Engagement 4 Improvement Framework 2012 - 2015

Transcription

Engagement 4 Improvement
Framework 2012 - 2015
“We want to make engagement everyone‟s business so that we
reach a better understanding and are more in tune with the needs
of all the communities we serve. Our Trust does not intend to do
this passively, peoples‟ needs are better met, when they are
involved in equal and mutual relationships with professionals and
others, working together to get thing done - by being „better
together”.
Kathryn Blackshaw, Acting Chief Executive and Chair of
Equalities, Engagement, Experience & Enablement Committee
(4Es)
Ratified version: Board of Directors 28.5.2012
Foreword
This document sets out the Engagement 4 Improvement for Derbyshire Healthcare NHS
Foundation Trust for 2012-2015. It outlines our plans for engagement for the next three years
and the priorities for action that will help us to embed engagement into the culture and
behaviours of our organisation. We want to develop and deliver fully inclusive and
compassionate services that we can be proud of, knowing that we have the confidence and
endorsement of the whole community in all its diversity. We want to make engagement
everyone‟s business so that we reach a better understanding and are more in tune with the
needs of all the communities we serve.
We welcome this framework as it will bring a range of benefits to the organisation and the
people of Derbyshire. It will inform our understanding of the individual patient experience,
carers, our community, staff and their health and wellbeing needs. It will underpin the work
we do and is key to achieving our vision “to improve the health and wellbeing of all the
communities we serve”.
Our goal is to ensure that stakeholder perception of our Trust is built on sincere engagement
by developing real, credible and open relationships based on a two-way meaningful dialogue
with all the people we serve, our partners and those who work within our services. We will
know if we have achieved our goal by demonstrating year on year improvements in our
service quality, engagement and experience and evidence of increased levels of confidence
and trust reported by all of our stakeholders.
Better outcomes
Better quality of life
better governance
better patient
experience
better recovery
Foreword
Meaningful engagement is the right thing to do – it will help us to be “better together”
because it contributes to:
a better
organisation
We recognise the need to develop an organisational ethos that places engagement and
experience at the heart of decision making and sets clear lines of accountability. In
order for this to happen in all aspects of our work we have decided to take a structured
and joined-up approach which will allow us to bring together - patient experience, staff
engagement and wider community engagement across the organisational levels. This
will ensure consistency, openness and assurance that views are actively sought and
acted upon within care delivery and inclusive practice throughout our Trust.
In January 2012, we launched the Equalities, Engagement, Experience and
Enablement Committee (4Es), which has created an exciting opportunity for joint
working with all our stakeholders and most importantly has
established clear routes to enable them to hold our Trust to
account for the delivery of the Engagement 4 Improvement
Framework, the NHS Constitution pledges and the Equality
Delivery System. Most importantly, it creates possibilities for joint
working, planning, innovation, development and better delivery of
services. This is an ambitious framework but one which will make
us close to the people we serve and work with.
Kathryn Blackshaw, Acting Chief Executive
and Chair of Equalities, Engagement, Experience
& Enablement Committee (4Es)
Engagement & Patient Experience Framework ratified 28.5.2012 updated Dec 2012 H Dhaliwal
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1 Introduction
1.1
This framework sets out the Derbyshire Healthcare NHS Foundation Trust‟s
commitment to engagement and patient experience so that our pledge and
approach to „sincere and deep‟ engagement with our stakeholders is clearly
understood. We recognise that in order for stakeholders to view our Trust as
genuinely engaging we need to develop sustainable relationships and create
an open, caring and compassionate environment built on mutual respect and
two-way dialogue with all the people we serve; our partners and those who
work within our services.
Last year a national equality performance framework called the Equality
Delivery System (EDS) was developed. The EDS supports NHS staff and
organisations to work closely with the communities they serve to deliver
services that are personal, fair and diverse; to champion continuous
improvement in the quality of patient services; promote good practice; and
support the NHS to implement the Equality Act 2010. The EDS has four goals
namely; Better health outcomes for all; improved patient access and
experience; empowered, engaged and included staff and inclusive leadership
at all levels. This fits in with our goals around engagement and we have
embraced the EDS through the active involvement of staff, public and
community organisations in setting objectives and monitoring of performance
for equality.
1.3 The public sector Equality Duty, part of the Equality Act 2010, is made up of a
„general duty‟ which is the overarching requirement and the „specific duties‟
which are intended to help performance of the general duty. The general duty
has three aims and it applies to most public authorities, who must, in the
exercise of their functions, have due regard to the need to:
• eliminate unlawful discrimination, harassment and victimisation and other
conduct prohibited under the Act
• advance equality of opportunity between persons who share a relevant
protected characteristics and persons who do not share it
• foster good relations between persons who share a relevant protected
characteristic and persons who do not share it.
Introduction
1.2
1.4
The NHS Constitution, lies at the heart of this framework- it is our duty to create
a culture where local people are armed with the power and knowledge to get
involved, participate in and influence our work.
