Health and social care staff experience: report 2018

Team Story Topics

In this section we explore in more detail a number of specific topics that have been highlighted through iMatter and are covered in several of the Team Stories. These would be applicable to large numbers of teams across the organisation.

The Communications Challenge: Finding Solutions

A recurring theme across the Team Stories is around communication and a recognition that getting the team together in a forum where ideas and opinions can be shared is important. Where possible to do, some have seen the value of getting whole teams together in one place:

"The team used to have three bases. It felt as though there were three teams not one…..(now) start the days from just one of the bases and all meet together…Passing on information face to face stimulates more discussion and conversation." NHS Lothian South East Community Midwives

While many Stories talk about the value of face to face meetings, Fife H & SCP Children and Young People's Occupational Therapy Service had to find an alternative solution as they were an integrated team spread across 4 geographical locations. This team has therefore embraced technology and fully utilised online meetings software to enable virtual sessions.

Through video technology and screen/document sharing facilities, the team are able to recreate the face to face meeting environment. This approach has the added benefit of increased efficiency through reduced travel time.

Team Cohesion

Throughout all of the Team Stories there are examples of how the team are working together more closely, making the most of the skills and experience within the team:

"What we do well: Work together as an adaptable and accommodating team utilising the skills of all of our team members to deliver a good pharmacy service." Golden Jubilee Pharmacy Team

"We have introduced fortnightly pharmacy peer review meetings. This is a chance over lunch for team members to lead a session and share learning." Golden Jubilee Pharmacy Team

"Two members of staff one, one from each award would prepare a team building activity to demonstrate skills and energise everyone prior to our Business Planning session…..The aim being to fully utilise the skills of all the team - communication, negotiation, creativity and have fun together." NHS Health Scotland Awards Team

There are also practical solutions put forward for dealing with the situation when the whole team cannot be together such as splitting the team into two or three sub-groups to workshop action plans and then share the feedback with the wider team.

Vertical Team Integration

There are a variety of examples of how iMatter has enabled teams to identify and address areas for improvement through working together. This has involved using activities such as meetings, huddles and training activities which have the added benefit of enabling junior/trainee staff get to see more of what the seniors do.

"We have adopted an inclusive approach to learning and development, for example our upcoming leadership development workshops "Better Conversations" include leaders and managers from across the H & SCP all learning, reflecting and practicing new skills together. This provides opportunities to build relationships and increase visibility." Inverclyde H & SCP

Several Team Stories talk about various techniques for integrating staff across the team including, staff inclusion in forums and encouraging them to share views with their union representatives.

Cross Team Activity

Several stories focus on the need to build stronger relationships across teams, to improve working relationships and improve the patient experience. This could easily slip into a mindset of 'not my team, not my problem'. However, several teams provide ideas on how to actively improve cross-team collaboration.

One story talks of achieving greater integration with other teams by getting involved through working groups etc. which in turn leads to improved communications:

"A broader knowledge of what is happening across NSS as well as making connections with colleagues working in different areas of NSS." NHS NSS Clinical Dental Team

Another acknowledges the need to work at inter-team relationships and a proactive, solution-focused action plan focuses on addressing the issues head-on.

"There was agreement that these frustrations were likely to always be there unless we tried to do something different. We would need to invest time to try and influence this." South Ayrshire H & SCP Dietetic Team

Team Leadership

Team leadership is a topic covered in many of the stories, demonstrating the importance of leadership in achieving team success. The qualities of good leadership are referenced in several Team Stories:

"Our Team Leader's door is always open. He is approachable and makes time to keep staff informed." Scottish Ambulance Service Shotts Station

"Professional leader in our team who we have confidence in to take forward any issues identified." NHS Grampian Programmes Team

"Our team does already have an open honest and professional approach to discussions and very much respect each other's views and contributions to team meetings. We are always listened to by our line management and always made to feel valued in our roles within the team. It was good to discuss the action plan as a team to take forward improvements identified." NHS Grampian Programmes Team

From Team to Individual

Several Team Stories make the transition from team actions to individual accountability, with agreed actions being taken on by individuals in their personal development plans. Once such example from South Ayrshire H & SCP Dietetic team focuses on the need to improve inter-team working.

"Each Dietitian identified their own improvement plan for the individual ward they had identified. This became their service improvement objective which every AHP member of staff was expected to have, as directed by the AHP Associate Director. A report setting out the situation, background, assessment and recommendation (SBAR) was completed by each member of staff and discussed with their line manager at their 3 monthly review." South Ayrshire H & SCP Dietetic Team

The example given was one of a team member carrying out an accurate assessment of the situation and then developing a set of personal development actions to implement that would make it easier for other teams to support them. This particular example not only showed how individual staff are taking ownership of team issues, but also a recognition that there is a collective responsibility to take actions to improve across teams.

Another illustration comes from NHS Greater Glasgow Clyde Sector Acute Division who have actioned a formal structured training programme for nurses that addresses many of the areas included within iMatter.

"The programme incorporates Attendance Management, Delegation skills, Finance, Minimizing Complaints, Managing Difficult Conversations, Recruitment and Selection, Emotional Intelligence, Team Development and Effectiveness, Managing Conduct and Quality Improvement. All key skills identified for being managers and leaders of the future."

