SUMMARY REPORT TRUST BOARD IN PUBLIC 3 May 2018 Agenda Number: 9

SUMMARY REPORT TRUST BOARD IN PUBLIC 3 May 2018 Agenda Number: 9 Title of Report Accountable Officer Author(s) Purpose of Report Recommendation Consultation Undertaken to Date Signed off by Executive Owner Reviewed by Executive Team Reviewed by Board Committee (where applicable) Reviewed by Trust Board (where applicable) Date(s) at which previously discussed by Trust Board / Committee Next Steps 2017 National NHS Staff Survey Results from Royal Cornwall Hospitals NHS Trust Catrin Asbrey Director HR and Organisational Development Ruth Evans Associate Director HR and Organisational Development This paper presents the nationally benchmarked 2017 Staff Survey for Royal Cornwall Hospitals Trust. The Board is recommended to: Receive the 2017 National Staff Survey Report and endorse the actions proposed. The results of this survey have been tested through the work done as part of the culture and leadership diagnostic. 10 th April 2018 Executive Director HR and OD Trust Management Group 19 th April 2018 People and Organisational Development Committee 3 rd May 2018 Trust Board High level, non weighted data has been previously circulated to the Executive Team. We will continue to work with staff on improving the way it feels to work at Royal Cornwall Hospitals Trust through the work set out in the Culture and Leadership Improvement Plan. Summary The 2017 Staff Survey was completed by 2860 staff throughout October and November 2017. At this time, the Trust had just been placed in Special Measures following a Care Quality Commission Inspection during the summer months. Of the 32 measures, the Trust has either improved or remained the same. This is contrary to the national position, which has generally declined. Historically the Trust has featured significantly in the bottom 20% of Trusts. In 2016 21 measures (68%) were in the bottom 20%, this year 10 (31%) measures feature in the bottom 20% with most improvement being seen in the Job Satisfaction key findings. We are not complacent, there is still much to do to improve the reported experience of staff here at Royal Cornwall Hospitals Trust. The Quality Improvement Plan, and work already underway to deliver this, seeks to address clear priorities with full involvement from staff. A key part of this work are the enabling work streams that address culture and leadership, communications and engagement and the 1

development of a Quality Improvement Hub; put more simply the way we do things around here, how we talk about what and how we are doing and the tools we will provide to do the things we need to do. The data from the 2017 National Staff Survey has informed this work. Actions are already underway to address the elements set out in this report. Financial Risks Key Risks Disclosure Statement Equality and Diversity Statement We know that productivity is greatly affected by the way staff feel. Through improvement of staff experience, we will see efficiency related to the overall performance of the Trust. Small improvements noted in this survey are fragile and require ongoing support to deliver a sustained position. Data from this survey alone does not identify all of the aspects the Trust is working on to deliver an improved Staff Experience Data within and accompanying this report has been compiled by Picker from the submission of our Quality Health Data. This report contains data directly associated with the experience of staff with protected characteristics. 2

2017 National NHS Staff Survey Results From Royal Cornwall Hospitals NHS Trust 1. Introduction This paper accompanies the 2017 National NHS Staff Survey Report from Picker (appendix 1). The Picker Report takes all the staff survey results in England, applies a weighting to particular staff groups and provides Trusts with national comparators upon which they can benchmark themselves. The Trust increased the response rate for the survey, with 2860 staff taking the time to give feedback this year. This equates to a response rate of 56%, putting us in the top 20% of Trusts for acute Trusts in England (44% nationally). Overall, Royal Cornwall Hospitals Trust continues to receive disappointing feedback from staff with regard to their experience of working here. For many metrics we remain in the bottom 20% of Trusts. 2. Findings The Key Findings we are performing well in (our best scores) are as follows: % Staff experiencing discrimination at work in the last 12 months 9% (Nat 12%) % staff experiencing physical violence from staff in the last 12 months 2% (Nat 2%) % staff/colleagues reporting most recent experience of violence 70% (Nat 66%) % staff reporting error. Near misses or incidents witnessed in the last month 91% (Nat 90%) % staff attending work in the last 12 months despite feeling unwell because they felt pressure from their line manager, colleagues or themselves 51% (Nat 52%) The Key Findings we are performing less well in (our worst scores) are as follows: Staff satisfaction with the quality of work and care they are able to give 3.72 (Nat 3.91) Fairness and effectiveness of procedures for reporting errors, near misses and incidents 3.49 (Nat 3.73) % staff satisfied with the opportunities for flexible working patterns 44% (Nat 51%) Quality of appraisals 2.90 (Nat 3.11) Staff recommendation of the organisation as a place to work or receive treatment 3.46 (Nat 3.75) The Trust has made the biggest improvement this year in the following metrics: Effective use of patient/service user feedback 3.60 (Nat 3.42) % Staff able to contribute towards improvement at work 68% (Nat 64%) Staff satisfaction with level of responsibility 3.86 (Nat 3.79) Effective team working 3.73 (Nat 3.66) Quality of non mandatory training, learning and development 4.04 (Nat 3.99) Key Findings within the Picker report have been structured thematically as follows: Appraisals & support for development Equality and Diversity 3

