About the trust
Hampshire Primary Care Trust (PCT) was the largest PCT in the country. The trust was a major provider of services with a variety of diagnostic, inpatient and outpatient services in various community hospitals. HCHC provided many primary care services through hard-working teams in the community throughout Hampshire.
Background to the project
Concerns were raised at JCNC meetings that whilst the organisation had put in place all of the building blocks needed to improve the employment practices of staff, and therefore the patient care the trust provides, some staff did not appreciate their own responsibilities in tackling poor practice whilst others felt a lack of empowerment to deliver high quality care.
The trust had benefited in the past from tackling problems in partnership and so when issues of complacency were highlighted the HR team and RCN embarked on a project aimed at raising awareness of the key requirements of the NMC Code of Conduct (which ensures that nurses are aware of their professional accountability). The awareness sessions also focused on the requirements of the Dignity and Respect regulations.
A lot of work had already been done to reinforce these messages to acute-based staff, however, less focus had been placed on reinforcing the messages to community based staff. With over 3,500 community based staff working on the front line this group was targeted with the awareness sessions being held in each of the 13 community hospitals as well as supporting business units.
Project delivery
The HR team worked closely with members of the local RCN to deliver the project with the trust Board providing support.
A joint undertaking between local RCN representatives and the HR team provided sessions to community based staff on the NMC Code of Practice and the requirements of the Dignity and Respect Standards, reminding them of their Professional Nurse Accountability and the increasing demands placed upon them relating to the dignity and respect agenda.
Key elements of the project delivery included:
- A five-day leadership course (including 2 x 2 residential units) provided managers with the tools and techniques to maximise input of their staff and effectively manage performance. This clearly had an impact as the trust improved its PDR (Performance, Development and Review Process) which focused on behaviour as well as outcomes.
- A series of large scale events allowed cross-team working, access to high profile speakers, and the opportunity to hear about related issues such as whistle blowing, risk management, trade union membership and learning and development opportunities.
- Awareness sessions focused on the key requirements of the NMC Code of Conduct.
- Development of a communications strategy which included compulsory attendance at the event for fully qualified nurses and therapists.
Project outputs
Over 500 Band 7, 8 and 9 staff attended a leadership development programme. (74% of those attending responded to a questionnaire saying that they had found the event informative/useful). The trust piloted the Productive Community Hospital series in four areas where the project lead shared learning and achievements.
In total 10 large scale accountability conferences were held in April/May 2010 with 1,453 staff from the community trust attending the conferences, where scenario based workshops, panel question and answer sessions involving a Barrister, union representatives and senior clinical managers were utilised. There has been an increased request for further accountability-style training sessions, in particular on record keeping from managers and staff.
Internally, since the larger style accountability conferences that were arranged for the community side of the trust there have been a further three training sessions called: Legal & Professional Issues in Relation to Clinical Record Keeping and The Jury is out - Medico Legal CPD for Non Medical Prescribers. These sessions included mock legal scenarios relating to record keeping and the resulting accountability from the completed paperwork, utilising clinicians, senior managers and union representatives. The sessions were extremely well evaluated in putting the theory into practice regarding accountability and record keeping.
Additional accountability training sessions for the Mental Health & Learning Disabilities side of the trust via the RCN are due to start in 2012 and will ensure that both sides of the newly merged trust can have confidence in the right approach to accountability and recording keeping. In addition the trust has instigated via its governance teams mock “CQC inspections” to reinforce the message that staff are accountable both through internal processes and external governing bodies for the care they give and the records they keep of that care and the trust hopes that this leads to an increased accountability overall within the trust.
Further task and finish groups evolved following the conferences in relation to the trust’s risk reporting processes (the electronic Datix incident reporting method), training needs on record keeping, and the potential to improve clinical supervision training.
Top tips
- Be flexible and willing to listen to good ideas
- Break it down into what is actually achievable – you might need to manage other interlinked projects separately
- All sides have to agree – discussion is important but agreement has to be reached
- Meet regularly with the project manager to make sure progress is as you think it is
- Have a lively Steering Group making sure the right people are part of it and that the Board are kept informed of progress
- Keep the range and number of interlinked projects to a minimum in order to keep the initial project on track
Further information and contact information
Bobby Scott
Head of Learning & Development
For Hampshire Community Health Care
Learning and Development Department
Tel: 02380 874091
Direct Dial: 02380 874289
Mobile: 07880 783734
Email: bobby.scott@hchc.nhs.uk
Sandra Grant
Workforce and Communications Director
Sandra.grant@hchc.nhs.uk
0753 1488 730
Sue Donne
Project Manager
02380 87 4048
suedonne@btinternet.com