developing high trust cultures - king's fund · 11.40 insights from great place to work data...

1Great Place to Work® Institute, Inc. 2013 All Rights

Reserved

Developing High Trust Cultures

Charles Fair, Great Place To Work®

Eleanor Shingleton-Smith, Frimley Health NHS

Foundation Trust

King’s Fund conference, 23rd March 2016

© 2014 Great Place to Work® Institute Inc. All rights reserved.

11.30 Welcome, icebreaker

11.40 Insights from Great Place to Work data Charles Fair

12.00 Frimley Health NHS Foundation Trust

case study

Eleanor Shingleton-Smith

12.10 The Evolution of Leadership Charles Fair

12.15 Q&A

12.30 Close

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Admin, finances, organising Match, sporting event

Birdwatching, nature watching Meditating, religious activities

Browsing the Internet Other games, puzzles

Care or help for adults Pet care, playing with pets

Childcare, playing with children Reading

Computer games, iPhone games Shopping, errands

Cooking, preparing food Sick in bed

Drinking alcohol Singing, performing

Drinking tea/coffee Sleeping, resting, relaxing

Eating, snacking Smoking

Exhibition, museum, library Sports, running, exercise

Gambling, betting Talking, chatting, socialising

Gardening, allotment Texting, email, social media

Hobbies, arts, crafts Theatre, dance, concert

Housework, chores, DIY Travelling, commuting

Hunting, fishing Waiting, queueing

In a meeting, seminar, class Walking, hiking

Intimacy, making love Washing, dressing, grooming

Listening to music Watching TV, film

Listening to speech/podcast Working, studying4


40 Sick in bed

39 Working, studying

38 Care or help for adults

37 Waiting, queueing

36 Admin, finances, organising

5 Gardening, allotment

4 Sports, running, exercise

3 Exhibition, museum, library

2 Theatre, dance, concert

1 Intimacy, making love

35 In a meeting, seminar, class

34 Travelling, commuting

33 Housework, chores, DIY

32 Texting, email, social media

31 Browsing the Internet

30 Smoking

29 Sleeping, resting, relaxing

28 Washing, dressing, grooming

27 Listening to speech/podcast

26 Reading

25 Drinking tea/coffee

24 Cooking, preparing food

23 Eating, snacking

22 Computer games, iPhone games

21 Watching TV, film

20 Gambling, betting

19 Shopping, errands

18 Other games, puzzles

17 Listening to music

16 Pet care, playing with pets

15 Childcare, playing with children

14 Match, sporting event

13 Meditating, religious activities

12 Hobbies, arts, crafts

11 Drinking alcohol

10 Hunting, fishing

9 Walking, hiking

8 Birdwatching, nature watching

7 Talking, chatting, socialising

6 Singing, performing

Unhappie

st

Happie

st

Source: Are you happy while you work?, Alex Bryson and George Mackerron, Economic Journal, 20155

8Great Place to Work® Institute, Inc. 2013 All Rights

Reserved

Insights from

Great Place to Work®



• Who are Great Place to Work®?

• Why do culture and trust matter?

• What does a High-Trust workplace look like?

• What does Great Place to Work® data tell us?

• What are the benefits of being a High-Trust

workplace?

• High Trust Cultures and Organisational Performance

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© 2014 Great Place to Work® Institute Inc. All rights reserved.11

50 countries

7,000+ organisations per year, 4 million employee responses

http://www.google.co.uk/imgres?imgurl=http://bestboyz.de/wp-content/uploads/2009/07/logo.png&imgrefurl=http://bestboyz.de/apple-iphone-3g-s-fur-o2-bestandskunden/&usg=__-RtWQn0KAG0VCrRWbVepEsupQTM=&h=380&w=379&sz=91&hl=en&start=4&um=1&itbs=1&tbnid=wlimgzUL9belZM:&tbnh=123&tbnw=123&prev=/images?q=telefonica+o2+logo+2010&um=1&hl=en&sa=N&rlz=1T4GPTB_en-GBGB292GB292&tbs=isch:1




Copyright © 2015 Great Place to Work® Institute, Inc. All Rights Reserved.

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Copyright © 2015 Great Place to Work® Institute, Inc. All Rights Reserved.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

UK Not-for-profit Best Workplaces - 82%

UK National Average Public Sector - 53%

14


Culture = practices + behaviours

How do your practices and the behaviours of your managers align

with the culture you want?