Errors and incidents Health and Wellbeing Working patterns Job satisfaction Managers Patient Care and experience Violence Harassment and bullying 2.1 Appraisals & support for development The results tell us that there are more appraisals happening with 87% staff reporting that they have had an appraisal (higher than the national average). Whilst the score for the quality of those appraisals has increased in year (from 2.79 to 2.90), the Trust is still considerably lower than the national average (3.11). The score relating to the quality of non mandatory training learning and development continues to improve and is in line with the national average. Action: the Managers Passport training will be reviewed to improve the sills for managers to deliver a quality appraisal. 2.2 Equality and Diversity Scores relating to discrimination and equity of opportunity at the Trust remain unchanged this year and we continue to perform in line with national averages. Action: We will continue to impact assess all activity and will be looking at a talent management framework with the Leadership Academy for use across the Trust. 2.3 Errors and incidents Numbers of incidences witnessed by staff has stayed the same as last year with 91% of staff saying they report any incident error or near miss (higher than the national average). We score well below national averages for fairness and effectiveness of procedures for reporting incidents errors and near misses however, staff do feel more confident and secure in reporting unsafe clinical practice. Action: we will continue to strengthen governance throughout the Trust, which includes the utilisation of systems, processes to help the organisation learn from incidents, errors and near misses. 2.4 Health and Wellbeing Staff reporting work related stress has reduced by 1% to 37% (national 36%). Staff also report lower than national averages for pressure form managers, colleagues and themselves to attend work when feeling unwell. We have seen a positive increase in key findings associated with staff feeling that the Trust and management are interested in staff health and wellbeing. Action: We will build on the work undertaken so far as set out in our Health and Wellbeing Strategy. 2.5 Working patterns We score well below the national averages for opportunities to work more flexible. This could be in response to staffing levels with less flexibility offered in order to safely staff areas. We score slightly higher than national scores on staff working extra hours although this is reduced from 2016. Action: Recruitment activity is underway, with a proposal for International Campaigns later in the year. The Trust has a flexible working policy in place. 2.6 Job satisfaction All metrics in this key finding improved, however we are still some way off the national averages on most findings. Only 54% of staff would recommend the Trust as a place to receive care or treatment and 48% would recommend the Trust as a place to work. (Nationally 71% and 61% respectively). Staff report 4

feeling more motivated are more satisfied with their level of responsibility and feel better able to contribute to improvements. Team working satisfaction scores are equal to national averages. Action: Team working and communication are key elements of the Culture and leadership plans in the Trust. The implementation of Team Huddles is rolling out with favourable evaluation so far. 2.7 Managers We have seen a 3% increase in satisfaction of staff with communication between senior managers and staff, although this remains in the lowest 20% of Trusts. Staff feel more valued and also feel supported by their immediate Managers. Action: Communication is a key enabler of the Trust Improvement program. This includes a range of activity to improve the visibility and communication with senior managers. We will continue to strengthen the Improving Working Lives Thankyou Awards. The Managers Passport is also undergoing review. We will continue to run LEAD, our internal Leadership Development Program, with a further 3 cohorts delivering this year. We will focus activity in team building to help spread the positive feelings described at local team level to create Team RCHT. 2.8 Patient Care and experience There was a significant improvement in staff reporting effective use of patient/service user feedback (up to 3.60 from 3.42) This is still, however, in the bottom 20% of acute Trusts. Staff report feeling that their role makes a difference to patients/service users (in line with national average) and whilst we saw improvement in this measure staff feel less satisfied with the quality of work they are able to deliver (bottom 20%). It is interesting to note that this declined significantly in the national scores this year Action: We will continue to share feedback from patients with staff and promote the activity on the Trust Wonderwalls. 2.9 Violence Harassment and bullying Staff experience of physical violence at work from patients, relatives, the public or their own colleagues remains the same as last year, although reporting of incidences is increased. We saw a 4% reduction in the percentage of staff experiencing bullying and harassment by colleagues this year, and compare similarly with the national average. We have also seen increased positive responses to staff reporting their experiences. Action: We have a program of activity planned throughout the year to support staff in understanding the behavioural context of bullying. This includes a range of media and events. 3. Conclusion Of the 32 measures, the Trust has either improved or remained the same. This is contrary to the national position, which has generally declined. Historically the Trust has featured significantly in the bottom 20% of Trusts. In 2016 21 measures (68%) were in the bottom 20%, this year 31% of measures feature in the bottom 20% with most improvement being seen in the Job Satisfaction key findings. We are not complacent, there is still much to do to improve the reported experience of staff here at Royal Cornwall Hospitals Trust. The Quality Improvement Plan and work already underway to deliver this seeks to address clear priorities with full involvement from staff. The data from the 2017 National Staff Survey has informed this work. Actions are already underway to address the elements set out in this report. 5

