isle of wight healthcare nhs trust

QUALITY HEALTHQUALITY HEALTH

National Staff Survey Results 2004

Isle of Wight Healthcare Isle of Wight Healthcare NHS TrustNHS Trust


Strategic PointsStrategic Points• Differences between staff and Managers/Boards views

• Methodology: random sample from staff records – up to 850 per Trust

• QH National Comparisons: 100,000+ respondents, 121 Trusts

• Weaknesses:– Duplication of questions,

length, scaling– “Missed” issues: pay,

conditions– Internal distribution problems

in Trusts– Poor internal addresses

• Positive Features:– No halo effect; national

survey therefore no variations and high comparability

– Sample designed to give good confidence interval between Trusts (but not within them)

– High national response rate, up from 2003


Response RatesResponse Rates

• Response rate high for an Acute Trust : 66% (513 respondents)

• National assumption was 60%

– Straight ‘read across’ from patient surveys

• Response Rate outcomes:

– Acute Trusts score lower

– Inner London lower

• Influences on response rates:– Internal distribution– Uniformity of workforce– Large/small Trusts– Bank staff– Pro active management

Median Response Rates:

Acute Trusts: 56.7%

PCTs: 65.5%

Mental Health: 58.4%

Ambulance: 50.6%


The RespondentsThe Respondents

• Women 76% (81% UK)

• Men 24% (19% UK)

• White British 89% (86% UK)

• Ethnic Minorities 04% ( 8% UK)

• Over 50’s 26% (24% UK)

• 16-40 38% (45% UK)

• With dependants 51% (47% UK)

• Permanent contracts 96% (98% UK)

• Biggest occupational groups:– Registered nurses 29% (29%

UK)

– Admin/clerical 16% (22% UK)


Work-Life BalanceWork-Life Balance

• Additional hours worked per week:

– 16% work 6 hrs+ over standard hours (19% UK) PAID

– 10% work 6hrs+ over standard hours (12% UK) UNPAID

• Main Reasons for extra hours:

– Meet deadlines: 56% (58% UK)

– Provide best care for patients: 80% (77% UK)

– Don’t want to let down colleagues: 74% (71% UK)

– Least popular reason: to get ahead in career

• Ask manager about flexible working: 61% (62% UK)


Flexible Work OptionsFlexible Work Options• Awareness highly variable between occupational

groups, managers usually most aware:– Flexi-time: 33% (37% UK)

– Reduced hrs: 43% (46% UK)

– Work from home: 12% (11% UK)

– Annual hrs: 13% (13% UK)

– Control rotas: 44% (42% UK)

– Job sharing: 30% (43% UK)

– Career breaks: 25% (31% UK)

– Flexi retirement: 16% (21% UK)

• Asked for flexi-option: 25% (24% UK)


Child & Carer SupportChild & Carer Support

• Awareness of childcare & carer support patchy:– Childcare co-ordinator:

17% (27% UK)

– Subsidised childcare: 28% (20% UK)

– Childcare vouchers: 17% (13% UK)

– Other childcare support: 7% (9% UK)

– Carer support:8% (11% UK)

• Awareness highly variable by occupational group in 2003 and 2004

• Awareness of those in age groups potentially needing childcare etc higher than in workforce generally


Appraisal and PDPsAppraisal and PDPs

• Higher proportion of staff had had an IPR in last year: 64% (60% UK)

– Was it useful in doing the job: 73% (70% UK)

– Agree clear objectives for their work in IPR: 89% (87% UK)

• Did they have a PDP agreed with their line manager: Yes 50% (45% UK)– Received training etc. identified in PDP: 54% (55% UK)

• Did those undertaking IPRs have training to do them?:

– More than 1 in 6 (18%, 29% UK) not trained by present employer to do so


Staff TrainingStaff Training

• Large proportion of staff received “teaching, instruction or supervised study”: 82% (76% UK)

