NGH Pharmacy Ethos Paul Rowbotham, Chief Pharmacist Mar-2013

1. NGH Pharmacy Ethos Paul Rowbotham, Chief Pharmacist Mar-2013

2. What is an Ethos? The distinctive character, spirit, & attitudes of a people, culture, era When an ethos is written down, it is an expression of what we feel are the common values etc of the staff of NGH pharmacy. An ethos is not a motto or slogan [Be Prepared, Every little helps, Because I’m worth it!] Patients first / safety / quality & value / support one another / enjoy work

3. Why a [written] Ethos for NGH Pharmacy? If you asked 10 staff what our priorities are you would get 10 different answers, but some common themes. If you asked 10 staff what the principles, values & pledges are in the NHS Constitution, most would not know. If you asked 10 staff what the NGH mission & values are, many would not know. A written ethos is a way to bring some focus, consistency & clarity for staff working in a changing environment with a complex range of priorities, aims & objectives. Patients first / safety / quality & value / support one another / enjoy work

4. Developing our ethos? • We started in Jul-12. • The concept was supported by the Pharmacy Management Board. • Members of our Pharmacy Management Group [30+] were consulted & all responded with comments & observations. • Finally a group of PMG representatives, who each brought along another member of staff, met to refine the ethos words. • In Mar-13 our ethos was presented to staff. • Our criteria were: • Simplicity – everyone should be able to remember it. • Say what we do & our values – some conflict with simplicity as we do a lot & have many values. • For use WITHIN pharmacy – not for advertising what we do to others; however, it must not adversely affect perception when seen by others. • Unanimous – amongst the group. Patients first / safety / quality & value / support one another / enjoy work

5. This is our ethos Patients first Safety Quality & value Support one another Enjoy work With a visual display: Patients first / safety / quality & value / support one another / enjoy work

6. Patients first Patients are why we are at work. Everyone in pharmacy provides services to patients or supports those that do. Our work also concerns groups of patients rather than individuals, eg. ensuring we use NICE approved medicines, Patient Group Directions etc Sometimes our jobs can be very busy & repetitive & having ‘patients’ as the first thing in our ethos will help ensure they are always prominent in our minds. Patients first / safety / quality & value / support one another / enjoy work

7. Safety All pharmacy staff identify with safety – from ensuring prescriptions are correct, to dispensing accurately or making sure medicines are stored in the correct place & the right medicines are held as stock. Those who do not handle medicines have a role in safety by supporting safe systems, audit, guidelines, MMC, MSG etc. Health & Safety of staff is also a priority in which we all have a role. When people are under pressure in their work it will help to reinforce safety over speed, convenience etc. Patients first / safety / quality & value / support one another / enjoy work

8. Quality & Value Quality: of medicines – this is pharmacy’s responsibility. Quality of services – to do the best we can in everything we do. High Quality Care for All*defines quality as three dimensions: ensuring that care is safe, effective, & provides patients with the most positive experience possible. Value: Medicines are the largest part of NHS non-pay expenditure & we have a great responsibility to manage this properly. We handle around £25m worth of medicines each year & our efficiency directly affects NGH’s cash flow & the risk of waste. Other ‘value’ systems include: the introduction of new medicines; contract systems; administration to recover costs when necessary etc. * High Quality Care for All, DH 2008 http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_085825 Patients first / safety / quality & value / support one another / enjoy work

9. Support* one another We all need support, particularly new staff, those with personal difficulties, those with too much work etc. If staff feel supported, then they will support others. Support must be balanced with ‘challenge*’. If the balance is not right it can lead to apathy or stress. We aim for high challenge & high support which results in highperformance. *Support: things that help develop/ nurture the necessary capabilities. *Challenge: must be willingly accepted by the individual, rather than imposed, can be anything that requires extra effort or capability. Patients first / safety / quality & value / support one another / enjoy work

10. Enjoy work [1] • There is now good evidence that: • the experience of NHS staff is linked with the quality of care & • good staff management leads to higher quality of care, more satisfied patients & lower patient mortality. • So, the experience of our staff is critical and we try to improve this by doing various things…….. • NHS Staff Management and Health Service Quality, DH 2011 http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_129643 Patients first / safety / quality & value / support one another / enjoy work

11. Enjoy work [2] We state responsibilities in our Handbook based on ‘What matters to NHS staff’. Managers/supervisors should try to address these issues to make pharmacy a great place to work: 1. I’ve got the knowledge/skills/equipment to do a good job. 2. I feel trusted, listened to and valued at work. 3. My manager/supervisor supports me when I need it. 4. Senior managers are involved with our work. 5. I’ve got a worthwhile job that makes a difference. 6. I help provide high quality patient care. 7. I have the opportunity to develop my potential. 8. I understand my role and where it fits in. 9. I am able to improve the way we work in my team. 10. I feel fairly treated with pay, benefits and staff facilities. What matters to staff in the NHS: research study 2008, DH. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/DH_085536 Patients first / safety / quality & value / support one another / enjoy work

12. Enjoy work [3] • We promote & encourage organizational citizenship. This is about doing things that aren’t in anyone’s job description but when people do them they create a good environment. The more people that act as citizens at work, the more others will do the same. This sort of behaviour cannot be enforced. • Behaviours we actively encourageinclude: • Willingness to give time to help others. • Doing more than the minimum required. • Tolerating inevitable inconveniences. • Sharing ideas. • Attending meetings that are not required but encouraged. • Positively representing the department & organisation etc • And we discourage other behaviours……….. Patients first / safety / quality & value / support one another / enjoy work

13. Enjoy work [4] • And, to actively discourage certain behaviours that do not help to provide a good working environment, eg: • Abrupt or demeaning notes/emails. • Treating others like children. • Excluding people from conversations. • Cutting people off mid-conversation. • Not greeting colleagues. • Not giving thanks when you are helped by others. • Failing to keep communal areas clean [e.g. kitchens/toilets]. • Expressing strong criticism. • Sarcasm. • Pessimistic predictions. Patients first / safety / quality & value / support one another / enjoy work

14. Enjoy work [5] So, in summary – if staff enjoy work they will deliver better quality & patients will benefit. We aim to help staff enjoy work by addressing the things that are important to them at work, & by encouraging behaviour to create a good working environment. Patients first / safety / quality & value / support one another / enjoy work

15. What does the ethos mean to you? [1] It depends! If we looked at all the staff….how many will have the factors in our ethos as part of their personal ethos? It could look something like this… What we are trying to achieve is this……. So, it will be different for different people. Patients first / safety / quality & value / support one another / enjoy work

16. What does the ethos mean to you? [2] It gives all staff permission to question the behaviour of others. It provides another way to look at achievements & developments in appraisals. It gives line managers clearer responsibilities, particularly around support & enjoy. It tries to make it clear to all staff what our focus is & how we are trying to improve quality & patient experience whilst enjoying our jobs. Patients first / safety / quality & value / support one another / enjoy work

17. The End Patients first / safety / quality & value / support one another / enjoy work