Title Trust Ref No 2049-34592 Local Ref (optional) Main points the document covers Who is the document aimed at? Author Consultation Approved by (Committee/Director) Document Details Staff Health & Wellbeing Strategy N/A A strategic vision for health and wellbeing to create a working environment which is conducive and beneficial to the health and wellbeing of our staff and patient care All Staff Juliet Morris, Human Resources Manager and Clare Guerreiro, Occupational Health Manager Approval process HR Team, HR and Workforce Group and JNP HR & Workforce Group Approval Date 11 October 2016 Initial Equality Impact Screening Full Equality Impact Assessment Lead Director Category Sub Category Yes No Review date October 2017 Who the policy will be distributed to Method Required by CQC Other Director of Corporate Affairs Human Resources & Workforce Distribution To senior staff as defined by Directors for cascading Publication on the Trust Intranet No No Date Amendment CQUIN 1 October 2016 New Strategy 2 3 Document Links Amendments History 1
Staff Health and Wellbeing Strategy 2016 2019 Trust Vision We will work closely with our health and social care partners to give patients more control over their own care and find necessary treatments more readily available. We will support people with multiple health conditions, not just single diseases, and deliver care as locally and conveniently as possible for our patients. We will develop our current and future workforce and introduce innovative ways to use technology. 2
Our Values Improving Lives We make things happen to improve people's lives in our communities. Introduction and Purpose Welcome to our Health & Wellbeing Strategy 2016 19 Everyone Counts We make sure no-one feels excluded or left behind - patients, carers, staff and the whole community. Commitment to Quality We all strive for excellence and getting it right for patients, carers and staff every time. Working Together for Patients Patients come first. We work and communicate closely with other teams, services and organisations to make that a reality. Compassionate Care We put compassionate care at the heart of everything we do. Julie Thornby Director of Corporate Affairs Nuala O Kane Non-Executive Director Our strategic vision for Health & Wellbeing is to create a working environment which is conducive and beneficial to the health and wellbeing of our staff and patient care. We serve one of the largest geographical areas to be served by a local health system in the NHS (1,235 square miles), which is more than twice the size of Greater London with a population of 455,000. We employ around 1600 staff. Respect and Dignity We see the person every time - respecting their values, aspirations and commitments in life for patients, carers and staff. Every employee will be supported to maintain and improve their health and wellbeing and every employee will be expected to take reasonable steps to improve their own health and wellbeing. 3
NHS Five Year Forward View Getting serious about prevention Hard hitting national action on obesity, smoking, alcohol and other major health risks Incentivising and supporting healthier behaviours Targeted prevention primary and secondary Empowering patients and supporting people and communities to be actively involved in their own health to stay healthy, assist in managing long-term and other conditions and avoid complications Supporting NHS staff to stay healthy and serve as ambassadors for health in their communities New models of care dissolving traditional boundaries, working in partnership and engaging the whole community The Case for Action Our responsibility for the health and wellbeing of our staff extends far beyond a core responsibility to provide a safe working environment. We want to inspire our staff to take a greater interest in their own health and wellbeing Patient Care The NHS Health and Wellbeing Review (Boorman, 2009) provided evidence that good staff health wellbeing is vital for ensuring that the NHS can meet the productivity challenge it faces now and in the future. This important recent research into NHS health and wellbeing, found that there were clear links between staff health and wellbeing and the three dimensions of service quality: 1. Patient Safety 2. Patient Experience 3. Effectiveness of patient care It is really important to be honest with our staff about the mutual benefits that arise from a staff health and wellbeing strategy. As part of this honesty about the mutual benefits there is the compelling economic argument for improving the health and wellbeing of our staff. In 2015 Public Health England estimated the cost of sickness absence to the NHS at 2.4bn. Some reports have estimated this to be 27% higher than the UK public sector average, and 46% higher than the average for all sectors. It is estimated that absence is currently costing our Trust 1,775,397 per year in pay alone (without adding the cost of agency cover). This is equivalent to losing 55 full-time band 5 nurses per year (based on a salary including on-costs of 32,394 per year) at a time when effective management of resources, whether staff or other costs, is a top priority. 4
