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
Paper Number:
WL1590
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.
Action required:
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
financial control.
Equality & Diversity and Public & Patient Involvement Implications:
None specific.
1
ENCLOSURE F
Paper WL1590
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 BACKGROUND
1.1 The Board will recall that they received an initial analysis of the 2008 Staff Survey at their
March meeting.
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.
2
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
place.
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.
2
3
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.
Capacity
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.
Competence
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
incidents.
The action plan will therefore focus on trying to ensure this caring support is consistently
delivered by managers across the Trust.
Communication
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.
3
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 PROPOSED
ACTION
PLAN
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
improvement.
5 RECOMMENDATIONS
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.
Kelvin Cheatle
Executive Director of Workforce and Environment
June 2009
4
Annex A
Key Findings/Areas of priority
Issue/priority Work
Area/Directorate
Occupational Group
with poorest score
with Poorest score
KF 21 - % of staff
• DSPD
• Nurses
witnessing Potentially
• WLF
women
• Doctors
Harmful errors, near
• Ealing
Acute
• Occupational
misses or incidents in
Therapists
the last month
KF25 - % of staff
• Ealing
Acute
• Nurses
experiencing physical
• Hounslow
Adult
• Maintenance/
violence from staff in
• WLF
Women
Ancillary
last 12 months
KF32 – Staff job
• Security
• Nurses
satisfaction
• WLF Men’s Central
• Maintenance/
• BM
Men’s
South
Ancillary
England
• WLF
Women
KF33 – Staff intention
• WLF Men’s Central
• Nurses
to leave jobs
• WLF
Women
• Psychologists
• BM
Mens
London
• Other
AHPs
KF3 - % of staff feeling
• WLF
Women
• Nurses
valued by their work
• BM Men’s South of
• General
colleagues
England
Managers
• BM
Men’s
London
• Maintenance
• WLF Men’s central /Ancillary
KF29 - % of staff
• Security
• Occupational
reporting good
• WLF
Women
Therapists
communication
• BM
Men’s
London
• Psychologist
between senior
• BM Men’s South of
• Admin
and
management and staff
England
Clerical
• WLF
Central
• Maintenance
• WLF Men’s Central / Ancillary
• Ealing
Acute
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Annex B
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
• Competence
• Communication and Staff engagement
• Capacity
• Caring and Support
Area for Action
Action/Task
Lead
Timescale
Bullying and
• Continue
work
Director of
Board
Harassment
through Bullying and
Strategy &
approval of
harassment steering
Performance
new
Group
protocols
• Act
on
June 2009
Recommendation
from MIDDX
University Research
findings
• Design set of
Director of
Finish
interventions with
Workforce &
qualitative
qualitative valuation.
Environment
evaluation
• Target SDUs with
and Board
poorest scores
meeting
• Design
and
Promote
report sent
a Zero tolerance
2009
campaign
Competence
• Simplify
PDR
Director of
Revised
process and
Workforce &
procedures
documentation
Environment
in place by
• Develop PDR on-line
September
facility via Exchange
2009
• Ensure
local
Monitoring
monitoring
report to
• Change PDR cycle
Board
to reflect Business
September
process/Financial
2009
year (April-March)
• Develop
Team
objectives to link with
corporate objectives
• Group PDRs where
appropriate
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Communication
• Continue CEO staff
Director of
As per
and Staff
forum
Communications/
Annual
engagement
• Staff
Survey
Executive
Schedule
Roadshows/Forum
Directors/
with corporate and
SDU Directors
SDU leads
• Face to Face
briefings on what the
Trust and SDUs are
doing in response to
what staff are saying
in the survey
• Promote
effective
two way
communications at
every level find out
what would improve
staff satisfaction and
improvements in
care.
Building Capacity
• Reconstitute
Director of
May 2009
Recruitment and
Workforce &
Retention Forum as
Environment
key Trust driver for
recruitment
strategies
• Set individual SDU
SDU Directors
June 2009
recruitment, training
Deputy Chief
and retention targets
Executive,
via the forum for
Director of High
monitoring via
Secure Services
performance review
process
Caring/Support
• Develop
middle
Director of
Progress
management
Workforce &
design and
development
Environment
report to
progression to
Board 2009
ensure managers
have
skills/awareness to
properly support
staff.
• Reconstitute
and
SDU Directors
July 2009
communicate
systems and
procedures for staff
support following
SUIs and CIRs
• Centre to publicise
Director of
July 2009
availability of Trusts
Workforce &
24/7 staff counselling Environment
and support
services.
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