About Knowsley Primary Care Trust
Knowsley Primary Care Trust (PCT) also known as NHS Knowsley is part of the North West Strategic Health Authority region. It employs over 1400 staff and has a strong relationship with Knowsley Council’s directorate of well-being services, which employs a further 900 staff.
The PCT serves a population of 150,000 residents in the eighth most deprived district in England, though 70 per cent of the land is rural /green belt.
Drivers for partnership working
There were a number of drivers towards partnership working prior to a partnership agreement being introduced in 2004, these were:
- a lack of cohesion among staff side with infrequent management and staff side meetings and no formal structure in place
- the HR director’s previous experience with partnership working in health and education
- the need for joint working to implement the Agenda for Change pay system
- the desire for the shared values of partnership working together with a set of behaviours that were expected to be displayed in the course of partnership working.
Developing the partnership agreement
The partnership agreement was developed during a ‘time out’ opportunity, which recognised the need for a clean break from past structures. The agreement is reviewed annually, during a ‘timeout’ to make sure it is still relevant to meet future priorities and ensure both sides are still working within their parameters. There have also been developmental days, which have included employment law and the ‘dignity and respect’ agenda.
The Joint Negotiating Consultative Committee (JNCC) meets on a monthly basis with formal agenda papers. The work of the JNCC focuses on organisational developments and their implications for staff and the development of the HR/employment strategy. There is also a joint policy and procedure group which develops, reviews and equality impact assesses all human resources policies and procedures, which are then ratified by the JNCC.
Governance and meeting structures
- Staff side have a place on both the trust board and the provider board, with resources also having been made available for the staff-side chair and deputy positions.
- The joint policy and procedure group includes two experienced union representatives (not the staff-side chair or deputy). Additional staff representatives have also participated in the development of a new change management policy.
- The Improving Working Lives (IWL) infrastructure has been maintained and all representatives participate in the facilitation of focus groups.
- Trade union representatives contribute to corporate inductions and also management development programmes.
- The widespread involvement of staff representatives and service managers ensures partnership working has extended outside traditional JNCC membership.
Improving the performance of the PCT
Partnership working has had an important contribution to many of the improvements in the performance of the trust, including:
- advancements in integrated working - as an integrated PCT/Council organisation (Knowsley health and well-being is a partnership between NHS Knowsley and Knowsley Council), many union representatives work in integrated teams and are, therefore, able to influence HR policies and approaches in respect of the integration agenda
- greater Knowledge and Skills Framework (KSF) implementation and uptake of Personal Development Reviews (PDRs) and Personal Development Plans (PDPs)
- the mainstreaming of Improving Working Lives (IWL)
- the introduction of the Listeners Scheme, the listeners are a team of people that have been set up to support individuals who need advice and guidance on equality and diversity related issues, specifically those relating to harassment and bullying. Over the last two years the listeners have helped many staff deal with workplace issues that have caused them difficulty or distress outside the formal policy structures
- a commendation from the HPMA – in full for the ‘talent pool’. In response to problems facing newly qualified physiotherapists in 2005/06, the organisation identified that developing a ‘talent pool’ would allow the physiotherapists to gain much needed work experience and well as support training and service development initiatives in the organisation. The therapies manager discussed this with staff side representatives who gave their support – seeing the benefits for the current and future workforce, for patients and for the healthy workforce strategy across both the PCT and Knowsley Council.
The most noticeable improvement has been in staff morale and motivation, this is evidenced through the results of the staff survey.
Knowsley PCT consistently performs well on health and wellbeing indicators in the annual NHS Staff Survey usually achieving better than average response rates, as well as better than average scores on nearly all measures, many of which relate to staff involvement and engagement. Some examples from the 2008 survey are as follows:
- 61 per cent of respondents agreed or strongly agreed that their manager helps them when their workload is not manageable, compared to 54 per cent nationally
- 50 per cent of respondents are satisfied or very satisfied with the recognition they received for good work, compared to 47 per cent nationally and up 2 per cent on the PCTs score last year
- 42 per cent are satisfied or very satisfied with the extent to which the trust values their work, compared to 34 per cent nationally
- 51 per cent agreed they were encouraged by senior managers to suggest new ideas for improving services, compared to 38 per cent nationally and up 5 per cent on the PCTs score last year
- 41 per cent agreed or strongly agreed that senior managers try to involve staff in important decisions, compared to 32 per cent nationally and 38 per cent last year
- 44 per cent felt communication between senior management and staff is effective compared to 30 per cent nationally
- 46 per cent of respondents felt that senior managers act on staff feedback compared to 32 pr cent nationally
- 64 per cent agreed or strongly agreed that when errors, near misses or incidents are reported, the trust takes action to ensure they do not happen again, compared to 51 per cent nationally and 44 per cent last year
- 78 per cent agreed or strongly agreed that they can approach their immediate manager to talk openly about flexible working, compared to 70 per cent nationally and 71 per cent last year
- 60 per cent agreed or strongly agreed that they are involved in deciding on changes introduced that affect their work area/team/department, compared to 55 per cent nationally
- 67 per cent agreed or strongly agreed that the trust communicates clearly with staff about what it is trying to do, compared to 46 per cent nationally
- 80 per cent agreed or strongly agreed that they are able to make suggestions to improve the work of their department/team, compared to 78 per cent nationally.
In the development of the contestability arrangements for provider services, communication was vital, as well as having an ongoing dialogue between management and trade union representatives. There were some challenges along the way but a special ‘time out’ was held, to have a candid and constructive discussion on the issues that were of concern to staff side colleagues. This led to the development of an information sharing protocol and a JNCC part b agenda item for ‘commercial in confidence issues’.
Top Tips from Knowsley PCT
For successful partnership working:
- recognise and respect each other's perspectives
don't overcomplicate it
- have a clear vision and shared value - patients and high-quality care
- use the staff survey to inform your HR strategy and evidence the benefit of partnership working
- use the national enablers - NHS constitution, NHS social partnership agreement
- talk as soon as problems emerge – do not leave them to grow and fester
- deliver on your respective agreed actions and if you can’t, explain why
- agree to disagree at times
- provide staff side facilities to carry out their roles
encourage partners to bring new ideas to the table - partnership can bring innovation.
and what to avoid:
- don’t try to over-manage the staff-side chair – they are not part of the management team
- don’t rely on good relationships between the HR director and staff-side chair – the partnership needs to be sustained at all levels of the organisation
- don’t forget to communicate joint achievements and successes
- don’t ignore the staff survey findings – they are an opportunity for joint action.
Further information and contact details
For more details about partnership working at Knowsley PCT, contact