What are your chances of being disciplined?

These days there is a whole host of information that we can access about the NHS workforce. This comes from a variety of routes including the Trust’s staff survey results and data published in response to the equality legislative requirements.

A few weeks ago, I discovered that if you look carefully at the figures of the top Teaching Hospitals in London, you’ll see that you’re more likely to be disciplined if you are a BME member of staff, working in a lower-paid job.

But why should this be the case? And why is it happening in more than one NHS Trust?  So far, I’ve only focussed on the larger Inner-London Hospitals, and I wonder if this is a nation-wide issue?

And what are the links to Bullying?   In a number of these Trusts, more BME staff are likely to report that they are being bullied.  There’s no way of determining if these are the same staff that have been subject to disciplinary procedures…..but there question is still there to be answered.

Over the next few months I’ll be looking into why this is the case, and what Trusts can do about it.   In the meantime, I would be grateful for any comments or suggestions on this topic.

Flexible working & Staff Surveys

Every year in the NHS, we undertake a staff survey.  It seeks to measure a range of different topics and the results can be analysed on a national level.   One of these topics is flexible working. 

Flexible working is incredibly important in the NHS and is a key element of any staff engagement strategy.  

Last week I triggered a discussion with an HRD around the uptake of flexible working within their Trust (they had not performed well in this area on their most recent staff survey).  I shared the findings from an assignment I undertook last year with another NHS Trust.   I had been asked to explore the reasons why the uptake of flexible working was so poor within this organisation.   The outcome was that staff were working flexibly;  they just didn’t realise it, and they hadn’t formalised any flexible working agreements.  As a result, the staff hadn’t ticked the “I work flexibly” box on the survey. 

In response to these findings, this Trust invested in promotional materials and raised awareness of the different types of flexible working that are available to staff.  In this year’s staff survey, the Trust scored higher than last year on flexible working.

I’ve been asked to explore this issue with another Trust this year – who are expecting similar results: they believe they do have a significant number of staff working flexibly, it’s just not reflected in their survey.   

I like to be an optimist, and think that flexible working is embedded in the NHS; that in it’s natural form it’s a working arrangement that arises out of an informal chat between a member of staff and their manager.   But the realist in me is asking: is it really that simple?

Can the office environment affect staff satisfaction?

Last week I went for a meeting with a potential new client.  I had visited this hospital once before to visit a friend.  This time, I entered through the blue cast iron gates with my “What would it be like to work here?” hat on.

I was immediately struck by how smart and clean the building was.  The reception and security area looked modern, and I was even more impressed by the faux-leather seats in the staff-only cafe.  Every member of staff wore a visible name badge.  There was an energetic buzz in the air that I could almost touch.   Before I even got to meet the client, my impressions of this hospital were overwhelmingly positive. 

As I left the hospital, I began to think about the impact the hospital environment had left on me, and how this might also impact on the staff who work there.  I had done my homework so I knew that this hospital has a high staff satisfaction rating.  I then thought about the other hospitals or PCTs that I know well:  those Trusts whose staff work in poor office environments also performed badly on their staff satisfaction scores*.  I’ll admit that there are a number of factors that are considered in determining a Trust’s Staff Satisfaction Score.  But correlation (slightly unscientific) between the working environment and the staff satisfaction scores is so strong that it cannot be ignored.  But this should not come as a surprise, as the famous Hawthorne experiments have already demonstrated this.

And this is where the dilema lies for public organisations.   Michael West of Aston University has demonstrated through his research that there is a direct correlation between staff engagement and the quality of clinincal care.   A pleasant office environment will raise staff satisfaction & engagement, but to create this requires money to be invested in the building, maintenance and furniture (at the very minimum).  This is money which is diverted from services delivering clinical care to patients.   In other words, to create the environment for staff to provide high levels of clinical care, money needs to be taken out of these services to improve the working environment. 

Managing the public relations of this is difficult.  How do you explain to patients that they will have to wait a bit longer for their operation because money is being spent on improving the hospital building, but it is hoped that, as a result, they will receive better patient care as a result?  

And are NHS Trusts who have influential HRDs and / or have Board members who are interested in staff engagement and satisfication more likely to support investment in this area whilst simultaneously managing the public perception of this?  And why should it depend on members of the senior team to drive this agenda, when the evidence on potential benefits is clear?

The staff engagement agenda and the associated measure of staff satisfaction is high on the agenda of NHS HR Directors at present.  It will interesting to see the developments in this area over the next couple of years.

* All NHS Trusts are required to complete a staff attitude survey every year.  As this is a national survey, the results can be meaningfully compared bewteen NHS Trust.