NLG(17)427

DATE OF MEETING 31 October 2017

REPORT FOR Trust Board of Directors – Public

REPORT FROM Jayne Adamson, Director of People and Organisational Effectiveness

CONTACT OFFICER Jayne Adamson, Director of People and Organisational Effectiveness

SUBJECT Listening into Action Update

BACKGROUND DOCUMENT (IF ANY) N/A

PURPOSE OF THE PAPER: For Information

EXECUTIVE SUMMARY (PLEASE INCLUDE A BRIEF SUMMARY OF THE PAPER, KEY POINTS & ANY RISK ISSUES AND MITIGATING ACTIONS WHERE APPROPRIATE)

Informs the Board about the LiA approach the Trust has adopted towards improving staff engagement and its progress in a broader context of organisational change

HAVE STAFF SIDE BEEN CONSULTED ON THE PROPOSALS? NOT APPLICABLE

HAVE THE RELEVANT SERVICE USERS/CARERS BEEN CONSULTED ON THE PROPOSALS?

NOT APPLICABLE

ARE THERE ANY FINANCIAL CONSEQUENCES ARISING FROM THE RECOMMENDATIONS?

NOT APPLICABLE

IF YES, HAVE THESE BEEN AGREED WITH THE RELEVANT BUDGET HOLDER AND DIRECTOR OF FINANCE, AND HAVE ANY FUNDING ISSUES BEEN RESOLVED?

NOT APPLICABLE

ARE THERE ANY LEGAL IMPLICATIONS ARISING FROM THIS PAPER THAT THE BOARD NEED TO BE MADE AWARE OF?

NO

WHERE RELEVANT, HAS PROPER CONSIDERATION BEEN GIVEN TO THE NHS CONSTITUTION IN ANY DECISIONS OR ACTIONS PROPOSED?

NOT APPLICABLE

WHERE RELEVANT, HAS PROPER CONSIDERATION BEEN GIVEN TO SUSTAINABILITY IMPLICATIONS (QUALITY & FINANCIAL) & CLIMATE CHANGE?

NOT APPLICABLE

THE PROPOPSALS OR ARRANGEMNTS OUTLINED IN THIS PAPER SUPPORT THE ACHIEVEMENT OF THE TRUST OBJECTIVE(S)

YES

THE PROPOSAL OR ARRANGEMENTS OUTLINED IN THIS PAPER ENSRE COMPLIANCE WITH THE REGULATORY OR GOVERNANCE REQUIREMENTS LISTED

NOT APPLICABLE

THE PROPOSALS OR ARRAGEMENTS OUTLINED IN THIS PAPER TAKE ACCOUNT OF REQUIREMENTS IN RESPECT OF EQUALITY & DIVERSITY

YES

________________________________________________________________________________________________________

ACTION REQUIRED BY THE BOARD

The Board is asked to note the contents of the LiA Report

NORTHERN LINCOLNSHIRE AND GOOLE NHS FOUNDATION TRUST

STAFF ENGAGEMENT

1 PURPOSE OF THE REPORT

To inform the board about the Listening into Action approach the Trust has adopted towards improving staff engagement and its progress in the broader context of organisational change.

2 BACKGROUND Data from recent staff and patient surveys alongside CQC visits has provided the Trust with strong evidence that there is considerable work to be done to improve the way the trust engages with its staff. Furthermore the recent Barrett survey indicated a significant disconnect between our staff personal values and the current culture of the organisation. The Trust remains a poor performer nationally against three key indicators in the National Staff Survey. These are percentage of staff able to contribute towards improvements at work, recommendation of the trust as a place to work or receive treatment and staff motivation at work.(Figure 1 and 2).

Figure 1: Staff Survey 2016 engagement results.

Figure 2: Overall ranking for staff engagement.