Also the NHS Act 2006 places a legal duty to
involve patients and their representatives in
decisions about services.
1.5
We are committed to using engagement and
experiences of care as levers to directly
improve person-centred care. People will feel
more empowered by being involved and at
the centre of decision making and as a result
will have better experiences and achieve
better outcomes. Most importantly, we will
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have made a positive difference to the quality of peoples‟ lives by improving
social inclusion, fairness, hope, recovery and independence.
We will become a better organisation by building on our engagement and
relationships with all stakeholders. The Engagement 4 Improvement
Framework is one way of putting into practice our vision „to improve the health
and wellbeing‟ of all the communities we serve. It will ensure that the following
strategic aims and core values are being acted upon.
1.7
This framework is for all our stakeholders - service users, carers, staff,
governors, partners and the local and wider community in Derbyshire.
Introduction
1.6
1.8 We will:
use engagement and experiences of care as levers to directly improve the
quality of care, good experience and outcomes for all people. This will be
achieved by actively engaging and putting people at the centre of decision
making, promoting person-centred care, hope, recovery and social inclusion
reach out to our communities and create an environment that is open, built on
compassionate and caring relationships, where power is shared and values
such as, equal rights, equal dialogue (exchange of views, ideas and
concerns), dignity and respect are upheld
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demonstrate that everyone is included and that we proactively advance
equalities and promote good relations between different groups (Equality Act
2010)
work more closely with our partners and communities to learn more about
how we can best meet the needs of people from particular communities or
REGARDS groups. REGARDS is our way of remembering the 9 protected
characteristics as defined by the Equality Act 2012 - Race, Gender, Gender
Identity, Age, Religion/belief, Disability, Sexual Orientation, Marriage & Civil
Partnership and Pregnancy & Maternity.
raise awareness of the issues of mental health, stigma, discrimination and
inequalities, particularly for seldom heard or vulnerable groups
Introduction
ensure our staff are engaged; feel connected and have a good experience of
working for us.
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Our Approach
We have joined up the different strands of engagement activity that are currently
taking place e.g. patient experience, staff engagement and wider community
engagement. Horizontal and vertical embedding across our trust levels should
ensure that engagement is hardwired into our relationships, processes and
structures. This will ensure a solid approach across the organisation and enable us
to use and share resources, information and feedback to drive improvements and
ensure that care delivery focuses on the needs and preferences of patients, carers
and local communities.
Internal relationships/channels
External relationships/channels
Operational
Strategic
Patient experience activity “The lived experience”
Our Approach
Using engagement to drive improvements in service quality and outcomes
Patients and Carers
Consumers of our services
Service
Improvement
Staff
Community
Engagement
Partners, Public Members
Voluntary and Community
groups
We will know if we have achieved our vision by demonstrating year on year
improvements in our quality of care and outcomes, engagement and experience
activity and evidence of increased levels of confidence and trust reported by all of
our stakeholders.
This framework will be applied across the four organisational levels:
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Level 1
Level 2
Level 3
Level 4
Corporate
Division
or Service
Team,
Ward or
Service
Individual
This document is divided into a number of sections devoted to each engagement
strand and designed around the following key headings:
Our Approach
Why we are doing it?
What we need to do to achieve our goal and by when? (performance
measure)
How we will do it (the process)?
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3.1
Patient Experience
Why Engage with Patients and Carers?
Engaging with Patients and carers means that we have the opportunity to learn from
their feedback in order for their experiences to influence the ways in which services
are provided and improved upon. We do this by building on a „do with‟ approach
rather than a „do to‟. By using this approach we can be sure that the patient needs
are always at the centre of our service delivery improvement plans.
The Health Service Ombudsman‟s report, „Listening and Learning‟, described an
inconsistent and at times unacceptable approach by some NHS organisations to
complaints handling. Good complaints handling is really important in ensuring a
culture in the NHS where patients are listened to and organisations learn from
mistakes. NHS organisations must actively seek out, respond positively and improve
services in line with patient feedback. This includes acting on complaints, patient
comments, local and national surveys and results from “real time” information
gathering such as internet based questionnaires, discussion forums or paper
surveys.
Patients and carers should feel that services are integrated and co-ordinated and
this should form part of survey questions. The Government announced in its
response to the NHS Future Forum on 20 June 2011 that it would introduce a “Duty
of Candour”, a new contractual requirement on providers of NHS funded care to be
open and transparent with patients and service users in admitting mistakes.
3.2
What we need to do to achieve our goal
The performance measures we will use to demonstrate delivery of outcome/s from
2012 -2015
Level 1: Corporate
The How
Performance Measure
Complaints monitoring
Concerns monitoring
Positive feedback and
compliments monitoring
Serious Untoward Incident
reviews
Carers Forum
Mental Health Action Group
involvement in projects
Derbyshire Voice involvement in
projects.
From our engagement meetings through to local health
community stakeholder meetings and national patient
surveys it demonstrates that we are open, reflective
and responsive to the views of service users. This
process is reviewed yearly.