* From Deal T. E. and Kennedy, A. A. Corporate Cultures: The Rites and Rituals of Corporate Life, 1982

18


Source: Ipsos-MORI Veracity Index 2013. Base 1,018 British Adults aged 18 or more

23


Source: Ipsos-MORI Veracity Index 2013. Base 1,018 British Adults aged 18 or more

24


Sources: Gallup, Confidence In Institutions Study; Edelman Trust Barometer, 2012

William Lever

Port Sunlight

“If we leave the human

factor out of our business

calculations, we shall fail

every time”

"Port Sunlight" by Rich Daley. Licensed under CC BY-SA 2.0 via Wikimedia Commons27


Purpose

Employee Voice

Transparency

Values – integrity etc.

Consistency of behaviours

Senior Leaders lead by example

Line manager capability

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®

30

Trust Index© improvement over time

UK National

Average

55

UK Top 100 Best

Workplaces

85

‘good’ ‘great’

70

Threshold for

consideration as a

‘Best Workplace

‘Fine Tuning’ actions

Focus on making marginal improvements

e.g. 1) programme and policy updates

2) targeted action focusing on low scoring

teams or other demographic groups e.g.

line manager coaching

‘Big Picture’ actions

Focus on organisation-wide

programmes and senior leaders

leading by example

31


86

91

86

82

82

79

75

55

53

52

41

40

40

38

0 10 20 30 40 50 60 70 80 90 100

Trust Index©

Management is honest and ethical in itsbusiness practices

If I am unfairly treated, I believe I’ll be given a fair hearing if I appeal

Management's actions match its words

Management delivers on its promises

People avoid politics and backstabbing asways to get things done

Managers avoid favouritism

UK's 100 Best Workplaces 2016 UK National Average

40+

percentage

point

differences

32

© 2015 Great Place to Work® Institute Inc. All rights reserved.Source: 2015 Great Place to Work® Trust Index© survey data.

+40%

On average, Best Workplaces

receive nearly half as many

applications per job opening than

their peers…

36

Turnover costs the

average company 30-

50% of the annual salary

of entry-level employees,

150% of middle level

employees, and up to

400% for specialized,

high level employees.1

How much could you

save if you cut

turnover in half?

1. Blake, R. (2006). Employee retention: What employee turnover really costs your company. ManagerNewz37


Sources: Professor Alex Edmans http://alexedmans.com/

TEDx talk on “The Social Responsibility of Business”: http://bit.ly/TEDxCSR

https://agenda.weforum.org/2015/01/why-happier-workers-matter/

1. Employee Wellbeing Improves Firm Value• Great Workplaces outperform the market by 2% to

3% per year

2. The Stock Market Undervalues

Intangibles• Great Place To Work® survey is highly visible, but

market does not take it into account

• Equity analysts systematically underpredict

earnings

• Market takes 4-5 years to fully incorporate the

benefits of employee well-being

3. Investing for the Long Term• Building intangible assets requires significant and

sustained investment, but …

• intangible investment takes a long time to pay off

• Short-term effect may be reduced earnings

Alex EdmansProfessor of Finance, London Business School

40

http://alexedmans.com/

http://bit.ly/TEDxCSR

https://agenda.weforum.org/2015/01/why-happier-workers-matter/

Improving patient safety and experience at Wexham Park Hospital by increasing trust and staff engagement

Case Study• Wexham Park Hospital before acquisition in 2014

• How we built up trust and staff engagement to drive up performance and patient satisfaction

• Wexham Park Hospital today

Frimley Health FT

Turnover £600m8,200 staff: 410 consultants

400 junior doctors3,500 nurses & midwives

Ministry of Defence Unit

Activity:230k A&E – 4th largest activity in England80k Emergency Admissions20k Inpatient - elective78k Day Cases800k Outpatients10k Births

Comprises:Frimley Park HospitalWexham Park HospitalHeatherwood Hospital

Provides specialist services:VascularHeart AttackStrokePlasticsCystic Fibrosis

CQC Rating:Frimley – Outstanding (Sept 14)Wexham – Inadequate (Feb 14)Heatherwood – Good (Feb 14)

Wexham Park Hospital in 2014

70+ patient complaints per month

Reputation and negative press attention

23% vacancies for nurses -400 vacancies

50% of leadership roles filled by interims as leaders haemorrhaged from organisation

Organisation essentially rudderless with no clear direction or values

CQC Ratings of Wexham Park in 2014

Planning to build trust and staff engagement

• Cultural analysis 2014:

– Desk-top review

– Structured interviews with 70 staff

• Involvement of and feedback from “buddies”

