Healthy NHS Staff = Healthy NHS Organisations

#Expo15NHS

@SallyPezaro

pezaros@uni.coventry.ac.uk

Healthy NHS Staff = Healthy NHS Organisations

Welcome • This presentation will initially set the scene in healthcare;

• Discover the benefits of having a healthy workforce

• Discover the business case

• Check out some lived examples

• See some results

• Link staff health to staff engagement

• Offer practical solutions going forward

What is your Organisational 'health culture‘? The Challenge Ahead

• The workplace is a priority setting for health promotion (DoH, 2009, DoH 2004, WHO,2010)

• NHS workers display a relatively low health profile (Blake et al, 2012; Malik et al, 2011)

• UK health workers report stress, unhealthy organisational cultures, exhaustion and burnout (Wilkinson, 2015).

• Ill health in NHS staff negatively impacts upon the quality & safety of

patient care (RCP, 2015; Boorman, 2010)

• NHS workplaces should ‘set the example’

The Health of NHS staff • 68% of NHS staff in England report having recently attended work despite not feeling well enough to perform their

duties (NHS staff survey, 2013).

• Poor mental health = ¼ of staff absences (Boorman, 2009).

• Self-reported stress affects nearly 1:4 of NHS employees (England) (Staff survey, 2013).

• Death by suicide is highest amongst the caring professions (Roberts et al, 2013)

• 300,000 NHS staff are obese, 400,000 are overweight (Van Solk et al, 2009)

• NHS staff are all more prone to work-related illness (Hodgeson, 2015)

• Stress and mental health issues have overtaken musculo-skeletal disorders as the main reason for sickness

absence (NHS Employers, 2014).

• ‘Currently the view from the [patient’s] bed is of short-staffed teams working hard to deliver minimum

standards of care. Morale is at an all-time low.’ (RCP, 2014).

The benefits of a healthy workforce • Reduced sickness

• Fewer accidents/errors

• Improved ‘brand’

• Improved retention

• Improved resilience

• Higher commitment

• Higher productivity

Source: The Work Foundation

Business Case Study: Royal Mail

Royal Mail introduces: • Health screening • Health clinics at 90 sites • Fast access to occupational health services • Access to physiotherapy • Employee assistance programme (EAP) • Incentive scheme • Rehabilitation centres • Phased and partial return to work (RTW) • Case management.

Results after 4 years: • Sickness absence levels had fallen to 4 per cent (10 days per employee) • Cost Savings of almost £230m • Up to 3,600 more staff were available to work each day as a result of these measures (Marsden and Moriconi, 2008)

NHS Case Study: Five-year workplace wellness intervention in the NHS (2006 to 2011) – (Blake et al, 2013)

• 7,000 -13,000 employees had access to the intervention

The Intervention included:

• Dedicated website and exercise class timetable

• Staff gym

• Dedicated well-being rooms, cycle storage/schemes and showers

• Dietary interventions (e.g. slimming classes, healthy eating schemes)

• Regular health campaigns (Wellbeing Week/Mental Health Week)

• Community interventions

• Health education

• Access to health screening checks

• Complementary and relaxation therapies

Results after 5 years… • Sickness absence 4.9% at baseline to 2.6% at follow-up (4.24% less than

national figures)

• Healthy eating 56.9% at baseline, 61.1% at follow-up

• Smoking Behaviour 10.5% of the sample at baseline to 8.6%

• Who gets 7 hours of sleep? 59.6% at baseline to 61.7%

• Those reporting low mood (8.9%) compared with baseline (12.1%)

• Performance at work up from 92.3% to 93.5% (staff perception)

• Greater organisational commitment was reported at five years

What do we get when we invest in staff wellbeing…?

• An average of 50% cost reduction in relation to workplace accidents has been seen in a variety of settings (PWC, 2008).

• Improved alertness, concentration and judgement

• Dramatically improve staff retention rates

• Increased resilience in staff

• Increased productivity

• Safer patient care

• Improved patient experience

• Improved staff experience

• Optimal staff engagement

(Bevan, 2010)

What is Staff Engagement? “A measure of how people connect in their work and feel committed to their organisation and its goals”.

When staff are engaged:

• They say “Time passes quickly at work”

• They feel excited and enthusiastic about their role

• They devote extra time, thinking and effort to their work

• They resist distractions

• They find it easy to stay focused

• Their enthusiasm is contagious

(NHS National Workforce Projects 2007)

Guess what?

Healthy employees are more engaged and engaged

employees are more healthy….

(Van Stolk, 2009; The RCP, 2015)

Linking Staff wellbeing with Staff Engagement

Sickness absence is lower when staff: • Are highly motivated

• Are engaged

• Are well managed

• Are working within good quality job

• Have a high level of control in their job

(Coats and Max, 2005)

The Business Case for investing in staff

• Staff retention/absence rates are higher when staff feel cared for, engaged with & supported by their organisation (Reducing the need for temporary staff (estimated cost £1.45 billion per yr)) (Boorman, 2009).

• Reduction in recruitment costs (estimated to total £4,500 per vacancy) (CIPD, 2012).

• Reduced infection rates (Boorman, 2009)

• Improved patient safety/reduction in litigation claims

(Prins et al, 2010).

• Lower Mortality rates (Keogh, 2013)

How can we make this happen?

1. Demonstrate a commitment to a health and wellness programme that is fully integrated with your organisation’s mission, values and long-term vision

(Consider the NICE workplace intervention guidance resources).

