About Blackpool, Fylde and Wyre Hospitals NHS Foundation Trust
The Blackpool, Fylde and Wyre Hospitals NHS Foundation Trust was established on 1 December 2007. It serves a population of around 330,000 residents of Blackpool, Fylde and Wyre and the 12 million holidaymakers who visit the area every year. The trust employs approximately 4,500 staff and has an annual budget is in excess of £200m.
The trust comprises Victoria Hospital which is a large busy acute hospital, two smaller community hospitals, three elderly rehabilitation hospitals, the National Artificial Eye Service and a child development centre.
The trust has 864 beds across all sites and sees more than 97,000 day-case and inpatients, 266,000 outpatients and over 92,000 accident and emergency patients every year.
Blackpool is also one of four tertiary cardiac centres in the North West, providing specialist cardiac services to heart patients from Lancashire and South Cumbria.
Embedding partnership working
The trust achieved excellent working relationships with the trade unions through the implementation of Agenda for Change. Previously, the trade unions and managers only met in times of conflict.
A decision was made to continue with partnership working in all areas and at all levels of the trust – the theory being that if staff understood the need for change and are involved, then they are more likely to make a positive contribution - even if they do not actually like the change.
For this effective partnership working to happen, HR Professionals must step outside their traditional boundaries and contribute their expertise in the delivery of patient services through true integrated planning.
Meeting the Financial Challenge
In 2006 the trust was facing a projected budget deficit of nearly £21m. This was as a result of several years of overspending with shortfalls being addressed by non-recurrent methods, for example, land sales. In order to maintain activity levels and progress towards becoming a Foundation Trust, drastic efficiency savings were needed, 70 per cent of the trusts £200m budget was spent on staff salaries and wages, so the biggest changes had to take place in this area.
The trust had to improve costs within two years, while maintaining activity levels and minimising the need for expensive compulsory redundancies.
How we did it
The human resources (HR) team put together a consultation process and communications strategy with the trade unions before any changes took place. The aim was for true partnership working with the unions to meet the very real business need.
The trust established a turnaround team and the operational divisions identified potential service reconfigurations that would deliver the required efficiency savings.
The HR team then had high level consultations with the trade unions, both individually and at the Joint Negotiation and Consultative Committee. These talks resulted in an agreed way forward on how to make the required savings.
HR managers, together with trade union representatives, carried out interviews with all affected staff and completed a mapping process that resulted in staff being moved to suitable new posts.
New posts were identified largely as a result of tighter vacancy controls and less reliance on temporary and agency staff. Progress was monitored by the turnaround team and the HR team developed a workforce monitoring tool that was reported to the board each month and shared with staff side representatives. This ensured that the project maintained impetus and achieved its milestones.
The results
The project was a success and the trust met its cost improvement target in one year rather than the planned two. This enabled the trust to achieve foundation trust status one year earlier than expected and has therefore been able to deliver its planned improvements to patient care.
A total of 523 full time equivalent posts were removed from the budget, this figure is made up from:
- actual redeployments of staff into suitable alternative posts
- removal of vacant posts from budgets
- reductions in the use of agency and temporary bank staff.
Becoming less reliant on the use of temporary staffing saved over £2m. Also the trust maintained and slightly increased its activity levels (and therefore its income) and actually reduced the average patient length of stay by nearly a third. None of this could have been achieved so quickly and effectively without the full cooperation and support of the trade unions and their representatives.
If financial problems had not been addressed in a timely manner, there is no doubt that patient care would have deteriorated.
The trust has lead the way in reducing waiting times (it was one of only a few in the NHS to deliver the 18 week target one year earlier than planned). With the surpluses generated through more efficient working, the design and construction of a new surgical block has begun, this will include all theatres and some surgical wards at a cost of £54m. None of these, and many other improvements, would have been possible had our partnership working with the trade unions not been so effective and productive.
The future
The partnership working has continued with the delivery of the trust’s workforce plan, which is underpinned by a comprehensive workforce engagement strategy which incorporates every department and operation across the trust.
One of the most significant partnership outcomes has been the ‘partnership for learning’ project supported by the trust, UNISON and Blackpool and the Fylde College. The project’s goals are:
- to improve literacy and numeracy skills
- improve the motivation and confidence of staff
- to widen participation in learning.
The project has seen over 1,000 members of staff undertake a wide variety of courses. In particular literacy and numeracy skills have been improved as well as basic IT skills, and all partners believe it has been significant in breaking down barriers to learning.
The project now aims to expand its horizons by offering financial advice and support, working with the Financial Services Authority, Blackpool Council and a local credit union.
Top tips for successful partnership working:
- partnership working should be embedded at all levels of the organisation
- partnership working needs to be part of the culture to be truly effective
- HR Professionals need to step outside their traditional and comfortable boundaries and contribute their expertise in the delivery of patient services through true integrated planning.
And what to avoid:
- don’t concentrate on financial cuts but emphasise the improvements to patient care that will result from financial stability
- don’t view working in partnership as an additional layer of bureaucracy but rather as an enabler to service improvement
- don’t fall into the trap of thinking that partnership working is just about getting on with staff representatives
- don’t fall into the trap of believing that true partnership working exists because you have a Partnership Agreement document.
Further information and contact details
For more details about partnership working at Blackpool, Fylde and Wyre Hospitals NHS Foundation Trust, contact: