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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?