Thematic reviews of information gathered from all
feedback will enable actions feeding straight into the
Divisional structure support a „You said, we did‟
approach. This is reported on a quarterly cycle.
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Patient Experience
The Operating Framework for the NHS in England 2012/2013 - Domain 4: Ensuring
people have a positive experience of care stated in section 2.27: “Each patient‟s
experience is the final arbiter in everything the NHS does.”
Patient Survey Action Group
Monitoring against national
drivers:
 Mid Staffordshire Report
 NICE guidance
 Delivering Dignity
 74 Deaths and Counting
We will see a decrease in complaints & concerns
regarding involvement in care planning. April 2011 –
February 2012 30 complaints were raised in respect to
care planning. We will see a reduction to the value of
25% in year 1 and a further year on year reduction
(30% 2014, 35% 2015).
We received 600 compliments for 2011-12, we will see
a 20% increase in by 2012-13. 25% increase 2014 & a
35% increase in 2015. This is by way of receiving more
positive feedback having rolled out customer care
training and also by highlighting under reporting across
our Trust.
We will see year on year improvement across the 4
EDS goals and our rating. - progressing from
„developing‟ to „excelling‟ by 2015.
The How
Divisional Engagement
Meeting
Acute Care Forum
Drugs &Therapeutic
Live EIA
PEAT – ensure patients
attends future visits
Clinical Reference Groups
Performance Measure
These methods improve communication between
patients, carers and staff are a tangible demonstration
that the quality of care as reflected in the experience of
our patients is a top priority. All actions will be in
embedded by May 2012.
We will see year on year improvement in our Divisional
EDS ratings - progressing from „developing‟ to
„excelling‟ by 2015.
Annual Divisional EDS
assessment and
improvement action plans.
Level 3: Team, ward or service
The How
Performance Measure
Multi-Disciplinary Meetings &
Ward Rounds
Secret shopper within crisis &
home treatment teams
Board to Ward
Core Care Standards
implementation
Recruitment & Selection
Training
Patient Experience Leads within
These systems enable patients & carers to shape &
influence the services that they use.
We will see a decrease in complaints & concerns
regarding staff attitude.
We received 600 compliments for 2011-12; we will see
a 20% increase in by 2012-13 due to the roll out of
customer care training 25% increase 2014 & a 35%
increase in 2015.
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Patient Experience
Level 2: Division
all clinical settings
Continued audit of patient care
through robust supervision,
case discussion & case file
audit
We will see a 500% increase in concerns being
addressed without the need for a formal investigation
by 2015
Level 4: Individual
What we need to do to achieve our goal.
The How
Performance Measure
Effective care plan coordination
through CPA or named nurse
The independent interviewing of
BME patients within services to
gather qualitative information
about individual experience that
is fed back into service
improvement - carried out in
partnership with Southern
Derbyshire Voluntary Sector
Mental Health Forum (CQIN L4)
This process informs planning and service
improvement and helps us target the health needs of
both current and future patients and carers.
They help our organisation to provide an accessible
and responsive service based on people‟s identified
needs/wants and puts the patient at the centre.
Auditing of application will act as an indicator that our
strategic plans and objectives are having the desired
impact.
We will see an improvement in patient surveys
particularly with regard to Care Planning and being
involved in their care. 68% of service users stated that
they were involved in the care planning. 54% of service
users said they had a care plan. We will see a
significant improvement in year up to the value of 95%
by 2013 patient survey results with on-going
maintenance of this target in year 2014 & 2015.
2012 Risk, CPA & Records audit results indicate only
1/3 of service users had been offered a copy of their
care plan. In year 1 (12/13) we will see an increase to
75% of service users being offered a copy of their care
plan, 2014 target of 95%, maintained in 2015. We will
see an improvement in the co-production of care
planning.
We will continue to see a month on month
improvement in Net Promoter scores for the Golden
Question. Baseline has been set at +36.66% April
2012. This will improve to + 45% by March 2013
We will see an increase in recognised carer
involvement – in the County this would be an increase
in referrals for assessment, in the city this would be an
increase in assessments being offered & undertaken.
Bench mark data required broken down by County
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Patient Experience
Care planning & evaluation
Core care standards
implementation
Volunteers within service areas
Patient survey
Advocacy
Involve patients in policy
development
Golden Question
Floor walk Wednesdays
Values Exchange Real Time
Surveys
Council and Derbyshire Healthcare Foundation Trust –
June 2012.
Independent face-to-face interviews with 80% BME
service users in the designated settings. Detailed joint
analysis of BME patient interviews and
recommendations for change having been fed into
appropriate service improvement structures with action
plan for implementation.(CQIN L4)
We will see a maintenance of 7 day follow up
performance (2011/12 data indicates 99.24% against a
target of 95%)
We will see a maintenance of performance regarding
CPA reviews (2011/12 data indicates 97.35% against a
target of 95%)
Patient Experience
We will see a maintenance of Crisis Team
Gatekeeping performance (2011/12 data indicates
100% against a target of 90%)
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4
Community Engagement
4.1 Why are we engaging with the wider community?
Our goal is to make engagement everyone‟s business so that we reach a better
understanding and are more in tune with the needs of all the communities we serve.
Our plans and service delivery will be informed and guided by the understanding and
insights that all aspects of the community can contribute. We will be accessible and
involve everyone in shaping local services to meet individual needs and achieve
better outcomes. As a result, people will be more empowered and better able to use
services. Most importantly, we will have made a positive difference to peoples‟ lives
by improving social inclusion, fairness, dignity, hope, recovery and independence.
We will actively work together with our partners, service users, carers, voluntary and
community sector groups and the wider community to give people a voice and make
sure that everyone counts.
In this framework „Community‟ can include:
Communities of Place – people in a defined area like Derby, Derbyshire or a
neighbourhood.
Communities of Interest – people who share a particular experience, interest
or characteristic, such as carers, service users, young people, faith groups,
older people, disabled people, ethnic groups, lesbian, gay, bisexual and
transgender people.
People often belong to more than one community and communities are nearly
always diverse. This framework includes all communities.
4.3 What is community engagement?
Community engagement is about working together and talking to people about their
health needs and listening to what they have to say about our services and how we
can develop joint outcomes. Effective community engagement is a lever for
improving quality and has a significant role to play as it acknowledges the existence
of inequalities and barriers to healthcare services. It further recognises that within
some communities there is lack of awareness and knowledge around a range of
health and social care issues and services. Stigma and denial exist around some of
these issues (e.g. mental health, substance misuse) and within some communities.
Community engagement also produces evidence that makes sense of local
population needs and health statistics so that services can be designed to meet
people‟s needs.
4.4 What we need to do to achieve our goal?
2012 -2015.
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4.2 What do we mean by wider community?
Level 1: Corporate
The How
What we need to do to achieve our goal and by
when
Performance Measure
Chairman and senior manager
visits–a programme of on-going
engagement visits with REGARDS
organisations to address issues of
access and stigma. (CQUIN)
Board template and quality visits
to include REGARDS – Board
members to actively ask about
equality and REGARDS
implications and seek assurance
that groups affected by our
decisions have been proactively
engaged from the beginning and
that the board have a full
understanding of the equality risks
to patients and staff.
Sustainable relationships with key
community stakeholders Assistant Director of Engagement
devotes half a day a week to
maintain relationships and ensures
introductions and links are made
with appropriate internal leads
(senior and operational
managers/leads).
Equalities, Engagement,
Experience and Enablement
Committee (4Es) to oversee and
Centralised Customer Relationship Management
Database in place by September 2012.
Increase in the number of relationships with
community groups segmented by REGARDS and
geographical area from last year. (25% increase
year on year)
Community Engagement Log to record all
community engagement activity by December 2012.
Year on year increase in visits to REGARDS
community groups and faith centres. Faith
leaders/key leads report a positive improvement in
the perception of our Trust (trust and confidence)
from last previous year (50%, 75% & 100% by
2015). (CQUIN)
Evidence of 20% increase in Mental Health
awareness sessions delivered to REGARDS
community groups to reduce stigma. (CQUIN)
Year on year Improvement of REGARDS and
engagement implications noted in papers presented
to the board and in meeting notes. Evidence of
actions to address gaps or deficits (50%, 75% &
100% by 2015).
Annual report, Quality Account, Annual Members
Meeting –year on year increase in inclusion of
REGARDS, membership and attendance.
Increase the number of „focused‟ and „purposeful‟
engagement and health events in line with key
diversity days & REGARDS compared to last year.
Year on year Increase in Derbyshire Healthcare
Foundation Trust representation at external
community and health engagement events (50%,
75% & 100% by 2015).
4Es membership representative of REGARDS, 3rd
sector and geographical area. 90% members report
that engagement and relationships have improved
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High level stakeholder analysis
completed and Customer
Relationship Leads assigned to
engage with key stakeholders in
line with the power and influence
of stakeholder (matrix) –
completed by the Board February
2012.
Centralised Customer Relationship
Management Database
commissioned – Assistant Director
Business Strategy by July 2012.
Attendance at Health & Well-being
Board and sub-groups – Acting
Chief Executive and Assistant
Director Engagement.
Derbyshire Community Health
Equality Panel (DCHEP –
voluntary sector alliance
responsible for moderating our
Equality Delivery System grades
and evidence) – Assistant Director
Engagement ensures the group is
kept informed of the work of the
Trust.
and increase in confidence in our approach.
Engagement is seen as key to influencing decisions
and helping to shape services.
DCHEP agree with our EDS rating and report
positively on our engagement. EDS grading
increases to achieving (green) by 2013 and
excelling (purple) by 2015.
Connect magazine – at least 3 items per publication
to include reference to engagement with REGARDS
and voluntary and community sector organisations.
The number of collaborative events with partners to
ensure effective working and minimising
consultation fatigue.