The programme has had a positive impact on staff, who feel more empowered. It has also led to identification of further areas to be included in future training.

"Staff reported feeling 'more confident and empowered' for their role. They reported appreciation for the time out and focus given to their development. There was great feedback given that has allowed the course to be further refined and targeted to include resilience and business continuity under difficult circumstances." NHS Greater Glasgow Clyde Sector Acute Division

The Wider Organisation

Whilst the Team Stories are outstanding examples of teams taking ownership of their iMatter results and developing action plans that make a difference, they are typically from the smaller units within the overall organisation. This is reflective of the Action Planning process that starts at individual team level.

However, the areas that perform less well in iMatter, tend to be those that relate to senior management and interactions with the wider organisation.

"It felt like there was a gap that needed bridging between expectations of the organisation and the reality faced by QPS teams and staff." NHS Highlands Quality Programme Service Teams

The reference in this Team Story to 'the gap' highlights the perceived lack of understanding of challenges faced by staff. Improved communication will be key to addressing this 'gap'.

Senior Managers

The Team Stories contain two perspectives on senior managers, reflecting the importance of both trust in them and their visibility and accessibility through the organisation. There are examples of senior management teams initiating actions to be more accessible and approachable in their areas.

"I am keen to be much more visible and to meet up with you and your teams over a coffee." NHS Forth Valley Chief Executive Office Team

The approach to this is generally informal and open, which should in turn build confidence and trust among staff. For example NHS Lanarkshire Corporate Management Team have increased Director visibility by sharing names and photos of the team, writing personal blogs and doing 'back to the floor' walk-arounds.

There are also examples of staff exploring ways of getting more access to senior managers:

"We need to share our concerns with senior managers regarding the issues QPS teams faced on a daily basis." NHS Highlands QPS Teams

However, it is notable that in this particular example the reference is to the sharing of concerns, where perhaps there is an opportunity to not only share concerns but also to present suggested solutions.

"The issue of visible senior leadership in the organisation….suggested informal invitations to Directors to join our team meetings….a chance to chat and ask questions of senior managers that we might not interact with otherwise and that's been really positive." NHS Grampian Programmes Team

Some Team Stories do talk of senior management presence at meetings and events, which is certainly an important first step, but it is essential that this attendance is back-up with interaction, openness and action, in order that staff feel truly listened to and supported.

Recognition

A number of teams have instigated award processes to recognise achievements in areas such as:

• going the extra mile
• providing great care to the team and patients
• brilliant teamwork

They typically acknowledge small achievements, done by individuals - often a simple spoken word or gesture - not expensive, not time consuming but able to make a significant difference.

The recognition/award mechanism is often noted as an engagement process with large numbers of staff getting involved in nominations and award events. This demonstrates that whilst the individual winners love the experience, the wider team also benefits from the positivity.

The comments (below) illustrate this well from NHS Tayside Emergency Department and their focus on recognising and rewarding colleagues.

The NHS Western Isles Physiotherapy Team have a campaign running based on "Our focus is you!" which can be interpreted differently by whoever sees it, be they team members, visitors, patients etc. The recognition mechanism set up acknowledges that patient care and staff appreciation go hand-in-hand

"An appreciation board will be developed which will record these positive messages for all to see. These efforts will not only see improvements within staff morale, but will inevitably see considerable benefits to the patient experience within the Physiotherapy Department." NHS Western Isles Physiotherapy Team

The Ayrshire and Arran Oral Health Dental Diamond Award Programme launched by The Public Dental Services' Oral Health Improvement Team is a great example of how teams can influence and improve staff experience. Their awards programme engages staff interest staff throughout the team. It includes awards in the following categories:

• Care and compassion
• Helping Hand
• Encouraging Word
• Calm in the eye of a storm
• Excellence in humour and entertainment
• Outstanding innovation

The purpose of the awards speak to many of the topics covered in this report.

"Committed to ensuring all our staff feel valued, and recognise the important role they play in the provision of dental care."

This particular story was told through an excellent film introducing the awards to the staff. Click here to view the video. These awards are accessible to all as they are based on ways of working that anyone can deliver. They are in turn celebrated by the nominee, the nominator and all involved in the awards event.

Allen Stevenson, Head of Health and Community Care with the LD Redesign Team at our 2018 Staff Awards
Inverclyde H & SCP

Seeking Further Insight

There are several examples where teams felt they need to explore topics further within their teams. In the example below we can see how staff have been actively involved in the strategic plan development and therefore will feel part of the future of their team and that they are being listened to:

"We are currently co-creating our Strategic Plan with our staff through a staff survey, focus groups to explore our values, vision and priorities, and targeted discussions with groups whose views are traditionally not heard, for example homecare staff and residential care home staff." Inverclyde H & SCP

In this second example focus groups were conducted to get a better understanding of the actions needed. It's notable also that the focus groups themselves will have begun the journey of better communications with the senior team:

"We met again to discuss the focus group finding and these were pivotal in helping us shape our action plan to be taken forward in the coming year with support of our organisational development and communication team colleagues." NHS Lanarkshire Corporate Management Team

NHS Dumfries and Galloway Nithsdale Health and Social Care Locality Management Team carried out a survey on integration and partnership as well as establishing a multi-disciplinary team workforce forum and staff engagement sessions for the wider team.