About Oxleas NHS Foundation Trust
Oxleas NHS Foundation Trust was originally formed in 1994 as Bexley Community Trust and has grown to become both more specialised in the services it provides and geographically widespread.
It has been providing mental health and adult learning disability services in both Bexley and Greenwich since 1995 and, in 1997, it took over mental health services in Bromley. The name Oxleas was taken in 1995, after the ancient Oxleas Woods which borders Bexley and Greenwich and continues to be a central point to the areas care is provided in.
In 2001, the trust began providing child and adolescent mental health services across the three boroughs. The specialist forensic mental health services have also grown and now provide services at HM Prison at Belmarsh.
Oxleas became a Foundation Trust in May 2006, following several years as a high-performing NHS Trust. In 2007 it began providing adult learning disability services in Bromley-the Trust is now the main provider of mental health and learning disability services across the boroughs of Bexley, Bromley and Greenwich.
It currently employs 2028 staff and is within the London strategic health authority.
Contents
Background
What Oxleas did
Key steps at Oxleas NHS Foundation Trust towards staff engagement
The results
Top tips for other trusts
Contact details
Oxleas Foundation Trust have made concerted efforts, in partnership with staff side representatives, to enhance their performance in the NHS staff survey key findings that relate to the NHS Constitution, staff pledge four around staff engagement.
Pledge four states:
“to engage staff in decisions that affect them and the services they provide, individually, through representative organisations and through local partnership working arrangements. All staff will be empowered to put forward ways to deliver better and safer services for patients and their families.”
The improved staff survey responses have resulted from a focused effort by Oxleas to highlight those areas where the trust has “underperformed”. Each year the NHS staff survey results get reported to the executive, the main board, the Staff Partnership Forum and the workforce governance group. They are also presented to the Senior Staff Forum, which is made up of senior managers and the heads of professions. The discussions within these fora identify the worst performing issues (currently safety and PDR’s) and develop action plans.
Results are also broken down into directorate levels, so each directorate can take ownership of their results and develop some pride in any improvements in performance.
The impressive performance of the trust in areas relating to staff engagement goes right back to 2002, with the appointment of a new chief executive. The arrival began a series of new initiatives including, breakfast and lunch talks with staff members. Engagement with staff representatives was then enhanced with the commencement of the Agenda for Change” pay modernisation process.
The staff side convener’s role was consolidated with a Head of partnership working role, to create a full time position. The Head of partnership working is line managed directly by the chief executive, this allows for a very open relationship with the director of HR & OD. Regular scheduled meetings are arranged between the head of partnership and each service director, embedding consultation at the highest levels of management.
Deficiencies in the HR function were also identified and addressed. New structures were developed, with more engagement both with line management and with staff side. Solution-focused processes were implemented, based on a more professional relationship between HR, line management and staff side, working in partnership, to examine issues such as capability. All of these changes have set a clear example of good practice that is being adopted by line managers at all levels across the trust.
The new culture of engagement was not without its problems; it was recognised that what was happening at a corporate level was not always replicated down the line, where traditional, and occasionally confrontational, relationships persisted.
Whilst directorates had signed up to partnership working, some individuals were uncomfortable with this new approach. Therefore, a formal partnership agreement was developed in 2008, to ensure this was acknowledged as the trust template for relationships.
To assist in embedding a long-term cultural change, the Head of partnership working and the HRD give a joint presentation on partnership working at corporate induction. Staff side have become involved in governance issues, such as performance and development and workforce governance.
The Head of partnership working, in partnership with HR managers developed focus groups, to ensure that staff felt they had a means of discussing issues that were important to them and feeding them back to managers for action.
Despite the impressive staff survey results, improving staff engagement is still part of a longer term strategy. Efforts are being made to continue the roll out of focus groups, to ensure they are firmly embedded at all levels within the organisation.
As the trust embarks on a period of large scale change the active and early engagement of staff will be critical and this will form a key part of the staff partnership work in the future. There are plans to increase partnership working capacity, both within HR teams and staff side, with particular reference to workforce planning.
Partnership working will also be included on the agenda of future leadership and management training programs and there will also be further joint training on mediation.