Improvement in the number of public governor
„surgeries‟ segmented by REGARDS and
geographical area. Year on year increase 50%, 75%
and 100% by year 3.
Derbyshire Diversity Network and
the Strategic Health Authority
Inclusion Board (network of health
community equality leads) Assistant Director Engagement
continues to lead/attend local,
regional and national forums.
Multi-agency Derbyshire Inclusion
Leads Network – Assistant
Director Engagement devotes time
to contribute and share good
practice.
Public Governors are responsible
for engaging with their constituents
– each governor devotes time to
hold public surgeries in their
respective geographical areas.
Public Governors to spend time
understanding and mapping their
local population and communities
leads in their geographical areas
and target key stakeholders.
Partnership working with 3rd sector
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monitor implementation of the
Engagement and Experience
Framework.
Community Engagement subgroup to map current community
engagement activity across our
organisation.
- Service Level Agreement with
SDVSMHF – Community
Equalities Officer to support
engagement work.
Launch of REGARDS wheel and
respect campaign – Chairman &
Assistant Director Engagement
from June 2012.
Equality Delivery Framework and
objectives drive service
improvement and includes
engagement of REGARDS groups
as required by Equality Act 2010.
Ensuring proactive use of
REGARDS wheel and prompts.
Performance Measure
The number of REGARDS and seldom heard
groups represented at meetings within the Divisions.
Ensuring proactive REGARDS and
seldom heard groups‟
representation and involvement at
divisional engagement forums and
meetings.
Divisional annual EDS improvement plans show
delivery of defined objectives and improvement in
outcomes and engagement for REGARDS. EDS
grading increases to achieving (green) by 2013 and
excelling (purple by 2015).
Equality Impact Analysis (EIA) and
proactive engagement of
REGARDS affected by service
development and pathways.
The number of Equality Impact Analysis of service
changes and policies carried out as part of the
decision making process from the beginning – which
enables us to have a full understanding of the
equality risks to patients and staff. Evidence of
100% increase in the engagement of REGARDS
and seldom heard groups affected by service
change and decisions.
The How
Divisional Annual EDS selfassessment and improvement
plans to address gaps and
improve outcomes evidence
segmented by REGARDS and
engagement activity by April 2012.
Number of equality monitoring trainers and increase
in number of staff trained within each division. 90%
of target group trained by March 2013.
Equality monitoring training
programme and electronic guide –
lead trainers nominated to
cascade training within their
division and areas.
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Level 2: Division
The How
Performance Measure
REGARDS annual calendar of
learning events and cultural
events.
LIVE Equality Impact Analysis
(environment and 5 senses
assessment) undertaken at
Hartington Unit, Kedleston Unit,
Melbourne House, Cherry Tree
Close and Cubley Court).
Swartz rounds – teams/staff have
protected time to meet and
discuss quality practice
Production of annual Multi-faith calendar by
December 2013 - evidence of calendar being used
to inform care planning and delivery.
The number of LIVE EIAs and representation of
REGARDS and seldom heard groups. Timely
production of “you said, we did” feedback report
shared with REGARDS cohort. Evaluation report of
EIA process and group reports positive feedback
and confidence that suggestions have been acted
upon.
Quality of EIAs - REGARDS intelligence including
published research, internal data and evidence from
diverse stakeholders taken into account. Manager
ensures that this REGARDS intelligence is not
ignored, but directly informs action to plan and
improve services.
Increase in number of cultural and diversity events
within the service areas and involvement of
REGARDS groups. .
Level 4: Individual
The How
Performance Measure
Training Passport
Swartz rounds – teams/staff have
protected time to meet and
discuss quality practice.
90% compliance with E-learning Diversity training
and Equality & Cultural Competency Training.
CRM updated with named senior lead – 90%
improvement in community and key stakeholders
contacts.
Staff have dedicated time to attend
training and specific REGARDS
workshops to enhance
understanding of issues and
engagement particularly with
seldom heard groups in their
Equality monitoring 90% compliant by March 2013.
geographical area.
Managers and leads maintain and
sustain community relationships
with key stakeholders in
accordance with their specialist
T2 „Making a difference as a leader‟ leadership
event report and attendance on 31st May 2013.
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Multi-faith calendar
and geographical area.
Equality monitoring policy and
training to be developed by
subgroup, led by Assistant
Director Engagement.
Launch and map national Equality
Competency Leadership
Framework at T2 Leadership
event in May 2012.
Implementation of Equality Competency Leadership
Framework action plan to address gaps and
leadership competencies by September 2012.
Evidence that Equality Competency Leadership
Framework competencies are embedded and
included in mainstream leadership development
programmes (AD Leadership)
Deputy Director Workforce and
Assistant Director Leadership to
develop Equality Competency
Leadership Framework Action plan
to address gaps and leadership
competencies from initial
diagnostic by July 2012.
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5
Engaging our staff
5.1 Why engage with staff?
Our goal is to ensure our staff are engaged; feel connected and have a good
experience of working for us.
