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Why NHS staff involvement is essential to improving care

Brendan Martin, 9 September 2013

One in three nurses surveyed by the Chartered Institute of Personnel and Development (CIPD) say they have come under excessive pressure to behave in ways that undermine patient care.

It is a shocking finding -- but the danger is that we will cease to be shocked by such evidence because it is no longer surprising.

This is literally the 15th blog piece Public World has published in the last six months that has referred to a report or a study showing that inadequate staff voice is putting patients at risk.

It is not that we keep referring to the same evidence. The fact is that the CIPD findings are as shocking as they are not because they are new but because they confirm so much other research.

Of the hundreds of pages of the Francis Report into Mid Staffs, for us its key lesson was expressed concisely in paragraph 1.118, which stated (emphasis added):

“The patient must be first in everything that is done: there must be no tolerance of substandard care; frontline staff must be empowered with responsibility and freedom to act in this way under strong and stable leadership in stable organisations.”

Since Francis we have had the Keogh and Berwick reports confirming much the same message, as well as the NHS Staff Survey revealing much the same findings as the CIPD research.

So what is to be done? The CIPD itself stresses the importance of data: “Better collection, reporting and analysis of data on, for example, training and development, appraisals, employee engagement, stress and absence can provide trust boards with key intelligence on how NHS Trusts are really functioning and highlight early warning signs which might indicate patient care is being compromised.”

Important though that is, however, surely the familiarity of the CIPD findings suggests that the core problem is not too little information but too little commitment to using it, or too little clarity about how to do so.

As Kevin Croft, president of the Health People Management Association (HPMA), for which CIPD conducted the research, commented:

“These survey results are disappointing but similar to messages from the national staff survey.  The findings reinforce the need for a much greater focus on the staff experience, good people management and staff engagement, at both a system and local level, to improve the patient experience.”

We agree, which is why Public World has invested this year in the development of two new resources we believe can help NHS Trusts and their staff make the changes required:

  • With the support of NHS Employers, we are offering an innovative approach to staff involvement. Our approach is based on the Best Workplace methodology, which is the product of 20 years experience of our Swedish partners Alamanco. It has a tried and tested record of simultaneously improving health and social care quality, resource use and job satisfaction.
  • We also offer training support linked to our Duty of Care handbook and website, in which nurses and other health care staff can find practical guidance about how to raise concerns and combat bullying. With the support of Unite the Union, we are currently producing a special edition of this resource for their health professional members, and we can do the same for others.

The CIPD and HPMA are to be congratulated for research that should be on the agenda of every NHS trust this week, but surely not one of those trusts will be surprised by the findings.

The challenge now it to ensure that if a similar survey is conducted 12 months from now the findings show the right direction of travel.

Our own contribution may be modest, but we could not be more committed to making it, and we welcome conversations with any NHS trust or staff side organisation about how we can help you.

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