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							From:          Lynne Hunt, Deputy Chief Executive/Director of Nursing &
               Partnerships

To:            Trust Board

Date:          25 June 2009

Subject:       Employee Engagement Strategy



1.0     Purpose of the Report

1.1     The purpose of this paper is to brief the Trust Board of the main findings
        of the employee engagement survey regarding the levels of current
        employee engagement at the Trust. The paper outlines briefly the
        employee engagement strategy and the suggested activities to improve
        the levels of engagement with the workforce.

1.2     The Employee Engagement Strategy is currently being considered as
        part of the Organisational Development programme lead by the Deputy
        Chief Executive, and will be submitted to the Trust Board at a future
        meeting.

2.0     Executive Summary

2.1     Employee Engagement is not easily definable, although it is largely
        accepted that it goes beyond employee satisfaction. “Engaged employees
        are not only satisfied with their pay and benefits and working conditions,
        but they also have an understanding of business needs, are committed to
        their work and are more likely to exert discretionary effort and add value
        to the organisation” (IDS-Incomes Dates Services, 2009).

2.2     The paper assesses the findings of the engagement survey which
        included the distribution of circa 1190 surveys (49% of the entire
        workforce, with a 29% response); focus groups and one to one
        consultation with key stakeholders. The aim of the consultation was to
        gauge the levels of engagement and to provide the Trust with a platform
        to understand opportunities and possible barriers for employee
        engagement. The strategy outlines all areas identified by staff as matters
        for improvement.

2.3     The introduction of employee engagement activities will have a direct
        impact on the Trust becoming a Mental Health Employer of Choice,
        increasing the numbers of engaged staff and meeting the Investors in
        People Standards should the Trust chose to apply for this.


3.0     Background/Introduction

3.1     In March 2009 the HR Engagement team was commissioned by the
        Director of Human Resources to write an employee engagement strategy.



Chairman: Baroness Molly Meacher        1              Chief Executive: Dr Robert Dolan
          When developing the engagement strategy, there were several
          considerations taken into account:

      •   The findings of the engagement survey carried out in March-April 2009
      •   32 one to one interviews with senior managers including the Trust Chair,
          the Chief Executive, the Deputy Chief Executive, all Executive Directors,
          all Borough/Service Directors, the Medical Director and other Senior
          Clinicians; Local Head of Departments; the Service User Lead and the
          Trust Staff Side Chair.
      •   Focus groups with other key stakeholders, e.g. local senior managers and
          senior HR staff
      •   Linking the strategy to the Trust’s current 5 year annual plan; the NHS
          London Patient Safety and Quality Strategy; the NHS London Productivity
          Programme and the NHS London Engagement Strategy
      •   The research carried out by NHS London with regard to the issues of
          barriers to engagement within the NHS in London
      •   Building on existing initiatives at local level
      •   Best practice drawn from research on other organisations including
          successful commercial organisations amongst the 100 Best
          Organisations to work for
      •   Tested frameworks that have been successful in increasing employee
          engagement

3.2       The engagement strategy paper proposes initiatives which include a
          potential action plan for the next 3 years. It is aimed to assist the Trust to
          improve the engagement with its workforce, enabling it to become an
          Employer of Choice and to meet the Investors in People (IIP) standards.


4.0       Report Content

4.1       A possible definition of engagement suggested for the Trust is:
          “Employee Engagement for East London NHS Foundation Trust
          means a highly engaged workforce working consciously towards
          the improvement of service user’s health and wellbeing whilst
          fulfilling their professional aspirations feeling connected to the
          Trust.”

4.2       The main drivers of employee engagement lies with excellent people
          management, the development of robust and clear policies and
          processes, active support of line managers in alignment with the
          organisational objectives and values and giving employees a voice.

