitr staff experience thrughut the year Cntinue t develp alignment between staff and patient survey plans Integrate staff survey plans int the Quality Review prcess Thrugh the Freedm t Speak Up actin grup implement principles and actins that will embed gd practice and imprve perfrmance in handling cncerns and the treatment f thse wh raise them. A high level actin plan is included as appendix A. 11 Page