Shape Our Future

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					                               Shape Our Future
Introduction
The aim of Shape our Future was to give Ridgeway Partnership’s staff, users, partners
and public dedicated opportunities to be fully informed and involved in the latest thinking
around the challenges of changing the Ridgeway Partnership’s organisational form. As
a fundamental part of its decision-making process, the Trust Board was keen to listen to
people’s own questions, preferences and concerns about the options available.

Shape our Future built on the programme of roadshows held through the summer of
2006, providing stakeholders with more specific and comparative information on the
different choices available and with informal forums in which to ask further questions of
the management team.

Process
Shape our Future took place over the course of 8 weeks. During this time,
approximately 2200 information booklets, of which 900 were in an accessible format,
were distributed as hard-copies to all staff members and users. This included posting
copies to all tenants who receive support from Ridgeway Partnership. The information
booklets were also emailed to “all Trust” users and made available on the Trust website.
Electronic copies were sent to more than 15 external organisations, including
commissioners, members of Ridgeway Partnership’s Patient & Public Involvement
Forum (PPIF) and the Overview & Scrutiny Committees, as well as to several interested
individuals in other parts of the country (i.e. Plymouth, West Sussex and Sunderland).

Attendance at the roadshows was voluntary for staff and open to all. Sessions were
arranged through discussions with the Communications Group to offer staff/users a
choice of two different venues within their immediate regions, at two different times of
day. Managers were asked to encourage their teams to attend, or to invite members of
the Shape our Future team to visit staff team meetings. The programme for the staff
roadshows was published in News n’Views and details of both staff and user
programmes were given in emails and posters around the Ridgeway Partnership.

Feedback could be given in person at the roadshows, through the booklet response
sheets, by email (dedicated email address) or by phone. Two senior managers and/or
directors facilitated each of the roadshow sessions.

Responses

       15 roadshows took place around the three counties, which 167 people attended.
       33 booklet feedback sheets have been returned.
       Several emails have been received, including two collective trade union memos.
       An official response from the Ridgeway Partnership’s Public & Patient
       Involvement Forum has been recorded (attached in Board papers).
       Separate briefings have been given at the Learning Disability Partnership Board,
       Public & Patient Involvement Forum, Commissioners’ meetings, OMT and other
       staff team meetings.

                                            1
        The programme of roadshows for users/carers was cancelled early on, due to
        lack of attendance.

Roadshows

The programme for users/families was cancelled after lack of interest in attendance.
Feedback from families and carers through the Ridgeway Partnership PPIF indicates
that as long as the nature and quality of services remains the same and that these
services remain together in a specialist organisation, families/carers are not concerned
about which organisational form is chosen. This information supports early feedback
gathered in the summer roadshows, in which families/carers affirmed that their priorities
are that specialist health services retain NHS quality standards and that the delivery of
services in the community does not change. It is therefore reasonable to suggest that
the lack of interest from these stakeholders in the roadshows was probably due to the
fact that the issues most important to them are not materially effected by the options
available.

The below sections therefore offer a brief summary of some of the key themes that staff
have raised at their roadshows. There are approximately 1300 staff employed by the
Ridgeway Partnership. Attendance at the roadshows was very mixed with numbers
ranging from 0 – 30 people coming to a session.1


   1.      Pensions, terms & conditions
This area also rated most highly in the scoring sheets of the booklet responses (see
below). Discussions, questions and concerns ranged from the need for assurance over
job security (TUPE feels inadequate for some individuals), to professionals’ concern with
recruitment and retention potential in the future. Implications for those with Mental
Health Officer Status are of particular concern to many. There were several technical
questions concerning contracting arrangements through TUPE.

There were conflicting feelings about terms and conditions in relation to Agenda for
Change – some individuals said they would like to see reward packages linked more
closely to people’s attitudes in order to increase an equity of responsibility in the
workplace; others were concerned they would lose the benefits they have.

    2.    The NHS ‘brand’ and its benefits
The concern that Ridgeway Partnership might lose the values and benefits of an identity
with the NHS that is recognisable, trusted and valued by the public came through
strongly. However, there was also acknowledgement that the ‘NHS’ could be
interpreted differently in health and social arenas and be an advantage or a
disadvantage depending on the nature of the task.         Several people, including
commissioners, voiced concerns that the quality and standards expected by the NHS
must remain. Many people also expressed frustration that the NHS as it stands does
not value people with a learning disability, or those who support them. There was
widespread consensus that the Ridgeway Partnership must remain true to its purpose –

1
  The ratio of Specialist Health/Supported Lifestyles staff group representation at the roadshows,
appeared to vary according to the region they were held in (figures still need collation).

                                                2
delivering high quality services and increasing the involvement of users. There were
several comments that ‘the system is only as good as the people within it’.

