NHS staff engagement

Involving the whole NHS workforce in improvement means asking their opinion and responding to feedback. Alastair Henderson puts the business case for staff inclusion

Staff engagement is not a new concept for the health service, but in the last year it has risen to become a top priority for many NHS managers. It is a central enabler, crucial to the success of the next stage review, critical to making the service a better employer and essential to ensuring we can recruit and keep staff in a fast-changing and competitive global market.

The business case for improving staff experience, morale and engagement is compelling and most major organisations recognise its importance. The Institute for Employment Studies reviewed the evidence in the five years to 2008, finding that staff engagement is linked to performance in terms of:

• revenue growth;

• customer satisfaction/loyalty, profitability, productivity, labour turnover;

• trust and confidence in public institutions;

• retention of staff;

• facilitating change.

The Chartered Institute of Personnel and Development sees engaged employees as protectors of an organisation's brand, guarding against the risks associated with poor service levels or product quality.

In the NHS, staff engagement has been linked with improved productivity and organisational performance. Partnership working is well established through long-standing relationships, evident in the Social Partnership Forum where employers, government and unions are represented, and trusts are doing lots of work on partnerships locally.

Earlier this year, the Department of Health published its What Matters to Staff in the NHS research. Building on earlier research from Aston University linking engagement to patient outcomes, it mapped the 10 factors that matter most to staff against important outcomes of patient and public satisfaction, staff advocacy of the NHS and the motivation to provide high quality patient care.

Locally, the things that matter most will vary depending on the type of organisation and what staff themselves tell us through the staff survey, other research and feedback. Local leadership and ownership of initiatives is important, and trusts are using tools, including the staff survey and local action planning, to drive improvements.

Meanwhile, there is a significant national focus on developing the staff survey and identifying levers and incentives for improving staff engagement.

In the most successful trusts, identifying and acting on quick wins demonstrates a commitment to respond to staff and empower them to make changes. Just some of the results from a listening exercise at Sandwell and West Birmingham Hospitals trust have been:

• "top 10 eyesores", decided by staff;

• 50 more staff car parking spaces;

• two weeks taken out of the recruitment process.

As part of its staff engagement work Warwickshire primary care trust developed a staff support forum that initiated:

• a scheme that enables staff to make savings on a bike for work;

• supporting the eight-week healthy working and living challenge;

• providing harassment and bullying awareness training sessions.

National staff pledges, designed to set out for the first time what the NHS expects from its staff and what staff can expect from NHS employers, have received support across the service.

Employers have welcomed the pledges, launched as part of the proposed NHS constitution in July, and are concerned with how to make them ambitious enough to continue to drive improvement while allowing for local autonomy and avoiding additional performance management regimes.

Awards are increasingly seen as a vehicle for both celebrating good employment practice and promoting learning. HSJ and Nursing Times's own new set of awards, the Healthcare 100, aims to identify the best places to work in healthcare.

NHS Employers is the official supporter of the awards and we see them as a way to encourage and spread good practice.

Staff engagement is one of the four themes at this week's NHS Employers annual conference on Leading Workforce Thinking in Birmingham.

www.nhsemployers.org/2008