The Populations We Serve Shropshire 75.4% of the adult population are low risk drinkers, similar to the national proportion of 72.1%. Cardio-vascular disease (CVD) is the most common cause of death in Shropshire, accounting for around 35% of all deaths annually. Cancer is the second most common cause of death, accounting for around 27% of deaths annually. Obesity prevalence in both adults and children is similar to the national figures, this still amounts to a very large number of affected people. Telford 26.2%, of people are higher or increasing risk drinkers (around 34,000 people) 2 in 10 adults (around 27,000 people) in Telford and Wrekin smoke The majority of adults, about 7 in 10 (around 94,000 people), are overweight or obese Levels of physical activity are showing signs of improving, however, in 2014, 28.1% of the population aged 16 and over were classified as inactive. Caring for our Staff As an organisation set up to care for our population s health, we have a responsibility to look after our employee s health too. Our staff spend a large portion of their time at work, which is an opportunity to impact positively on their overall health, wellbeing and happiness. We recognise that the vast majority of our staff not only work in Shropshire and Telford, but are resident here too. Therefore, understanding the local factors that can aid or hinder health and wellbeing and the fact that our two most prevalent reasons for absence (by number of days lost) are musculoskeletal (including back) and anxiety, stress and depression, have been fundamental in developing this strategy. Taking into account the demographic of our workforce, we are mindful that the initiatives that we introduce must be inclusive of all. In addition to this we acknowledge that our workforce is predominantly female within the age bracket of 45 to 55 and targeted support for this group will be included within the plan. In the first year of our strategy we will focus on reducing absence due to musculoskeletal and stress issues which will contribute to a reduction in overall sickness absence and help us to reach our sickness absence target of 3.39% which is currently under review. Well at Work The Five Year Forward View says that we should support our staff to stay healthy and serve as ambassadors for health in their communities. We will do this for our staff by providing the opportunity for staff to have a health and wellbeing check through Occupational Health. The checks will include health and lifestyle advice including obesity, smoking, alcohol intake, menopause, stress levels and musculoskeletal issues and the chance to have blood pressure and cholesterol checked. We also think it is important that we encourage our staff to stay healthy themselves and will make changes to food and drink provided on our premises. We will help to protect our patients and staff from illness by offering all staff immunisation against flu. 5
OUR VISION FOR HEALTH AND WELLBEING Our aim through this Health & Wellbeing Strategy is to help everyone to. Be supported to look after their health and wellbeing Have nutritious and tasty healthy eating choices open to them at work Be encouraged to act as role models to their colleagues and the wider community Be more active at home and at work Gain access to a range of health and wellbeing tips Be supported with their mental wellbeing 6
Some Current Areas of Focus Mental Wellbeing Mental Health First Aid and Awareness training Promote benefits of Coaching and Mentoring Targeted HR and Occupational Health support Actions to address findings of Staff Survey Keeping Active Cycle to Work Scheme 5k Every Day Any Way Walking Meetings Fast Track Physiotherapy Do You Sit at your Desk all Day Campaign Health and Wellbeing Champions Healthy Lifestyle Health and Wellbeing Days Flu Campaign Healthy Eating healthy options at Trust sites Help2Change Smoking Cessation and Health Checks Supporting National Campaigns 7