3.     Partnerships
Linked to concerns about Ridgeway Partnership’s relationship with the ‘NHS’ were
several questions about the implications for partnership arrangements with other
organisations. These included questions about: how links and invitations to NHS forums
could be preserved if the Ridgeway Partnership became a Social Enterprise; what other
Trusts in the local area, as well as Learning Disability services nationally, were doing
and how commissioners and the SHA viewed Ridgeway’s strategic direction. Some of
these questions also expanded into ones about Ridgeway’s need to tender for business,
and areas for growth. Many people reflected awareness of the need for flexibility and
increased financial freedoms.

4.     Financial benefits
Several people asked about the comparative financial benefits of the different options
(‘Which option would give us more money?’), whether the changes would prevent other
parts of the NHS drawing on Ridgeway’s finances, and whether/how the size of the
Ridgeway Partnership might play a part in final decisions.

5.     Decision-making
In almost every roadshow, questions were asked regarding the nature of the decision-
making process. People wanted to know whether the booklet responses or the
roadshows would ‘carry more weight’; they also wanted to see evidence that whichever
organisational form was chosen would be best for service users. Family members at the
Partnership Board underlined this request. One support worker asked for a cost benefit
analysis to be carried out in these next months, directly comparing any narrowed down
options. People related that there is an impression in the Ridgeway Partnership that
decisions had already been made – however, there were simultaneous rumours of both
options having been already chosen!

Summary
Overall, people who attended the roadshows brought varying levels of understanding
about the reasons for Ridgeway’s plans to change organizational form. Comments
reflected the nature of confusion that there still is around both national and local policy-
making. People also brought with them a great deal of interest, a richness of
perspectives and an openness to recognizing the complexities of the issues under
consideration.


Booklet responses
i.   Only 33 booklet response forms were received. The greatest number came from
     support/admin staff, with the Learning Disability Teams forming the next most
     responsive group. Only one response was received from a specialist health
     inpatient unit. None were received from families/carers or the public, although
     Ridgeway Partnership’s Public & Patient Involvement Forum prepared a separate
     and collective response (separate report).

ii.    The majority of those who responded had a preference for Foundation Trust
       status.

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Figure 1: Preferences for organisational model (all stakeholders)




                                                                 3.23%

                                                                                               19.35%
                                              16.13%




                                                                                                                              Social Enterprise

                                                                                                                              Foundation Trust

                                                                                                                              Don't Mind

                                                                                                                              Not Sure




                                                                       61.29%




Figure 2: Staff group categories and organisational model preferences
                12




                10




                 8

                                                                                                             Don't Mind
   Preference




                                                                                                             Not Sure
                                                                                                             Foundation Trust
                 6
                                                                                                             Community Interest-limited by shares
                                                                                                             Communtiy Interest Company-limited by guarantee
                                                                                                             Charitable Company
                 4




                 2




                 0
                     Support/admin   Specialist health-   Supported       Specialist Health-       Unknown
                         staff         Community          Lifestyles       Inpatient units
                                         Teams
                                                           Group



iii.                 4 responses were received from service-users. Of these, 3 said they ‘didn’t mind’
                     which organisational model was chosen, with one stating a preference for ‘social
                     enterprise’.

iv.                  The majority of points were allocated to ‘pensions, terms & conditions’ as the
                     aspect that mattered most to people overall. This was followed by ‘ethos &
                     values’. Other categories were attributed almost equal weighting.



                                                                                               4
Figure 3: Overall weighting given by staff to 5 key areas


                                                     12%                          11%




                               12%



                                                                                                                                     Community partnerships
                                                                                                         23%
                                                                                                                                     Ethos & Values
                                                                                                                                     Membership & Involvement
                                                                                                                                     Pensions, terms & conditions
                                                                                                                                     Regulatory Requirements
                                                                                                                                     Financial flexibility




                                             31%                                              11%




Figure 4: Weighting given to key areas by staff group
          90



          80



          70



          60

                                                                                                                           Financial flexibility
          50                                                                                                               Regulatory Requirements
 Points




                                                                                                                           Pensions, terms & conditions
                                                                                                                           Membership & Involvement
          40                                                                                                               Ethos & Values
                                                                                                                           Community partnerships

          30



          20



          10



           0
               Specialist Health-Community         Support/Admin      Specialist Health-Inpatient   Supported Lifestyles
                           Teams
                                                                   Group




v.               23 of the responses include comments:

9 of these comments express a strong identity with NHS ‘ethos and values’, stating that
being part of the NHS is about ‘more than pensions’ or an NHS logo. They affirm the
reputation the NHS has with the public, and its prospects for training and security. For a
couple of people, a social enterprise option feels like ‘moving towards a private sector
ethos’. 2 people reflect the feeling that staff would leave if the Ridgeway Partnership left
the NHS.


