Coventry Teaching Primary Care Trust
Coventry Teaching Primary Care Trust (PCT) is part of the West Midlands Strategic Health Authority region and employs 1522 staff. It provides community nursing and school nursing services for over 300,000 residents and provides speech and language therapy, physiotherapy, foot health, sexual health, dental care, psychological, learning disability, occupational therapy, palliative and intermediate care and child and family healthcare. A Walk-in Centre and GP out of hours service are also provided.
Partnership arrangements
Until the establishment of the Agenda for Change project team in 2004, employee relations within Coventry PCT focused almost entirely on the rigid, formal Joint Staff Committee (JSC) meeting structure. This structure, whilst enabling two -way communications to flourish, did little to foster innovation or joint consideration of issues and how to address them practically.
However, the Agenda for Change project team promoted partnership working as a core element to planning, job evaluation and assimilation and, where appropriate, local decision making on the implementation of national terms and conditions.
During 2006 and early 2007, widespread restructuring took place across the PCT in the wake of financial difficulties. Whilst this led to pressures within employee relations, it also led to closer working partnerships being forged between staff representatives, HR managers and many of the PCT line managers, in dealing with organisational change. Partnership working at this time was undertaken within a negative context, with low staff morale across the PCT reflected in the 2006 staff survey results.
Revising committee arrangements
To address the cultural difficulties arising from the widespread restructuring, it was agreed to revise and refresh the JSC arrangements. It was agreed to alternate formal JSC meetings with two sub-group meetings:
- one within community health services
- one covering commissioning and corporate issues.
These sub-groups enabled an open dialogue covering operational issues directly affecting staff and managers in their respective areas. Although less formal than the full JSC meetings, the sub-groups have jointly developed agendas, and minutes are considered at each full bi-monthly JSC.
The staff survey action group
In May 2007, a Staff Survey Action Group (SAGG) was created, initially to address the 2006 staff survey results, which showed that:
- only 18 per cent of staff felt that the different parts of the PCT communicated effectively with each other
- 52 per cent of staff had not had an appraisal or Personal Development Review (PDR) in the previous 12 months
- only 21 per cent of staff had agreed a Personal Development Plan (PDP)
- only 36 per cent of staff believed that direct care of patients/service users was the trust’s top priority
- line managers lacked consistency in dealing with staff issues, for example, sickness absence, and in applying HR policies and procedures.
The SSAG includes three staff representatives, a communications manager; HR and line management representatives; and the director of HR and OD as chair. It reports directly to the Joint Staff Committee (JSC), with monthly feedback to the PCT board.
The 2006 staff survey was undertaken during the intense period of restructuring within provider services and further reorganisation of corporate and commissioning services. Both management and staff representatives recognised that a joint partnership approach, through forming the SSAG, was necessary to tackle the fundamental issues highlighted in the staff survey.
Increasing staff involvement and improving communications
A number of initiatives were introduced, designed to increase staff involvement and improve communications:
- 40 ‘communications champions’, maintaining department communication folders containing weekly updated organisational/ departmental information, including descriptions of the PCT services
- a re-formatted electronic staff newsletter, produced weekly
- senior managers mandated to attend bi-monthly chief executive team briefings, and cascade information to staff within two weeks
- a ‘you say we say’ intranet page enabling staff to ask questions over services, HR issues; responses provided within seven days
- an annual awards evening with individual and team awards, ‘hosted’ by the PCT chair
- 250 managers/supervisors attended the ‘Help Me, I’m a Manager’ course constructed by staff representatives and managers, providing consistent messages relating to HR management, communications and ‘management style’.
Listening to and valuing our staff project
In June 2007, a partnership project called ‘Listening to and valuing our staff’ was launched, with a jointly constructed action plan. This covered four specific, but linked themes:
- improving communications to all staff
- valuing our staff to support patients
- appraisals - a must do
- promoting quality training.
For each theme, actions with measurable or identifiable outcomes were developed by the project team, and reported monthly to the JSC, as the project board.