The need to create an engaged, motivated workforce is one of the key components
of our People Strategy. Over the recent years there have been developments in
linkages between employee engagement, quality of care and improved productivity.
A European study undertaken by Tower Perrin in 2004 showed employees who
could identify with their CEO in two-way communication, who were able to instil
business priorities and understand their role and contribution scored high on
indicators such as customer satisfaction.
“Leadership, line management and the employee voice are key enablers of
engagement, and the correlation between engagement, wellbeing and performance
is repeated too often for it to be a coincidence.”
Engagement is therefore an essential ingredient in meeting the challenges facing the
NHS and subsequently our Trust, in particular to secure efficiency savings and
achieve the outcomes our patients expect. NHS organisations with high levels of
staff engagement tend to have reduced sickness absence levels and overall better
performance.
Employee engagement can be viewed as a combination of commitment to the
organisation and its values and extra discretionary effort (organisational citizenship).
Kim and Mauborgne (2005) describe engagement as:
Expectation – involving individuals in decisions by inviting their input and
encouraging them to challenge one another‟s ideas
Explanation – Clarifying the thinking behind final decisions
Expectation Clarity – stating the new rules of the game, including performance
standards, penalties for failure and new responsibilities
For the Trust to achieve its Quality, Innovation, Productivity and Prevention (QIPP)
objectives and address the challenges ahead, the organisation needs to move from
managers only owning the agenda, to one where our staff are fully engaged and not
only have ownership of our Trust but are passionate about its future and what
happens within it. Therefore, engagement will be a main pillar of our People
Strategy for the coming years.
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Engaging our staff
A more recent study conducted by the CIPD which involved private and public sector
organisations, highlighted that employees who were engaged performed better, were
more innovative, enjoyed a greater level of wellbeing and were more likely to act as
organisational advocates. In 2009 the Government published the report of a review
on employee engagement (MacLeod review) which concluded that:
5.1 Creating our Employee Voice
Engagement should not be viewed as just improving communication but using
engagement opportunities with staff to shape our decisions and strategic
approaches. Successful engagement will need commitment and visible support from
the Board, Executives, managers and supervisors at every level of the organisation.
Our leadership and management development is underpinned by the core principles
of employee engagement and will be one of the main indicators for evaluating our
leadership strategy.
One element of our approach is the creation of an employee engagement sub-group,
which is accountable to the Workforce Strategy Group. The sub-group comprises of
a cross section of representatives from the organisation including one of our staff
governors, junior doctors, communication expertise and staff side representatives.
Work will be undertaken to understand how we engage with our workforce and to
shape a series of engagement opportunities. The group will explore good practice
from private, public sector and other NHS organisations to develop our approaches.
Engagement has to underpin all our activities and will require changes in style,
attitude and behaviour throughout the organisation. Whilst the leadership and
management development programmes have engagement as a central key element,
it has to be embedded into the fabric of the organisation through role modelling
behaviour, visibility of our executive team and senior managers, listening to our staff
etc.
One of the key tools for measuring staff engagement is the national staff survey.
Since 2003 the Trust has conducted the staff survey providing a wealth of data on
where the organisation needs to focus its efforts to assist in creating the employee
voice. It is important that staff views are sought on a continual basis rather than just
on an annual basis and therefore in collaboration with the quality department, work
will be undertaken to obtain real time information from our staff through the use of
the Values Exchange survey tool.
The „Values Exchange survey tool‟ is a piece of software that can be used by any
health professional and can be arranged in any number of groupings in order to
undertake a comprehensive review on a host of topics providing real-time
information. The Values Exchange can be used for surveys or issues that require
further analyses. This will assist the organisation to obtain specific information from
either patients and staff or both. This approach will also enable the organisation to
correlate responses from our patients and our workforce.
19
Engaging our staff
We have begun to shape a number of initiatives which form the foundations of our
Employee Voice. For example the Quality Visits facilitate a discussion between the
Trust leaders and members of staff around the services they provide, with a focus on
recognising good practice and discussing improvements. Our organisation has also
adopted approaches such as „You said, we did‟ which provides a systematic
approach to providing feedback and responses to people‟s questions, comments or
queries. The Chief Executive has undertaken a series of road shows to engage and
discuss the challenges the organisation will need to address.
5.2 Staff Side Partnership
Our staff side partners will play a key role in developing our employee‟s voice. Our
staff side representatives already have a voice in to the organisation‟s decisions
through relevant forums such as the Workforce Strategy Group, the Health &
Wellbeing Group, the Engagement sub-group, in addition to their involvement in the
Trust‟s formal joint consultation and negotiation machinery. Our Trust has always
recognised the value of staff side representation and has established agreements for
providing the necessary time off for them to undertake these duties.
Building on these agreements, the organisation will be creating a set of principles
which balances the formal trade union role with organisational citizenship objectives,
supported by clear development plans.
5.3 What we need to do to achieve our goal.
The How
Performance Measure
Trust Values development in partnership
with staff. Launch 22 May 2012.
Value based recruitment and assessment
People Strategy - key goal is to look
workforce engagement.
