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Having a good day
On the edge
On the go slow
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Improvement Zones
• NHS Healthy Workforce Programme
• June 2016
Today’s Agenda
1:00 - 1:10: Introduction to CQUIN
1:10-1:20: Background and Introduction to Improvement Zones
1:20 - 1:50: Topic 1- Raising awareness and increasing uptake of employer led mental health initiatives/services
• Solution generation
• Solution prioritisation
• Feedback
1:50-2:00: Wrap-up and feedback
www.england.nhs.uk
The Health & Wellbeing CQUIN
22
In March 2016 NHS England announced a health and wellbeing CQUIN,
linking 0.75% of Provider income to improving staff health and wellbeing
0.25%
• Banning price promotions on HFSS foods
• Banning advertising on HFSS foods
• Stopping the sale of HFSS foods at checkouts
• Ensuring healthier meals are available out of hours
Healthy food for NHS
staff, visitors and
patients
2
• Introducing improved mental health initiatives
• Introducing physical activity schemes
• Improving access to physio for those with MSK
issues
Introduction of health
& wellbeing initiatives1
• Achieving an uptake of flu vaccinations by frontline
healthcare workers of 75% by December 2016Improving uptake of
flu vaccinations3
0.25%
0.25%
• Why are we doing this?
• To identify problems, share best practice and learn from others to re-use knowledge and avoid replicating mistakes
• To give you the opportunity to solve challenges together as well as demonstrate your success to others
What is an Improvement Zone?
• Why will I benefit?
• You will gain key solutions and strategies for overcoming specific barriers in your organisation
• You will learn from each other to develop and provide better solutions
• You will leave the session with a list of prioritised initiatives
• What’s involved?
• Provides you an opportunity to focus your energy on one initiative of the Healthy Workforce programme at a time
• Identify a specific area of need and solve challenges as a group
• How would it work?
• A structured 8 week timeline including events where you will come together for a workshop and problem solving session focusing on Healthy Workforce initiatives classified into ‘zones.’
Improvement Zone: week by week activities
WEEK ACTIVITIES
Week 1
Week 2
Create and submit a list of specific problems your organisation faces when implementing mental health initiatives such as counselling, talking therapies and mindfulness.
Workshop held to identify solutions and prioritise them into priority areas for implementation
Week 3-5 Focus on introducing the ‘quick win’ changes identified within your organisation
Week 6
Week 7
Follow up meeting via conference call (if required) to discuss progress, discuss success/difficulties & any other changes
Final implementation of quick win areas and preparation for longer term changes
Week 8 Finalise preparation for longer term planning and submit feedback about the Improvement Zone
Topic 1 Prioritisation
Requires More Planning Quick Wins
Reconsider Little Value Added
Effort/Ease of Implementation
Imp
act
High
Low
HardEasy
Proposed Action Timeline
Week 3 Week 5 Week 6 Week 7Week 4
Barking Havering & redbridge university hospitals nhs trust
H&WB Network Leads Meeting
Healthy Eating at BHRUT
Tuesday 7 June 2016
Profile:• Barking ,Havering and Redbridge University Hospitals NHS Trust
• We have two main sites and six outreach sites
• 6,500 Staff
• Sickness Absence Rate 3.7%
• Turnover Rate 14.3%
• The Trust is based on two main sites and serves a population of 750,000 and is one of the busiest outside central London
Health & wellbeing for our staff• Is important and is recognised in our Trust objectives
• Set up in 2010 and growing daily
• Dedicated Health and Wellbeing team
• 12 month programme with action plan
• Health and wellbeing Strategy
• Close working with our Partners: Health and Safety Team
Human Resources
Estates
Communication team
• Healthy Workplace Charter – Excellence Award- awarded April 2016
Our approach
• We take a holistic approach and aim to help and support staff to take responsibility for their Health & Wellbeing and aim to encourage staff to be healthy and motivated.
• We evaluate all projects.
• Survey staff and engage with external partners to deliver a programme that offers hopefully something for everyone.
• Health and wellbeing champions across the Trust
• Employees are trained and offered help support and advice in order to take responsibility for their own wellbeing and lead by example to the local community and beyond.
What have we done ?
