Report by Ray Stewart, Quality Improvement Lead (Staff Experience) and Anne Gent, Director of Human Resources

Transcription

1 Highland NHS Board 12 August 2014 Item 4.2 STAFF EXPERIENCE imatter IMPLEMENTATION OVERVIEW Report by Ray Stewart, Quality Improvement Lead (Staff Experience) and Anne Gent, Director of Human Resources The Board is asked to: Note the update to the development of the national imatter Staff Experience Tool. Endorse the proposed imatter implementation plan for NHS Highland which forms part of the requirements of Everyone Matters 20:20 Workforce Vision the Healthy Organisational Culture strand. Note that the ongoing oversight of implementation will be taken forward by the Staff Governance Committee and the Highland Partnership Forum at local level. Note that the SGHSCD will provide overall leadership, co-ordination and governance at national level, through the Scottish Workforce and Staff Governance Committee. 1 Background and Summary This paper provides key background information about imatter, the bespoke Staff Experience Tool for NHS Scotland, and a proposed approach for implementation in NHS Highland. This follows approval for use of the Tool across all Health Boards during 2014/15, reflected in the Healthy Organisational Cultures' strand of Everyone Matters the 2020 Workforce Vision Implementation Plan published in November The tool, which was initially developed through co-production with over 200 NHS Scotland staff in the 4 pilot Boards and is based on a model of continuous improvement, can be considered as a leading edge development in the field of employee engagement. It is attracting interest across the UK - in particular from NHS England and the Scottish Government hopes it will be income generating in future years. imatter should be considered in light of the revised monitoring arrangements for the Staff Governance Standard, currently intended by SGHSCD to be coterminous with the tool. It also provides the opportunity for more focussed and responsive reporting at a team and line manager level around issues that the NHS Scotland Staff Survey which continues to be operational is only able to report on at local level, by professional group or by pay-band. The implementation of imatter is entirely consistent with what we are seeking to achieve in NHS Highland with the Highland Quality Approach. In its simplest form imatter is a tool for measuring employee engagement and then as part of a quality improvement cycle putting in place actions to make improvements. Employee engagement can be defined as a workplace approach designed to ensure that employees are committed to their organisation s goals and values, motivated to contribute to organisational success, and are able at the same time to enhance their own sense of wellbeing 1. 1 MacLeod, D & Clarke, N (2009) Engaging for Success: Enhancing Performance Through Employee Engagement (London, Dept for Business, Innovation and Skills)

2 This definition has attracted increasing attention in the five years since it was published, as organisations have recognised the key role that employees play in adding value for customers and service users in a way that fixed assets cannot. Accordingly, the definition was adopted by NHS Scotland in 2012 as that which all Health Boards should aspire to. The authors of this definition have identified four key enablers of employee engagement found in high-performing organisations. Namely: a. Leadership provides a strong strategic narrative giving a line of sight between the job and the organisation s vision b. Engaging Managers, who offer clarity, who treat people as individuals, who listen and encourage and who ensure work is organised efficiently c. There is employee voice in the organisation, for reinforcing and challenging views; between functions and externally d. There is organisational integrity: espoused values are reflected in behavioural norms 2 The Case for Measuring Staff Experience The extensive literature review undertaken by the national Staff Experience Project Team at the start of the project in 2011 demonstrates amongst other things that the experience of an individual at work has a direct positive correlation with their motivation, engagement and ultimately their contribution. Therefore, it is felt that measuring the experience of staff in the workplace offers a valuable opportunity to understand and address factors affecting engagement, and ultimately person centred care. To a certain extent, this has been done periodically through the national Staff Survey, which gathers data at the individual level, and Boards have also been required to develop and progress Staff Governance Action Plans as a proxy measure of staff experience. However, as some Board Members may be aware, Prof Michael West established some time ago through his research in to the English NHS, that there is a clear link between the effectiveness of teams and the experience of patients and service users, something which these approaches do not measure. As Prof West s research also shows, the majority of NHS staff work in teams. Therefore, their experience in these teams can be considered as a valuable proxy for patient and service user experience. These findings were central to the recommendations accepted by SGHSCD to measure staff experience at the individual, team and organisational level in NHS Scotland moving forward, leading to the development of the imatter tool. 3 Development of imatter Following the literature review and acceptance by SGHSCD of a number of key recommendations, the project subsequently involved approximately 200 staff, staff side representatives and managers from across NHS Dumfries & Galloway, NHS Forth Valley, NHS Tayside and the National Waiting Times Centre in the co-production of a Staff Experience Framework and the identification of 20 Employee Engagement Components, felt to describe the key elements of a positive workplace experience. These were linked back through the 5 strands of the Staff Governance Standard to the 3 Quality Ambitions for NHS Scotland, reflecting the conclusions drawn from the literature about the link between outcomes for patients and service users and the experience of staff. 2