Leadership Strategy
Quality Visits – lead by Directors (includes
Non-Executive Directors and senior
managers)
Listening events (26 areas) – senior team
meet service managers
Directors “Walk in their shoes” - shadowing
staff.
EDS diagnostic and rating for Goal 4:
Empowered, engaged and well supported
staff - diagnostic undertaken in partnership
with staff and shared with staff-side. EDS
improvement action plan includes:
reviewing and developing Human
Resource Policy to ensure equality
outcomes
Evidence of values is embedded in
behaviours and processes such as
recruitment & selection. Individual
Performance Reviews – audit of quality of
process rather than quantity.
Implementation of action plan and
evidence of where we are engaging staff in
decision making.
Evaluation of strategy by internal audit to
measure impact and if it‟s starting to make
a difference. External evaluation by Price
Waterhouse Cooper (PWC) – annual
review commencing Oct 2012.
Walk in their shoes – 4 visits per year by
each director
Staff survey – 10% year on year
improvement.
Quality visits - minimum of 16 visits per
Director by March 2013. (80 areas)
We would expect to see year on year
improvement across the 4 EDS goals.
More specifically our EDS rating for Goal 4:
20
Engaging our staff
2012 -2015
Level 1: Corporate
Ensuring our workforce Information is
inclusive of all protected
characteristics and reflects all areas
of the employment pathway from
labour market to leaving the
organisation.
workforce data collection exercise
and analysis (commencing April
2012)
Review of Recruitment & Selection
process – introduction of „Values
Based Recruitment (includes service
users and carers)
Empowered, engaged and well supported
staff progressing from „developing‟ to
„excelling‟ by 2015.
We would expect to see evidence that
workforce data and progressive human
resource policies are used to identify and
address any areas of staff/workforce
related inequalities within our organisation.
Level 2: Division
Performance Measure
T2 Leadership events for Bands
7upwards held on alternate months.
Number of events (6), feedback from
attendees and PWC review.
T2 Leadership events for Bands 5/6
(operational staff) held on alternate
months commencing June 2012.
Number of events (6), Number of bands
5/6 nominated by managers, feedback
from attendees and PWC review.
Leadership Programme for Consultants
(12 months module – commencing
September 2012.
Feedback from attendees, presentation to
Directors,
Coaching programme delivered to 100
senior managers.
Evaluate and re-run 360 a year later and
map.
To schedule 360 degree feedback for all
managers (including directors) to ensure
that leaders actively demonstrate the
expected behaviours and values of our
organisation.
Evidence that the national Competency
Framework for Equality & Diversity
Leadership is delivered and embedded in
mainstream leadership development
programmes. (AD Leadership)
Inclusive leadership at all levels –
implementation of Competency
Framework for Equality & Diversity
Leadership.
21
Engaging our staff
The How
The How
Performance Measure
Project to map people engagement activity
within divisions to identify potential areas of
good practice and gaps by July 2012
Team meetings
Team building days.
Level 4: Individual
The How
Performance Measure
Evidence through IPR documentation.
Engaging our staff
Individual Performance Review –
performance management of inclusive and
engaging - (national Competency
Framework for Equality & Diversity 5
competencies)
22
Monitoring the implementation of the Engagement and
Patient Experience Framework
This framework sets our commitment to engagement and experience so that the
organisation‟s approach is „open and sincere‟ and clearly understood by all
stakeholders. The actions set out in this document are focused on building on-going,
successful working and caring relationships with all stakeholders who are interested
or affected by what the Trust does and are empowered to participate in and influence
decision making. Our Trust does not intend to do this passively, peoples‟ needs are
better met when they are involved in equal and mutual relationships with
professionals and others, working together to get things done - by being „better
together’.
Our quality account states our intention to seek feedback from service users and
carers, listening to feedback and acting upon this. The generation of real time
feedback remains a priority as we work to improve the patient and carer experience
of care delivery. We will be developing our expertise over the lifetime of this
framework so that use of data becomes routine and key part of on-going process of
service and care delivery approach.
6.1 How will this framework be monitored?
This framework will be monitored through the Trust governance process, by 4Es and
delivered across the four organisational levels. This will ensure engagement is
owned and that services and care delivery is designed, delivered around the needs
of the patient, carers and the community.
Our Equalities, Engagement, Experience and Enablement Committee (4Es), which
consists of members of the community, service user and carer forums, staff and
representatives from the voluntary and community sector, has created an exciting
opportunity for joint working with all our stakeholders and most importantly has
established clear routes to enable them to hold us to account for the delivery of the
framework, the NHS Constitution pledges and the Equality Delivery System (EDS).
Our EDS baseline assessment will be used to demonstrate performance through
evidence and outcomes. Our equality performance will be improved if we can show
we have listened to and engaged with patients, carers, voluntary organisations and
staff and identified where improvements can be made and acted on these findings.
We will then see year on year improvement across the 4 EDS goals and our rating progressing from „developing‟ to „excelling‟ by 2015.