Bike to Work Week‘On yer Bike’
Smoothie Bike
Healthy Holiday's• Healthy BBQ• Free Fruit • Free Alpro
Healthy Eating Areas in Shop & Restaurant
SaladsFresh Fruit
Low Cal YogurtsSugar Free DrinksWater Fountains
Nuts & Seeds
National cquin target 2016/17 1b. Healthy food for NHS Staff, visitors and patients• Engaged with Sodexo Partners and plans in place for:-
• Monthly meetings• Action Plan drawn up for next year to monitor progress
• By 1st July 2016 Sodexo has committed sign up and data provided for all partners
• The Retail teams at both sites will be briefed new recommended guidelines. Actions to include:-
• Rearranging displays in both shop and restaurant• Promotions Reduction on grab size bags crisps / chocolates
• The Retail teams should be briefed on the food strategy- including allergens, calorie info, presentation etc.
• The central Retail team will review this is implemented as part of the regular retail audits.
And changes on merchandising and advertising will be in place by the 1st July 2016. • Work with the partners Subway and Costco • Look at provision in vending machines
Occupational health and wellbeingInitiatives
Eatright 12 week challenge
The Kit:Health Check MOT and follow-upNHS Choices weight loss planWeekly Weigh-in
PlusPhotoWater bottleTape Measure All for £20.00Folder FREE Monthly raffleLunchtime walking group twice weekly
David’s fruit & veg stall
Raising awareness
National
Vegetarian
Week
Where we go now?
We Listen We promoteWe Support
We continue to growWe lead by example
AGM & H&WB YearbookVisit Wards, Departments
& Conferences
Document name
1
Employee Health & Wellbeing Staff Survey 2015/16
www.bhrhospitals.nhs.uk
@BHR_hospitals
Barking, Havering and Redbridge University Hospitals NHS Trust
Our success
• We are on a continuous path and aim to build on all our success and learn from any failings
Any questions?
Emotional ResilienceOccupational Health & Staff Psychology Service
Liz Lipsham – Specialist Nurse Manager, Occupational Health
Introduction
• Workshop created by Clinical Psychologist in
Occupational Health
• Sessions co-facilitated with Senior OH Nurse
• Delivered to 196 Trust staff throughout 2015
• Overwhelming positive response from
participants
• Intention to develop and increase workshops
in 2016
Background
● Pilot with Occupational Health Team
● Systemic Approach for Health Visitors
● Request for Heads of Nursing/Matrons
● Acute Teams -
• Control of Infection
• Matrons
• Estates and Facilities Team Leaders
• Corporate Clinical Practice Unit
Format
• 1 full day, 3hr follow-up
• Team approach – multi disciplinary
• Flexible/fluid content
• Based on model of resilience
comprising four parts; - social
support, confidence, adaptability,
purposefulness
Key components of resilience
RESILIENCE
CONFIDENCE
Self-Confidence
Self-Awareness
ADAPTABILITY Problem Solving
Organisation
PURPOSEFULNESS Vision
Determination
SOCIAL SUPPORT Interaction
Relationships
Evaluation
• User satisfaction questionnaire
• Resilience assessment questionnaire
• Sickness absence statistics
Outcomes
• 100% responded content relevant
• 98% responded quality of teaching
excellent or satisfactory
• Interactive nature of team working &
development
• Assessment & development of personal
resilience
• Forum to discuss recent work stressors
constructively
Outcomes cont…
Positive impact on;
• Self confidence
• Interactions with colleagues or managers
• Ability to seek support at work from
colleagues or managers
• Ability to adapt to change at work
• Identify & promote a sense of purpose at work
• Create positive change within a team
What are my core shared
values for work in my team?
• What are the shared values of your
team?
• How do you live those values every
day?
• Is there anything you want to focus
on more as a team?
Benefits• Investing in employee wellness leads to organisational
cost savings – (PriceWaterhouseCooper, 2008)
• Improving psychological and physical wellbeing of
employees increases engagement – (Business in the
Community, 2010)
• Resilience at organisational level, collectively, can enable
workforce to adjust its processes and culture to adapt to
adversity and survive – (CIPD, 2011a)
• Resilience at team level combines individual and
organisational resilience to develop a collective sense of
team values and social capital in the face of adversity –
(CIPD, 2011b)
Key Recommendations• Systemic approach
• Consistent management support – promote
material/attendance
• Clear communication about content &
practicalities
• Thorough assessment
• Facilitators intrinsic knowledge of Trust
and gateway for support
• Reliable/valid measure
Any Questions?
What is Resilience?• “The capacity to withstand exceptional stresses and
demands without developing stress-related problems” (Carr, 2004)
• “A set of conditions that allow individual adaptation to different forms of adversity at different points in the life course” (Bartley et al., 2006)
• It’s a skill that is learnt over time, not something we are born with.
