A recent report from The Point of Care Foundation is a breath of fresh air, as is the charity itself. Formed last May in the wake of the Francis Report, its goal is to provide practical solutions to improve both the patient and staff experience. The fact that Robert Francis is one of its trustees suggests the foundation means business.
Staff care: how to engage staff in the NHS and why it matters, its first report, makes the case plainly. There is a gap “between conceptual debates about culture and staff engagement and the reality of life in the NHS”. This needs to be bridged because the experience of healthcare staff has a massive direct impact on the experience of patients. It’s the same point I made in a masterclass on internal communication I gave at a conference on improving patient care in December (you can find a link to it here). At the heart of improvement are staff who feel valued and confident that when they make suggestions for change or raise concerns these will be listened to and acted upon.
But senior managers and staff don’t always see things the same way. Even if staff engagement is one of an organisation’s stated priorities, it may not feel like that to people on the ‘shop floor’. For instance, based on various surveys, the report points out that while 86% of chief executives believe staff are able to raise concerns, only just over half of staff (58%) say they feel confident about doing so. Managers are doing some of the right things, such as appraisals, but most of these are not seen as well-structured. Staff are being invited to have their say on what could be improved, but left feeling that their view makes little difference.
Effective communication forms the basis of staff engagement, but according to the report, only in three NHS staff say communication between them and senior managers is effective, and nearly half of foundation trusts rely solely on the annual staff survey to formally canvass their opinions.
As I said in my masterclass, communication needs to be approached not as an abstract concept but a whole host of activities rooted in reality and geared towards achieving specific outcomes. The Point of Care Foundation report makes much the same argument, suggesting practical steps senior managers can take to improve staff engagement. It includes eight case studies of good practice in action, like the staff who helped redesign patient information and complex staff documentation to make navigating a particular clinical pathway easier for everyone.
And Jo Cubbon, chief executive of Taunton and Somerset NHS Foundation Trust, has a message for those who don’t believe staff engagement should be a top priority when money is tight. “Engaging staff is not an add-on or an extra expense; it is a fundamental part of how you operate as a hospital. And when staff believe they have the power to change things, they create the time to make it happen.
“My job has been to get a ‘just do it’ message out to staff. Giving people the freedom to act can be both scary and extremely liberating, and we have to be brave in allowing people to make mistakes along the way without fear of blame.”