Trust initiates a culture change programme for empowering staff to provide compassionate and high quality care for patients, enhancing staff experience and achieving positive response

Challenges

 Our trust has faced many challenges in recent years, including an attempted merger and a difficult CQC inspection in 2013. We knew there we had some very strong teams and pockets of great practice. However, anecdotally we also had a culture that was not a supportive one and there were issues of poor behaviour not being tackled and inequalities for staff. We embarked on a culture change programme. The first phase was to discover what it felt like to work at RBCH, and then to make changes to help us move towards a compassionate and collectivewell-led organisation.

Actions

 We established a team of 15 Change Champions, nominated by their line managers. A panel of senior leaders selected them based on a mix of skills, roles, bands and experience. They included an F2 doctor, a newly qualified nurse, a consultant and a patient volunteer. We met for monthly workshops. These were a mixture of discovery work and personal development. During our first workshop we completed a group MBTI session so that the newly formed multi-professional team had a better understanding of their own and others’ preferences. We also asked everyone to produce a short video introducing themselves so that we started to get to know each other.

During the Discovery phase, we had no formal budget so the OD team facilitated each session, produced materials for each exercise, and we used a disused meeting room in our Christchurch site while it was being redeveloped. The Champions were tasked with finding out what it felt like to work at RBCH. By the end of the Discovery phase they had gathered over 900 views. They held focus groups, interviewed every member of the Board and conducted an online survey. They reviewed the trust data, such as complaints data, Staff FFT data, and Staff Survey reports. They reviewed external information too, including looking at other trusts. Some of the champions visited Frimley Health. The Champions themed their findings and made a series of recommendations based on what our staff had told them they wanted.

They presented these to the Board at a special development session.These recommendations were accepted in full and the Champions were tasked with moving to the Design phase to implement these changes. We recruited a further 10 champions to help us in the work. During the Design Phase there were some “Just Do It” actions, some that needed a plan and a third category that will take us longer to achieve. In the last year we have achieved a lot. We have appointed a Freedom to Speak Up Guardian, introduced Customer Care and Personal Resilience workshops. We have started Difficult Conversations training for our managers. We have a Matrons and Care Group Development programmes. We held more focus groups, changed how we recognise staff, developed new understandable trust objectives, started to take our communications out to the wards differently, listened to staff about inclusion concerns and continued to roll our values based appraisal.

Results

 We believe there is a change in how staff feel about working here, and the measures are starting to support this:

•Staff Survey 2016 – Our best results and best completion rates

•Staff Impressions Survey (includes Staff FFT) – shows significant improvements. In June 2017 77% of respondents recommended us as a place to work and 94% said their experience here was mainly good.

•Better attended feedback sessions & positive responses

•Increased number of #ThankYous! raised about our staff, by our staff and patients.

•Over 800 members of staff have had at least one leadership development activity since September 2016.

Spread

 When we recruited our second cohort of Champions, we had lots of interest from across the Trust. The Champions continue to spread the messages in their professional areas. We have been able to deliver many of our new initiatives using our interested staff who have heard about our journey – e.g. in-house Customer care trainers – rather than spending on external “experts”. We have been a case study in an NHSI publication on the Discovery phase, and have piloted their new 360 tool. We are being approached by lots of other trusts who wish to learn and share best practice with us.