4. Recommendation The Board is recommended to receive the 2017 National Staff Survey Report and endorse the actions proposed. 6

2017 National NHS staff survey Results from Royal Cornwall Hospitals NHS Trust

Table of Contents 1: Introduction to this report 3 2: Overall indicator of staff engagement for Royal Cornwall Hospitals NHS Trust 5 3: Summary of 2017 Key Findings for Royal Cornwall Hospitals NHS Trust 6 4: Full description of 2017 Key Findings for Royal Cornwall Hospitals NHS Trust (including comparisons with the trust s 2016 survey and with other acute trusts) 16 5: Workforce Race Equality Standard (WRES) 25 6: Key Findings by work group characteristics 26 7: Key Findings by demographic groups 35 8: Work and demographic profile of the survey respondents 40 Appendix 1: Key Findings for Royal Cornwall Hospitals NHS Trust benchmarked against other acute trusts Appendix 2: Changes to the Key Findings since the 2015 and 2016 staff surveys (including indication of statistically significant changes) Appendix 3: Data tables: 2017 Key Findings and the responses to all survey questions (including comparisons with other acute trusts in 2017, and with the trust s 2016 survey) 44 47 52 Appendix 4: Other NHS staff survey 2017 documentation 62 2

1. Introduction to this report This report presents the findings of the 2017 national NHS staff survey conducted in Royal Cornwall Hospitals NHS Trust. In section 2 of this report, we present an overall indicator of staff engagement. Full details of how this indicator was created can be found in the document Making sense of your staff survey data, which can be downloaded from www.nhsstaffsurveys.com. In sections 3, 4, 6 and 7 of this report, the findings of the questionnaire have been summarised and presented in the form of 32 Key Findings. In section 5 of this report, the data required for the Workforce Race Equality Standard (WRES) is presented. These sections of the report have been structured thematically so that Key Findings are grouped appropriately. There are nine themes within this report: Appraisals & support for development Equality & diversity Errors & incidents Health and wellbeing Working patterns Job satisfaction Managers Patient care & experience Violence, harassment & bullying Please note, two Key Findings have had their calculation changed and there have been minor changes to the benchmarking groups for social enterprises since last year. For more detail on these changes, please see the Making sense of your staff survey data document. As in previous years, there are two types of Key Finding: - percentage scores, i.e. percentage of staff giving a particular response to one, or a series of, survey questions - scale summary scores, calculated by converting staff responses to particular questions into scores. For each of these scale summary scores, the minimum score is always 1 and the maximum score is 5 Responses to the individual survey questions can be found in Appendix 3 of this report, along with details of which survey questions were used to calculate the Key Findings. 3

Your Organisation The scores presented below are un-weighted question level scores for questions Q21a, Q21b, Q21c and Q21d and the un-weighted score for Key Finding 1. The percentages for Q21a Q21d are created by combining the responses for those who Agree and Strongly Agree compared to the total number of staff that responded to the question. Q21a, Q21c and Q21d feed into Key Finding 1 Staff recommendation of the organisation as a place to work or receive treatment. Q21a "Care of patients / service users is my organisation's top priority" Q21b "My organisation acts on concerns raised by patients / service users" Q21c Q21d KF1. "I would recommend my organisation as a place to work" "If a friend or relative needed treatment, I would be happy with the standard of care provided by this organisation" Staff recommendation of the organisation as a place to work or receive treatment (Q21a, 21c-d) Your Trust in 2017 Average (median) for acute trusts Your Trust in 2016 63% 76% 58% 57% 73% 57% 48% 61% 47% 54% 71% 54% 3.46 3.76 3.39 4

