About Blackpool, Fylde and Wyre Hospitals NHS Foundation Trust
The trust was established, in its present form, on 1st December 2007. The trust serves a population of approximately 330,000 residents of Blackpool, Fylde and Wyre with high levels of social deprivation and the additional pressures of 12 million holidaymakers who visit the area every year.
The trust comprises Blackpool Victoria Hospital a large busy acute hospital, two smaller community hospitals - Clifton Hospital and Fleetwood Hospital - three elderly rehabilitation hospitals - Wesham Hospital Rehabilitation Unit, Rossall Hospital Rehabilitation Unit and Bispham Hospital (which is a Nurse Led Therapy Unit) - the National Artificial Eye Service and Blenheim House Child Development Centre.
It employs approximately 4,500 staff with a budget is in excess of £200m per year. There are around 830 beds across all sites and more than 56,000 day-case and inpatients, 250,000 outpatients and over 91,000 A & E patients are seen every year.
It is also one of four tertiary cardiac centres in the North West, providing specialist cardiac services to heart patients from Lancashire and South Cumbria.
Contents
Background and what we did
The importance of partnership working
The outcomes
The future
The learning experience
More about the 'Blackpool Way'
Contact details
In the 2006/07 financial year, the trust had a sickness absence rate of 5.34%, with over 55% of the sickness absence being of over 28 days duration, and was undergoing a significant amount of change,due to an ambitious cost improvement target of £21m, that was largely achieved through large scale redeployment of nursing staff.
The consultant for occupational health noted a marked increase in the number of employees who were presenting at his clinics with work related stress issues that were causing them to be unfit for work. The normal ratio of patients with psychological problems (stress, depression and anxiety) compared to patients with musculoskeletal problems (muscle, joint or bone problems) is about 2:1.
In 2007 this ratio rose dramatically to a ratio of almost 4:1.
The occupational health data indicated that the principal causes of stress in the workplace were excessive hours, restructuring and bullying and harassment. This was reinforced by the NHS staff survey. The evidence from occupational health and from the staff survey prompted the trust to target workplace stress as a major issue that had to be tackled as a matter of urgency.
At the same time as this evidence was becoming known, the Health and Safety Executive was planning to audit the trust in relation to its management of stress in the workplace and how far it complied with the Health and Safety Executive Management Standards for stress in the workplace. As an alternative to this approach the trust proposed to the Health and Safety Executive that it undertake its own stress project to identify and explore in some detail the sources of stress in the workplace.
Having identified the sources, the project members would then make recommendations aimed at reducing stress levels by changes in organisational behaviors and develop a robust action plan that would ensure the implementation of all the key identified solutions.
The Trust established a Stress Management Group to oversee the project. This was chaired by the Director of HR and included representatives from occupational health, line managers from each clinical division and staff representatives. The group meets each month and uses project management tools to ensure deadlines are met and targets hit.
The comprehensive action plan identified key personnel and detailed exactly what was expected of them and in what time period. This plan has evolved as progress has been made and is still monitored on a monthly basis. Progress against the plan is reported monthly to the Executive Directors, the Joint Negotiating and Consultative Committee and the HR & OD Governance Committee.
A traffic light scoring system was developed to show progress and all minutes from meetings, reports and action plans are made available to the entire workforce via the trust’s intranet site where there is a dedicated stress management site.
It was critical to the success of the project that partnership working underpinned all its work streams. The trust also had a major organisational development programme, ‘The Blackpool Way’ that aimed to improve employee engagement and had involved focus groups with over 2000 staff.
The group also:
- used regular meetings with stakeholders to highlight problems and consider solutions
- set up targeted focus groups to gain workforce thoughts, suggestions and issues
- had frequent meetings with staff side reps to keep them updated with progress
- used the Trust’s dedicated Stress Management site to keep people informed
All these communications were supplemented by “one to ones” between the project manager and members of staff
The key objectives for the project were established as:
- identify key causes for those experiencing stress
- reduce the causes of work related stress
- review of current occupational health services
There was some anticipated resistance to the project, with an expectation that views would be expressed such as:
“What problem?”
