BOARD – SUMMARY REPORT
Date of Board meeting:
9th June 2009
Title of Report:
Action Plan to Respond to 2008 Staff Survey
Title of Director:
Executive Director of Workforce & Environment
Purpose of the report:
The Board is asked to approve the enclosed action plan at Annex B with specific action relating
to workforce capacity, competence, care and communication
Recommendations to the Board:
The Board is asked is asked to approve the Action Plan, and to note proposed leads, timescales
and to receive regular monitoring reports as outlined in the action plan and the Bullying and
Harassment workstream is included as it is derived from staff survey evidence but is subject to a
separate report to the Board meeting.
The Board is asked to approve the action plan to the 2008 Staff Survey.
Relationship with the Assurance Framework (Risks, Controls, and Assurance):
CO9 To achieve Foundation Trust equivalent status
CO1 To further develop and measure safe and high quality care
Healthcare Standards (Core / Developments):
C11: ensuring that staff concerned with all aspects of the provision of healthcare are
appropriately recruited, trained and qualified for the work they undertake.
Summary of Financial and Legal Implications:
Proper Workforce utilisation and development is a key component of corporate governance and
Equality & Diversity and Public & Patient Involvement Implications:
WEST LONDON MENTAL HEALTH NHS TRUST
ACTION PLAN TO RESPOND TO 2008 STAFF SURVEY
FROM THE EXECUTIVE DIRECTOR OF WORKFORCE & ENVIRONMENT
The Board is asked to note the contents of this report.
1.1 The Board will recall that they received an initial analysis of the 2008 Staff Survey at their
1.2 A brief resume of the key findings is included at Annex A of this report. The full copy of the
findings has been circulated previously to all Board members. It was noted that whilst the
Trust had an improved rating from staff in some areas in overall terms the results of the
survey were disappointing.
1.3 Of particular concern was the apparent inability to improve significantly in areas where major
action plans had been developed and a “credibility” gap between the action the Trust was
trying to take to resolve staff concerns and the confidence staff had in the Trust on key
issues such as bullying or support from the managers.
PROCESS TO DETERMINE ACTION PLAN
2.1 It is critical therefore that if the Trust truly aspires to be seen as a leading Mental Health
Trust this is reflected in the staff’s view of the organisation and there is a consistent view
that the organisation is learning, responding and improving as an employer.
2.2 It is not enough for these principles to be simply owned by the Board, or SDU Directors -
they must be embedded in all levels of the organisation for sustained improvement to take
2.3 For this reason, the 2008 action plan has been built around the key themes and pledges
contained in the NHS Constitution and developed in collaboration with the Trust’s Senior
Leader Group at a management conference in April.
2.4 These themes have been shared with staff in staff forums, the Trust Partnership Forum and
other meetings since and appear to resonate with staff views. The Trust has also been
discussing how to improve its Staff Survey response with other MH Trusts who appear to fair
better. In these organisations a Board led but widely supported and sustained series of
focused action appears to be the key.
2.5 The action plan presented to the Board therefore has five key strands to it.
KEY AREAS FOR ACTION
3.1 The five key areas that it is proposed will provide the key focus for the action plan areas are
as follows. These are explained in detail in the proposed action plan at Annex B.
A recurrent theme in the draft HC report, in performance activity and staff feedback is that
high vacancy and turnover levels erode staff confidence, dilute the consistency of patient
care and create financial pressures due to over reliance on bank and agency staff.
Whilst the Trust has generally performed well in terms of its vacancy management, there are
areas of concern and hotspots that need to be addressed by a consistent level of high
quality recruitment activity. Retention is also of high importance.
Having high levels of staff in post, recruited to good standards will not be enough to ensure
a high quality of care and instil staff confidence by itself – we must ensure all staff have the
core skills necessary to fulfil their role and provide high levels of job satisfaction.
For these reasons compliance with the Trusts statutory and mandatory training framework –
another issue highlighted in the draft HC report – and comprehensive take-up of appraisal
and personal development reviews are essential tools. Whilst these are areas in which the
Trust’s performance has improved, it is still an area for development.
Care and Support
A consistent feature of the Staff Survey over the past four years is that whilst staff feel the
Trust’s Staff Health and Counselling Services provide high levels of care and support, this is
not always replicated by front line management. We know our staff are often exposed to
challenging patient situations and having confidence in the caring support offered by the
line-manager is key.
Research by the Kings Fund in 2007 also reveals that high levels of patient care are
inextricably linked with staff feeling cared for – especially at times of major untoward
The action plan will therefore focus on trying to ensure this caring support is consistently
delivered by managers across the Trust.
Staff communication and understanding is a major challenge in every large complex
organisation. The Trust has done much to improve its internal communication’s strategy –
Mental Health Matters, Team Brief, Monday and Training Matters and the Exchange all
represent major steps forward – but there are still gaps in consistency and understanding
that need to be addressed.
Again some of the defects are at local and team level – well managed and led teams have
consistently better levels of satisfaction and performance than those where this happens in
a more fragmented manner.
Bullying and Harassment
This is a key Board objective and is the subject of a separate paper to the Board; it is
included as a Staff Survey Action as this was the source for the development of this work.
4.1 The proposed Trust Action Plan is included at Annex B for Board discussion and approval.
4.2 Once agreed the plan will be embedded into the objectives of Executive Directors and SDU
Directors and progress will be monitored through the Quarterly Performance Review
meetings and the PDR process.
4.3 The Chief Executive will be setting clear expectations of this senior group of leaders that this
is a key area of activity requiring personal and focused attention to ensure consistent
5.1 The Board is asked to approve the enclosed action plan at Annex B with specific
plans relating to workforce capability, competence, caring and communication.
5.2 The Board is asked to note the proposed Leads, timescales and to receive regular
monitoring reports as outlined in the action plan.
5.3 The Bullying and Harassment workstream is included as it is derived from staff
survey evidence, but is subject to a separate report to the Board meeting.
Executive Director of Workforce and Environment
Key Findings/Areas of priority
with poorest score
with Poorest score
- % of staff
Harmful errors, near
misses or incidents in
the last month KF25
- % of staff
violence from staff in
last 12 months KF32
– Staff job
• WLF Men’s Central
– Staff intention
• WLF Men’s Central
to leave jobs
- % of staff feeling
valued by their work
• BM Men’s South of
• WLF Men’s central /Ancillary
% of staff
• BM Men’s South of
management and staff
• WLF Men’s Central / Ancillary
Recommended Way Forward
The proposed way forward should be two fold:
1 In relation to the Key priority areas identified below, work should be focussed and
concentrated in the particular Directorate/Work area with Localised Plans to
address the necessary actions.
2 Trust wide actions in relation to the following five key areas
• Bullying and Harassment
• Communication and Staff engagement
• Caring and Support
Area for Action
through Bullying and
• Design set of
• Target SDUs with
a Zero tolerance
in place by
• Develop PDR on-line
facility via Exchange
• Change PDR cycle
to reflect Business
objectives to link with
• Group PDRs where
• Continue CEO staff
with corporate and
• Face to Face
briefings on what the
Trust and SDUs are
doing in response to
what staff are saying
in the survey
every level find out
what would improve
staff satisfaction and
Retention Forum as
key Trust driver for
• Set individual SDU
and retention targets
via the forum for
Director of High
procedures for staff
SUIs and CIRs
• Centre to publicise
availability of Trusts
24/7 staff counselling Environment