4.3       Results from the Quantitative (Engagement Survey) and Qualitative
          Research

4.3.1     Please see the finding set out in the graph below.




Chairman: Baroness Molly Meacher            2               Chief Executive: Dr Robert Dolan
                       Bre akdown of Staff who are Engaged/Not
                             Engage d/Active ly Disengaged


                100%                                   5%         11%
                                 22%                                                    17%
                                           24%                               25%
                 90%
                                                       31%        16%
                 80%
                                           14%                                          23%
                 70%             26%                                         25%
                 60%
   Percentage




                 50%
                 40%                                              73%
                 30%             53%       62%         64%                              60%
                                                                             51%
                 20%
                 10%
                  0%
                        City &   Corporate Forensics    New ham    Tow er      Trust-
                       Hackney   (Inc. HR)                         Hamlets      w ide

                                                 Locality

                            Engaged    Not Engaged    Actively Disengaged




4.3.2           Results from the survey showed that 26% of the respondents indicated
                that they were likely or highly likely to leave the Trust voluntarily in
                the coming year.

4.3.3           46% of the respondents stated that they are proud to work for the Trust.

4.3.4           30% of the respondents do not agree that they have had a meaningful
                PDP/appraisal, whilst 10% of the respondents have indicated that they
                either disagreed or strongly disagreed to the statement that they have
                had opportunities at work to learn and grow.

4.3.5           Staff have mentioned that a lack of training/development opportunities is
                one of the main reasons for leaving the Trust.

4.3.6           51% of the respondents have indicated that they do not feel involved in
                the decision making process.

4.3.7           An analysis of the exit Interviews carried out in the past year reviewed
                that the main factors that contributed to staff leaving the organisation
                were:
                ▪      Poor Communication
                ▪      Dissatisfaction with current role
                ▪      Career development
                ▪      Broaden their experience
                ▪      Pay

4.3.8           An analysis carried out with new starters since February 2009 reviewed
                that what attracted people to work for the Trust were:
                ▪      Career prospects
                ▪      Interesting work
                ▪      Better use of skills and experience



Chairman: Baroness Molly Meacher                  3                Chief Executive: Dr Robert Dolan
        ▪      Close to home
        ▪      Good development/training opportunities

4.3.9   Career prospects and development were both a high indicator for
        attracting and losing staff.

4.3.10 There are several costs associated with managing increasing levels of
       conflict at work which include time spent on resolving cases and also the
       missed opportunities for HR/Investigating Officers to be do more
       constructive work. An analysis of the employee relations cases in the past
       6 months outlined that there has been a reduction in the number of cases
       from 49 to 35 at the time the analysis was carried out.

4.3.11 The CIPD’s Leadership and the Management of Conflict at Work Survey
       (2008) found that on average HR professionals from the public sector
       spent 3.8 hours every week managing conflict at work. The CIPD’s
       Managing Conflict at Work survey (2007) found that on an average, the
       public sector employers spent 21 days managing each disciplinary case
       and 12 days in managing each grievance case.

4.3.12 An average number of hours spent by each locality HR team in resolving
       a case are mentioned below and this is specific to our Trust.

        ▪      On average, each HR advisor spends approximately 5-10 hours a
               week on various cases. This is aside from the time spent by the
               Investigating Officers, HR Manager & panel members.
        ▪      Investigating Officers spend approximately 45 hours per case
        ▪      HR Manager spend approximately 5 hours per case
        ▪      If the case goes to a hearing the panel members (group of 3) will
               spend 5 hours on average per case.

        Based on the above calculations, managing each case would take 117
        hours i.e. 16 days per case per year.

4.3.13 Absence is another important measure which reflects the true health of an
       organisation and how engaged a workforce is or is likely to be. A
       comparison of overall figures from 2007/2008 to 2008/2009 indicates an
       increase in sickness absence from 4.16% to 4.42%.


        The table below details an average of costs per band per locality. The
        calculations are based on the mid-point salary under Agenda for Change
        (including NI & super annuation) for each band and the actual recorded
        number of FTE days lost per band within each locality for the financial
        period of 2008/2009.