2. Galvanize proactive occupational health teams

3. Value staff and their wellbeing in the workplace

4. Enable your staff to innovate and influence within the organisation

5. Source wellbeing champion talent at every level

6. Lead the way in turning these visions into practice

Practical Solutions

• Early intervention from line managers from the first day of sickness

• Prioritise a plan to support the mental wellbeing of staff and ensure there is provision of psychological therapies

• Ensure 24 hour access to affordable healthy food on site

• Ensure staff have access to smoking cessation services during working hours.

• Ensure that there is equality in support for outsourced staff

• Monitor uptake & impact across different groups (age, gender, pay grades,

shift patterns) and adapt services accordingly.

(Royal College of Psychiatrists, 2015).

References • Blake H, Malik S, Mo PKH, Pisano C ‘Do as I say, but not as I do’: are next generation nurses role models for health? Perspectives in Public Health 2011;131: 231–9

• Boorman, Steven. "Health and well-being of the NHS workforce." Journal of Public Mental Health 9.1 (2010): 4-7. • Blake, Holly, Dingyuan Zhou, and Mark E. Batt. "Five-year workplace wellness intervention in the NHS." Perspectives in public health 133.5 (2013): 262-271.

• Boorman S. NHS health and wellbeing review: interim report. London: Department of Health, 2009. • CIPD. Managing for sustainable employee engagement: Guidance for employers and managers. London: CIPD, 2012.

• Bev an, S (2010) The Business Case for Employees Health and Wellbeing A report prepared for Investors in People UK. The Work Foundation. • Coats, D. & Max, C. Healthy Work: Productive Workplaces. Why the UK needs more ‘Good Jobs’, London:The Work Foundation, 2005

• Department of Health. Choosing Health: Making Healthy Choices Easier.London: The Stationery Office, 2004 • Department of Health. NHS Health and Wellbeing Review: Interim Report.London: The Stationery Office, 2009

• Hodgson, Humphrey. "A national support service." Clinical Medicine 15.3 (2015): 219-220. • Keogh B. Rev iew into the quality of care and treatment provided by 14 hospital trusts in England: overview report. London: Department of Health, 2013

• Malik S, Blake H, Batt ME. How healthy are our nurses? New and registered nurses compared. British Journal of Nursing 2011; 20: 489–96 • Marsden, D. & Moriconi, S. (2008), The v alue of rude health, London School of Economics

• NHS Employers (2014) reducing sickness absence in the NHS using evidence-based strategies. Summary report. • National NHS Staff Survey Co-ordination Centre. NHS staff survey for England. 2013.

• NHS National Workforce Projects (2007). Maximising Staff Engagement. NHS National Workforce Projects, July. • Personal correspondence from patient to Royal College of Physicians. London: RCP, 2014.

• PWC, Building the Case for Wellness, February 2008 • Prins JT, Hoekstra-Weebers JE, GazendamDonofrio SM et al. Burnout and engagement among resident doctors in the Netherlands: a national study. Med Educ .

• Roberts, S. E., B. Jaremin, and K. Lloyd. "High-risk occupations for suicide."Psychological medicine 43.06 (2013): 1231-1240 • RCP. Work and wellbeing in the NHS: why staff health matters to patient care. London:RCP, 2015.

• Van Stolk C, Starkey T, Shehabi A, Hassan E. NHS workforce health and wellbeing review: staff perception research. London: Department of Health, 2009. • Wilkinson, E. (2015). UK NHS staff: stressed, exhausted, burnt out. The Lancet, 385(9971), 841-842.

• World Health Organisation (WHO). Healthy Workplaces: A Model for Action.Geneva: WHO, 2010

Improving Staff Experience to

Improve Patient Experience

at Sheffield Teaching Hospitals NHS

Foundation Trust.

Rhian Bishop Staff Engagement Lead

Work across 5 factors for good staff engagement

Between 2010 and 2014…

STH moved from the bottom 20% for staff satisfaction and a

below average staff engagement score

To

Top 20% for staff satisfaction and above average staff

engagement score

Some of the things we have done

• Fast track MSK/ health and wellbeing festivals

• Introduced “Mindfulness” sessions (had established counselling

service).

• Developed organisational values (PROUD) which were introduced into

appraisal and recruitment.

• Introduced increasing visibility programme for senior managers.

• Engaging leadership skills included in leadership development

programmes/ coaching skills.

• Increased employee voice.

• Increased appreciation/ recognition.

employee voice through:

• Full staff survey of all 16,000 staff

• Staff FFT

• Microsystems Coaching

• LIA

Measure & Monitor SE scores

Staff Survey Template by Directorate

Staff Friends and Family Testing by Occupational

group within directorate

Monitored via Performance review process along with finance and activity

Engagement meetings with staff

“This is what you’ve told us.

What can we all do to improve?”

Found suggestions to improve staff experience = improvements for

patient experience

e.g.

• Urology inpatients changed skill mix.

• Agreement to keep BP monitors charged and in the same place.

• Reintroduction of protected meal times.

• Improved information sent to patients in advance

• Improved clinical preparation – quicker to order bloods.

• Change in scheduling to reduce number of patients waiting

Has led to

An improvement in staff FFT scores e.g

Urology nurses recommend Trust as a place to work increased form 40% (2014) to 80%

(2015)

AND a culture where staff are more willing to make suggestions for performance

improvements:

Listening into Action schemes

- improvements in outpatients

- transport

“Give it a go week” June 2015

“Right good week” August 2015