MEETING OF TRUST BOARD EXECUTIVE SUMMARY TITLE & DATE: AGENDA ITEM 4.2 National NHS Staff Survey and Trust Staff Satisfaction Survey 2013 Action Plan 27 February 2014 This paper is for: Approval x Decision Assurance - for Discussion Assurance - for Information only Paper Author & Job Title: Ruth Unwin Director of Communications and Engagement Responsible Director: Graham Briggs Director of People and Development The national 2013 staff survey results were published on February 24 th 2014 and provide comparative data relating to staff experience and motivation for all acute Trusts. The report also provides comparison to the Trust s performance for 2012. The report is based on a questionnaire distributed to staff in autumn 2013. All employees of the Trust were given the opportunity to participate in the survey, which is routinely sent to a sample of staff in each Trust (minimum 850 staff for an organisation employing more than 3000 staff. 46% of Trust staff responded. Summary of paper: (No more than 300 words) The overall results indicate that staff motivation and engagement is lower than average when compared with acute Trusts nationally. The Mid Yorkshire Hospitals Staff Satisfaction Survey 2013 Action Plan (the 2013 Action Plan),targets the issues of greatest concern for staff and focuses support on those teams that have scored lowest. It is designed to address four key themes: Resource planning recruitment, retention and deployment of staff Appraisal and development of staff Embedding the Trust s values Staff engagement and visibility of senior managers. The report allows results to be analysed by specific teams which has enabled a plan to be developed which prioritises areas where the most 1
intensive support should be focused. The 2013 Action Plan is based on the approach taken by Wigan, Wrightington and Leigh NHS Foundation Trust, which won the 2013 Health Service Journal Staff Engagement award. Their approach focuses on nine enablers of staff motivation and engagement and utilises a nationally recognised Listening into Action programme to support staff engagement as well as methodologies adopted by UNIPART. Action Required from Board: Does this paper provide evidence of assurance for the Board Assurance Framework? please outline Does this paper mitigate risk included in the Trust Risk Registers? please outline To note the findings of the national survey and approve the Trust Staff Survey Action Plan Maintaining a skilled and motivated workforce impacts on all of the key risks identified in the assurance framework. The staff survey results are identified as a mechanism by which the Trust Board can gain assurance that the objective to improve staff and patient experience is being achieved. The Corporate Risk register identifies specific risks relating to workforce pressure and workforce morale. This paper relates to the following corporate objectives and strategies: Corporate Objectives Sustained improvement in quality and patient safety Patient and staff experience Effectiveness Leadership and governance arrangement X X X X Risk X Research and Development Workforce and Organisational Wellbeing X Marketing Strategies Integrated Education and Development Clinical Services X Nursing and Midwifery X Customer Service IM&T X 2
THE MID YORKSHIRE HOSPITALS NHS TRUST 2013 National Staff Survey Results and Staff Satisfaction Survey 2013 Action Plan 1. Purpose of the Report The purpose of this paper is to provide the Mid Yorkshire Hospitals NHS Trust (the Trust) Board with a comprehensive picture of the key issues identified through the 2013 staff survey and to seek the Board s commitment to the 2013 Action Plan. 2. Background The NHS Constitution sets out seven commitments to staff. The national staff survey is designed to test staff opinion in relation to four of the commitments: To provide 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 education and training for their jobs and line management support to enable them to fulfill their potential To provide support and opportunities for staff to maintain their health, well being 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 to patients and their families. The survey also explores levels of staff satisfaction and equality and diversity for staff. The survey is carried out annually in the autumn. Routinely, trusts are required to issue the survey to a random sample of staff. In 2013, the Trust took the decision to offer all staff the opportunity to participate in the survey to enhance the richness of the data and paper surveys were issued to all staff with salary slips. 46% of staff responded. The report provides comparative data for the Trust in relation to other acute trusts and in relation to the previous year s results. 3. Overview of Trust Performance The Trust s results compared with 2012 are shown in the following table: 3
2012 2013 Number of Number of Key Findings Category Key Findings Category 5 Best 20% 0 Best 20% 3 Better than average 1 Better than average 6 Average 5 Average 5 Worse than average 6 Worse than average 9 Worst 20% 16 Worst 20% The overall results indicate that staff motivation and engagement is lower than average when compared with acute Trusts nationally. Appendix 2 shows how the Trust performance has changed against each of the NHS Constitution staff pledges over the four year period since 2010. Key issues for the Trust are: The Trust scored better than average in relation to: Staff working extra hours Staff experiencing discrimination Staff witnessing potentially harmful errors or near misses Staff believing the Trust provides equality of opportunity for career progression Staff experiencing physical violence from colleagues. The Trust scored worse than average in the following areas Staff recommending the Trust as a place to work or receive treatment Staff motivation Staff suffering work related stress 4
