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Buckinghamshire Hospitals Trust

Submitted May 2006

Background

The indicator tool was run across 1600 staff with approx 50% returns (originally 800 but due to poor return additional 800 sent out).

Actions so far include:

  1. How was commitment/buy-in to the stress management standards (SMS) process achieved throughout the organisation – senior management & employees (latter including Unions, Health and Safety representatives, etc)?

    Trust board welcomed participation in the project as they had already identified problem with stress and sickness absence. The Director of Nursing had helped secure commitment to SIP1 by making the link to the Improving Working Lives initiative (IWL). The Trust decided to use the existing IWL steering group to manage the project and appointed a Board Champion.

  2. What techniques/tools are you using to communicate to staff about the SMS process (outline those tried and discarded, including reasons for discarding)

    • Poster campaign
    • Management Standards branded under IWL
    • IWL newsletter (distributed monthly with pay slips)
    • Regional IWL workshops
    • Team meetings reinstated
    • Stress policy updated with HSE stress standards
    • Stress policy and stress management tools used during stress management workshops.

  3. What data did you collect and analyse to help you identify potential stress problems?

    Sickness absence data were available but not used to target the survey sample.

    Some data were already available through IWL initiative and HCC Annual Staff Survey – the latter helped identify bullying as an issue.

    The Trust had recently achieved Investor In People (IiP) status and felt this had improved role clarity/line of sight.

  4. How are you engaging with staff to explore issues and develop action plans? [If you elected not to use focus groups, why not? What alternative data sources have you used?]

    The Trust used Acas to help run focus groups.

  5. Have you thought about how you will monitor and evaluate the stress actions/interventions? If so, what methods are you planning to use and why?

    The Trust plan to use data from HcC Annual Staff Survey and repeat HSE stress survey. Initiatives such as bullying mediation scheme will be evaluated separately.

  6. Did the SMS have a wider impact? If so, please outline the benefits / disbenefits.

    The standards helped to Establish importance of other initiatives such as IWL and IiP in tackling workplace stress.

  7. What things in the SMS implementation process would you do differently and why?

    Not be as prescriptive with process.

    Survey fatigue - avoid duplication with HcC survey section on stress

  8. What is the best & worst thing about the SMS process?

    Bad

    • Bullying questions in the indicator tool are too broad for NHS – do not determine whether bulling is by staff or patients/relatives.
    • Discovering that this process does not eliminate stress and that some people will still be stressed from sources beyond our control

    Good

    • Staff can see that something is being done to address the problem
    • The SIP 1 project has encouraged the Trust to make a concerted effort to address a recognised problem

  9. What has been your organisation’s greatest challenge from SIP1 project participation?

    • Developing an action plan from focus group findings [Note: after discussion it was evident that much progress had been made, especially since some interventions (such as a senior manager talking to a merged department to explain their role) were seen as to small/insignificant to include in an action plan].
    • The NHS is still very centralised - we need to empower staff in lower grades for the ‘small interventions’ to be implemented successfully.
    • Low support for focus groups – NHS has particular problems around shift working
    • Lack of participation from General managers and Senior nurses due to insufficient time resources
    • Translating some solutions to actions.
    • Peer support – showed as problem on survey (possibly some ambiguity with the questions in the survey) but not in focus groups. (Possibly a problem between departments rather than within teams).

  10. What benefits has your organisation gained from SIP1 project participation? Were they expected?

    See Q 8

  11. Can you estimate the resources used so far in the SIP1 project? And associated costs?

    Too early to provide this information.

  12. If you could offer three tips to an organisation embarking on the SMS approach, what would it be?

    • Try and align stress management with existing initiatives – don’t reinvent the wheel!
    • Appoint a board level champion
    • Give early thought to how to communicate with staff

  13. What is the best way for HSE to share learning points from other organisations with you? (this will help inform how to circulate resulting case study data)

    • Workshop for participating trusts
    • Newsletter
    • Web community
    • Suggested SHRINE or successor as vehicle for engagement with senior management

  14. How would you sum up your experiences so far?

    “It’s been a lot of work, but we’re glad we’re doing it”

    “Leadership is core to culture change”

    “It is the small things that make the difference, e.g. regular time with my manager, 1:1 meetings and team meetings”.