• Review of research on staff engagement and trust

Trust and Security

Higher levels of staff

engagement

Energy and discretionary

effort

Higher levels of individual

and organisational performance

Building trust, staff engagement and a positive culture

Low morale

Poor engagement

Low levels of ownership

Poor accountability

Lack of trust in management

Lack of direction

Shared vision and values

Strong, capable leadership

An engaged workforce

A performance management culture and recognition, development and support for employees

Nov 14 - Refresh and launch of Trust’s values and behaviours

Nov 14 – Code of Conduct for Leaders (EMPOWER staff to live the values)

Values embedded in all HR systems including recruitment, induction, probation, appraisal and recognition

Dec 14 to Feb 15 – training for 300 leaders on values-based recruitment and appraisal

April 2015 – refreshed customer care programme articulating values launched and attended by 700 staff

May 2015 – Ceremony to recognise demonstration of the values (100 recognised)

Committed To Excellence✔ We make safety and quality a

priority for ourselves and others

✔ We go the extra mile

✔ We set ambitious goals for ourselves

✔ We strive to achieve our goals

consistently to the highest possible

quality standard, getting the basics

right every time

✔ We have a positive attitude

✔ We deliver what we promise

✔ We work hard to solve problems if

things go wrong and make them right

✔ We take responsibility for our own

performance and for bringing our

values to life

Working Together

✔ We are friendly, welcoming,

courteous and caring

✔ We act fairly and compassionately

✔ We are open, honest and candid

with others

✔ We treat other people as

individuals and respond to their needs

✔ We respect others’ privacy and dignity

✔ We listen and ensure we understand

✔ We encourage and support colleagues

✔ We work as part of one team with

colleagues within and outside the

Trust in support of patient needs

Facing The Future

✔ We challenge poor performance

in others and expect to be

challenged if our own performance

is poor

✔ We are open to developing

ourselves and to constructive

feedback

✔ We change things for the better

✔ We make best use of public money

by being as efficient as possible

✔ We engage with others to improve

how things are done

✔ We speak up if things could be done

in a better way

✔ We see change as an opportunity not

as a problem

We are committed to excellence in everything we do, striving to be one of the best acute trusts in the country.

We are working together as one team dedicated to meeting patient needs.

We are facing the future, continuously improving our performance and adapting services to meet demand.

EEngagement

1. Be visible and

available to the team

2. Be a positive role

model and actively

promote the Trust’s

Values

3. Be flexible in my

approach and adapt

my leadership style to

work

effectively with all staff

4. Inspire my staff so

that they feel they work

‘for’ Frimley Health

rather than ‘at’ Frimley

Health

5. Engage with other

teams - Internal,

external and with the

local community.

6. Look outside my

area of work for

information and ideas

that could bring

about continuous

improvement

MMotivation

1. Inspire staff to go

the extra mile for the

Trust by encouraging

a

climate of high

expectations in which

everyone looks

for ways for service

delivery to be even

better.

2. Communicate a

clear picture of the

Trust’s future and how

my staff fit

into that future.

3. Describe future

changes in a way that

reassures and inspires

staff,

patients and the public

4. Lead my team to

deliver a fully joined-

up service.

5. Stretch myself and

my team so that we

may seek new

challenges and

achieve ambitious

targets.

PPerformance

1. Nurture and develop

staff by providing

opportunities to gain

wider skills, knowledge

and experience

2. Set clear standards of

behaviour that ensure

tasks are achieved in

line with the Trust’s

values.

3. Hold regular,

constructive appraisals

including SMART

objectives

related to Trust,

departmental and

developmental objectives

4. Have frequent open

and honest conversations

with my staff about

their performance

5. Hold my staff to

account and act quickly

to manage poor

performance

or unacceptable

behaviour in a fair and

consistent way.

OOwnership

1. Support individuals

and my team to take

responsibility for their

performance and results

2. Specify and prioritise

what is expected of

individuals and my team

3. Encourage my team

to anticipate customers’

future needs

4. Support my staff to

feel empowered to

develop their own

solutions

to improve services

5. Hold regular team

meetings to ensure

everyone is kept

informed

and feels part of the

team.

WWell-Being

1. Demonstrate that the

health and well-being of

my team are important

to me

2. Create the conditions

that help my team

provide mutual care

and support

3. Provide a caring and

safe environment to

enable staff to develop

resilience and to

achieve a good work/life

balance

4. Bring new members

of staff on board

5. Notice any negative

and unsettling emotions

in my team and act to

put the situation right

6. Understand the

unique qualities and

needs of my team and

treat them as

individuals in a fair and

consistent way.

