About the trust
Imperial College Healthcare NHS Trust is one of the largest acute trusts in the country with an annual budget of approximately £900 million. The Trust employs 9,735 people and provides services to people right across North West London and beyond.
Background to the project
The 2008 annual staff survey indicated that staff at the Trust experienced more bullying, harassment and abuse from patients, their relatives, managers/team leaders and other colleagues than at many other Trusts. It also showed that the trust was in the lowest (worst) 20% when it came to perceptions of effective action by the employer towards violence and harassment.
This may have had an adverse effect on the quality of care that staff can provide to patients – not only in terms of the psychological impact that actual or threatened bullying has on individuals and their performance but the impact it has on lost days at work through time off to recover from having experienced such incidents.
The Trust wanted to reduce the number of staff absences as a result of bullying, harassment or abuse, creating a working environment free of such incidents, where staff feel empowered and confident to initiate improvements to patient care within their own work areas. It believed that this could only be achieved by working in partnership with trade union colleagues from a very early stage, enabling them to bring their collective knowledge to help understand and identify the problem and work together to reduce the amount of bullying, harassment and abuse experienced by staff.
Project delivery
The project involved working with an external partnership specialist to provide an independent and objective perspective. It was split into four stages:
Stage 1: Review & Diagnostic Assessment
A focus group was held between management and trade unions to assess the current position and provide a benchmark against which progress could be reviewed (through a structured questionnaire) with regard to partnership working. A report was produced setting out key enablers and barriers to achieving a more collaborative approach to the implementation of the trust’s strategic plans and objectives.
Stage 2: Joint Partnership Workshop
A 2-day offsite workshop was held for both management and trade unions based on the Stage 1 findings to gain a shared understanding of partnership working in practice; identify key goals and necessary structures/working arrangements for a formal partnership agreement; understand the behaviours needed to work more collaboratively together; develop an action plan to translate learning into practice; identify success criteria to measure the effectiveness of this enhanced way of working.
Stage 3: Implementing the Actions: Specialist Training and Support
An in-depth workshop for managers and staff side was held to ensure that staff are appropriately skilled to carry out investigations into bullying and harassment allegations. The purpose of the workshop was to ensure appropriate ongoing support for both management and unions in working together to quickly identify and resolve difficulties as well as identifying particular training needs so that the partnership could be taken forward in conjunction with the bullying and harassment action plan.
Stage 4: Review and Evaluation
The final stage was about assessing the effectiveness of the joint working to demonstrate the impact it has had on taking forward their modernisation plans against the agreed success criteria. This review also provided an opportunity to assess progress against their action plan and to evaluate cultural and attitudinal change against the benchmark questionnaire carried out as part of the initial review and diagnostic assessment.
Project outputs
To date the project has created more productive working relationships and a greater understanding between managers and staff side. Regular meetings are held between union representatives and managers in local areas of the hospital eg Pathology and Clinical Infections and Respiratory Medicine which have enabled changes to be handled more effectively. In addition, more managers engage with trade unions earlier, resulting in a smoother, more productive journey.
Funding has been identified to launch a quarterly partnership award recognising examples of good partnership working across the Trust. Trade union and management colleagues have worked jointly to agree the assessment and award process.
A Staff Experience Group has been established which includes union representation as well as representatives from different clinical directorates and staff groups. This group mirrors the Patient Experience Group which believes that good staff experiences will result in better patient experiences.
A Bullying and Harassment Action Plan has been developed which includes a new telephone helpline. An appraisal template for managers incorporates self assessment against the Trust’s values, including Respect. A new Grievance Procedure will make it easier to raise issues of bullying and harassment. Training provided to managers is being reviewed including mediation skills line managers.
Since the last update in 2010 the Trust has improved its staff survey scores:
- In 2010 the Trust score on perceptions of effective action by the Trust towards violence and harassment was average compared with below average in 2008
- Shown a reduction in the proportion of staff reporting staff-on-staff bullying from 23% in 2009 to 18%
- Achieved a top 20% rating for the ‘supra’ key finding on staff engagement, which is a composite of three other key findings. This is particularly important result as high levels of staff engagement are pre-requisite for good patient experience
Top tips
- External facilitation is very useful - facilitators need skills to address conflict openly and/or mediate where there are areas of difficulty.
- Careful timetabling is needed (including lead-in time) to ensure availability of key people; setting a very tight timeframe will be counter productive.
- Time off for staff side and management to attend workshops and other events.
- It is important to have buy-in at all levels of the organisation, i.e. management, HR and the staff side.
- A trust-wide communications plan should be agreed from the outset.
Off-site workshops are generally more productive and better attended than on-site.
Further information and contact information:
Lorry Phelan, Chair of Staffside, Lorry.phelan@imperial.nhs.uk
Telephone 020331 21084
Liz Grogan, Employment Relations Consultant, Elizabeth.grogan@imperial.nhs.uk
Telephone 020331 27889