DPT worked in partnership to completely transform their disciplinary, performance and grievance policies and procedures. They aimed to create an environment of transparency and fairness, where employees feel comfortable to speak up and confident that they will be treated justly. As a result of these changes, staff experience improved significantly, leading to enhanced quality of care.
DPT strives for an inclusive culture in which mental health and wellbeing are valued and understood. However, CQC feedback from 2019 noted that “the trust must take action to address the issues raised regarding the culture and ensure staff’s wellbeing is supported”. Feedback in 2020 identified that only 59 per cent of staff believed that teams deal with disagreements constructively. Alongside this, the number of suspensions for disciplinary matters was high. In 2021 the CQC provided feedback which included a comment that staff “did not feel able to raise concerns to senior leaders in the trust without fear of retribution”.
People professionals, senior leaders, and trade union reps agreed that the approaches taken in their people management procedures were leading to an unacceptable and negative experience for staff. They committed to a culture of high-quality and compassionate care across the organisation, using policy and procedure redesign as a key enabler for change. This would impact everything from clinical effectiveness and patient safety to staff health, wellbeing and engagement.
Trade union, clinical and people professionals established a working group in November 2021. Inspired by the NHS's focus on restorative, just and learning culture, they developed Promoting a Positive Working Environment policy and guidance documents. These documents replaced previous disciplinary, grievance, performance policies.
The language used in the new policy is exemplary and models the principles of restorative culture. It goes beyond other highly regarded policies in the NHS and provides an opportunity for DPT to be recognised as a centre of excellence. At a practical level, the new policy removed the option for an informal disciplinary warning or a colleague’s acceptance of a first written warning without a formal meeting, which were examples of an incongruous approach.
The role of partnership working
DPT held regular partnership meetings and established a restorative, just and learning working group to refine their vision and priorities. All partners worked together on the design of a new unified policy to replace previous policies.
The trust held a detailed joint review meeting with trade union reps to consider all ongoing employee relations situations. As an outcome of this approach, partners determined and communicated clear steps for transitional arrangements and guidance to all leading managers.
In partnership with working group members, the trust ran masterclasses on restorative, just learning for six months alongside immediate implementation of the policy and accompanying procedures in April 2022.
Results and benefits
The impacts of DPT’s joint working in comparison to 2021/22 are:
- Fact finding situations that recommend no case to answer, which accounted for 31 per cent of all disciplinary situations, reduced to zero.
- Formal concern meetings (disciplinary hearings) reduced by 50 per cent.
- Staff asked to take time away from work during an ongoing procedure (suspension), which accounted for 87 per cent of all restrictions in place, reduced to just 25 per cent of restrictions.
- In the 2022 NHS Staff Survey, the trust saw improvements in eight of the nine questions relating to the staff experience of their immediate manager.
DPT heard feedback from their staff:
- “I can’t say enough how good the restorative workshops were! The new policy and these workshops gave me the tools to address the problems (why) rather than just the symptoms (performance).”
- “I am so pleased that we are promoting psychological safety within teams, absolutely brilliant. Kindness matters so much, and I really like the new policy, well done to you and your colleagues on developing this, amazing work”.
- “Really good. Love the changes in language and how it still achieves what is needed but in a kinder and more restorative way.”
Several organisations are very interested in DPT’s work and progress. The language and design of their policy and procedure, achieved through partnership working, is set apart from other NHS organisations looking to strengthen a restorative just learning culture.
In March 2023, the largest employer in the county, Royal Devon University Healthcare NHS Foundation Trust, adopted the Promoting a Positive Working Environment Policy with very few adjustments.
Lessons learnt from the project
A partnership approach focussed on the same vision and strategy can bring about cultural change. This should lead to improved patient experience and higher staff engagement and ensure the organisation is a great place to work.
How the project will be sustained going forward
Together, people professionals, senior leaders, and unions will review the benefits and practical application of the policy and guidance.
For further information please contact Katharine Harris, Head of Organisational Development, Business Partnering and HR Advice, Devon Partnership Mental Health Trust.