2. Overall indicator of staff engagement for Royal Cornwall Hospitals NHS Trust The figure below shows how Royal Cornwall Hospitals NHS Trust compares with other acute trusts on an overall indicator of staff engagement. Possible scores range from 1 to 5, with 1 indicating that staff are poorly engaged (with their work, their team and their trust) and 5 indicating that staff are highly engaged. The trust's score of 3.67 was in the lowest (worst) 20% when compared with trusts of a similar type. OVERALL STAFF ENGAGEMENT This overall indicator of staff engagement has been calculated using the questions that make up Key Findings 1, 4 and 7. These Key Findings relate to the following aspects of staff engagement: staff members perceived ability to contribute to improvements at work (Key Finding 7); their willingness to recommend the trust as a place to work or receive treatment (Key Finding 1); and the extent to which they feel motivated and engaged with their work (Key Finding 4). The table below shows how Royal Cornwall Hospitals NHS Trust compares with other acute trusts on each of the sub-dimensions of staff engagement, and whether there has been a significant change since the 2016 survey. Change since 2016 survey Ranking, compared with all acute trusts OVERALL STAFF ENGAGEMENT Increase (better than 16)! Lowest (worst) 20% KF1. Staff recommendation of the trust as a place to work or receive treatment (the extent to which staff think care of patients/service users is the trust s top priority, would recommend their trust to others as a place to work, and would be happy with the standard of care provided by the trust if a friend or relative needed treatment.) KF4. Staff motivation at work (the extent to which they look forward to going to work, and are enthusiastic about and absorbed in their jobs.) KF7. Staff ability to contribute towards improvements at work (the extent to which staff are able to make suggestions to improve the work of their team, have frequent opportunities to show initiative in their role, and are able to make improvements at work.) Increase (better than 16)! Lowest (worst) 20% Increase (better than 16)! Below (worse than) average Increase (better than 16)! Below (worse than) average Full details of how the overall indicator of staff engagement was created can be found in the document Making sense of your staff survey data. 5

3. Summary of 2017 Key Findings for Royal Cornwall Hospitals NHS Trust 3.1 Top and Bottom Ranking Scores This page highlights the five Key Findings for which Royal Cornwall Hospitals NHS Trust compares most favourably with other acute trusts in England. TOP FIVE RANKING SCORES KF20. Percentage of staff experiencing discrimination at work in the last 12 months KF23. Percentage of staff experiencing physical violence from staff in last 12 months KF24. Percentage of staff / colleagues reporting most recent experience of violence KF29. Percentage of staff reporting errors, near misses or incidents witnessed in the last month KF18. Percentage of staff attending work in the last 3 months despite feeling unwell because they felt pressure from their manager, colleagues or themselves For each of the 32 Key Findings, the acute trusts in England were placed in order from 1 (the top ranking score) to 93 (the bottom ranking score). Royal Cornwall Hospitals NHS Trust s five highest ranking scores are presented here, i.e. those for which the trust s Key Finding score is ranked closest to 1. Further details about this can be found in the document Making sense of your staff survey data. 6

This page highlights the five Key Findings for which Royal Cornwall Hospitals NHS Trust compares least favourably with other acute trusts in England. It is suggested that these areas might be seen as a starting point for local action to improve as an employer. BOTTOM FIVE RANKING SCORES! KF2. Staff satisfaction with the quality of work and care they are able to deliver! KF30. Fairness and effectiveness of procedures for reporting errors, near misses and incidents! KF15. Percentage of staff satisfied with the opportunities for flexible working patterns! KF12. Quality of appraisals! KF1. Staff recommendation of the organisation as a place to work or receive treatment For each of the 32 Key Findings, the acute trusts in England were placed in order from 1 (the top ranking score) to 93 (the bottom ranking score). Royal Cornwall Hospitals NHS Trust s five lowest ranking scores are presented here, i.e. those for which the trust s Key Finding score is ranked closest to 93. Further details about this can be found in the document Making sense of your staff survey data. 7

