Embedding staff engagement with co-production and communication

In 2015-16 Northamptonshire Healthcare Foundation Trust was not in a great place. There had been a lot of organisational change, partly prompted by financial concerns, and a “requires improvement” rating from the Care Quality Commission. The difficulties of this period were reflected in the staff survey results with the percentage recommending it as a place to work dropping.

But the trust was determined it was going to change this with the board deciding that it needed to invest in the staff and to change the culture within the trust with a focus on co-production and communication.

This led to the “Let’s Talk” initiative which brought together diverse staff engagement initiatives into a cohesive plan covering the whole trust but with a recognition that there were local issues which could be addressed across the trust’s 100 sites. The plan was drawn up in 2017 and formally launched the following year.

“This is about making a difference for our staff and is in line with our mission statement which is to make a difference for you with you,” says Matt Asbrey, staff engagement lead.

Distributed leadership

One of the key pieces of work involved co-producing a definition of desirable leadership qualities with staff, clarity around what behaviours were wanted from staff, and a focus on distributed leadership.

Mr Asbrey says Christmas jumpers were part of the impetus for this: over Christmas 2015, many staff wanted to join in a Christmas jumper day but found the request to wear these were passed through seven layers of management. This was symptomatic of where the trust was at that time, he adds. It wanted to move to a point where staff took responsibility for their area of control and influence and did not have to push decisions “upstairs” unless it was necessary.

The trust won “primarily because they identified a real issue – a demotivated workforce that was less engaged than other trusts with a high staff turnover.”

Communication of this was important as was breaking down information for each site or team – for example, the staff survey results were distributed by team or service. Managers are increasingly seeking more depth and detail of information about their area. 

Staff were involved in co-producing locality objectives for particular areas of the trust which recognise the different issues and pressures they faced – for example, releasing time for staff to improve their own well-being in mental health services.

The trust has put more resources into providing counselling for staff which offers help with personal as well as work issues. “The work-related stress may be the thing that tips them over the edge,” he says.

There was a change in the focus on staff sickness to supporting staff back into work through wellbeing meetings and strengthening the occupational health offering.

Within a year, the initiative had started to show significant effects – with the trust jumping to the seventh highest staff engagement score nationally in 2018’s staff survey. Recommendation as a place to work – another critical part of the yearly staff survey – also increased giving the trust the highest score among its peers in 2018. It has also scored particularly well on the wellbeing measures and confidence around reporting unsafe clinical practice. Freedom to Speak Up reports have increased and the trust was the fourth highest rated for safety culture – partly due to its network of FTSU champions.

The trust is also successful in other areas – it has made a surplus for several years, compared with a deficit of £8m three years ago. It has reduced agency spend by more than half, has improved staff retention and has a lower level of staff sickness. “It is a win-win situation,” says Mr Asbrey.

But while the immediate improvements were important, they are not the end point. “We wanted something that could be successful in the long term,” he says.

Tim Flanagan, director of strategy and commercial at sponsors GRI, says the trust won “primarily because they identified a real issue – a demotivated workforce that was less engaged than other trusts with a high staff turnover.” The trust had been able to implement a “pragmatic, practical programme” with tangible benefits.

Entering the HSJ awards was a great opportunity to showcase the investment and work which had been put into staff, Mr Asbrey says.

The awards event itself was amazing, he adds. “It was fantastic to share it with the colleagues who were there and then to bring the trophy back and share it with colleagues in the trust,” he says.

Click here to find out more about how to enter the HSJ Awards 2020.