Staff job satisfaction Staff reporting good communication between senior management and staff. There has been deterioration in staff experience compared with last year in the following areas: Work pressure felt by staff Staff experiencing harassment, bullying or abuse by staff Staff witnessing potentially harmful errors or near misses Staff job satisfaction. The Report indicates, in comparison with other acute trusts, Trust staff were less likely to work extra hours, less likely to experience discrimination at work, as likely as staff in other organisations to witness potentially harmful errors or incidents, as likely to believe the Trust offered equal opportunity in career progression and less likely to have experienced physical violence from colleagues. However, the Report highlights a number of areas of concern with regard to overall satisfaction levels, which may be indicative of the significant challenges experienced by the Trust in recent years, namely, the measures required to address historic financial and performance improvement and the anticipation of major service change and the consequent impact on working patterns. Compared with other acute trusts, Trust staff are less likely to recommend the Trust as a place to work or receive treatment, less motivated at work, more likely to have experienced work related stress and experience lower job satisfaction. It is worth noting that the feedback from the local pilot Staff Friends and Family Testing was more favorable in respect of staff recommending the Trust as a place to work or receive care. The pilot staff Friends and Family test surveyed staff working in the inpatient areas where the patient FFT is already running. Of 665 staff who responded, 83% said based on the previous month they were happy with the standard of care provided. Further analysis will be needed to understand why there is this degree of variation in staff perceptions when asked about their own area of work and their perception of the Trust as a whole. The Trust is able to access drill down reports which provide separate analysis by staff group and by department which enables actions to be targeted and priority areas to be identified. 5
4. Summary of Key Actions The Trust was proactive in seeking views from a broader group of staff than the standard sample of 850 staff, to ensure the validity and richness of the intelligence that could be collected through the survey and it is imperative that there is a detailed and robust action plan developed to address the issues that have been identified. The Trust 2013 Action Plan targets the issues of greatest concern for staff and focuses support on those teams that have scored lowest. It is designed to address four key themes: Resource planning recruitment, retention and deployment of staff Appraisal and development of staff Embedding the Trust s values Staff engagement and visibility of senior managers. The interval between publication of the 2013 results and the launch of the 2014 survey is just over six months which is a relatively short time for plans to have an impact. An intensive and focused approach will be needed to deliver high impact changes and to target priority areas. The proposed approach delivers intensive support to teams that have been identified as particularly challenged and is designed to enable the Trust to draw on the expertise and experience of teams and departments where staff motivation and engagement is highest. The Trust action plan is based on learning from other organisations, including Wrightington Wigan, and Leigh NHS Foundation Trust (WWL), which won the 2013 Health Service Journal Staff Engagement award. The WWL approach focuses on nine enablers of staff motivation and engagement: Influence Clarity Work relationships Fairness Recognition Personal Development Mindset Resources 6
Trust. The WWL approach uses a nationally recognised Listening into Action programme to support staff engagement as well as methodologies adopted by UNIPART(see below). The Trust s proposed approach will be built around the same nine enablers covered by the WWL programme plus a tenth enabler around staff well being. 4.1 Listening into Action Listening into Action (LIA) is a comprehensive outcome focused approach to engaging key people in organisations around delivery of quality improvement, it is specifically designed around NHS organizations and has been widely used with positive effect. LIA looks at all aspects of how teams or departments work and focuses on three dimensions of change: quality and safety; patient experience and working together. It also provides a platform from which other improvement methodologies can be applied, which is why it works well with the UNIPART approach to improving efficiency by ensuring priorities are aligned to the Trust s overall objectives. LIA involves an initial 12 month programme which has demonstrable commitment from the top level leadership in the organisation and uses recognised methodologies to engage and empower teams to deliver change, for example appreciative enquiry techniques. The approach has proven to significantly improve staff feedback in the annual survey in other organisations. 4.2 UNIPART approach The Trust has been in discussion with UNIPART with a view to adopting aspects of their performance improvement and staff engagement methods as part of the Trust s overall approach to Striving for Excellence This includes a team based approach to performance management which will initially be centred around 12 teams, including some challenged teams where there are existing performance challenges. The plan is that the some of the teams selected for the UNIPART approach to performance improvement will be those teams that have been identified as priority areas through the staff survey and the team approach to performance improvement will be used to build capacity and capability for staff engagement. The Trust is also working with UNIPART to develop an approach to staff engagement based on their communication cells model, which involves a structured and highly visible approach to scheduled and systemized communication of organisational priorities to teams. This is included in the staff survey action plan. 7
5. Monitoring arrangements Each action in the 2013 Action Plan has an identified mechanism for monitoring whether the 2013 Action Plan is having a positive impact. This will enable the Trust to review the approaches being taken and respond quickly if actions are not having the required impact. A staff survey action planning group will be established which includes management and staff representatives. Their role will be to oversee the development and implementation of improvement plans. The Resource Planning Group will operate as a sub group of this. Delivery of the Plan will be monitored by the Workforce and Organisational Wellbeing Committee which will be responsible for assessing risk in relation to staff engagement and providing assurance to the Trust Board. 6 Recommendations The Board is asked to note the content of the report and to approve the 2013 Action Plan. Graham Briggs Director of People and Development February 2014 8