Chairman: Baroness Molly Meacher       4              Chief Executive: Dr Robert Dolan
            City &                      Estates &       Forensic                   Specialist      Tower
  Band     Hackney        Corporate      Facilities     Services      Newham       Services       Hamlets        TOTAL
Band 1              0     £17,156.72               0             0             0             0             0     £17,156.72
Band 2     £33,365.41     £14,469.84    £30,756.24         £563.76    £61,103.23             0     £7,203.60    £147,462.08
Band 3     £93,712.95     £12,044.28     £7,629.17     £152,837.21    £79,699.90   £38,366.62     £98,320.89    £482,611.02
Band 4     £32,261.95     £37,708.89     £7,721.42      £87,743.19    £55,539.79   £22,825.25     £61,846.95    £305,647.43
Band 5    £238,364.24     £24,058.11               0   £277,220.50   £236,404.07   £30,505.84    £171,140.13    £977,692.88
Band 6    £145,264.92     £30,424.18     £3,038.62      £53,877.07   £138,841.58   £29,139.59    £137,580.92    £538,166.89
Band 7     £83,946.06     £32,150.59       £411.39      £15,108.95    £91,147.05   £28,575.15     £98,486.77    £349,825.96
Band 8a    £28,252.55     £25,635.45       £661.56      £13,512.36    £35,921.16   £12,247.81     £45,696.33    £161,927.22
Band 8b     £6,210.22     £59,660.19               0     £3,299.36    £35,175.38   £68,054.61     £11,644.80    £184,044.57
Band 8c    £37,212.65        £884.93               0     £6,418.16    £28,578.04    £8,974.55     £44,686.42    £126,754.76
Band 8d     £8,326.60              0               0       £279.79     £8,863.80    £1,880.20      £2,973.79     £22,324.18
Band 9              0      £4,503.24               0             0             0             0             0      £4,503.24

TOTAL     £706,917.55     £258,696.43   £50,218.40     £610,860.35   £771,274.01   £240,569.61   £679,580.59   £3,318,116.93

             Please note that the figures above are purely a value ascribed to hours lost in
             sickness and it does not take into account staff replacement cost.


             4.1        Benefits to the Trust linked to increasing the levels of staff
                        engagement such as:

                        There are clear links between highly engaged employees and bottom line
                        performance:

                   •    Increase in motivation, which is directly linked to exertion of discretionary
                        effort to provide better service to our clients, leading to better business
                        performance and higher client satisfaction;

                   •    Employee engagement is a key ingredient in achieving high quality
                        performance, both at the individual, team and organisational level, so
                        improving the quality of service being delivered will enable the Trust to
                        tackle the drivers of quality;

                   •    Employees act as advocates for the Trust, which will enhance the Trust’s
                        image hence attracting higher calibre staff and the loyalty of the PCTs in
                        commissioning our services

                   •    Engaged staff stay longer, so there should be a reduction of recruitment
                        costs and turnover, and continuity of service delivered to our clients

                   •    Longer return on training investment costs, i.e. retention of intellectual
                        capital

                   •    More motivated staff tend to enjoy their work and their place of work,
                        which should reduce levels of absence and conflict

                   •    Increase in the levels of employee satisfaction and the association of
                        positive attitude and emotions towards their work, leading to
                        organisational citizenship/advocacy, reduction of grievances and bullying
                        and harassment




             Chairman: Baroness Molly Meacher               5               Chief Executive: Dr Robert Dolan
      •      Highly engaged staff are more connected with the true values of the
             organisation, with real potential to offer business benefits, for example
             enabling more creativity and innovation in how services are delivered,
             hence improving the quality of care to our clients

      •      Reduction of complaints both from clients and staff

      •      Increase in client satisfaction

5.0          Recommendations

5.1          The main areas identified for improvement were:

        I.   Reward and Recognition
       II.   To invest in leadership and career succession
      III.   To improve the skills of line managers
      IV.    To enable “real” employee involvement in decision making e.g.
             improving the avenues for a two-way communication
          V. To create a learning and engaging culture

A brief summary of the activities are outlined below:

      I. Reward & recognition of staff
To introduce initiatives to recognise the contribution of staff across all areas.
Some of the activities suggested are:

To develop an annual scheme for the nomination and award of staff on several
categories, such as an Annual Staff Awards

To introduce Local schemes to recognise contributions at a local level, which will
lead to improvement of service delivery and greater connectivity with local
services – Local Employee of the Month Scheme.

