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A Healthy Workforce
NHS Employers, Health & Wellbeing, Leeds, June 2017
Context
• Ageing population – people working longer
• Working with increasing comorbidities
• Long term sickness is increasing (NHS nationally)
• Reducing sigma around mental ill health
• Lead by example to wider population (smoke free)
Current demand against a sustainable model
Too little here
Strength
• In-house multidisciplinary team• Starting to innovate• Improvement in staff survey scores• Manager satisfaction / recommender scores• CQUINs being achieved• Scalable model• Only training centre in the EoE for OH doctors• Clinical lead – Fellow of Faculty OH medicine• Starting to grow our own• SEQOHS• Partnerships
Opportunity
• Continue to improve relationships (internal)
• Regional provider / STP
• Co-locate and collaboration
• CQUIN
• NHS England and PHE
• Cambridge biomedical economy
• Regional OH school
• Engaging and diverse workforce
Weakness
• Capacity for referrals (Immediate/short-term)
• Demand and complexity of cases
• National Shortage of OH qualified staff
• Financial pressures
• Complexity of challenge/scale of site and workforce
Threat
• Lack of staff available short-term to deliver service
• External agenda/pressures distracts
• CQUINs/resource disappears/reduced investment available
• Increasing workforce health needs
So what’s our strategy?
Reach & inform
• Understand the harms
• Understand the evidence / ‘hot-spots’
• Social media
• Bulletins
• Campaigns (Flu, Feeling Overwhelmed? and others)
• Fact sheets / website / resources
Self-help
• Care First
• Tools, apps, links to sources, information booklets
• Checklists/self-diagnostics (DSE)
• Health Checks
• Empower and educate
• Manager training (mental health)
• Team training/awareness (Physio/MSK)
• eLearning
• Reduce opportunity (smoke free campus)
Supported
• Protect from occupational harms/risk to health
• Psychological wellbeing service(s)
• Physio – rapid access clinic, group therapy
• OH referrals
• Case management
• Targeted work
• Weight Management Programme
• Rapid assessment (psychiatry)
• Navigating secondary care
What next…
Harrogate and District NHS
Foundation Trust
Our Health & Wellbeing ‘Offer’
Zinnia Ritz, HR Business Partner
Angela Carr, Wellbeing Manager
About HDFT• Employs 4,200 staff
• Provide hospital based services in Harrogate & Ripon and community services within Harrogate, North Leeds, Scarborough, Skipton and Children’s Services in County Durham, Darlington & Middlesbrough
• Our Vision: Excellence Every Time
• Workforce & Organisational Development Strategy
• Clinical Transformation Board
Our Health & Wellbeing OfferWe have successfully delivered on the following:• Provided free SHU Wellness Assessments to 330 staff• Developed our mental health ‘offer’ to staff through:
– Piloting Personal Resilience training– Implemented Mentally healthy workplace training– Trained Mental Health First Aiders– Implemented Schwartz Rounds
• Developed a Physical Activity group with staff members• Promoted healthy eating by providing a fruit stall at Harrogate Hospital• Continued to develop our Health & Wellbeing brand, through revamping our
Intranet pages with key resources for staff• Celebrating Success Awards 2017• Quality Conference – June 2017
ImpactPositive increase in the Trust’s staff engagement and health & wellbeing indicators:
• National Staff Survey (2016):- Overall staff engagement score 3.92 out of 5- Increase in “interest and action on health and wellbeing” score from 3.66 to 3.69- “Presenteeism” score reduced from 58% to 50%
• Staff Friends & FamilyResults showed an improvement of between 2-3%, with verbatim positive comments received that staff feel valued by the Trust, in particular the Trust values their welfare
• Reduction in sickness absence
What are Schwartz Rounds?
• Multidisciplinary meetings for staff to talk about and reflect on the non-clinical aspects of working in health care
• Emphasis on the emotional and social aspects of our jobs
• Background
– Ken Schwartz
– Promote compassion and support staff
– Make the “unbearable, bearable” for patients
Having a voice and being heard has an impact on staff wellbeing
• We need to ensure that staff have a voice and a place to be heard. The benefits of this process are two-fold : they provide staff with a voice and enable the organisation to ‘hear’ what can be difficult stories.
• Alimo-Metcalfe (2000) and Alban-Metcalfem’s (2001) research in healthcare environments show that the highest motivator for team engagement is showing a genuine interest in staff members. The process of being listened to and heard encourages motivation and engagement
• The stories we tell ourselves and each other create and recreate the beliefs, values and relationships of the team culture: Arranda & Street (2001, p796)
• Given that clinical microsystems at a ward, team or department level are the most potent unit for healthcare delivery (Ham & Dickinson 2008, Toussaint & Berry 2013) then staff narratives are the vital resource for maintaining staff resilience
What have we done so far?
• Initial 1 year pilot focus on HDFT site
• Steering group and key roles
• 4 rounds:
– “A patient I’ll never forget”
– “The view from the other side of the bed”
– “The buck stops here”
– “ The extra miles I have walked”
Feedback from staff• 164 staff have attended over four rounds and 135 people have completed
feedback forms on their experiences of rounds. Over 75% completely agree that they ‘would recommend Schwartz round to colleagues’
• “Made me think about the impact on patients/relatives when staff don’t give of themselves emotionally”
• “Really good to explore emotions rather than solutions”• “Brilliant to focus on feelings and being human”• “Most enlightening, porter’s story particularly moving”• “Was really good to hear stories from a variety of professionals”• “I realised that from porter, through manager and to consultant level we
are all dealing with our human feelings of working in the NHS – the round brought me out of my bubble and enabled me to see other’s bubbles”
• “Very valuable – all staff should attend at least one session”
Learning points
• Strong steering group
• Clarity around roles and time
• Admin support
• Budget for ongoing costs
• Big rewards
Questions?