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3 of the comments express the importance of keeping pensions and current terms &
conditions. Another states: ‘I would like to see a smaller gap between the highest and
lowest paid once we are out of an NHS structure’.

3 relate to community involvement, affirming support for a greater focus on individuals
the Ridgeway Partnership supports, involving people from all levels of the Trust and
building staff involvement from the ‘bottom up’.

3 comments draw attention to the differences in business within the Ridgeway
Partnership and reflect awareness of tension between different mindsets &
marketplaces. 1 person asks – ‘has a split between the two been considered as an
option? (This is not what I would necessarily want, but it feels logical!)’ Another
expresses concern that if we were not within the NHS, health focus could be diluted and
we may become focused on social care’.

1 comment expresses frustration with the current need to ‘bail out other NHS Trusts’
financially, and a strong desire to move away from this.

Other comments include: a plea for language to be kept simple & jargon-free and
further questions about the unknowns – ‘are we just too different (again)?’


vi.   Collective responses

Unions – Memos were received from Amicus and UNISON requesting further clarity
around information contained in the booklet, expressing concern over the security of
pensions, and current terms & conditions and highlighting the importance of the ‘NHS’ to
staff both internal and external to the Ridgeway Partnership. There is disappointment
that there were not more details on reward packages within the information booklet.

These concerns help highlight where communication within roadshows and
documentation could be improved. They have also helped to raise awareness within the
Ridgeway Partnership of wider anxieties in the local health economy.

Commissioners – Ongoing conversations reflect commissioners openness to engaging
with all of the different models put forward, subject to consideration of their respective
costs. There has been some indication expressed that social enterprise models sit
comfortably with the culture of local authorities.

Ridgeway Partnership PPIF - This response has been officially lodged as a separate
Board paper.




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Findings
The outcomes of Shape our Future need careful analysis. The return of feedback
booklet sheets was extremely low. Attendance at the roadshows was higher, but still
amounts to considerably less than 20% of staff numbers. It would not therefore be fair
to treat responses received as necessarily representative of stakeholder views across
the whole of the Ridgeway Partnership.

The low response rate would seem to be due to a mix of reasons. Comments at the
roadshows and on some booklet sheets suggest many people are still confused about
the reasons for change and that there are too many unknowns or too many complexities
for people to feel ready to state a preference. It is also possible that some staff
members and users did not receive a copy of the booklet.

Other comments suggest that in light of the fact that services themselves will not
change, people ‘do not mind’ which organisational form is chosen. This supports the
feedback that the Ridgeway Partnership’s PPIF has brought back from carers. In
addition, there would appear to be a feeling amongst some staff that the decision on the
Ridgeway Partnership’s future has already been made, and/or that people’s involvement
would not make any difference to the outcome.

Interest and attendance has grown in the final two weeks of the programme, with
requests for further sessions to be held for some Supported Lifestyles teams over the
next fortnight.

There are some consistent themes in feedback received both from the roadshows and
booklets which are important to capture and cross-compare.


Post script – Closing the loop
There is lots of learning to take away from the process, low response rate and outcomes
of Shape our Future. Further analysis is needed on how best to take forward the
learning and messages through action.

A record of gaps in distribution-lists, in distribution itself and in any confusing
language/content has been kept to help make improvements next time a mass
communication of this nature takes place.

It would seem useful to review whether we are involving users and carers/families in the
most flexible and fruitful ways we can. It also appears that more work might need to be
done in encouraging staff to take interest in and ownership of big strategic decisions –
both Foundation Trust and Social Enterprise models will require this participation to be
truly successful. Moreover, comments and questions throughout Shape our Future have
helped demonstrate that communication of key messages and facts is taking a lot of
time to reach all parts of the organisation.

Those who feel strongly about their affiliation to the NHS and/or are concerned about
their pensions, are articulating a strong preference for the Trust to move towards
Foundation Trust status. This preference is important to hear. However, there are still

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many others who are suspending their preferences until more is understood. There is a
shared appreciation of the complexities of the issues at stake and staff have often
expressed gratitude for the Trust’s ‘transparency and honesty’ about these.

It is anticipated that there will be greater interest, especially from user/family/carer
groups, in discussions around the involvement and membership structures as this work
progresses.

An accessible news-sheet for all stakeholders involved in this exercise will be produced
in these next weeks. This will publish feedback on Shape our Future alongside other
learning activities held during the last three months, and will consolidate answers to
some of the most Frequently Asked Questions coming out of the roadshows. This
should offer an opportunity to those who have not attended any of the roadshows to
share in the learning that is taking place.




Rachel Hill
Projects Manager
March 2007




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