3.2 Largest Local Changes since the 2016 Survey This page highlights the five Key Findings where staff experiences have improved at Royal Cornwall Hospitals NHS Trust since the 2016 survey. (This is a positive local result. However, please note that, as shown in section 3.3, when compared with other acute trusts in England, the scores for Key findings KF7, KF8, and KF32 are worse than average). WHERE STAFF EXPERIENCE HAS IMPROVED KF32. Effective use of patient / service user feedback KF7. Percentage of staff able to contribute towards improvements at work KF8. Staff satisfaction with level of responsibility and involvement KF9. Effective team working 8

KF13. Quality of non-mandatory training, learning or development Because the Key Findings vary considerably in terms of subject matter and format (e.g. some are percentage scores, others are scale scores), a straightforward comparison of score changes is not the appropriate way to establish which Key Findings have improved the most. Rather, the extent of 2016-2017 change for each Key Finding has been measured in relation to the national variation for that Key Finding. Further details about this can be found in the document Making sense of your staff survey data. 9

3.2. Summary of all Key Findings for Royal Cornwall Hospitals NHS Trust KEY Green = Positive finding, e.g. there has been a statistically significant positive change in the Key Finding since the 2016 survey. Red = Negative finding, e.g. there has been a statistically significant negative change in the Key Finding since the 2016 survey. Grey = No change, e.g. there has been no statistically significant change in this Key Finding since the 2016 survey. For most of the Key Finding scores in this table, the higher the score the better. However, there are some scores for which a high score would represent a negative finding. For these scores, which are marked with an asterisk and in italics, the lower the score the better. Change since 2016 survey 10

3.2. Summary of all Key Findings for Royal Cornwall Hospitals NHS Trust KEY Green = Positive finding, e.g. better than average. If a is shown the score is in the best 20% of acute trusts Red = Negative finding, i.e. worse than average. If a! is shown the score is in the worst 20% of acute trusts. Grey = Average. For most of the Key Finding scores in this table, the higher the score the better. However, there are some scores for which a high score would represent a negative finding. For these scores, which are marked with an asterisk and in italics, the lower the score the better. Comparison with all acute trusts in 2017 12

3.3. Summary of all Key Findings for Royal Cornwall Hospitals NHS Trust KEY Green = Positive finding, e.g. in the best 20% of acute trusts, better than average, better than 2016.! Red = Negative finding, e.g. in the worst 20% of acute trusts, worse than average, worse than 2016. 'Change since 2016 survey' indicates whether there has been a statistically significant change in the Key Finding since the 2016 survey. -- No comparison to the 2016 data is possible. * For most of the Key Finding scores in this table, the higher the score the better. However, there are some scores for which a high score would represent a negative finding. For these scores, which are marked with an asterisk and in italics, the lower the score the better. Appraisals & support for development Change since 2016 survey KF11. % appraised in last 12 mths Increase (better than 16) Average Ranking, compared with all acute trusts in 2017 KF12. Quality of appraisals Increase (better than 16)! Lowest (worst) 20% KF13. Quality of non-mandatory training, learning or development Equality & diversity Increase (better than 16)! Below (worse than) average * KF20. % experiencing discrimination at work in last 12 mths No change Lowest (best) 20% KF21. % believing the organisation provides equal opportunities for career progression / promotion Errors & incidents * KF28. % witnessing potentially harmful errors, near misses or incidents in last mth KF29. % reporting errors, near misses or incidents witnessed in last mth No change No change No change Average! Above (worse than) average Above (better than) average KF30. Fairness and effectiveness of procedures for reporting errors, near misses and incidents KF31. Staff confidence and security in reporting unsafe clinical practice No change! Lowest (worst) 20% Increase (better than 16)! Lowest (worst) 20% Health and wellbeing * KF17. % feeling unwell due to work related stress in last 12 mths * KF18. % attending work in last 3 mths despite feeling unwell because they felt pressure No change No change Average Below (better than) average KF19. Org and mgmt interest in and action on health and wellbeing Increase (better than 16)! Lowest (worst) 20% Working patterns KF15. % satisfied with the opportunities for flexible working patterns No change! Lowest (worst) 20% * KF16. % working extra hours No change! Above (worse than) average 14