EEncouragement

1. Give regular and

constructive feedback and

direction

2. Ask for feedback from

my team

3. Encourage my team to

learn from each other

4. Actively invite input,

ideas and contributions

from my team in order

to shape future plans.


put themselves in other

people’s shoes.


look at problems from a

different perspective

and to learn from mistakes


work collaboratively with

other teams.

RRecognition

1. Recognise and

actively appreciate

each person’s

unique perspectives

and experience

2. Actively look for

opportunities to

recognise and

celebrate success

3. Praise good

practice and

encourage initiative

4. Give recognition

for extra effort

5. Constantly look

out for opportunities

to reward high

standards.

As a Leader At Frimley I Will:

Leading Staff At Frimley HealthEMPOWER people to live the values

“Leadership and culture are two sides of the same coin” Schein 2004

Leadership priorities from Oct 14:

• Communication of an inspiring vision and strategic narrative from day 1

• Organisation re-structured with visible and approachable clinical leaders who role model the values at its heart

• Emphasis on engaging and empowering staff to take responsibility

• Leadership focus on challenging and managing dysfunctional behaviour

• Leadership Development Strategy underpinned by EMPOWER Code

• Team-based working and Aston Team Journey

The importance of recognition

Health and well-being for staff – current areas of focus

H

Workplace Challenge

Pedometer Challenge

Midday milers – Liven up your Lunch

Cycle/Walk to Work Weeks

Charity challenges eg Run Frimley/Wexham

Taster sessions

Subsidised staff gym

Exercise classes (eg Pilates, Boxercise, Couch to 5k)

Subidised massage and complementary therapies

Employee assistance programme Face to face counsellor

Signing up to Mindful Employer

Schwartz rounds

Spiritual and pastoral care –Listening ears

Samaritans in ED

Raising Concerns Policy

Mindfulness group pilot

Mental Health First Aider pilot

On-line book club

Summer reading challenge

EMPOWER Code of Conduct for Leaders

Leadership development programmes

Coaching and 360 feedback

Training in use of people management policies

Stress management training

Personal resilience for leaders

Organised trips (egChristmas Market in Bath, London, Kew

Gardens)

Quiz night

Workplace Choir –Healthy Harmonies

Knitting and Natter club

Crochet club

Improving Working Lives Lottery

OH service

Rehabilitation/workplace adjustments

Risk assessment

Stress auditing

Range of training (eg conflict resolution, manual handling)

Coaching and mentoring

Flu campaign

Smoke Free Site Policy

Level 1 smoking cessation for OH nurses

Eye tests and glasses for DSE users

Fast track access to physiotherapy and other appointments

Employee Well-Being

Staff Health Days on cancer awareness

Highlighing national campaigns (eg

No Smoking Day,

Time to Talk Day,

Global Wellness Day,

Workout @ Work Day)

Wexham Park Hospital today"The new leadership have brought with them a set of values which has put excellent patient care and experience at the heart of the hospital. At this inspection we found a positive and ambitious workforce who are now prepared to recommend their trust as a place to work and to have treatment. “CQC Feb 16

Nursing turnover reduced from 23% to 16%

Improved reputation….elective referrals up 10%

Good evidence that trust is growing.......91% agreed they share the same values, 89% say behaviour reflects values and 81% say the values guide the way the organisation operates and makes decisions. Investors in People July 2016

CIPD Best Employee Engagement Initiative and Overall Winner 2016

CEO

front line staff

i.e. hierarchy, bureaucracy,

control, power

60

“I’m alright Jack”

Collins, Jim, The Death of the Charismatic Leader (And the Birth of an Architect), 1997

www.jimcollins.com61

http://www.jimcollins.com/

• Superficial charm

• Lack of humility

• Parent/Child behaviours

62

• ‘Control freak’

• Inflexible

• Toxic behaviours - bullying

Source: City AM 27 May 2015

63

Sources: City A.M., 28th May 2015 and ‘Attracting & Retaining Millennial Professionals’, Robert Walters, 2015

What Millennials want from work

64

CEO

front line staff

i.e. hierarchy, bureaucracy,

control, power

CEO

front line staff

i.e. support, coaching, employee

voice, collective power

65

Low Technical Competencies High

High

Management

and Leadership

Competencies

(includes ‘Emotional

Intelligence’)

Low

‘Dilbert

Zone’

‘Peter

Principle’

Zone

‘Strong

Zone’

66


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developing high trust cultures - king's fund · 11.40 insights from great place to work data...

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