NHS Tayside Transformation Support Team: second progress report

AAG Recommendation 7 – Engagement

"In order to continue to ensure safe and effective services for the people of Tayside in a challenging and changing environment, the Board must ensure early, meaningful and sustained engagement in partnership with its staff, its stakeholders and moreover the public and political representatives."

NHS Tayside's Assessment

"Significant progress has been made with staff and partnership engagement leading to the sign-off by the Employee Director and Chief Executive of a refreshed Partnership Agreement in November 2017. All Area Partnership Fora ( APF) reporting is now jointly presented and a short life working group is continuing to enhance ways of working and gather collective feedback. This has built upon the refreshed schemes of delegation for Local Partnership Fora agreed in August 2017. In September, the Employee Director and Director of Human Resources and Organisational Development started holding open conversations with staff, which has provided a route for staff to engage directly with NHS Tayside's senior leaders. This has allowed for the speedy resolution of any issues and the identification of service improvement suggestions, whilst further informing staff of activity to develop the organisation's culture. This partnership approach is being adopted by the Programme Management Office and will continue as a 'business as usual' practice.

In July, an Executive Review Team was established which includes senior management and partnership representation. The Team have daily huddles to discvuss and promote collective leadership for the 10 recommendations.

Staff side lead engagement on the Transformation Programme Board commenced in August 2017 and meetings are now an open forum, with papers published on NHS Tayside's website.

Communications with both staff and public have been enhanced. A weekly Transforming Tayside progress update is issued to staff with signposting as to how to get engaged with the Transformation Programme. A newsletter is also issued and available on NHS Tayside's website, along with the Transformation Programme Board papers and the Assurance and Advisory Group's progress report.

As outlined in the section relating to recommendation 3, three sessions have been held with involve. Sessions were held on 21 October 2017 with the Integrated Clinical Strategy team to help understand and appreciate new and innovative approaches to engagements and involvement of key stakeholders. A session was also held with colleagues from Health and Social Care Partnerships and other staff working within the engagement field to help develop a mutual and common understanding of what will need to be put in place to help develop the robust approach to engagement to support the Integrated Clinical Strategy. At the Board Development Event on 30 November 2017, involve ran a session to highlight the important issues to consider in developing engagement and consultation for the Integrated Clinical Strategy.

The Chairman, Chief Executive and Directors are actively engaging with key stakeholders including MPs, MSPs, Local Councillors, Local Authority Chief Executives, Scottish Government colleagues and other key organisations.

Next Steps

The Local Partnership Fora engagement with Directorate Resource Allocation Budget Planning will continue during January to March 2018. This will ensure a financial plan for 2018/19 and beyond is completed in partnership and aligned to workforce plans, NHS Tayside's one-year plan and key transformation activity for 2018/19. Following on from the refreshed APF Partnership Agreement, a series of facilitation exercises, sponsored by the APF co-chairs, are planned and will be completed by March 2018.

involve will continue to work with the Integrated Clinical Strategy Team, the Communications and Engagement teams and the newly established Communications and Engagement Reference Group to help develop a robust approach to engagement with staff, the public and all key stakeholders. Ongoing regular quarterly update meetings with local MPs and MSPs will continue."

TST comment

The TST endorses the Board's assessment that significant progress has been made in relation to engagement with all key stakeholder groups. Building on the improvements to transparency and communication which were highlighted in our September report, NHS Tayside has continued to make progress in developing its approach to stakeholder engagement over the last three months. We have seen the focus shifting from increased transparency towards relationship building; both important aspects of the trust which underpins authentic engagement.

In addition to the revised Partnership Agreement, steps have been taken to ensure that staff representatives are fully informed, involved and able to contribute to the whole range of senior level activities across the Transformation Programme. This includes the identification of workable solutions, shared decision-making and shared responsibility for ensuring the effective delivery of outcomes. The central role of the Vacancy Management Group in influencing key workforce decisions is a good illustration of how that is working in practice.

The work which is now well underway to roll out active Local Partnership Fora, to take a more active role to support service level and local change, will complement the work at Board level, allowing the Area Partnership Forum to focus on more strategic issues.

These structural changes are a necessary and timely development. However, having a sound structure in place alone will not in itself lead to productive partnership working. That also requires regular, open conversations and a culture of respect between management and staff-side that allows for an honest and responsible approach to difficult conversations. Following in-depth conversations with both parties, we believe that there is a genuine aspiration to improve this relationship, and though it is still to be fully tested in the crucible of change, we are seeing some positive indications of joint-working.

As the commentary against recommendation 3 makes clear, we recognise the notable progress that has been made to date in developing the ICS as a framework for transforming services. To ensure that the valuable work done to date with the clinical communities really bears fruit, the Board must move swiftly to bring wider groups, such as patients, their families, carers and the wider public, into the conversations – as informed and active participants.

In recognition of this, we note the commitment by NHS Tayside to secure expert help to plan and implement the next phase of its Engagement Strategy; to provide constructive challenge on where and how to seek and use public engagement inputs; to provide guidance on innovative approaches to engagement and to help upskill core staff and embed good engagement practices across the organisation.

Going forward, we would like to see NHS Tayside continue to build on the networks that already exist with partner organisations, in particular Local Authorities and IJBs, to share local knowledge and tap into existing resources in relation to effective engagement.

We would also hope to see this open engagement culture embedded right across the organisation so that everyone sees engagement with patients and members of the public not as a one off event but as a core and continuous part of their role.

TST rating in September 2017 = Amber
TST rating in January 2018 = Amber