Responding to the Francis Report: Listening to Staff

1. Responding to the Francis Report: Listening to Staff HPMA Conference 16th May 2013

2. Working Differently Working Together

3. The Francis Report: “passivity...not listening....insufficient attention....lip service....lacking awareness....communication failure...” ‘Working Differently – Working Together” - developed with stakeholders and agreed with all recognised trade unions Here’s what we said we would deliver in NHS Wales’: An engaged workforce aligned and committed to the delivery of the vision for NHS Wales A sustainable and skilled workforce focussed on helping the people of Wales to improve their health as well as treating sickness A redesigned workforce working together to deliver healthcare for the 21st Century A workforce that aims at excellence everywhere within available resources Culture….the importance of listening

4. Does Working Differently Working Together Align with Francis? • Based on NHS Wales Values: • Putting Quality and Safety above all else; Integrating improvement into everyday working; Focussing on prevention; Working in true partnership; Investing in staff • Describes behaviours required of all staff .... • Treat everyone with dignity and respect • Be accountable for the quality of care delivered • And leaders.... • Engage staff by listening to concerns • Demonstrate NHS Wales values in the way they lead • Evidence Base: • Links between positive employment practices and service quality; • Impact of increased health and wellbeing of staff on patient experience

5. Chief Executives established a programme to carry this work forward Programme Board with a partnership membership from across the NHS in Wales The challenge: How we can work differently Be specific about what this means in practice Do this together WDWT Programme

6. WDWT Programme • Three core projects underway • Aim is to provide practical ‘how to’ guides • Working together productively • Engagement for health care improvement • Driving health and well being • A workbook in chapters – publishing starts in June

7. Small scale local surveys:An example of a “Pulse Check” • Do you know what is expected of you at work? • Do you have the materials and equipment you need in order to do your work right? • At work, do you have the opportunity to do what you do best every day? • In the last seven days, have you received recognition or praise for doing good work? • Does your supervisor, or someone at work, seem to care about you as a person? • Is there someone at work who encourages your development? • At work, do your opinions seem to count? • Do the Mission and Vision of the trust make you feel your job is important? • Are your fellow work colleagues committed to doing quality work. • In the last six months, has someone at work talked to you about your progress? • In the last year, have you had opportunities at work to learn and grow? Adapted from East Cheshire NHS Trust

8. Working Differently – Working Together • We’ll know if its working when: • People say implementation of WDWT is easier on the ground because they know what works • The NHS in Wales is working differently and the weight of evidence supports this view • We have avoided ‘islands of success’ and staff report the NHS in Wales is changing for the better • Our starting point is underpinned by the latest Staff Survey.

9. NHS Wales staff survey 2013 • Developed and implemented by the Welsh Partnership Forum. • Specialist advice on links between staff engagement & service quality provided by Professor Michael West. • Implemented January/February 2013. • 22,356 responses (27% national response rate). • All LHBs now have their own tailored report

10. Theme 1: Creating positive work climates • Focus on staff well-being. • Perceptions of work pressures • Line manager support • Taking action against bullying, harassment & violence Headlines: Most staff agree they get positive support from colleagues, … but Do not agree that senior managers involve staff in difficult decisions.

11. Theme 2: Focus on quality and patient care • Individual perception of standards of care • Personal contribution to patient care • Perception of organisation focus on care quality • Responding to errors, incidents & near misses Headlines: Most staff feel their role makes a difference to patients and that they are encouraged to report errors and incidents, …but do not agree that they are encouraged to suggest ways to improve services.

12. Theme 3: Supporting staff through positive human resource management practices • Role design & workforce capacity planning • Training & development • Appraisal processes • Equality & diversity Headlines: Most staff agree the people they work with treat them with dignity and respect, …but do not agree that change is well managed.

13. Headlines: Most staff agree that they work in a team, …but are much less likely to agree that the team meet to review objectives and effectiveness. Theme 4: Ensuring effective team working • Team membership • Team objectives • Team effectiveness

14. Theme 5: Building Trust • Trust between colleagues • Trust between staff & line managers • Trust between staff and senior leaders Headlines: Most staff agree that they are trusted to do their job, …but do not agree that senior managers act on staff feedback or that communication between staff and senior managers is effective.

15. Theme 6: Headline measures of engagement and satisfaction Overall job satisfaction Intrinsic psychological engagement Ability to contribute to improvements at work Staff advocacy & recommendations Headlines: Most staff agree that they are happy to go the extra mile when required, …but are less likely to agree that they are encouraged to suggest ways of improving services.

16. Acting on the survey A thermometer to compare…or...A microscope to learn What you do with the findings is more important than the findings themselves A large majority of survey responders felt that senior managers will not act on the results of the survey

17. Life is 10% what happens to you, and 90% how you react it “The longer I live, the more I realize the impact of attitude on life. Attitude, to me, is more important than facts. It is more important than the past, the education, the money, than circumstances, than failure, than successes, than what other people think or say or do. It is more important than appearance, giftedness or skill. It will make or break a company... a church... a home. The remarkable thing is we have a choice everyday regarding the attitude we will embrace for that day. We cannot change our past... we cannot change the fact that people will act in a certain way. We cannot change the inevitable. The only thing we can do is play on the one string we have, and that is our attitude. I am convinced that life is 10% what happens to me and 90% of how I react to it. And so it is with you... we are in charge of our Attitudes.”