The team met bi-monthly to consider suggestions that were put forward. The time scale agreed for implementation was nine months, to March 2008. After the nine months the actions agreed by the project team and JSC would be evaluated jointly.
Each targeted theme was evaluated separately by:
- auditing the communications initiatives implemented
- feedback from managers on related training provided
- monthly monitoring of PDRs completed.
As the SSAG had been formed following concerns over the 2006 staff survey results, it was important to compare results from the subsequent surveys in 2007 and 2008. The table below provides the comparative results for this three year period covering key performance indicators included in the ‘HSC Vital Signs’, introduced nationally in 2007, and those question areas which formed the initial focus for work undertaken locally during the period by the SSAG.
Staff survey results
|
Key performance indicator question |
2006 |
2007 |
2008 |
|
Overall response rate |
51% (53.6) |
53% (54.5) |
68% (57%) |
|
Trust committed to achieving a good work/life balance. |
39% (50%) |
48% (49%) |
56% (51%) |
|
Received an appraisal in last 12 months*. |
48% (71%) |
61% (64%) |
73% (66%) |
|
Staff have clear planned goals. |
58% (67%) |
61% (64%) |
53% (56%) |
|
Staff cannot meet conflicting demands. |
44% (45%) |
41% (43%) |
41% (43%) |
|
The Trust values your work. |
26% (33%) |
29% (30%) |
39% (34%) |
|
Senior managers involve staff. |
35% (30%) |
32% (29%) |
38% (32%) |
|
Care of patients is top priority*. |
36% (51%) |
43% (47%) |
58% (55%) |
|
Experienced work related stress during the last year. |
32% (33%) |
29% (32%) |
26% (28%) |
|
Different parts of the trust communicate effectively*. |
18% (24%) |
19% (19%) |
28% (21%) |
- figures in brackets are the national median scores
- questions marked * linked specifically to SSAG work ‘themes’.
As the percentage responses indicate, there has been a general and growing improvement across the key performance indicators, particularly relating to those issues covered by the SSAG. Although training is a key area covered by the SSAG, most questions relating to training in the survey focus on specific training areas. However, 52 per cent of PCT staff agreed in response to the newly introduced question in 2008, that ‘there is strong support for training in my area of work’, against the 50 per cent national average response.
The SSAG has established a plan for future work, to make sure that the improved results in the 2008 staff survey are continued, and to focus on those areas where the survey results indicated that the PCT was behind the national average or had particular weaknesses.
The latest jointly agreed action plan comprises a range of initiatives including:
- creating a draft policy web link to enable staff and managers to provide comments, and provide a synopsis of all new or revised policies following sign off by the PCT board to improve communication and understanding
- development of a checklist for managers to include items such as completion of all staff appraisals; fulfilment of staff training needs identified in PDPs and team briefs undertaken. Each checklist to be incorporated within managers’ PDR documentation
- expansion and devolvement of 360º appraisal process initially to all Band 8 employees to enhance feedback to individuals. Assessment questionnaire to be developed for newly appointed managers
- an induction pack to be introduced covering equality and diversity, and an e-learning programme to be launched for all employees.
The PCT is also progressing a review of options, through staff focus groups, relating to well-being and this work will be monitored and reported to the SSAG. The improvements made in staff involvement and communication could not have been delivered without management and staff side working together to tackle the issues raised in 2006, through the SSAG. This included a willingness to be innovative and to consider new ways of tackling the problems.
Top tips from Coventry
For successful partnership working:
- informal is better than formal - make sure discussion takes place, wherever possible, at local level, not just at the top table
- one size does not fit all, adapt the structure to fit the individuals
- provide staff side facilities, so they can engage in partnership
particularly early on, look for easy and quick gains
- involve managers and staff representatives who want to make a difference as part of a joint team.
And what to avoid:
- don't promise what you can't deliver
- don’t agree unrealistic timescales.
Further information and contact details
For more details regarding partnership working at Coventry Teaching PCT contact: