Getting engaged - staff engagement, managing stress and physios as problem-solvers

Health service leaders opening a Point of Care Foundation report published earlier this year may have had a disappointing read.

The charity, which counts Robert Francis (who led the review into abuses in the NHS in mid Staffordshire) among its trustees, says 60 per cent of NHS staff feel their work is undervalued by their employers and that appraisals and other forms of engagement are inadequate.

On the plus side, the document, titled Staff care: how to engage staff in the NHS and why it matters, says staff engagement is getting better and sets out measures for further improvement.

These include training for line mangers, regular reviews of team performance, setting coherent goals and providing staff with ongoing training and support.

Claire Sullivan agrees that staff engagement is getting better, but from a pretty low base.

The CSP’s assistant director of employment relations says that implementing a staff engagement strategy across the NHS is ‘challenging’ because it is comprised of many large and geographically scattered organisations. But it is not impossible, she says.

‘The best way to get staff engagement right,’ she says, ‘is to plan the approach in local partnership forums, involving both managers and stewards.’

She represents the CSP on the England Social Partnership Forum of health organisations and unions, which is chaired by health minister Dan Poulter (see Box, far right). It is, Ms Sullivan thinks, an ideal body for leading improvements in staff engagement. ‘And a positive organisational culture is integrally linked to good staff engagement.’

Goal of improving patient care

Ann Ross, allied health profession lead at Glasgow’s Western Infirmary, believes Staff care’s recommendations are common sense: ‘We’re doing a lot of redesign now, and so it’s about using the staff themselves to help me make changes. Maybe the problems I perceive are not the real ones.’

In the view of Ruth Emmanuel, physiotherapy manager at Swansea’s Abertawe Bro Morgannwg University Health Board, the main reason staff engage with work-related issues is because they want better patient care. But Ms Emmanuel says that including staff in decision-making is vital, and is involved in staff meetings where people are consulted about changes and encouraged to raise issues.

In England alone cutting sickness absence by a third would save £55 million a year. Healthcare professionals suffer higher rates of stress, depression and burnout than their counterparts in other areas of the public sector.

Ms Emmanuel says the NHS in Wales suffers from high levels of sickness absence, mostly due to stress and musculoskeletal injuries. She thinks that making counselling available and adjustments to working hours can be helpful, but also says simply listening to concerns can reap dividends.

Key role for stewards and safety reps

‘What I find is that stress is often accumulative, and this is only my personal opinion.

Stress can be in the home as well, affecting how work goes and vice versa,’ Ms Emmanuel says. ‘The important thing to say is that we cannot get rid of stress, it’s part of everyday life. But the issues can be how to manage stress and come up with coping strategies and we can try and signpost staff in the right direction.’

Ms Sullivan says that addressing stress has been a top priority during her 20 years with the CSP. ‘We want our members to know that there are effective ways of tackling stress at work. As a first point of call, they should speak to their safety reps and stewards.’

She believes that a really good appraisal system and supportive line management arrangements should help with the problems relating to stress in the workplace.

Later this month, the England Social Partnership Forum will publish a report on staff engagement, which Ms Sullivan says brings together information from the NHS staff survey, the NHS Constitution pledge on partnership working and staff engagement. She thinks it should be a useful resource for physios.

When it comes to solving problems, Glasgow-based Ms Ross believes physiotherapists are part of the answer: ‘I think physios and occupational therapists are solutions people. The profession attracts people who are looking for solutions to patients’ problems.’ fl

Staff care: how to engage staff in the NHS and why it matters:

Key findings from Staff care: how to engage staff in the NHS and why it matters

• 74% of staff say they are able to make suggestions for improvements

• 26% of staff say senior managers act on their suggestions

• 65% of staff say communication between senior managers and staff is not effective

• 60% of staff are not satisfied with how their trust values their work

• 30% of sickness absence in the NHS is due to stress

• 45% of staff would not recommend their organisation as a place to work

Social partnership forum

The forum was set up in March 1998 after it was recognised that partnership working can make a positive contribution to improving patient care by involving employers and employees and their trade unions in decision- making.

Primary aims are to:

• contribute staff and employer perspectives to emerging policy

• improve policy development and implementation by including ideas on workforce implications

• promote effective communication between ‘partners’, including staff, employers and unions

• For more information, visit: www.socialpartnershipforum.org

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