HSJ Live 15.01.14 NHS called on to make greater effort to engage staff in order to improve performance

4.20pm Commenting on the NHS Support Federation’s research about the independent sector, David Hare, chief executive of NHS Partners Network, said:

“The figures quoted by the NHS Support Federation are based on a very small sample of contracts and are not representative of the wider NHS. Overall the independent sector currently provides around 6% of NHS clinical care and this figures has only increased by 1% since 2010.

“Involvement of the independent sector in the NHS is not new. For many years independent providers have supported the NHS and this has benefitted patients and delivered real value for the NHS.

“Open competition for NHS contracts allows commissioners to choose the best available provider for services regardless of whether public, private or voluntary sector. But this is not privatisation of the NHS. Services delivered by independent sector providers under the NHS banner have always been free at the point of delivery and we know that the vast majority of people do not mind who delivers their care as long it is free.”

4.10pm Sir Kevin Barron MP, Chair of the All-Party Pharmacy group today responded to a new campaign to raise awareness of the pharmacy service.

Speaking about the Pharmacy Voice-backed Dispensing Health campaign he said: “Community pharmacies are the ideal first port of call for people with minor ailments, coughs and simple aches and pains. Yet too few people know about the support that’s on offer and so go to their GP or, worse, A&E instead.

“The Dispensing Health campaign makes absolutely clear the important role that pharmacy can play in easing the burden on primary and emergency care services.  It chimes with what I and my colleagues on the All-Party Pharmacy group have been saying consistently to ministers, parliamentary colleagues and the NHS. I’m delighted that this is now being recognised by the national media. I hope that we will see far more people making the most of the expert help available from their local pharmacies rather than heading straight to their GP or hospital for minor ailments.”

2.30pm Sean Duggan, chief executive of Centre for Mental Health has responded to HSJ’s exclusive story revealing that Monitor and NHS England have been accused of “institutional bias” against mental health and community services.

He said: “It is extremely worrying to see the existing disparity in NHS spending between mental and physical health care being widened.”

“Reinvesting scarce resources in effective mental health interventions like liaison psychiatry and psychological therapies can help to make the NHS more efficient and improve people’s lives. Mental health services have as much need to act on the Francis Report’s recommendations as acute hospitals. We hope this decision will be reconsidered with evidence of the pressing need to reinvest in mental health support and reverse the institutional bias in NHS funds.”

2.00pm A report published today by The Point of Care Foundation shows that the way healthcare staff feel about their work has a direct impact on the quality of patient care as well as on an organisation’s efficiency and financial performance.

The report, Staff Care: how to engage staff in the NHS and why it matters, argues that it is not only necessary for healthcare providers to encourage staff engagement (the process by which staff come to have a positive attitude towards the organisation and its values) but to accelerate it. 

The report, which reviewed evidence from a wide range of sources, highlights that:

• Patient satisfaction is consistently higher in trusts with better rates of staff health and wellbeing
• There is a link between higher staff satisfaction and lower rates of mortality and hospital-acquired infection
• The NHS could save £555 million a year if it reduced sickness absence by a third.
• Stress and burnout are more frequent in the NHS than in other sectors. Approximately 30 per cent of sickness absence in the NHS is due to stress.

It points out that NHS staff engagement fell for three consecutive years from 2009 before rising very slightly in 2012. Only 55 per cent of staff would recommend their organisation as a place to work.

The Foundation calls on healthcare organisations to increase staff engagement at both a strategic and operational level by making support for staff central to their strategies to improve patient care, productivity and financial performance. It also sets out simple steps being used in parts of the NHS to improve staff engagement.