3 INTRODUCTION In this changing NHS environment and as part of the development needed to help us move out of special measures, the Trust has developed a programme of Organisational Development to enable us to achieve our corporate strategic objectives and vision of We Care, We Respect, We Deliver. The list of programmes we have underway is significant and includes diverse projects including workforce planning, staff engagement, the development of a far-reaching programme of leadership development, countless Service Improvement projects, reward and recognition of staff and a drive to recruit staff members and governors to our Foundation Trust and retain the staff we have. The vast majority of staff hear snippets of detail about some, but rarely all, of these programmes of change. It is difficult for leaders within the Trust to articulate connections between all of the many programmes of change that are currently in place. And yet, it is vital that staff understand their role in revitalising our organisation to enable us to thrive. Engaging with staff to enable them to believe in our mission and live the Trust’s values has never been more important or more challenging.

4 COMPLEXITY

In order to make some sense of the large amount of organisational change that is underway, embed LiA methodology in the Trust and provide a connection between seemingly disparate programmes of work the Trust is pulling together an overarching strategy. This is based on a number of pillars which are central to the Organisational Development work currently underway:

• Workforce – DEVELOPING OUR STAFF (PDR, workforce planning, Education and

Development) • Leadership – YOU CAN MAKE IT HAPPEN (, Insights, middle management

development and leadership community) • Staff engagement – EVERY PERSON MATTERS (Listening into Action,

Vision/values, Barrett Values) • Service Improvement – WE’RE MAKING IT BETTER (Creative service improvement,

Reducing harm to patients, improving patient safety, ) • Reward and Recognition – PRIDE IN OUR STAFF (Our Stars, Lottery) • Our Behaviours – HOW WE BEHAVE (Focusing on People, patient and customer

care, CEO led anti-bullying programme) • Trust transformation– STRONGER TOGETHER (Staff membership, staff governors)

This encompasses many of the central tenets of the trust’s values (every person has something of value to add) and gives life to the LiA programme now underway. In essence we are trying to build a shift from and to described below. (Figure3)

Figure 3: Shift required

5 LISTENING INTO ACTION

In May the Trust was successful in being selected as one of just six trusts nationally to take part in a pioneering staff engagement initiative: Listening into Action (LiA). This approach to engagement has been developed by Optimise Limited, an Edinburgh-based business, which has demonstrated great success with a number of other NHS organisations. The Listening into Action methodology seeks to embed a fundamental shift in the way organisations engage with their staff and empower them to make changes that deliver patient and organisational benefits. The approach encourages organisations to listen effectively to their staff about their frustrations, and ask them what they would do differently. Key to the success of LiA is then acting upon that feedback. LiA will enable us to move to a new mind-set where we:

- Take responsibility - Share ownership - Help to ‘unblock the way - Learn from our mistakes - Celebrate successes

LiA has enabled other NHS organisations to achieve much improved results in their patient and staff surveys.

6 LIA PROGRESS TO DATE

At present the Trust has attended three LiA workshops in Birmingham and London and over the course of the next 9 months the Trust will be attending further LiA events along with the other six trusts to learn more about new ways of engaging with our staff.

From ToConfusionandambiguityoverrolesand

responsibilitiesAllstaffknowwhattheirroleisandhowtheycontributetotheTrust’sobjectives

Managersroutinelybeingdrawnintooperationalissues

Performanceofstaffbeingmanagedattherightlevel

WorkinginsilosandinisolationEngagingwithourcolleaguesandourpartners

PayinglipservicetoempoweringstaffGenuinelyenablingstafftomakedecisionsabouttheservicestheyprovide

Reactingtoissuespurelytohelpservicessurvive

Workinginaplanned,proactiveandcreativeway

KPIsareoptional Havingrobuststandardsofperformance

Believingthat‘businessasusual’isacceptable

Transformationandcontinualimprovementispartofourdailyroutine

Lackofbasicskillsandknowledgewithinourleaders

Providingourleaderswiththeskillstodotheirjobs

Figure 4: Crowdfixing feedback Figure 5: Pulsecheck results A ‘sponsor’ group to lead on the LiA work has been established since June and includes passionate staff, who are recognised as leaders from the Directorates, both clinical and non-clinical. This is led by the Deputy Chief Executive, supported by the LIA lead and the Director of People and OE.