Delivery of the Health and Wellbeing Strategy The Health and Wellbeing Strategy is an important part of a suite of organisational strategies and plans which link together to help deliver our overall Trust vision and aims. The Health and Wellbeing Strategy is designed to deliver some of the aims in our overall Trust People and Workforce Strategy. The People and Workforce Strategy in turn supports the delivery of our clinical and quality strategies and others, as shown in the diagram below. Delivery of the Health and Wellbeing Strategy is supported by a three year operational plan, the first year of which forms an appendix to this document. Sustainability and Transformation Plan Quality Strategy Clinical Strategy Trust Strategic Goals, Objectives and Values IM&T Strategy Estates Strategy People and Workforce Strategy Organisational Development Framework Culture Working Group Implementation Plan HR Resourcing Strategy (recruitment) Health & Wellbeing Strategy Everyone Counts Equality and Diversity plan People Management Policy Framework & workforce metrics CQUIN stands for Commission for Quality and Innovation and was introduced by the Department of Health in 2009 as a way for commissioners of healthcare to encourage and reward service quality improvement. The goal of the CQUIN on staff health and wellbeing is to improve the support available to NHS staff to help promote their health and wellbeing in order for them to remain healthy. For the first year of the plan our aim is to focus on our main reasons for sickness absence which are stress and musculoskeletal issues, which is in line with the Commissioning for Quality and Innovation (CQUIN) requirements for 2016/17. There will also be a review of current food and drink provision at Trust sites with a view to offering healthier options to our staff and patients. We will continually monitor and evaluate progress against key performance indicators (KPI s) and develop plans for years two and three taking into account learning from year one, national health initiatives and future CQUIN requirements. For years two and three, we anticipate that we will continue to focus on physical activity and the further development of mental health and stress programmes of support. In line with other aspects of the Five Year Forward View, and from what we have learnt from analysis and feedback from work undertaken in year one, we will develop further ways to support staff health and wellbeing such as support for those staff who wish to lose weight or give up smoking. 8
Health and Wellbeing Operational Plan Year One CQUIN: We will: Indicator of success: (CQUIN measure in brackets) Introducing a range of physical activity schemes for staff. Providers would be expected to offer physical activity schemes with an emphasis on promoting active travel, building physical activity into working hours and reducing sedentary behaviour. They could also introduce physical activity sessions for staff which could include a range of physical activities such as; team sports, fitness classes, running clubs and team challenges Promote healthy travel to work Cycle to work scheme through staff benefits to encourage cycling to work and making it easier for staff to build physical activity into their working day. Encourage the use of walking meetings ideal for one to one s, or meetings of up to four people. Fresh air is a known mood booster and physical activity can spark new ideas. Information, facts and guidelines to be published on intranet and health and wellbeing section in Inform. Launch a campaign - Do you sit at a desk all day? - Promotion of and information on exercises to do throughout the working day, with particular emphasis on sedentary roles, to be published on intranet and health and wellbeing section of inform. Recruit health and wellbeing champions located within various teams around the County to encourage, motivate and organise physical activities for their colleagues, such as walking groups, Pilates, Zumba or yoga classes. (Limited time from working day or subsidised classes) Pledge Five - Launch of 5k Every Day - Any Way staff will be asked to sign up and pledge to undertake physical activity such as walking, swimming, on the treadmill at the gym, running, etc., equating to 5k in distance every day for a period of 5 weeks. Staff will be expected to sign a commitment contract which will detail by what means their distance will be monitored, what activity they will be undertaking and to agree to give feedback on the positive impact it has had on the health and wellbeing. All those who take part and complete the challenge will be entered into a prize draw with the opportunity to win some great prizes. Increase in the uptake of Cycle to Work Scheme (A) Qualitative feedback from participants to gauge physical and mental health benefits plus numbers participating through regular surveys (B) Qualitative feedback from participants to gauge physical and mental health benefits plus numbers participating through regular surveys (B) Number of H&WB champions with active groups (C) Number of participants.(b) Qualitative feedback from participants to gauge physical and mental health benefits plus numbers participating through regular surveys (B) 9