To invest in activities which will foster employee citizenship and identification with
the Trust, such as sports activities, family events and volunteering activities

Discretionary reward points: Award discretionary points to reward staff self
initiatives beyond their core duties and behaviour (going over and above), which
fully contributes/enhances the Trust objectives and linked to the direct
improvement of patient care.

To develop training to be delivered in-house educating line managers on the
importance and the benefits of praising, giving constructive feedback and saying
thank you to staff more often.

To reduce the “relationship gap” between staff on the shop floor and senior
managers by introducing local and trust wide initiatives such as “thank you
walkabouts” and “back to the shop floor”.

       II. To Invest in leadership and career succession/Talent Management
Career Succession/Investing in Leaders
It is proposed that the Trust introduces the “East London NHS Trainee Scheme”
targeted at internal potential leaders.




Chairman: Baroness Molly Meacher               6             Chief Executive: Dr Robert Dolan
    III. To improve the Skills of Line managers
To develop and agree a core competency framework for managers that will
enable the Trust to ensure excellent delivery of high quality service and people
management.

Identify the real gap between these core competencies against the current levels
of competencies by auditing managers skills using the Investors in People (IIP)
assessment tool (Self scoring) and a 360 degree exercise (scored by others),
ensuring that any training to be attended will be linked to the needs analysis and
focused on practical, hands-on experience that will lead to direct improvement of
services and people development.

     IV. To enable “real” employee involvement in decision making e.g.
          improving the avenues for a two-way communication
To strengthen the use of the Trust Intranet as a communication vehicle, creating
opportunities for staff to contribute, make suggestions and ask questions relevant
to their day to day activities.

To introduce meaningful two-way communication for senior managers to inform
staff of current service developments as well as to consult with staff, providing a
forum for queries, suggestions and concerns to be expressed, which will lead to
greater involvement of staff in decision making.

To revamp the Communication Pathways and invest in educating managers in
how to communicate with their staff, highlighting the advantages of having clear
communication channels, such as increase in motivation, reduction of conflict,
absence and turnover.

To introduce activities locally to provide a forum for staff and local managers to
discuss developments and celebrate achievements.

       V. To create a learning and engaging culture
To develop a culture that will reinforce the change in attitude, behaviours and
actions required in order to deliver the quality agenda and the Trust vision. This
will include:

Senior Trust Board Members to commit to and support a change in culture, which
will include taking more risks, creating a supportive and trusting environment
whilst being clear regarding the expectations of accountabilities and
responsibilities that lies with each role within the Trust.

To introduce a clear message to all staff regarding where the Trust is heading to
and how they “fit in” in delivering this vision.

Reinforce the beliefs it has regarding the workforce shaping policies, procedures,
processes and audit tools that will reinforce these beliefs, ensuring that staff start
to behave in this way and that it recruits people who match this description.




Chairman: Baroness Molly Meacher          7               Chief Executive: Dr Robert Dolan
6.1      Financial Implications

6.1.1    The proposals outlined in the strategy paper will have to be cost
         assessed individually and brought to the Service Delivery Board and trust
         board in due course for discussion and approval.

6.1.2    It is envisaged that there should be an improvement in several areas,
         such as lower turnover, lower levels of absence and less employee
         relations disputes.

7.0      Recommendations

7.1      It is recommended that when the Trust agrees its employee engagement
         strategy that its focus is initially upon a couple of priorities. From the
         consultation exercise, it is anticipated that the activities such as
         recognition & reward and the improvement of line manager’s skills may
         lead to a quicker increase in the levels of employee engagement,
         ultimately achieving the benefits outlined in section 4.4 above.

7.0      Action being requested

7.1     The Trust Board is asked to RECEIVE and NOTE the report.




Chairman: Baroness Molly Meacher         8              Chief Executive: Dr Robert Dolan

						
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