Agenda Item: Report Number: Venue: Date: Meeting:

10 GB91-16 NWS CCG HQ, 58 Church St, Weybridge, Surrey, KT13 8DP 25 July 2016 North West Surrey CCG Governing Body Part One

Title of Report

Staff Survey 2016 and Update

Purpose of the report

To discuss the findings of the 2016 Staff Survey Report and to seek approval for realignment of the staff survey in accordance with the national NHS staff survey framework.

Reason for presentation to the Governing Body

For Information  For Discussion  For Decision Describe To make the Governing Body (GB) aware of the results from the Staff Survey which took place between January and March 2016 and the consequent recommendations made. In addition, to request that GB approve alignment of Staff Survey to the National NHS Staff Survey framework due to be rolled out during September 2016.

Prepared and Presented by: Relative Legislation & Source Documents:

Anthony Shipley, Director of Corporate Development and Assurance The Picker Institute (Europe) North West Surrey – Overall Report

Freedom of Information: This report has previously been presented to the following Committee/Group/s

Restricted

Open

Clinical Executive

Quality Committee

(please state date)

Operational Leadership Team Audit and Risk Committee



Contracts and Finance Committee Remuneration and Nominations Committee



The outcome of previous presentation/s or reviews

The Governing Body received a debrief of the 2015 Staff Survey in July 2015, which detailed the results of questions asked around key areas of staff engagement. Consequently extra work was commissioned through SECSU to address key areas of concern, specifically around perceptions of bullying and harassment. The commissioned “deep dive” was presented to GB in January 2016 with recommendations for action being presented at that time.

. Executive Summary This report outlines the results from the Staff Survey which took place between January and March 2016 and highlights recommendations made and proposed further actions. In addition, it highlights the benefits of aligning to the National NHS Staff Survey framework and asks for GB approval for the CCG to switch to this framework and its timings.

Recommendations: The Governing Body is asked to: 1.

Note the report and the action plan agreed by the staff forum.

2.

Approve switch to National NHS Staff Survey framework.

Health Impact:

Financial Implications:

Legal Implications: Equality & Diversity Communication & Engagement

Reputational Implication:

Risk Register:

The working environment can have a positive impact on the motivation, health and wellbeing of staff in turn, impacting positively on organisational performance. The recommended actions and recommendations arising from the staff survey can be implemented within existing budget provision. Not applicable. The needs of all staff are reflected in the staff survey and resulting action plan. The Staff Survey Management Report was presented and discussed at a whole team meeting lead by the Director of Corporate Development & Assurance and made available to staff. A motivated, engaged and well supported staff group are an asset to the organisation’s reputation and help makes it an employer of choice leading to better retention of staff. No direct implications.

1.

Background

1.1 The 2016 Staff Survey was commissioned by South East Commissioning Support Unit (SECSU) on behalf of North West Surrey CCG (NWSCCG), and was facilitated by the Picker Institute Europe (PI), who have acted as the market research organisation for its formulation and reporting. 1.2. Within it, comparative scores are taken from the NWS CCG 2015 survey, comparing staff responses to questions asked utilising the concept of ‘problem scores’ as a summary measure. These problem scores show the percentage of staff who gave a negative response to applicable questions and help monitor results over time. 1.3. The key areas questioned focussed on the following headings: Your Personal Development; Leadership and Career Development; Your Job; Your Managers; Your Organisation; and Your Health, Well-being and Safety at work. 1.4. The CCG is not obliged to align to the National NHS Staff Survey Framework so consequently, the CCG Staff Survey is bespoke to a certain degree, matching some elements of the framework but not all. In turn, the PI classify the survey as a “pulse check” for the organisation. 1.5 The CCG is also not obliged to publish staff survey results although it deems it good practice to do so through its annual GB report, which is placed in the public domain. 1.6. 62 from a total number of 75 eligible personnel responded to the survey, equating this to an 83% return. This compares more favourably to the 2015 survey where 49 from a total number of 89 eligible personnel responded to the survey, equating this to a 55% return. 1.7. This is a particularly positive return as internal surveys will generally receive a 3040% response rate or more on average, compared to an average 10-15% response rate for external surveys1. Whilst it is perceived that this response rate is reasonable in context, it is recognised that some further engagement work needs to be undertaken to increase response rates so that the picture given is as representative as it can possible be. 1.8. A synopsis of the key areas within the survey is presented, with the recommendations shown being taken and adapted from the PI Executive Summary. This paper does not explore statistical detail which is shown in the attached Staff Survey Management Report for further perusal if required.

1

http://www.surveygizmo.com/survey-blog/survey-response-rates/

2.

Your Personal Development

2.1. At the time of staff survey issue, the newly launched 2015 appraisal procedure was being utilised. It was subsequently fedback by many staff that the process felt too complex and difficult to apply. It is felt that a lack of formalised training around its application may well have been an influencing factor to responses around appraisal completion, which were only marginally better than 2015. An independent KPMG audit also showed that some of the quality of appraisals delivered were not up to the required standards. 2.2. In 2016, two new questions were added to the staff survey. These were ‘Have you had clear objectives set for your role?’ (31% no) and ‘Have you had your performance reviewed regularly’ (48% no). As these are new questions testing the rigour of the appraisal and supervision process, there is no comparative data however, the percentages shown are deemed as high. 2.3. Although not measured as significantly different it is worth nothing that 7% of staff have said they have had no manager support for training, learning or development which when was reported as 0% last year. 2.4. This year 12% of people have marked disagree or strongly disagree to the question ‘My training, learning and development has helped me to do my job more effectively’ compared to 0% last year. 2.5. The problem scores for ‘Have you had an appraisal in the last 12 months?’ is lower than 2015 (38% from 51%) so this has improved but not significantly so. Interestingly, the internal return from managers was that 96% had received appraisals, however, it would appear that many staff were either not aware of the fact or had forgotten. 2.6. Looking at personal development overall, the percentages of problem scores around appraisals are higher this year than in 2015. Clearly this warrants more focussed work in this area. 2.7. There were no scores recorded as significantly better than 2015 against PIs problem scoring model. Recommendations: 1)

2)

3)

review of the appraisal process is underway with a focus being given on engagement with staff around creation of values and, behaviours framework; process application; and documentation; a formal launch of the new procedure is planned so that staff are aware of the processes involved, importance of clear objective and personal development plan (PDP) setting, management supervision; and summative appraisal. This will ensure that: clear objectives are set; PDPs are relevant, appropriate and supported; and formative feedback is given; and completed appraisal documentation will be forwarded to HR/OD so that it can be quality checked and recorded as completed. Where there are doubts around quality, managers will receive feedback from the HR/OD team.

3.

Leadership and Career Development

3.1 Staff generally felt that their managers created opportunities for professional growth. A significant amount of staff also agreed that they were encouraged to become a leader in their area of work. 3.2. The highest score in this section is in answer to the question ‘There are opportunities for me to develop my career in this organisation’. Although not significantly changed from last year it is still a high score (from 17% to 25%). 3.3. This year, 15% of individuals indicated they did not feel encouraged to motivate others in their area of work compared to 3% last year. This is a significant change from last year. Recommendations: 1)

2) 3)

expedite in the process of introducing a talent management approach that will help to identify high performance, high potential staff, which will help prepare talent to move into more senior or diverse roles; hold focus groups to explore why there might be lower responses to the question ‘I feel encouraged to motivate others in my area of work’; and develop further actions in this area once more data is received.

3.4. There were no scores recorded as significantly better than 2015 against PIs problem scoring model. 4.

Your Job

4.1. Of the 24 questions in this area, there were nine distinct improvements in comparable positive scores, but none were deemed as significantly better than 2015 against PIs problem scoring model. 4.2. There are some areas of concern which do require attention around: recognition for good work; value shown by the organisation for work done; staffing levels to get jobs; and conflicting demands. 4.3.