CQUIN: We will: Indicator of success: (CQUIN measure in brackets) Improving access to physiotherapy services for staff. A fast track physiotherapy service for staff suffering from musculoskeletal (MSK) issues to ensure staff who are referred via GPs or Occupational Health can access it in a timely manner without delay We already have in place: Staff are able to self-refer for physiotherapy which is undertaken by the Trust s physiotherapy teams via the Occupational Health Service (OHS). Staff with musculoskeletal (joint or muscular) pain, discomfort or injury, e.g. low back pain, recent strains and sprains, that go off sick with this problem or are reaching a point where they are struggling to stay at work telephone the OHS. The OHS go through some standard questions on a referral form, that once completed is sent through to the appropriate physiotherapy team. The staff member is contacted by physiotherapy within 2 working days for telephone triage and an appointment if required is offered within 7 days. Treatment is offered at the following locations - Whitchurch, Bridgnorth, Ludlow, Bishops Castle, Newport, Shrewsbury and Market Drayton. Number accessing Fast-track Physiotherapy (D) Time to access Fast-track Physiotherapy (E) Evaluation through survey We will: Undertake a survey of participants to evaluate reasons for referral, timeliness of appointments, benefits of service in sustaining attendance at work or a quicker return to work if absent and client satisfaction. Act on results, especially to speed up the process if indicated 10
CQUIN: We will: Indicator of success: (CQUIN measure in brackets) Introducing a range of mental health initiatives for staff. Providers would be expected to offer support to staff such as, but not restricted to; stress management courses, line management training, mindfulness courses, counselling services including sleep counselling and mental health first aid training We already have in place: Staff have access to a counselling service through NOSS (Network of Staff Support). NOSS are a British Association of Counselling and Psychotherapy (BACP) accredited service. They offer many different therapeutic approaches such as CBT, mindfulness, resilience and post trauma therapy. Support is provided via face to face counselling with telephone and e-mail support. NOSS also provide support with mediation and during change management as and when required. Continue to provide Essential Skills Training for managers covering HR skills, management practice, managing attendance including stress awareness. Offer training courses through our OD team such as Coaching Skills - Changing Conversations, Managing Productive workshops, Being an Effective Team Player which offer a rounded approach to managing and leadership. We will: Jointly develop with NOSS training programmes for managers to help them in recognising their own behaviours and understanding their own stress and to recognise and understand stress in the people they manage and Mental Health Awareness/First Aid courses for staff. No. of staff accessing counselling through NOSS (F) No. of staff attending training or development which includes an element of supporting psychological wellbeing (G) Evaluation of training A six month Leadership Programme is currently under development by the Head of Organisational Development which will cover managing self, others, across other disciplines and strategically. It will also look at behaviours and how they can have a positive or negative impact on teams and their psychological wellbeing. Programme of attendance by OH at team meetings to discuss stress, spotting signs and symptoms and how to support each other. 11
Measuring Success Year One Measure BENCHMARK Q1 Q2 Q3 Q4 31 Mar 2016 30 Jun 2016 30 Sep 2016 31 Dec 2016 31 Mar 2017 Organisational Absence Measures from ESR 1 12 month rolling absence rate 4.29% 2 12 month MSK absence rate (% of days lost) 3 12 month Stress absence rate (% of days lost) 4 12 month rolling long term absence 5 12 month rolling short term absence 21.3% 20.2% 2.92% 1.67% 6 Overall cost per annum (nominal) 1,775,397 12
Measure BENCHMARK Q1 Q2 Q3 Q4 31 Mar 2016 30 Jun 2016 30 Sep 2016 31 Dec 2016 31 Mar 2017 Staff Survey Measures Percentage of Respondents 7 Manager interest in H&WB 65% - - - 8 Org positive action H&WB 29% - - - 9 MSK problems last 12 months (work related) 10 Unwell through stress in last 12 months (work related) 11 Attended work in last 3 months when not well enough 24% 41% 61% If yes to q above 12 Due to pressure from manager 23% 13 Due to pressure from colleagues 17% 14 Due to pressure from self 95% 13
Measure BENCHMARK Q1 Q2 Q3 Q4 31 Mar 2016 30 Jun 2016 30 Sep 2016 31 Dec 2016 31 Mar 2017 A B C D E F No. accessing Cycle to Work Scheme No. accessing physical activity through organisational schemes No. of staff joining Champion-led groups No. accessing Fast track Physiotherapy Time to access Fast track Physiotherapy following OH referral (no. of working days) No. of staff accessing counselling through NOSS CQUIN Measures (Last Quarter unless Stated Otherwise) 1 6 0-0 - 54 70 61% 1-2 days 55% 1-2 days 31% 3-5 days 35% 3-5 days 8% > 5 days 10% > 5 days 51 49 G Flu Immunisation Uptake 68.4% - H No. of staff attending training or development which includes an element of supporting psychological wellbeing 0 14