- very visible senior management and Chief Executive who "walks the floors"
- staff induction led by chief executive, HR director and head of staff side
- a partnership agreement
- joint policy writing
- pre-consultation talks
- team briefings whenever there is something to say
- fortnightly e-bulletin
- bi-monthly trust paper
- intranet that offers staff and clinical support/relaunched website
- focus groups run by the Head of Partnership Working & HR managers
- head of partnership is also 50% chair of staff side
- chair of staff side meets all service directors on regular basis
chief executive attends partnership forum
Oxleas have been rewarded with a series of impressive results in the 2008 NHS staff survey, the outcomes from a series of initiatives taken after the recognition in 2004/2005 that there was insufficient engagement with the staff of an expanding NHS organisation:
KEY FINDING 30
Percentage of staff agreeing that they understand their role and where it fits in
68% of staff at the trust agreed with at least three of the following four statements - that the trust communicates clearly with staff about what it is trying to achieve, that they personally know how their role contributes to this, that they know how the trust contributes to what the NHS is trying to achieve and that they understand the national vision for the NHS.
The trust's score of 68% was in the highest (best) 20% of mental health/learning disability trusts in England. These questions were not asked in 2007.
KEY FINDING 29
Percentage of staff reporting good communication between senior management and staff (the higher the score the better)
47% of staff agreed with at least four of the following six statements - that they know who senior managers are, that senior managers communicate effectively with staff, that they try to involve staff in important decisions, that they encourage staff to suggest new ideas for improving services, that they act on staff feedback and that healthcare professionals and managers in non-clinical roles work well together.
The trust's score of 47% was in the highest (best) 20% of mental health/learning disability trusts in England. (These questions were not asked in 2007)
KEY FINDING 31
Percentage of staff able to contribute towards improvements at work
79% of staff at the trust agreed with at least two of the following three statements - that they are able to make suggestions to improve the work of their team, that there are frequent opportunities for them to show initiative in their role, and that they are able to make improvements at work.
The trust's score of 79% was in the highest (best) 20% of mental health/learning disability Trusts in England. These questions were not asked in 2007.
Improvements in staff engagement also appear to have led to increased job satisfaction:
KEY FINDING 32
Staff job satisfaction
Staff were asked questions about how satisfied they are with various aspects of their job including:
Recognition for good work; support from their immediate manager and colleagues; freedom to choose methods of working; amount of responsibility; opportunities to use their skills and the extent to which the trust values their work.
Possible scores range from 1 to 5, with 1 representing very unsatisfied staff and 5 representing very satisfied staff.
The trust's score of 3.77 was in the highest (best) 20% of mental health/learning disability trusts in England.
It is also a statistically significant increase since 2007 (i.e. a better score than in 2007), when the trust scored 3.61.
Increased job satisfaction then leads to a reduced number of staff intending to leave their jobs at the Trust:
KEY FINDING 33
Staff intention to leave their jobs
Staff were asked questions to assess the extent to which they are considering leaving their trust and looking for a new job, either within or outside the NHS.
Possible scores range from 1 to 5, with 1 representing staff who have no intention of leaving their jobs, and 5 representing staff who are very keen to leave their jobs.
The trust's score of 2.43 was in the lowest (best) 20% of mental health/learning disability trusts in England. It is also a statistically significant decrease since 2007 (i.e. a better score than in 2007), when the trust scored 2.53.
Staff engagement and job satisfaction can also be measured in other ways, the number of tribunal applications since 2006 has fallen dramatically and no case has gone to full tribunal, resulting in a considerable saving to the trust in legal fees. The overall number of grievances across the trust in 2008/09 is now less than those raised in a single directorate in 2005/06.
What to do and how to do it
- build strong working relationship between HR & Staff side
- ensure staff side have regular meetings with senior management to build a level of mutual trust
- develop an open management culture with opportunities for staff to access senior management
- buy in from Board and senior executives as to importance of staff partnership working and staff engagement
- regular feedback of results to management from local focus groups as well as national staff surveys
- engagement of staff side colleagues as early as possible in change programmes
ensure that managers are trained and empowered to lead and thus be better able to respond to the challenge of staff engagement and partnership working.
What not to do and why
- an HR/staff side initiative on its own will not succeed, senior management must be engaged and willing to listen and act on feedback
- make assumptions that communication has worked without checking it has!
create a post without understanding the organisational context in which it sits, how and to whom it reports and what are the plans and expectations for delivery
cling to old structures and formats that have inbuilt division and unnecessary process which ultimately hinders real partnership working
- rely solely on a few key relationships without backing them up with a wider cultural and organisational shift in thinking, expectation and action
For further information regarding staff engagement at Oxleas NHS foundation trust contact:
Management side
Simon Hart, HR Director
Simon.Hart@oxleas.nhs.uk
Staff side
Wendy Lyon, Staff Side Convener/Head of partnership working Wendy.Lyon@oxleas.nhs.uk