The following questions are used frequently across the NHS to measure overall engagement and are shown as scores that are significantly worse than 2015 against PIs problem scoring model:     

‘I never/rarely look forward to going to work’ (20% from 3%); ‘I am never/rarely enthusiastic about my job’ (10% from 0%); ‘opportunities to show initiative are infrequent in my role’ (10% from 0%), ‘I am not able to make suggestions to improve the work of my team/ department’ (8% from 0%); and ‘I am able to make improvements happen in my area of work’ (7% from 0%)

4.4. It is worth noting that at the time of staff survey, there were many pressures on staff in terms of: concurrent re-procurements; re-negotiation of contracts; and year end activity, all of which put a large amount of pressure on key elements of the workforce.

Recommendations: 1)

2)

5.

Hold focus groups with staff, as to why they do not look forward to coming to work or feel enthusiastic about their jobs as these are seen as strong indicators of levels of motivation within an organisation and act on recommendations made; and Ensure that there are clear arrangements in place to listen to staff proposals, individual or collective, for improving processes, systems, and patterns of care; committing to responding to these proposals constructively.

Your Managers

5.1. There are no significant comparative differences in this area of the survey and there were no scores recorded as significantly better or worse than 2015 against PIs problem scoring model. 5.2. It is noted though that whilst not different from last year, there are still relatively high scores around questions relating to relationships with senior management. ‘Communication between senior management and staff is not effective’ scored marginally higher that 2015 (26% to 22%) and ‘Senior management do not involve staff in important decisions’ showed no improvement (20% to 20%). Recommendations: 1) 2)

Review with the Senior Leadership Team how and when senior management communicate with staff; and Work on further increasing the visibility of the senior management through use of media, stand up meetings, whole team meetings and presentations.

6. Your Organisation 6.1. 75% of staff would recommend the organisation as a place to work, with over half still feeling part of the organisation’s vision for the future. The majority of respondents stated that patient care and health outcomes are still the organisation's top priority. 6.2. Problem scores for ‘There are no positive role models in the organisation’ has increased from 0% to 7%. Recommendations: 1)

2) 3)

‘I would not recommend my organisation as a place to work’ is an engagement indicator for advocacy of the organisation. With 25% of staff stating they would not recommend the CCG as a place to work, it is deemed important that we engage with staff to explore why that is in the form of questionnaires to ensure anonymity. Once results are obtained, appropriate interventions will be planned; explore links between the question and the increased problem scores for the motivation and involvement engagement questions; further explore with senior management teams the impact on their leadership styles on staff through systematic management development

4) 5)

activity; make sure the organisation’s role in delivering its vision with its focus on patients is clear; and take action to inform staff of service transformations and changes to the patient focus in the organisation.

7. Your Health, Well-being and Safety at Work 7.1. As stated, NWSCCG acknowledges that there were significant pressures at the time of Staff Survey. It is felt that those pressures may have been contributing factors to some of the scores within this section of the survey. 7.2. There were some scores significantly worse than 2015 against PIs problem scoring model. The following have specifically got significantly worse:  

‘felt pressure from colleagues to come to work’ (24% from 0%); ‘I would not feel safe raising a concern’ [about fraud, malpractice and wrongdoing] (10% from 0%).