3 These components formed the basis of a bespoke staff experience questionnaire intended to provide reliable metrics on different aspects of staff experience. This was piloted at 3 stages of development with over 3,500 staff across the 4 Boards during 2012/13. The Highland Partnership Forum has been directly appraised of these developments by the national Staff Experience Project Lead and has enthusiastically endorsed the approach being taken. In addition the Staff Governance Committee has also been routinely updated as have the Chief Executive and Director of HR within their peer groups. The bespoke questionnaire was designed to gauge via completion of an online survey the collective views of staff on their workplace experience over the previous 12 months across three broad categories: as an individual of team and direct line manager of the organisation Respondents were asked to indicate their level of agreement or otherwise with 28 statements, grouped in to one of the above categories, plus a 29 th asking them to rate their overall experience of working in their Board over the previous 12 months. The combined responses from all individuals in a team provided for the production of a report, which includes an overall rating of engagement known as the Employee Engagement Index (EEI). The data from the 3 pilots was externally validated by the University of the West of Scotland. They found it both a robust and reliable measure of staff engagement and means with which to measure improvement. This led to the development of the Continuous Improvement Cycle for Staff Experience shown below which, in addition to introducing the principles at a team level, puts an onus on managers and individual team members to ensure that priorities for improvement are reflected in individual objectives and PDPs, not just team Action Plans. 3

4 The process is felt to offer a valuable opportunity to involve all team members in improvement activities, engaging and empowering staff in a very practical sense. This is reflected in further work with the teams involved in the pilot to agree appropriate branding to support the wider roll out of the tool in NHS Scotland, subject to approval by SWAG. This led to the official title imatter being introduced in October 2013, as reflected in the 2020 Workforce Vision Implementation Plan. 4 Relationship with the NHS Scotland Staff Survey At the current time, imatter is not replacing the NHS Scotland Staff Survey, which is part of the national partnership agreement covering NHS Scotland. However, it provides an opportunity to address what the Staff Experience Project s final recommendations report describes as the main deficit with the NHS Scotland Staff Survey, that although issues could be identified within a locality or Directorate, the responses to these issues tended to be generic rather than have a specific team focus creating no real sense of accountability for issues amongst line managers or staff. As such, staff involved in the development of the tool regularly expressed the view that filling in the survey in its usual format offered them no personal sense or expectation of change. Importantly the model developed within the Staff Experience Project eliminates the need for such a generalised strategy and can highlight the need for remedial intervention to the core of issues at team level. This provides a valuable opportunity for line managers and their teams to identify and understand good practice, and to agree actions in respect of areas where improvement is felt necessary. Further, after an initial implementation across the whole of a Directorate, it is expected that imatter will be accessible for use as a pulse survey to allow periodic review and reporting at a team or Directorate level, helping managers to measure progress with improvement action plans. What this means for the future of the NHS Scotland Staff Survey is currently under discussion, although SGHSCD have advised Boards that a 2014 Staff Survey will be run in the autumn. There is little doubt however that there is significant support for imatter nationally, both within Health Boards and Scottish Government, reflecting its significant potential to enhance understanding of issues affecting staff experience and as a level for improving employee engagement. This is reflected by the inclusion of its implementation as an action for all Boards in the 2020 Workforce Vision Implementation Plan published in November. 4