However, the report demonstrates there are discrepancies between what senior managers and staff think and say when it comes to how effectively their organisation supports staff and promotes high quality patient care:

• Putting patients first: While 62 per cent of NHS staff agree the care of patients and service users is their organisation’s top priority, over a third either disagree (17 percent) or neither agree or disagree (21 percent). In contrast, 95 percent of chief executives who responded to a survey for the Foundation reported that a focus on the quality of patient care was either fully in place or mostly in place within their organisation.
• Solving problems: While 74 percent of staff say are able to make improvement suggestions, only one in four (26 percent) say senior managers act on them.  CEOs, however, report that staff engagement is one of their top three priorities. Worryingly, while 86 percent of CEOs surveyed by the Foundation are confident staff are able to raise concerns, the Chartered Institute of Personnel Development found that fewer than six in ten staff (58 percent) felt confident about doing so.
• Listening to and involving staff: only one in three NHS staff (35 percent) say communication between senior managers and staff is effective. Yet despite CEOs reporting that they prioritise staff engagement, nearly half (46 percent) of foundation trusts rely solely on the annual staff survey to formally canvas staff opinions.  

Steps that board members and managers can take to increase staff engagement are set out in the report, including:

• articulating values in plain English and showing how they translate into behaviours
• giving staff responsibility and authority to solve the problems they think affect patient care
• creating space for staff to reflect on the emotional challenges of caring for patients
• training line managers in people management skills – including the large number of clinicians who lead and supervise other staff but who  don’t think of themselves as managers.

Director Jocelyn Cornwell, commenting on the report, said: “It’s the experiences of staff that shape patients’ experiences of care, for good or ill, not the other way around. Working in healthcare ought to rank amongst the best jobs in the world, but far too many healthcare professionals feel over-worked, disempowered and unappreciated.

 “Caring for patients is very hard and challenging. Boards need to support managers at every level so that they in turn support staff to deliver the best possible patient care.

“We want the NHS to be notable for being not only the largest employer in the country, but also the best. There is much good practice in the NHS, but for it to become the norm we need to close the gap between rhetoric and reality.”

Staff care includes eight case studies of good practice in supporting and engaging staff working in healthcare. The aim of the case studies, and the report overall, is to inspire senior managers and everyone responsible for leading healthcare staff to take action and support staff to deliver patient-centred care.

The report itself is viewable by clicking the link below.

1.50pm Dr Maureen Baker, Chair of the Royal College of GPs has said that GPs should make youth mental health a priority.

“The majority of GPs are skilled at supporting young people and families in their generalist role but fewer than half of GPs are given the opportunity to undertake a paediatric or psychiatry training placement during their training,” she said today.

“The vast majority of NHS care for children and young people is delivered by general practice teams and so GPs have a crucial role to play in improving the mental health of younger people. It is also important that children and young patients feel comfortable approaching their GP and that their GP is sufficiently prepared to discuss what are often sensitive issues with confidence.

“Youth mental health is a clinical priority for the RCGP and we are embarking on a number of important projects to raise awareness of youth mental health and simple things that GPs can do to give our younger patients a more positive experience.

“The RCGP is proposing that there should be increased focus on equipping GPs to deal with the common mental health problems faced by younger people – this includes improving mental resilience, managing anxiety, depression and self-harm, identifying suicide risk and in the early recognition of psychosis.

“The College is therefore recommending that in future, as part of an enhanced four-year training programme, all GP trainees should receive specialist-led training in both child health and mental health. The RCGP is also working with the Royal College of Paediatrics and Child Health, the Royal College of Psychiatrists, and Young Minds to develop ways that GPs and specialists might train together and so work more effectively when caring for young people with mental health problems and has set up a series of meetings to take this forward.

“Children and young peoples’ mental health and wellbeing is fundamental to their physical health. Statistics show that 75% of adults with mental health problems will have presented symptoms by the age of 18 – and 50 per cent by the age of 15 - and so it makes sense that we do more to tackle mental health problems as early as possible.”

1.35pm A campaign group has claimed that almost 70 per cent of contracts for NHS services in England between April-December 2013 were won by private firms.

The NHS Support Federation, a group which opposes private sector involvement in the NHS, said that, of a sample of 57 contracts they analysed, 39 of those went to private firms.

The federation said 15 of the 57 contracts they have sampled went to the NHS, two went to charities and one was shared between the NHS and a non-NHS supplier.

According to the group’s website, 400 contract opportunities have been advertised over the same period.

1.00pm HSJ can exclusively reveal healthcare leaders from across the community and mental health sectors have united against plans to cut the tariff price for their services by a fifth more than the reduction proposed for acute providers.