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Isle of Wight Healthcare NHS Trust

Isle of Wight Healthcare NHS Trust. 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

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Isle of Wight Healthcare NHS Trust

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  1. Isle of Wight Healthcare NHS Trust QUALITY HEALTH

  2. 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 Strategic Points • 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 QUALITY HEALTH

  3. 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 Response Rates Median Response Rates: Acute Trusts: 56.7% PCTs: 65.5% Mental Health: 58.4% Ambulance: 50.6% QUALITY HEALTH

  4. 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) The Respondents QUALITY HEALTH

  5. 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) Work-Life Balance QUALITY HEALTH

  6. 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) Flexible Work Options QUALITY HEALTH

  7. 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 Child & Carer Support QUALITY HEALTH

  8. Appraisal 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 QUALITY HEALTH

  9. Staff 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) QUALITY HEALTH

  10. 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) Team Working & H&S QUALITY HEALTH

  11. 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) Errors, Incidents, Illness QUALITY HEALTH

  12. The Job • 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) • 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) QUALITY HEALTH

  13. 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) Leaving QUALITY HEALTH

  14. 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 Management Values QUALITY HEALTH

  15. 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 Communication QUALITY HEALTH

  16. 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) Involving Staff The ultimate test? Would staff be happy to be a patient cared for by the Trust: Yes 42% (56% UK) No 26% (16% UK) QUALITY HEALTH

  17. 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) Violence & Harassment Around half the staff said employer took effective action on harassment etc, racial and sexual harassment. 33% to 53% don’t know QUALITY HEALTH

  18. Key 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. QUALITY HEALTH

  19. 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 Key Action Points QUALITY HEALTH

  20. 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 Management Recommendations QUALITY HEALTH

  21. Movement 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 QUALITY HEALTH

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