5 5 Proposed Implementation Plan for NHS Highland The imatter cycle follows a set cycle of 7 different activity stages: Stage Duration 1. Staff Briefings / Awareness Sessions 4 weeks 2. Online questionnaire live for completion 3 weeks 3. Data analysis & provision of reports 5 weeks 4. Feedback of results within teams 4 weeks 5. Develop and agree Action Plan, submitted to SE Lead 8 weeks 6. Begin to progress items from Action Plan 6 weeks 7. Provide written progress report on delivery against Action Plan 1 week NHS Highland has currently just over 10,000 staff spread over the various different organisational structures and as such there are a number of parameters set down arising from the national pilot recommendations that determine how it is being proposed to be implemented. Boards can either implement across the whole organisation at the same time, or on a rolling basis by Directorate (whole Directorates only). The CE and her direct reports should complete the exercise in the 1 st tranche to ensure the provision of a leadership team EEI. To promote understanding and awareness, and ensure integrity of the process, the Tool will be run for all teams in a Directorate at the same time. To ease introduction, only teams of 5 or more will be reported on during the first year (actual cut off to be agreed as part of the plan). All staff in a Directorate should be enabled to complete the imatter questionnaire when it is run for teams in their area. To ensure that all completed questionnaires contribute to an EEI, all staff should be aligned to a Director through a clear colour coding system. All of the EEI scores for teams within a Directorate will be used to derive a cumulative EEI score for that Director. All staff should be briefed by both the Board Staff Experience Lead and a member of the National Project team just before they are due to complete. The exercise should be completed once every 12 months, with the team level outputs tracked and reported on by line managers during the interim. The date that a Directorate / its teams commence imatter in 2014/15/16/17 will be the calendar date at which they should repeat the exercise in future years. Both organisational and Directorate specific EEI scores will need to be provided in the annual Staff Governance Monitoring Return in May each year. As such it is proposed to implement in NHS Highland over a 3 year period commencing late 2014 subject to the National procurement of an on line software tool which is crucial to the implementation. 5

6 NHS Highland will implement in 6 distinct phases as below RUN 1 OCTOBER 2014 Chief Executive (including PR and all Admin Support functions) Director of HR Director of Quality Improvement Chief Operating Officer Raigmore Hospital Director of Operations Surgical Specialities Division RUN 2 APRIL 2015 Director of Finance (including Procurement and Facilities) Medical Director (including Clinical Governance) Nurse Director Chief Operating Officer Raigmore Hospital Director of Operations Medical & Diagnostic Division RUN 3 SEPTEMBER 2015 Chief Operating Officer Raigmore Hospital Director of Operations Patient Support Division Chief Operating Officer Raigmore Hospital Director of Operations Central Chief Operating Officer Raigmore Hospital Director of Operations Hotel Services Chief Operating Officer Argyll & Bute CHP Director of Operations Oban, Lorn & Isles Locality Director of Adult Social Care Director of Adult Care RUN 4 APRIL 2016 Chief Operating Officer Argyll & Bute CHP Director of Operations Mid Argyll, Kintyre & Islay Locality Chief Operating Officer Argyll & Bute CHP Director of Operations Cowal, Bute, Helensburgh & Lomond Locality Chief Operating Officer Argyll & Bute CHP Director of Operations Central Services Chief Operating Officer Argyll & Bute CHP Director of Operations Mental Health Services Chief Operating Officer Argyll & Bute CHP Director of Operations Dental Chief Operating Officer ehealth Department Chief Operating Officer Integrated Pharmacy Director of Public Health RUN 5 SEPTEMBER 2016 Chief Operating Officer South / Mid Director of Operations (incl Grouped Services) RUN 6 APRIL 2017 Chief Operating Officer North / West Director of Operations Following the completion of the last run we would then be in a position to have a (the first) Employee Engagement Index (EEI) for the complete Board. 6

7 6 Contribution to Board Objectives Implementation of imatter is part of the wider implementation of Everyone Matters 20:20 Workforce Implementation Framework and Plan. This contributes and supports many of the Board Quality Objectives. 7 Governance Implications Staff Governance Implementation of imatter is very much about contributing to embedding Staff Governance at a local level especially about improving Staff Experience while at work. Clinical Governance There is a direct correlation to an enhanced Staff Experience leading to an enhanced Patient Experience. Financial Impact The rollout of the imatter improvement methodology will, in the main use existing resources with some national support from the Scottish Government around the on line support tool and some anticipated Organisational Development support. As far as possible this work will be progressed by the wider Workforce Team and Operational Managers. 8 Risk Assessment The Human Resources Workforce High Level Risk Assessment was shared with the Staff Governance Committee earlier in the year and implementation should contribute to reducing some of the Risks identified. There is an ongoing risk that due to competing priorities at individual team level that imatter may be seen as high as others. It is therefore important that a robust awareness/ communication plan highlighting the potential benefits is developed. 9 Planning for Fairness The overall Everyone Matters 20:20 Workforce Vision Implementation Framework and Plan of which imatter is part of a national document and as such any local assessment will take place on an ongoing basis. 10 Engagement and Communication There is an ongoing risk that due to competing priorities at individual and team level that imatter may not be seen as a high a priority. It is therefore important that a robust awareness / communication plan highlighting the potential benefits is developed. Ray Stewart Quality Improvement Lead (Staff Experience) Anne Gent Director of Human Resources 1 August