A ‘pulse check’ has been completed, inviting staff to fill out a survey to establish the depth of feeling around working for our Trust. Over 1,114 people completed the pulse check and the results have been communicated back to staff. This measure offers a baseline against which we can assess progress. The results from this and the leadership pulse check were presented to the Board in August 2017. It will be repeated in 6-9 months as part of the programme.. Our staff were invited to attend five crowdfixing events. These are Deputy Chief Executive-led events which invite staff to respond to two questions. These events have been held in September and were a great success. Feedback has been provided to staff on the Hub and through poster feedback. (Figure 4 and 5).

7 NEXT STEPS From the crowdfixing events we have reviewed all the issues identified, issues that can be quickly resolved known as ‘quick wins’ are being implemented.

We have also identified a top five list of issues for the Trust to work on and response teams are being set up for progressing this and we will continually feedback on progress made against these.( Figure 6).

Figure 6: 5 response teams areas. The other part of our LiA journey is at the heart of this methodology. We have ten teams selected from staff to have a piece of work ‘sponsored’ by the LiA sponsor group. The piece of work might be small (improve team morale) or large (re-design a patient pathway) but either way the approach will be to unblock everything that is getting in the way of that piece of work succeeding. At the end of three months the success of that piece of work will be communicated across the Trust and an event is being held on 12 December 2017 to celebrate their success. (Figure7).

LiATeam(Specialty/Function)

Mission(improvementtarget)

BaselinePerformanceMetrics(measuresdrivingcaseforchange)

KeyTeamMembers(triumvirate)

RecruitmentImprovingourrecruitmentprocess,identifyingbottlenecksandattractingpeopletoworkatourTrust

PaulBunyan

WardManager

Dr

Patientaccess

Improvingouradminsystem,makingitsaferforourpatientsandsimplifying theadminprocessforourstaff

JackieFrance/RichardSunley

Dr/Nurse

Patientsafetyonthewards

Ensuringthecorrectskillmixonwards,usingourvolunteerstohelp onwards

MelanieGravesAssociateChiefNurse

Dr

MandatoryTraining

Reviewing,streamliningandcondensingMandatoryTrainingrequirements

HarrietStevens– HeadofTraining(nurse)

RichardSunley

? Governance

BankStaffReview

Reducingourrelianceonexpensive agencystaffbychangingthewaywemanageourbankstaff

HelenClarke– HeadofClinicalRosteringandBank

ClaireLow–Business InnovationandTransformationManager

WardManager

Figure 7: Ten teams areas of focus Eventually this enables a fundamental shift in the way we approach issues and implement change, with our staff at the heart of the decision-making process and leaders and managers the people who unblock their pathway to success.

The LiA sponsor group will provide a three-monthly update to the Trust Board using these measures to highlight progress.

8 RECOMMENDATIONS

The Trust Board is asked to offer its support to the Listening into Action approach to staff engagement. Additionally the outputs from the crowdfixing events are attached in the Board section for information.

Jayne Adamson Director of People and OE

October 2017

LiATeam Step1:Crystalclearmission?

Step2:StrongSponsor

Group?

Step3:Greatinvitees/attendees?

Step4:Powerfulcaseforchange?

Step5:HadgreatLiAConversation?

Step6:Actions/owners/outcomes?

Step7:Continuingforward?

STATUSRed/Green

1.CriticalCareDPOW x x x x x x

2.WardC6 DPOW x x x x x x

3.Audiology andENTOutpatientClinicDPOW

x x X X X X

4.Theatres SGHx x x X X X

5.MindfulnessSGH/DPOW/GOOLE

x x x x x x

6.‘Homeward Bound’SCUNTHORPECOMMUNITY x x x x x x

7. CardiologyOutpatientDPOWx x x x x x

8.Medicaldoctor handoverDPOW x x x x X X

9.RespiratoryDPOW x x x x x x

10.CriticalCarePatientSurveyDPOW, x x x x x x