Blackpool Fylde and Wyre NHS Foundation Trust case study

Who are they?

The Blackpool, Fylde and Wyre Hospitals NHS Foundation Trust serves a population of approximately 330,000 residents of Blackpool, Fylde and Wyre and the 12
million holidaymakers who visit the area
every year.

No of employees:

4,500

Business Sector:

Health

The Blackpool Way – laying the foundations for stress management

The Blackpool Way is a process of deep employee engagement around themes of management style, communication and recognition.

The Trust carried out a large exercise with around four thousand staff asking them what it’s like working here. We received a lot of honest feedback:

• Poor communication
• The management styles are often unhelpful
• Issues around recognition - we never get any thanks for a job well done
• No real sense of improvement or innovation

This feedback proved really useful and helped us make some big changes to our culture.

The Blackpool Way set us in the right direction but allowed us to fit into the Management Standards slightly differently.

'One major benefit of the Blackpool Way project is the shared commitment to tackling problems based on effective staff engagement. We redefined the vision and values of the organisation.' – Nick Grimshaw, HR Manager.

Why We decided to tackle stress at work?

• Our Consultant for Occupational Health sees patients regularly, building up a picture of what’s going on from the stories they tell – we could see from this alone that there was an increase in stress. 
• The normal ratio of patients (staff members) with psychological problems (stress, depression and anxiety) compared to patients with musculoskeletal problems (muscle, joint or bone problems) is about 2:1.  In 2007 this ratio rose dramatically to a ratio of almost 4:1.   
• Sickness absence rate of 5.34% with more than 55% of all time lost by staff on long term sick leave (at least twenty eight days).  The main driver here was people off with stress.
• Period of significant change with an ambitious cost improvement target of £21M. 

This all coincided with a visit from the local HSE Inspector Stephen Garsed, who talked to us about the stress Management Standards.

When we took our idea to tackle stress to the board – as well as the rates of stress-related absence, they also picked up on the issue around excessive working hours. There’s a lot of information coming out now about the risk of tiredness; some say it’s worst than having drunk drivers in charge of the wards.

'We emphasised the importance of having a healthy workforce and the impact on productivity' - Phil Atkinson.

• One of our main targets was to see a reduction of 30% in cases of people with stress.

How we did it

We had a dedicated stress project manager who formalised our stress management group. After holding a series of focus groups across the eight sites, which involved a full cross section of the work force, we could start looking at some of the key issues that might be causing stress.

What we found

The main results from the focus groups centred around how we treat each other within the organisation. Some of the main findings included:

• How we managed poor performance & sickness /absence, with staff seeing people who they perceived to be problematic just moved from one department or even promoted within the organisation.
• Management style - some managers were very good at saying thank you to the staff some people didn’t speak to their teams from one week to the next.
• Car parking - big issue for us, we are set in a rural area with a workforce that are not all from the Blackpool area therefore inability to park on site is a major stressor.
• Communication - A portion of our work force do not use computers and so will not access this method of communication, we also have some staff who are IT illiterate which has identified training needs for those individuals.
• Learning & Development - some staff reported not having had an appraisal for over two years and not attending induction or mandatory sessions. Training and development needs were not being met either.

We came up with nine action plans and assigned key leads to each one. They all meet on a monthly basis as we monitor their performance. We also have our own dedicated stress website, which contains all action plans, as well as every meeting that takes place and every action that’s been dealt with.

General actions

1. Learning development - mandatory training induction programmes were not meeting the needs of the work force so they have started to revamp their programmes. 
2. The management style - we gave a lot of feed back on the types of style and we now have management dedicated courses.
3. Car parking - being reviewed by a car parking group
4. Communication - plans to launch a glossy magazine for our staff who don’t sit in front of a computer.
5. Employment Assistance Programme - confidential service for staff and family.

The legacy - what we achieved

• Almost 40 % reduction in cases of work-related stress
• Sickness absence has improved by over 10%
• Employee grievances reduced by 50%, disciplinary action reduced by 25%
• Running stress management training days for our workforce

Managers are being given the skills and tools to identify individuals within their departments who they believe are suffering with stress. So we’ve definitely got a culture change going on. We've got a much more informed and empowered work force now as well. We’ve definitely influenced the management styles, with HR reviewing their policies.

You've only got the look at the staff survey results - we've gone into the top twenty per cent on loads of things including the most important one for us: 'would you recommend the Trust as an employer'.

Messages to other trusts

Listen to your work force - go and ask them what they think, use their ideas, for as we have found a lot of the actions relate to changing ways of thinking or working.

Having senior management on board from the onset was key because you’ve got to have a director driving

HSE inspector's view – Stephen Garsed

We set out a high expectation with Blackpool and we have worked with the Trust in meeting that expectation. The inspector acts as a critical friend and having that relationship where you can say frank things and challenge assumptions is very important. Another thing to recognise is that this is a team effort and they all deserve praise for their efforts.

Blackpool has developed a superb way forward that we can promote to other Trusts.