• However:– Equal Ops training: 26% (26% UK)

– Racial awareness: 21% (22% UK)

– Gender awareness: 17% (15% UK)

– Disability awareness: 32% (24% UK)

– Harassment & bullying awareness: 37% (30% UK)

• 22% received no training (25% UK); 54% 3+ days (47% UK)


Team Working & H&STeam Working & H&S• Most staff worked in a

team: 91% (87% UK)

• Did team have clear objectives: 86% Yes (87% UK)

• BUT:– 7% claimed to work in

more than 5 teams (11% UK)

– “Team” has significant ambiguity

• Health & Safety training – Trust scores higher than Acute Trust comparators:– 75% had received H&S

training in last year (68% UK)

• Awareness of counselling service high: 90% (83% UK)

• Awareness of occupational health service at work very high: 99% (98% UK)


Errors, Incidents, IllnessErrors, Incidents, Illness• Almost 4 in 10 staff (39%)

saw error or near miss impacting on patients in last month (40% UK)

• Over 3 in 10 staff (34%) saw error or near miss impacting on staff in last month (32% UK)

• Specific injuries/illness:– Work related stress:

43% (36% UK)– Moving/handling injuries:

17% (16% UK)– Slips/trips/falls:

7% (5% UK)

• Stress much more significant issue than specific injuries

• Staff knew how to report errors?: 96% Yes (94% UK)

• BUT: 32% didn’t know if staff were treated fairly if involved in such an incident (34% UK)

• AND: 13% thought the employer blamed/punished staff making errors (10% UK)

• AND 64% said employer took action to stop recurrence (64% UK)


The Job The Job • 69% had clear planned

goals and objectives for job

(67% UK)

• More than 4 in 10 (46%) couldn’t meet the conflicting time pressures in the job (43% UK)

• Satisfied with support from:– Trust (values work):

39% (42% UK)

– Immediate manager: 55% (57% UK)

– Work colleagues: 78% (76% UK)

• Satisfied with:

– Responsibility given: 67% (69% UK)

– Able to use abilities: 61% (63% UK)

• Asked to do work without adequate resources: 43% (38% UK)

• Required to do unimportant tasks: 38% (36% UK)

• Consultation:

– About changes affecting work: 48% (51% UK)


LeavingLeaving• Will staff leave? How

many will go?:– Often think about leaving:

33% (35% UK)

– Look for a job in next year: 21% (25% UK)

– Will leave as soon as I find something: 18% (18% UK)

– Would not stay in NHS if they left: 22% (18% UK)

• Changing jobs obviously related to:– Richness of the job environment– Transferable skills– Perception of the employer– Perception of the NHS

• Reasons for changing jobs:

– Career dev: 17% (20% UK)

– Change career: 9% (10% UK)

– Unhappy with job: 18% (17% UK)

– Family/personal: 11% (10% UK)


Management ValuesManagement Values• Does senior management:

– Give clear vision on where headed: Yes 45% (45% UK)

– Support new ideas for improving services: Yes 52% (53% UK)

– Focus on meeting patients needs: Yes 53% (60% UK)

– Build strong relationships with the community: Yes 36% (32% UK)

– Build strong links with other organisations: Yes 35% (33% UK)

• Between a third and half of IOW employees don’t know if senior management holds these values

• NHS employees are not necessarily aware of Trust policies and values

• Finding replicates much research in the private and public sectors


CommunicationCommunication

• Communication in the Trust:

– Is effective on the whole: Yes 37% (37% UK)

– Between management and staff is effective: Yes 31% (30% UK)

– Different parts of Trust communicate effectively with each other: Yes 26% (28% UK)

• In NHS staff surveys, communication is most often rated top priority for improvement by staff, in two ways:

– Top down, bottom up communication of information

– Communication essential for good patient care


Involving StaffInvolving Staff

• Managers involving staff:

– Try to involve staff in important decisions: Yes 33% (32% UK)

– Encourage staff to suggest new ideas: Yes 58% (45% UK)

– Want staff to be involved in how organisation is run: Yes 28% (29% UK)

The ultimate test?