7.3. Also of concern is that 92% of staff stated that the put themselves under pressure to come to work despite not feeling well enough (albeit this is a slight drop from the 100% of staff who reported this last year). This also links to the question of staff in the last 12 months having felt unwell as a result of work related stress which is recorded as 45% (against a national average of 37%2). 7.4. On a positive note the question that focussed on ‘The last time you experienced or witnessed harassment, bullying or abuse at work, did you or a colleague report it?’ has improved significantly (28% didn’t report in 2016 as opposed to 78% in 2015). Whilst the report does not reflect this, further analysis data has shown that there has been a demonstrable improvement in areas around bullying. In the 2015 staff survey, the question ‘Have you personally experienced bullying at work in the past 12 months” showed a response of 33%. In the 2016 report this has dropped to 15% showing a significant decrease in this area. However, 19% of staff stated that they had personally experienced harassment at work in the past 12 months a rise from 13% in 2015. 7.5. This is a good indication of the success of the work conducted last year around ensuring that staff felt comfortable enough to report these types of incidents if they arose and that bullying behaviours were not acceptable within the organisation. Clearly though, there is still some work to be done around perceptions of harassment. 7.6. Of concern was the response that 2% of individuals stated that ‘the last time they did experienced physical violence at work it was not reported’; up from 0% last year especially as no reports have been made of this nature. 7.7. It is felt that last year’s move from Weybridge hospital to our current premises has had a positive impact on responses to relating to working environments. Significant overall improvements have been recorded with responses to ‘I have a comfortable work space’ decreasing from 74% saying they did not to 22%. The question around ‘I do not

2

Briefing note: Issues highlighted by the 2015 NHS Staff Survey in England updated 22nd march 2016

have a clean working space’ improved from 32% to 8%. In addition the question ‘I do not have the right equipment to do my job’ improved from 50% to 10% and ‘I do not feel safe and secure in my working environment’ changed from 18% to 0%. These responses were all categorised as better than 2015 against PIs problem scoring model. Recommendations: 1) 2) 3) 4)

5) 6) 7) 8) 9)

look at staffing levels against requirements to see if pressure from colleagues to attend work is due to over commitment; reinforce information on how people can report bullying and harassment; continue to openly address concerns around bullying at: whole team meeting events, H&S Group; Staff Forum and Senior Leadership events; prioritise the issue of stress at work and analyse ways in which the organisation can address legitimate problems through effective staff engagement; consider what can be done to improve communication, reduce conflicting pressures, and eliminate barriers to effective professional working; pulse check with formative surveys around bullying and harassment; continue to signpost staff to: CCG Bullying policy; CCG Whistleblowing policy and NHS confederation guidelines on bullying and harassment; actively support teams on identified key areas including better work-life balance; Explore health and wellbeing initiatives such as subsidised gym membership; bike to work scheme; regular health and well-being days; more inclusive social activities; mental health and psychological resilience events.

8. Aligning to National NHS Staff Survey Framework 8.1. Currently, CCGs are not obliged to conduct staff surveys in accordance with the National NHS Staff Survey Framework nor is it obliged to publish their results although it deems it good practice to do so through its annual GB report which is placed in the public domain. 8.2. The staff survey is commissioned by the CCG and is known as a “pulse check”, facilitated and reported on by PI. Questions delivered in this pulse check are legacy in nature and were created to ensure that staff opinions were sought around key areas. In some areas however they do mirror questions within the framework. This staff survey has historically been run between January and March. 8.3. Staff feedback has told us that running the survey in this timescale is problematic in that this period of the year is our most busy, demanding and challenging for significant elements of the workforce. It is felt by many that this is an influencing factor to some of the responses given in terms of how people feel about their roles and the organisation as a whole. 8.4. Responses given by staff are clearly taken from a point in time, however, intuitively, it is felt that some of the negative perceptions given may well be due to the extreme pressures on the workforce at those particular times.

8.5. The National NHS Staff Survey runs from September to October of it year. It is a standard survey that has been structured around the seven pledges to staff in the NHS Constitution, which was published in March 2013. These themes include:    

  

to provide all staff with clear roles and responsibilities and rewarding jobs for teams and individuals that make a difference to patients, their families and carers and communities; to provide all staff with personal development, access to appropriate education and training for their jobs, and line management support to enable them to fulfil their potential; to provide support and opportunities for staff to maintain their health, wellbeing and safety; to engage staff in decisions that affect them and the services they provide, individually, through representative organisations and through local partnership working arrangements. All staff will be empowered to put forward ways to deliver better and safer services for patients and their families; equality and diversity; errors and incidents; and patient experience measures.

