Health and social care staff experience: report 2019

Team Stories

Introduction to Team Stories

Team Stories are a vital part of the iMatter programme. They illustrate the way in which individuals and teams have come together to review the results and share thoughts and ideas in order to develop and implement Action Plans. Team Stories give best practice examples of how to address challenges that may be experienced by many teams. They therefore provide inspiration and ideas for other teams and for the organisation as a whole.

Team Stories are analysed in this section of the report with illustrative examples. Team Stories are incorporated elsewhere in this report, where they demonstrate how teams have addressed challenges in specific areas (e.g. response rates, long term trends, individual Staff Governance Standards etc.) A link to all Team Stories can be found on the Picture Boards in Appendix 2.

As was seen last year, Team Stories are demonstrative of the range of focus areas and actions that iMatter influences. In total 37 Team Stories have been submitted, 13 more than were put forward in 2018. They represent 15 NHSScotland Boards and include 11 Health and Social Care Partnership stories.

Health and Social Care
NHS Education for Scotland	NHS Health Scotland
The State Hospital	NHS Highland
NHS Lothian	NHS Lanarkshire
NHS Greater Glasgow & Clyde	NHS Orkney
NHS 24	NHS Tayside
NHS Borders	Scottish Ambulance Service
NHS Dumfries & Galloway	Golden Jubilee Foundation
NHS Grampian

 

HSCPs
Inverclyde (NHS Greater Glasgow & Clyde)
West Dunbartonshire (NHS Greater Glasgow & Clyde)
East Dunbartonshire (NHS Greater Glasgow & Clyde)
Angus (NHS Tayside)
Orkney HSCP
South Lanarkshire (NHS Lanarkshire)
North Lanarkshire (NHS Lanarkshire)
Dumfries & Galloway HSCP

It is notable that a number of the Team Stories are written against a background of change. Whether linked to personnel, organisational or working practice, change can cause uncertainty from which other issues emerge, such as lack of confidence, apparent lack of communication, workplace feelings of stress etc. Many stories start from a period of change, recognise the impact on the team and then move forward to turning that change into an opportunity for improvement as the example below illustrates:

The migration to the new hospital has put strain on NHS Orkney, making the need for teams to work well together and for roles and responsibilities to be clear even greater. With new team members the Organisational Development Team need to be proactive in establishing and strengthening their team:

“Team Development day was well spent mapping out roles and responsibilities, it included a lot of fun during the day – which continued on into the evening!”

NHS Orkney, Organisational Development and Learning. Knowing me, Knowing you

Summary of themes

Across the 37 stories there are a wide range of topics addressed and differing approaches to how Action Plans are developed and implemented. The format that stories are presented in also vary considerably demonstrating again how each Team Story is owned by, and is a reflection of, that individual team. 

In broad terms the following themes recur through the Team Stories. Each of these are explored in more depth in the following sections of the report:

• Staff wellbeing
• Collaboration and communication
• Teamwork
• Long-term commitment to improvement
• Outcomes beyond iMatter
• Improving the iMatter process

Staff Wellbeing

It is positive to see many stories focusing on staff wellbeing. In addition to the examples here, the topic is further explored in the Staff Governance Standard – My Organisation section of the report, through a powerful team story from the Scottish Ambulance Service.

An example of a proactive approach to understanding and improving the staff experience is provided by the Drum Ward, who have used an accessible approach to enable staff to be open about how they feel:

As a direct result of ‘poor’ scores for ‘experience as an individual’ the senior team has adopted the ‘Joy at Work’ programme for the Drum Ward. The programme focused on supporting staff health and wellbeing and has led to the Drum Ward team having an emotion board through which staff have an open opportunity to share and discuss their feelings.

NHS Grampian, Mental Health & Learning Disabilities Drum Ward. Team Journey

Sometimes it is simple things that can go a long way to supporting staff as illustrated in the Bee Happy at Work story:

“We are also making a conscious effort to spend lunch together allowing for time for social interaction with colleagues and building relationships….Looking after each other means we are better equipped to look after and support NHS Borders Staff.”

NHS Borders Work and Wellbeing – Occupational Health Team – Bee Happy at Work

The Domestic Services team at Raigmore Hospital started their iMatter journey in 2015, initially getting staff engaged in the programme. They firstly invested in training to improve communication skills and are now moving on to focus on staff wellbeing:

“Through working together we have now developed a workplace culture that fosters team work allowing us to set clear goals and agree objectives with our individual teams and wider service users.”

More recent focus has been on raising the team profile across the organisation and continued skills development of the team.

For 2019 the priority is the importance of happy staff:

“We began to think about mental health and wellbeing within the workplace, understanding how to deal with it positively and how to support each other.”

NHS Highland Domestic Services Team – Our Services Matter

Collaboration and Communication

Similar to last year, many team stories focus on how to improve communication and collaboration within teams, across teams or with senior management. There is a recognition that proactivity is needed, as illustrated by the example below: 

The Community Children’s Nursing Team took a very pro-active approach to improving two-way communication between their team and senior management.

The team identified a two-way knowledge gap between the team and senior management 

“who were they and what did they know about us as a team.”

Various actions were taken to engage with the senior team, including inviting them to meetings, running Q&A sessions and having regular informal ‘back to the floor’ sessions

North Lanarkshire HSCP, Integrated Nursing Service. Our iMatter Journey

Teamwork

Again, as last year, many stories demonstrate how teamwork has been improved, whether within the individual team or through greater understanding and collaboration across teams. The three examples below come from NHS Education for Scotland and illustrate different aspects of team building:

1. Celebrating Diversity 

“The diverse mix of our team members is also very helpful – we have a range of experiences, backgrounds and ambitions, and everyone is happy to share and learn from each other.”