3.3. Summary of all Key Findings for Royal Cornwall Hospitals NHS Trust (cont) Job satisfaction KF1. Staff recommendation of the organisation as a place to work or receive treatment Change since 2016 survey Ranking, compared with all acute trusts in 2017 Increase (better than 16)! Lowest (worst) 20% KF4. Staff motivation at work Increase (better than 16)! Below (worse than) average KF7. % able to contribute towards improvements at work KF8. Staff satisfaction with level of responsibility and involvement Increase (better than 16) Increase (better than 16) KF9. Effective team working Increase (better than 16) Average! Below (worse than) average! Below (worse than) average KF14. Staff satisfaction with resourcing and support Increase (better than 16)! Below (worse than) average Managers KF5. Recognition and value of staff by managers and the organisation KF6. % reporting good communication between senior management and staff Increase (better than 16)! Below (worse than) average Increase (better than 16)! Lowest (worst) 20% KF10. Support from immediate managers Increase (better than 16) Average Patient care & experience KF2. Staff satisfaction with the quality of work and care they are able to deliver KF3. % agreeing that their role makes a difference to patients / service users Increase (better than 16)! Lowest (worst) 20% No change Average KF32. Effective use of patient / service user feedback Increase (better than 16)! Lowest (worst) 20% Violence, harassment & bullying * KF22. % experiencing physical violence from patients, relatives or the public in last 12 mths * KF23. % experiencing physical violence from staff in last 12 mths No change! Above (worse than) average No change Lowest (best) 20% KF24. % reporting most recent experience of violence No change Above (better than) average * KF25. % experiencing harassment, bullying or abuse from patients, relatives or the public in last 12 mths * KF26. % experiencing harassment, bullying or abuse from staff in last 12 mths KF27. % reporting most recent experience of harassment, bullying or abuse No change Decrease (better than 16) Average! Above (worse than) average No change! Lowest (worst) 20% 15

4. Key Findings for Royal Cornwall Hospitals NHS Trust Royal Cornwall Hospitals NHS Trust had 2860 staff take part in this survey. This is a response rate of 56% 1 which is in the highest 20% of acute trusts in England (44%), and compares with a response rate of 43% in this trust in the 2016 survey. This section presents each of the 32 Key Findings, using data from the trust's 2017 survey, and compares these to other acute trusts in England and to the trust's performance in the 2016 survey. The findings are arranged under nine themes: appraisals and support for development, equality and diversity, errors and incidents, health and wellbeing, working patterns, job satisfaction, managers, patient care and experience, and violence, harassment and bullying. Positive findings are indicated with a green arrow (e.g. where the trust is in the best 20% of trusts, or where the score has improved since 2016). Negative findings are highlighted with a red arrow (e.g. where the trust s score is in the worst 20% of trusts, or where the score is not as good as 2016). An equals sign indicates that there has been no change. Appraisals & support for development KEY FINDING 11. Percentage of staff appraised in last 12 months KEY FINDING 12. Quality of appraisals 1 Questionnaires were sent to all 5143 staff eligible to receive the survey. This includes only staff employed directly by the trust (i.e. excluding staff working for external contractors). It excludes bank staff unless they are also employed directly elsewhere in the trust. When calculating the response rate, questionnaires could only be counted if they were received with their ID number intact, by the closing date. 16

KEY FINDING 13. Quality of non-mandatory training, learning or development Equality & diversity KEY FINDING 20. Percentage of staff experiencing discrimination at work in the last 12 months KEY FINDING 21. Percentage of staff believing that the organisation provides equal opportunities for career progression or promotion Errors & incidents KEY FINDING 28. Percentage of staff witnessing potentially harmful errors, near misses or incidents in last month 17

KEY FINDING 29. Percentage of staff reporting errors, near misses or incidents witnessed in the last month KEY FINDING 30. Fairness and effectiveness of procedures for reporting errors, near misses and incidents KEY FINDING 31. Staff confidence and security in reporting unsafe clinical practice Health and wellbeing KEY FINDING 17. Percentage of staff feeling unwell due to work related stress in the last 12 months 18

KEY FINDING 18. Percentage of staff attending work in the last 3 months despite feeling unwell because they felt pressure from their manager, colleagues or themselves KEY FINDING 19. Organisation and management interest in and action on health and wellbeing Working patterns KEY FINDING 15. Percentage of staff satisfied with the opportunities for flexible working patterns KEY FINDING 16. Percentage of staff working extra hours 19

Job satisfaction KEY FINDING 1. Staff recommendation of the organisation as a place to work or receive treatment KEY FINDING 4. Staff motivation at work KEY FINDING 7. Percentage of staff able to contribute towards improvements at work KEY FINDING 8. Staff satisfaction with level of responsibility and involvement 20