8.6. Verbatim comments can also be included if required. Reports are produced and published on the National NHS Staff Survey Co-ordination Centre website where a section is dedicated to CCGs have committed to undertake staff surveys in this format. 8.7. Unlike our current arrangement, responses can also be measured against other CCGs of which there are 53 registered. In terms of Surrey, NHS East Surrey CCG and NHS Surrey Heath are registered. 8.8. It is proposed that NWSCCG register and align to the National NHS Staff Survey Framework in order to: 1. 2. 3.

adopt a standardised approach to Staff Survey; be able to compare results against other NHS organisations; and conduct staff survey in a more reflective time period in terms of normal working practises.

Summary As an organisation, we are committed to ensuring that our workforce are well lead, well managed, developed, supported in their roles, understand their contribution and feel valued for their contribution. It is also important that their well-being and safety at work is an organisational priority. It is acknowledged that some of the results from the staff survey could be better, and we will strive to make them so; but it is also important to acknowledge and celebrate some of the positive responses and successes we have had over the past 12 months too especially around bullying and our work place environment. Going forward, the action plan shown at Annex A will be staffed to help address issues around advocacy, involvement and motivation to ensure that we further develop our

organisation, creating an environment and culture that continues to make North West Surrey CCG a high performing, high achieving organisation where people are content and happy in their work and their relationships with each other. Much of this work going forward will be led by the yet to be appointed Head of OD and Workforce. By aligning to the National NHS Staff Survey Framework, it is felt that we will be better positioned to measure staff attitudes against NHS Constitution pledges to staff.

Annex A: Staff Survey Action Plan Area Your Personal Development Leadership and Career Development

Action Full review of the appraisal review process with embedding of organisational values and behaviours. Development of Talent Management processes Development of a systematic leadership development programme

Your Job

Your Managers Your Organisation

Your Health, Well-being and Safety at Work

Organisation of 1:1s, anonymous surveys and focus groups to explore potential motivation issues leading to development of action plans to address key areas Organisation of 1:1s, anonymous surveys and focus groups to explore why staff might not look forward to coming to work or feel enthusiastic about their jobs leading to development of action plans to address key areas Creation of clear lines of communications to ensure that staff have mediums in place to voice proposals, individually or collectively, to help improve processes, systems, and patterns of care. Work on further increasing the visibility of the senior management through use of media, stand up meetings, whole team meetings and presentations Organisation of 1:1s, anonymous surveys and focus groups to explore why some staff would not recommend the organisation as a place to work leading to development of action plans to address key areas Engage with Comms team to ensure that the organisation’s role in delivering its vision with its focus on patients is clear utilising innovative methods of staff engagement Re-enforce information on how people can report bullying and harassment

Continue to openly address concerns around bullying at: whole team meeting events, H&S Group; Staff Forum and Senior Leadership events

Lead Dir of CD&A

Timescale Sep 16

Dir of CD&A/ Hd of OD Dir of CD&A/ Hd of OD Hd of OD

Jan 17

Hd of OD

Dec 16

Hd of OD

Jan 16

Hd of OD

Dec 16

Hd of OD

Dec 16

Hd of OD

Dec 16

Mar 17 Dec 16

Workforce Aug 16 Development Manager Dir of CD&A/ Hd On going of OD/ Workforce Development Manager

Your Health, Well-being and Safety at Work

Prioritise the issue of stress at work and analyse ways in which the organisation can address legitimate problems through effective staff engagement

Pulse check with formative surveys around bullying and harassment

Actively support teams on identified key areas including better work-life balance Explore health and wellbeing initiatives such as subsidised gym membership; bike to work scheme; regular health and well-being days; more inclusive social activities; mental health and psychological resilience events.

Hd of OD/ Workforce Development Manager/Comms Team Hd of OD/ Workforce Development Manager Workforce Development Manager Workforce Development Manager

On going

Sep 16

Sep 16

Sep 16