NHS Education for Scotland, CPD Connect Team. Better communication means better staff experience

2. Raising awareness of the team and what it does, by using new solutions to do so

“Our aim is to increase knowledge and awareness of the team’s activities, both within the NES organisation and externally…. maximising opportunities to showcase the team's work… new ways to network with key partners and would like to make more use of digital and social media in the future.”

NHS Education for Scotland, Oral Health Improvement Team. Raising the profile of the team

3. Dealing with the additional challenges of a dispersed team, recognising the increased need for two-way communication that this can present. This example demonstrates the importance both of speaking up and of listening:

“We introduced a weekly stand up every Monday to allow the whole team, from all offices, to hear and share the key areas of work for the upcoming week … they have improved awareness and transparency around priorities across the team.. allowed team members to become involved in decisions within the team, give and receive feedback on matters of priority to them or the team.”

NHS Education for Scotland – Pharmacy Team – Improving communication across the team

Long-term Commitment to Improvement 

Several of the stories track iMatter performance over time of response rate, scores or both. These show the importance and value of remaining committed to a specific course of action over extended periods of time in order to achieve sustained improvement. They also illustrate how it can sometimes take time for changes in behaviour to have an impact on performance and scores. Several stories highlight progress over 3 or 4 years of the iMatter programme, demonstrating the value of continued focus in driving sustained change. In addition to the examples below, another further Team Story is included in the EEIsection of this report.

The story from Stracathro Hospital below demonstrates how continued focus can have huge impact on scores:

The team have focused on one individual Component:  I have sufficient support to do my job well. In 2017 it scored 50, alongside an EEI of 57. Through open communication and clarity around roles and responsibilities they have seen the Component rating rise to 92 this year and an EEI that is now 92. 

Angus HSCP, Social Therapy and Recovery Service. Our iMatter Journey

The story below from an East Dunbartonshire HSCP team shows how the development of their intranet set has contributed to long term improvements both is response rate and EEI score:

‘Keep connected in Oral Health’ developed an intranet site, through which staff are able to get involved and see their contributions listened to and acted on. It has helped achieve continued increases in both response rate and EEI as well as having wider benefits for the team.

“The site is intended to be a resource that supports all staff by providing a variety of information and guidance on the services within oral health as well as a range of useful links and documents and has been found to be a very effective resource for staff induction.”

East Dunbartonshire Oral Health Directorate HSCP, NHS Greater Glasgow and Clyde

Improving the iMatter Process

Several team stories focus in on actions taken to improve the way in which iMatter is approached within their teams. For some this starts with a very honest reflection on staff scepticism towards the value iMatter. For others it is a recognition that awareness of iMatter is low and engagement with it is limited. Actions put in place to address these concerns show great results in raising the profile and importance of iMatter to those teams. Examples of these stories are also included within the Response Rates section of this report.

The Person Centred Improvement Team faced a positive challenge. For the last 3 years they have achieved 100% for My Team/My Direct Line Manager. This has led to some reticence towards iMatter:

“Feels like a tick-box we’re having to think about how we could improve things when we’re happy with the way the team works.”

“What’s the point? It just tells us the same thing every year.”

“We’re too busy to be taking time out to do something we don’t feel is of any value.”

In order to maintain the positivity, the team used the patient-focused ‘What Matters to You?’ initiative, testing the creative feedback model to explore how to overcome perceived barriers and ensure the whole team was able to contribute meaningfully to the Action Plan development process 

The State Hospital, Person Centred Improvement Team. Building Thoughts: Connecting Blocks

Outcomes Beyond iMatter

A number of stories refer to team Action Plans that were developed to address a specific area of iMatter performance and go further to have a considerable onward benefit to wider team performance (KPIs, patient care etc.). The example below illustrates this point well:

In 2018 the team scored 62 for ‘My team works well together’ and set about identifying their team values to drive their team culture. These values became a part of everyday life and led to a 2019 score for ‘My team works well together’ of 97; a huge increase. The additional outcome of this improvement was record highs in performance on all KPIs such as staff absence, products on time, right first time etc. It is notable also that this team remains committed to maintaining “this positive culture and further improve the team’s joy at work.”

NHS Lothian, Radio pharmacy, Royal Infirmary of Edinburgh. Improving Culture, Improves Performance

Best Practice in Communicating Messages

Every story is unique and each is an illustration of best practice and a focus on improvement. Each story can provide other teams across Health and Social Care with ideas that they can take back into their own teams. Often those that use visual illustrations such as this example, are powerful and can easily be adapted to be of value to other teams across the organisation:

“Sometimes it feels like we have to climb a mountain. It’s much easier to get to the top each day if we use the tools, resources and support of colleagues… There are many routes and after obstacles to overcome on the path.”

The mountain was pinned on the noticeboard and each team member put footprints on where they are on their journey. This will give the team a shared view of their current position and will be valuable to track over time as they work towards the ‘peak’

NHS Health Scotland, HWL Advice Line. Climbing a mountain

Summary

It is encouraging to see the increase in the number of Team Stories put forward this year. Each story is unique to its authors, both in the topic it addresses and the format it is told in. Many stories demonstrate considerable personal commitment from the team, along with creative and innovative approaches to developing solutions.

The Team Stories provide other teams with examples of best practice actions along with ideas and inspiration for how to address challenges they may be facing.