KEY FINDING 9. Effective team working KEY FINDING 14. Staff satisfaction with resourcing and support Managers KEY FINDING 5. Recognition and value of staff by managers and the organisation KEY FINDING 6. Percentage of staff reporting good communication between senior management and staff 21

KEY FINDING 10. Support from immediate managers Patient care & experience KEY FINDING 2. Staff satisfaction with the quality of work and care they are able to deliver KEY FINDING 3. Percentage of staff agreeing that their role makes a difference to patients / service users KEY FINDING 32. Effective use of patient / service user feedback 22

Violence, harassment & bullying KEY FINDING 22. Percentage of staff experiencing physical violence from patients, relatives or the public in last 12 months KEY FINDING 23. Percentage of staff experiencing physical violence from staff in last 12 months KEY FINDING 24. Percentage of staff / colleagues reporting most recent experience of violence KEY FINDING 25. Percentage of staff experiencing harassment, bullying or abuse from patients, relatives or the public in last 12 months 23

KEY FINDING 26. Percentage of staff experiencing harassment, bullying or abuse from staff in last 12 months KEY FINDING 27. Percentage of staff / colleagues reporting most recent experience of harassment, bullying or abuse 24

5. Workforce Race Equality Standard (WRES) The scores presented below are the un-weighted question level score for question Q17b and un-weighted scores for Key Findings 25, 26, and 21, split between White and Black and Minority Ethnic (BME) staff, as required for the Workforce Race Equality Standard. In order to preserve the anonymity of individual staff, a score is replaced with a dash if the staff group in question contributed fewer than 11 responses to that score. KF25 KF26 KF21 Q17b Percentage of staff experiencing harassment, bullying or abuse from patients, relatives or the public in last 12 months Percentage of staff experiencing harassment, bullying or abuse from staff in last 12 months Percentage of staff believing that the organisation provides equal opportunities for career progression or promotion In the 12 last months have you personally experienced discrimination at work from manager/team leader or other colleagues? Your Trust in 2017 Average (median) for acute trusts Your Trust in 2016 White 27% 27% 27% BME 23% 28% 26% White 27% 25% 30% BME 28% 27% 28% White 85% 87% 83% BME 75% 75% 71% White 6% 7% 8% BME 12% 15% 17% 25

6. Key Findings by work group characteristics Tables 6.1 to 6.4 show the Key Findings at Royal Cornwall Hospitals NHS Trust broken down by work group characteristics: occupational groups, staff groups, directorates and full time/part time staff. Technical notes: As in previous years, there are two types of Key Finding: - percentage scores, i.e. percentage of staff giving a particular response to one, or a series of, survey questions - scale summary scores, calculated by converting staff responses to particular questions into scores. For each of these scale summary scores, the minimum score is always 1 and the maximum score is 5 For most of the Key Findings presented in tables 6.1 to 6.4, the higher the score the better. However, there are some Key Findings for which a high score would represent a negative result. For these Key Findings, marked with an asterisk and shown in italics, the lower the score the better. Care should be taken not to over interpret the findings if scores differ slightly. For example, if for 'KF11. % appraised in the last 12 months' staff in Group A score 45%, and staff in Group B score 40%, it may appear that a higher proportion of staff in Group A have had appraisals than staff in Group B. However, because of small numbers in these sub-groups, it is probably not statistically significant. A more sensible interpretation would be that, on average, similar proportions of staff in Group A and B have had appraisals. Please note that, unlike the overall trust scores, data in this section are not weighted. Please also note that all percentage scores are shown to the nearest 1%. This means scores of less than 0.5% are displayed as 0%. In order to preserve anonymity of individual staff, a score is replaced with a dash if the staff group in question contributed fewer than 11 responses to that score. 26

