Strengthening NHS employee engagement post-Francis

Amid the furore surrounding publication of the Francis report into failings at Mid Staffordshire Foundation Trust, there are two important points regarding employee engagement within the health service that I think we should note.

Robert Francis talks extensively about the need to reshape the culture in the NHS. He highlights the need to significantly strengthen accountability and to build greater trust between managers and the front line. These are big issues for many organisations, but given the scale and scope of the NHS, they take on added importance and increased complexity here.

Within the many recommendations that Mr Francis provides, he raises the prospect of a “cultural barometer” to assess the strength of relationships between management and frontline staff. This immediately fills me with fear of a “top-down solution”, when we all know you don’t change cultures by imposing an initiative from on high.

‘Unless listening events are seen as one element of a general drive to increase engagement, they can also be seen as an excuse’

I do realise that it is only one, and some would say minor, recommendation that Francis makes − and that it is only raised in concept form − but I think there are other ways of addressing the issues he raises.

And this brings me to my second point of concern. In the immediate aftermath of the report’s publication, there was a call from the health secretary Jeremy Hunt and NHS chief executive Sir David Nicholson for trusts across the NHS to hold staff “listening events”. These would be designed to help leaders and managers connect with the people, seek their views and any ideas for the way ahead.

Someone else’s job

Now, “listening events” or exercises of this ilk can be very valuable. If they are well designed, well crafted and followed up they can help to strengthen the trust employees have in leaders and can help those leaders pick up issues and ideas from the front line which can really improve organisational performance.

‘Based on the views Francis has given, it seems the most urgent priority is to strengthen day-to-day engagement’

But unless their role is carefully explained to managers and they are seen as one element of a general drive to increase engagement, they can also be seen as an excuse.

Based on the views Mr Francis has given, it seems the most urgent priority is to strengthen day-to-day engagement, not to create a new wave of set-piece events. The picture he paints is of an NHS that needs stronger and more consistent engagement between leaders, managers and frontline employees every day.

There is a risk that if an organisation creates new sets of “listening events”, the managers could infer that listening is “someone else’s job” and think that, as a result, they don’t need to change their own behaviour.

Yet it’s very clear in the Francis report, and every good practice guide you will ever see, that the way managers interact with their people is critical to creating an effective culture of engagement that meets everyone’s needs. Every organisation needs its leaders and managers to rise to this challenge. There can be no abrogation for responsibility to a new set of corporate events, however compelling they may be.

So while I welcome the initiative, and the greater emphasis on employee engagement that lies behind it, I think we need to be careful in how intention is turned into action. “Listening events” need to be part of a wider response, in each trust, if their effect on cultural change is to be more than skimming the surface.

Paul Sweetman is director of employee engagement practice at Fishburn Hedges