“Stress makes people work harder”
“Nothing to do with the organisation”
“Targets will be affected if we have to take our eye off the ball”
“Everyone will claim to be stressed if we highlight it”
“They should try my job”
It was essential to the success of the project that key stakeholders had "bought in" to it’s objectives - the Chair/CEO, Executive/Non-Executive Directors, staff side representatives and the workforce.
Certainly the project has led to some impressive results from the 2008 Staff Survey, relevant to the reduction of workplace stress.
| % suffering work related stress in the last 12 months |
Decrease from 36% to 24% |
Lowest (ie best) 20% |
| Work pressure felt by staff |
Score down from 3.22 to 2.97 |
Lowest (ie best) 20% |
| % experiencing harassment, bullying or abuse from staff in the last 12 months |
No change (reduced from 21% to 16% but not regarded as signiifcant) |
Below (better than average) |
| Trust commitment to work/life balance |
Increase (better than 2007) |
Highest (ie best) 20% |
| Support from immediate line managers |
Increase (better than 2007) |
Highest (ie best 20%) |
| % reporting good communication between senior management and staff |
New question |
Highest (ie best) 20% |
| Staff job satisfaction |
Increase (better than 2007) |
Highest (ie best 20%) |
| Staff intention to leave their job |
Decrease (better than 2007) |
Lowest (ie best) 20% |
The trust also achieved improved scores (also amongst the highest for acute trusts) in many other of the key findings and increased the staff survey participation rate to 61%. Since 2006, the trust has moved from being in the bottom 20% of trusts to being in the top 20% in terms of its staff survey results. Moreover the wide variation in the results from different directorates within the trust has all but disappeared.
Since the beginning of the project, sickness absence rates have improved by over 10%, there has been an almost 50% reduction in cases of workplace stress, employee grievances have reduced by over 50%, disciplinary action is reduced by nearly 25% and participation in appraisal rates have increased from 27% to 88%. The work on stress has also helped the trust achieve CNST level II, resulting in over £150,000 savings on insurance premiums.
The project team won the 2009 Healthcare People Managements Association’s award in the “Best management practice in tackling workplace stress” category (in 2008 the Trust had received a HPMA award for its Partnership working).
The Team also provided evidence to the ”Boorman Review” on Health and Wellbeing in the NHS workforce and is currently working with the HSE on Stress Management.
Future work for the project group includes:
- focus groups to ask workforce what they want next, e.g. well being initiatives
- review of current occupational health services
- continuing monitoring of action plans to ensure implementation of recommendations and evaluation of project.
- gain the commitment of the chief executive and board at the outset; ensure they share the Vision and are proactive in implementation of the project plan
- identify key stakeholders and potential barriers to success as soon as possible
- develop contingency plans to deal with problems as they arise
- work in partnership with staff side, communicate with the workforce at all times and explain why some suggestions were acted on and some were not.
A common-sense approach to effective employee engagement and high
performance based on four key steps:
1. Good communication: educating, informing and involving all staff at all levels.
2. Recognition: acknowledging and rewarding staff both formally – through award ceremonies, certification for learning and qualifications completed, and regular appraisals – and informally, through effective day to day line management.
3. Continuous improvement: looking at people’s individual skills and abilities and
committing to ongoing investment in learning and development across the
organisation.
4. Enlightened management style: changing behaviours, attitudes and culture and improving management skills.
For further information regarding the Stress Management Project at Blackpool Fylde and Wear NHS Foundation Trust contact:
Management side:
Sue Grimshaw, Stress Project Manager
Sue.Grimshaw@bfwhospitals.nhs.uk
Staff side:
Kevin Smith , Learning Project Co-ordinator & Staff Side Rep - Kevin.Smith@bfwhospitals.nhs.uk