Our Equality Impact Analysis takes account of REGARDS intelligence including
published research, internal data and evidence from diverse stakeholders. We will
ensure that this REGARDS intelligence is not ignored, but directly informs action to
plan and improve services.
The staff engagement elements will be overseen by the Workforce and
Organisational Development Group. This framework and plan will be reviewed
annually and amended accordingly to reflect changes in the organisation, workforce
and environment.
23
Monitoring the implementation of the Engagement and Patient Experience Framework
6
This framework supports the delivery of privacy, dignity, equitable and culturally
sensitive and age appropriate services to tackle discrimination and unequal access
to services. It makes the link with quality – personalised care, improving service
experience, access and outcomes. It recognises that the cornerstone of tackling
inequalities is delivering truly personalised approach that identifies the specific needs
of each individual, family and carer. It acknowledges that all people including all
those protected characteristics (REGARDS) should have confidence that the
services and treatment they receive is equitable and safe.
Our EDS action plan contains priority areas derived from our EDS baseline. We
recognise that more robust monitoring and an accurate profile of our local community
can lead to better understanding of how services can be improved to meet
REGARDS needs. The Equality Monitoring group (subgroup of 4Es Committee) has
been charged with improving the volume and accuracy of equality information and
ensure it is routinely used and making services and information more accessible.
We recognise the need to focus on the most disadvantaged and those who
experience the poorest outcomes. We will ensure that appropriate methods for the
target group (s), particularly for REGARDS and „seldom heard‟ groups are adopted.
We have launched our REGARDS and respect wheel which has been designed as a
tool to develop a deeper understanding of individual and community needs and
opportunities for targeted service delivery, especially with groups that face
disadvantage and/or health related risk factors. It will ensure that equality and
engagement is systematically considered across the system.
We will also use the national
„Good engagement practice
for the NHS‟ guide to help
inform our approach and the
methods of engagement.
This guide provides practical
tips, checklists and
examples around good
engagement with protected
characteristics that are
protected under the Equality
Act 2012.
www.eastmidlands.nhs.uk/a
bout-us/inclusion/eds/goodengagement-practice-forthe-nhs
24
Monitoring the implementation of the Engagement and Patient Experience Framework
6.2 Equality Impact Analysis
The analysis suggests a positive impact on all groups, as the framework is designed
to improve engagement by placing emphasis on outcomes and transparency through
proactive engagement. It is important to note that this framework does not analyse
actual methods of engagement, but is designed to ensure that people are not
overlooked and drives improvement by focusing on achieving priority outcomes and
measuring success through analysis of data and feedback/out puts data (segmented
by REGARDS).
7
Acknowledgements
Angela Kerry & Emmanuel Williams, Southern Derbyshire Voluntary Sector MH
Forum.
Roger Kerry, North Derbyshire Voluntary Sector Forum
Elaine Jackson, South Derbyshire Carers Forum
Catherine Ingram, Nikki Rhodes, Jonathan Norton & Gary Brown, Derbyshire Voice
Dawn Longden-Whiting, Making Space
Amarjit Raju,& Martin Austen, Disability Syndicate/Equality & Human Rights
Partnership
Christine Williamson, Public Governor
Maura Teager, Tony Smith & Lesley Thompson, Non-Executive Directors
David Briggs, Derbyshire LINKs
Andy Cave, Derbyshire Friend (Lesbian, Gay & Bisexual)
Karen Duke, Derbyshire Centre Integrated Living/Derbyshire Disability Action Network
Steve Studham, Derby City LINk
Siobhan Spencer, Derbyshire Gypsy Liaison Association.
Phil Binding, Mental Health Action Group
Gillian Sewell, YMCA
Kirit Mistry, Derby & Derbyshire Race Equality Commission, BME Network &
Derbyshire Community Health Equality Panel
Margaret Spencer, Disability Employment Project Office (Derbyshire County Council)
Dr Phil Henry, Multi-Faith Centre at the University of Derby
Malcolm Grieve, North Derbyshire Carers Forum
Ferid Kevric, Bosnian & Herzegovina Association & New Communities in Social
Enterprise Derbyshire
Tony Michael, Hadhari Project.
Beth Seymour, Transgender Network
Trust Chaplaincy & Spirituality Services
Trust Equality, Engagement, Experience & Engagement Committee (4Es)
Trust Workforce & Organisational Development Group (includes staff side
representatives).
25
Acknowledgements
We would like to thank the following colleagues who have shared this document with
their respective networks and for their expertise in the development of this
framework.
If you would like this document in another format that would
better suit your needs or in another language, then please
contact:
Harinder Dhaliwal, Assistant Director of Engagement
Derbyshire Healthcare NHS Foundation Trust, Trust HQ,
Bramble House, Kingsway Site, Kingsway, Derby DE22 3LZ
Tel: 01332 623700 ext 3387.
Harinder.dhaliwal@derbyshcft.nhs.uk
26

Engagement 4 Improvement Framework 2012 - 2015

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