Would staff be happy to be a patient cared for by the Trust:

Yes 42% (56% UK)

No 26% (16% UK)


Violence & HarassmentViolence & Harassment

• Staff experienced violence in last year from:– Patients/clients: 15% (12% UK)– Patients relatives: 3% (4% UK)– Managers/supervisors: 1% (0%

UK)

• Staff experienced harassment, bullying etc in last year from:– Patients/clients: 24% (23% UK)– Patients relatives: 20% (21% UK)– Managers/supervisors:

8% (8% UK)– Colleagues: 12% (12% UK)

• Did staff report it? – Violence reported:

41% (33% UK)– Harassment reported:

40% (38% UK)

Around half the staff said employer took effective action on harassment etc, racial and sexual harassment. 33% to 53% don’t know


Key PositivesKey Positives Most could talk to manager about flexi working; most of those who asked

had it granted

High level of IPRs

Most felt IPRs useful in improving their work, most agreed clear objectives during the IPR

Substantial levels of training ongoing; improved coverage of training for those undertaking IPRs

High level of H&S training

Good team working scores

Good awareness of counselling and occupational health services

Good awareness of how to report errors, near misses etc.

Most had clear planned goals for their job

Most satisfied with support from work colleagues

Most satisfied with responsibility and use of their abilities

Most said Trust was committed to equal opportunities

Most staff knew how to report incidents of violence etc.


Key Action PointsKey Action Points Awareness of job flexibilities modest

overall

Awareness of childcare provision up but still low overall

Despite good scores, 1 in 3 employees not had an IPR

Half did not have a PDP

4 in 10+ made unwell by work related stress, down nationwide, but static and high at IOW

1 in 5 looking for a new job, 1 in 5 would leave as soon as they had found one. 1 in 6 potential leavers unhappy with present job

Nearly half cannot meet conflicting time demands at work

Substantial minorities did not get clear feedback about their work

Communication of management values and policies is unclear to many

Internal communication criticised by 1 in 3

Violence levels similar to Acute Trusts generally

Low reporting of violence and harassment etc. in absolute terms

Many not aware of action taken by the employer against violence, bullying, sex and race harassment

Recognise the real differences in awareness between staff at the heart of things and those in operational roles


Management RecommendationsManagement Recommendations

• Publicise the results to staff

• Prepare for the late 2005 survey and enhance policies and awareness accordingly

• Assess staffing levels in key areas in order to minimise time pressures and stress

• Increase awareness of job flexibility policies in order to improve recruitment and retention

• Increase awareness of childcare support

• Further improve the coverage of IPRs and PDPs and ensure that those doing them are trained to do so

• Prioritise stress at work as possible damage to health and retention problems

• Continue to communicate the Trust’s strategic vision for the future, and its actions in building co-operative relationships with others

• Enhance communications function to ensure that key messages upwards and downwards are clearer

• Improve awareness of need to report VHB, and tackle causes of levels of violence

• Recognise the different perspectives on, and awareness of, Trust policies and practice by different occupational groups and take specific action to improve awareness among key groups


Movement 2003-4Movement 2003-4• Fewer staff had asked for job flexibility, also

down nationally

• Awareness of some childcare options up a little

• More trained to undertake IPRs

• More receive H&S training: up from 70% to 75%

• Fewer staff notice errors/near misses affecting staff, as is the case nationwide

• No movement on stress at work, unlike most Trusts

• Reporting of VHB is down

• Scores are broadly unchanged since 2003

isle of wight healthcare nhs trust

Documents

uk paid10

uk unpaidmain reasons

acute trusts

standard hours

hsmost staff

childcare coordinator

uksubsidised childcare

ukother childcare support