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Trust establishes a model to value staff lives and recognise their contribution towards delivering appropriate patient care, resulting in increased staff appraisals and average engagement scores

HSJ Awards 2018/ Staff Engagement


    • Negative staff experiences led to adverse impacts on patient care
    • Staff survey scores showed lower than average engagement records
    • Trust performed below average with increased financial deficit
    • Establish staff engagement in line with the national average, improving patient outcomes


    • Created the Leeds Way engagement model for improving staff wellbeing
    • Identified five work streams and assigned a programme of activity for each stream
    • Implemented standard communication templates and feedback mechanisms to support local staff engagement
    • Facilitated a crowdsourcing platform, enabling staff to voice their opinions/ideas
    • Introduced the iFactor campaign and 8 week challenge to embed improvement ideas and enhance team-building


    • Improved staff engagement scores above the national average
    • Ranked 4th for percentage of staff appraised and 5th for percentage of staff reporting good communication with seniors
    • Ranked 7th in fairness/effectiveness of procedures reporting errors, near misses and incidents
    • 300-2000 staff participated in various campaigns, resulting in support-driven outcomes
    • Achieved a ‘good’ CQC rating


In 2014 Leeds Teaching Hospitals Trust (LTHT) co-created with staff the Leeds Way, the vision, values and goals for the organisation. This set the agenda and expected behaviours for all staff in the organisation and was well received by both staff and patients. However there was a recognition that in order to achieve the challenging goals the organisation had set itself, LTHT would need to ensure that all staff were engaged with the Leeds Way, felt a valued part of the organisation and were committed to delivering the ambitious goals they had set. 

The Board recognised that the best way to monitor shifts in engagement levels was through the annual staff survey. The challenge was considerable, in an organisation of 15,000 with a historically low staff engagement score, how do we reach all staff and show them that with a new leadership team, comes a new culture. The organisation’s culture and long term strategy was co-designed in partnership with staff in but how do we make it real?

Between 2012 and 2017 LTHT has seen the biggest positive shift nationally compared to other acute trusts on staff engagement score and has shifted from 18 of our key findings being below average in 2014 to 22 being above average in 2017.


The Trust recognised that staff felt their experiences were not as positive as staff in other organisations and understood the impact that this can have on patient care and experience. In addition the Trust was reporting a financial deficit and was about to embark on a large scale cost improvement programme. The staff survey scores for LTHT showed that staff reported lower than average staff engagement scores and that across the key findings the organisation was performing well below average compared to other acute trusts.

The Leadership Team set the goal of bringing the staff engagement score in line with the national average. In 2014, 18 of the Trust’s key findings were below average, so an additional goal of seeing a shift to average and above was also set. In addition to the staff survey goals, the Leadership Team also wanted to create an organisation where staff live our values, feel part of the hospitals community and would recommend us as a place to work.


The Trust took an organisational approach, acknowledging that in a large, multisite organisation, all leaders needed to be involved in the programme. LTHT established a Staff Engagement group chaired by the Chief Executive who would be accountable for delivering the staff engagement programme. Following consultation with staff, managers and staff side colleagues a staff engagement model was developed. The staff engagement model set the Leeds Way at its centre, with five workstreams:

• Health and Wellbeing

• Recognition and Celebration

• Effective two way communications and engagement - including freedom to speak up

• Organisational learning and leadership

• Employee journey Working in partnership with staff, a programme of activity for each workstream was established, setting challenging goals and ensuring that the activity reflected staff need.

In a large organisation, reaching all staff was a challenge, there was an early recognition that consistent, clear messaging about staff engagement activity was needed. In addition, whilst LTHT needed to get staff to feel part of the whole organisation the value of local connections also need to be acknowledged, so action plans developed at a local level.


LTHT recognised early on that there is a need for organisational wide activity, but as time has progressed has also established an infrastructure to enable managers to act locally. This includes standards communications templates and feedback mechanisms as well as supporting the establishment of local staff engagement and health and wellbeing groups.

LTHT has sought feedback from staff side at each stage of this programme and our crowdsourcing platform Wayfinder has been a key facilitator in enabling the organisation to ask for staff’s ideas on the activities and changes they want to see. The shift that we have experienced has seen the organisation invited to speak out a number of events including the Health Foundation, NHS England and NHS Employers as well as sharing our experiences with other trusts. In addition we have been part of a study undertaken by the Work Foundation.


Since 2014 our staff engagement score has improved from below average to above average, in 2017 it was 3.85 compared to the national average. We have also seen a shift in our key findings, with 22 now being above average. Our ranking for many of the key findings has also improved, we now have five of our key findings in the top 5 including percentage of staff appraised in last 12 months, for which we are fourth and fairness and effectiveness of procedures for reporting errors, near misses and incidents for which we are seventh. These key findings demonstrate the value we place in our staff, by appraising them and listening to what they tell us.

They also show us the importance LTHT places on safety, with staff confidence in the fairness of reporting errors in the top 10 nationally. The organisation is most proud of our ranking for percentage of staff reporting good communication between senior management and staff, placing fifth nationally. We are particularly proud of the fact that since 2014 in addition to achieving significant improvements in staff engagement, the Trust has also improved its CQC rating to Good and in 2017/18 we achieved the Trust’s largest financial surplus ever. This helps demonstrates the importance of a whole systems approach and the importance of focusing on culture and values.


The most important stakeholders in this programme were our staff. We consulted with them through a variety of mechanisms, including our crowdsourcing platform. Our plans were developed in partnership with them and adapted according to their needs. For example the recent report by the Work Foundation, highlighted that for staff the most important factor that impacts on their engagement levels is the team they work with. We have therefore expanded our model to include a sixth workstream, which provides opportunities for teams to work together on activities designed to enable them to engage with each other in support of the local community. Staff support for this programme of activity has been phenomenal, for example:

• Over 2,000 staff members participated in iFactor, a campaign to share improvement ideas.

• More than 300 staff supported local elderly action groups by joining in with Be a Santa to a Senior, buying Christmas presents for local elderly people.

• Over 800 staff have joined in our 8 week challenge, designed to help people work together as a team to improve their well-being.


Key individuals

Anna Edgren-Davies