• It does not mean never experiencing pain or stress
• Resilience develops after learning from difficult events, and working through emotions associated with them
Ben Towell
Health and Wellbeing Coordinator
Liverpool Community Health
• High levels of sickness absence
• Low levels of reported staff wellbeing
• High levels of stress related absence
• Low levels of physical activity
• High levels of smoking
• High levels of obesity
• Low staff morale
• High levels of consumption of alcohol
• High level of accidents/injury at work
Health Needs Assessment: Shaping the Strategy
How does our strategy support workforce health ?
Key Principles:
1: To provide the environment, conditions and culture to support Workforce Wellbeing
2: To have robust pathways and intervention in place to support a reduction in sickness and absence
3: To offer a wide range of occupational health intervention and support services to promote and support positive wellbeing.
What action have we taken ?
Strategic objective Action
Increase Physical Activity • Promote Physical activity schemes (local gym membership /Cycle scheme etc.)
• Development and Launch of local physical activity Programme #alltogetherfitterNHS
• Development of a physical activity policy
Survey circulated to understand:
• Who would like to attend, how many staff are interested?
• What activities staff would like to take part in?
• Where would staff like to attend?
• When is most suitable for staff to attend?
• How much would they be willing to pay
Physical activity offer- we asked staff what they want?
• Mapping exercise to understand what PA provision is already in place across local Trusts
• Explored opportunity to open existing sessions to employees from neighbouring Trusts
• Where there where gaps, we identified new centres/sites to mobilize new activity classes
• Secured instructors to deliver the sessions
• Advertised free sessions in April to staff across all Trusts
• Staff signed up to the programme using Eventbrite
• Staff completed a questionnaire to ascertain current levels of fitness & Physical exercise activity used as a benchmark
What happened next?
What was available?
• 13 different types of activity
• 50 hours of free classes
• Some sessions were delivered as a one off taster whilst others ran over a four week period
• Some sessions supported the ‘this girl can’ campaign and were women only
• Sessions include Badminton, Boxercise, Circuit training, Dance classes, Dodgeball, Golf, Pilates, Tai Chi, Tennis, Walking, Football, Yoga, Zumba.
• 6 Local NHS Trusts across Merseyside signed up
• 120 Staff from across all organisations took part
• 68% of staff who signed up did not meet the government physical activity recommended level.
• 45% were trying a type of sport/activity for the first time
• 94% class satisfaction rating of 8/10
• 81% reported improved activity levels
• 53% reported improved wellbeing levels
• In LCH, the S&A rate of staff who took part over April was 0.2% against a Trust average of 5.6%. S&A was 15% for the same staff over the same period in 2015
#alltogetherfitterNHS Activity Programme
‘I am still continuing to go and have no plans at this point to stop’
I’m still very unfit but I can see improvements every week’
I thought this was a great idea, great variety and some sports I haven't tried!
‘It focused me to become more physically active’ ‘It has given me the motivation to carry on
with exercise’
‘Everyone motivates one another to work harder and there is real camaraderie amongst the group’
‘I have continued to attend even after the taster sessions have finished’
‘Many thanks for starting ‘ladies only’ sessions’
‘Since attending the classes I have noticed an improvement in my fitness’
• 6 NHS Trusts across Merseyside launched a stepper challenge
• 205 LCH staff signed up to the challenge and walked a staggering 12,606,337 steps throughout April
• Approx 1,000 staff across all participating trusts totted up a whopping 40,000,000 step
• 213 unique individuals logged over 41,000,000 steps in 30 days
• 86% staff who registered were classed as inactive
• 90% staff said ‘taking part inspired them to be more active.’
• In LCH, the sickness absence % rate of staff who took part in the ‘Race to Rio’ throughout April was 1.4% against the Trust average of 5.6% The sickness absence percentage was 5.1% for the same staff over the same period in 2015.
In tribute to this years Olympics we did the ‘Race To Rio’
Next steps:
• Present findings local health #alltogetherfitterNHS steering group understand where there have been successes and challenges at a local level
• Understand commonalities between Trust findings & how this impacts on S&A rates across all partaking trusts.
• Triangulate data between the cohort who participated and align with performance dashboards data , ER cases etc –this could further build our business case!
• Present report to Exec/Board with recommendations that future programmes are subsidised/funded by local NHS organisations to sustain improved levels of workforce health
• Recommendation that managers can refer staff into the programme as part of a ‘passport for heath’ initiative which forms part of everyday conversations including Supervision, 1:1, PDR, RTW, Staff meetings, OH appointments etc.
• Circulate an additional survey 6 months after the programme to understand if there is any long term behavioural change.
Questions?