Table 6.1: Key Findings for different occupational groups Appraisals & support for development KF11. % appraised in last 12 mths 86 92 79 87 98 93 95 95 82 83 83 87 90 KF12. Quality of appraisals 3.05 3.20 2.99 2.76 2.85 3.16 2.74 2.91 3.05 2.95 2.75 2.59 2.33 KF13. Quality of non-mandatory training, learning or development Equality & diversity * KF20. % experiencing discrimination at work in last 12 mths KF21. % believing the organisation provides equal opportunities for career progression / promotion Errors & incidents * KF28. % witnessing potentially harmful errors, near misses or incidents in last mth KF29. % reporting errors, near misses or incidents witnessed in last mth KF30. Fairness and effectiveness of procedures for reporting errors, near misses and incidents KF31. Staff confidence and security in reporting unsafe clinical practice Health and wellbeing * KF17. % feeling unwell due to work related stress in last 12 mths * KF18. % attending work in last 3 mths despite feeling unwell because they felt pressure KF19. Org and mgmt interest in and action on health and wellbeing Working patterns KF15. % satisfied with the opportunities for flexible working patterns 4.16 4.19 4.02 4.07 4.15 4.33 4.07 4.04 3.96 3.89 3.76 3.91 3.88 11 10 14 11 9 7 13 11 7 7 4 6 12 87 87 81 92 92 90 84 82 77 84 86 76 70 42 42 37 48 36 30 34 39 24 36 13 8 18 92 94 89 92 94 86 90 90 82 96 83 100-3.45 3.76 3.62 3.31 3.31 3.34 3.71 3.60 3.35 3.59 3.51 3.28 3.29 3.61 3.73 3.52 3.47 3.43 3.42 3.60 3.56 3.52 3.48 3.43 3.32 3.38 44 44 39 38 50 43 30 43 42 32 30 31 30 58 50 56 32 63 51 49 55 52 52 52 49 45 3.34 3.47 3.49 3.24 3.30 3.45 3.47 3.52 3.51 3.55 3.56 3.59 3.44 44 45 37 31 48 49 43 42 61 31 49 62 42 * KF16. % working extra hours 86 91 67 89 81 76 70 70 86 69 53 62 63 Number of respondents 514 163 173 331 46 69 119 186 73 289 475 217 33 Due to low numbers of respondents, no scores are shown for the following occupational groups: Mental Health Nurses, Public Health / Health Improvement, Commissioning Staff, Ambulance Control Staff and Patient Transport Service. 27

Table 6.1: Key Findings for different occupational groups (cont) Job satisfaction KF1. Staff recommendation of the organisation as a place to work or receive treatment 3.36 3.53 3.57 3.43 3.15 3.40 3.52 3.48 3.48 3.43 3.52 3.49 3.56 KF4. Staff motivation at work 4.00 4.00 3.98 3.81 3.91 4.12 3.78 3.85 3.92 3.73 3.84 3.63 3.61 KF7. % able to contribute towards improvements at work KF8. Staff satisfaction with level of responsibility and involvement 73 72 60 65 67 77 65 69 90 70 61 75 55 3.93 4.01 3.80 3.95 3.80 3.96 3.83 3.90 4.02 3.80 3.80 3.79 3.48 KF9. Effective team working 3.76 3.76 3.69 3.87 3.84 3.76 3.70 3.71 3.81 3.75 3.69 3.68 3.32 KF14. Staff satisfaction with resourcing and support Managers KF5. Recognition and value of staff by managers and the organisation KF6. % reporting good communication between senior management and staff 3.19 3.10 3.27 3.11 3.02 3.00 3.29 3.22 3.17 3.16 3.40 3.25 3.37 3.31 3.49 3.43 3.31 3.18 3.45 3.40 3.46 3.61 3.32 3.36 3.43 2.96 21 36 26 26 22 14 31 26 42 34 23 24 21 KF10. Support from immediate managers 3.82 3.90 3.81 3.53 3.64 3.89 3.73 3.82 3.80 3.74 3.70 3.76 3.25 Patient care & experience KF2. Staff satisfaction with the quality of work and care they are able to deliver KF3. % agreeing that their role makes a difference to patients / service users KF32. Effective use of patient / service user feedback Violence, harassment & bullying * KF22. % experiencing physical violence from patients, relatives or the public in last 12 mths * KF23. % experiencing physical violence from staff in last 12 mths KF24. % reporting most recent experience of violence * KF25. % experiencing harassment, bullying or abuse from patients, relatives or the public in last 12 mths * KF26. % experiencing harassment, bullying or abuse from staff in last 12 mths KF27. % reporting most recent experience of harassment, bullying or abuse 3.68 3.53 3.95 3.47 3.44 3.51 3.93 3.80 3.12 3.72 3.92 3.46 3.65 93 93 93 93 93 99 92 95 80 88 83 84 88 3.71 3.74 3.67 3.43 3.04 3.22 3.72 3.63 3.63 3.54 3.44 3.22-34 9 45 12 15 17 20 18 0 4 2 1 3 2 1 5 0 2 0 3 1 0 0 1 0 3 74 69 80 37 - - 29 68 - - - - - 45 35 37 29 30 34 39 25 15 10 21 5 3 32 28 31 26 22 17 28 26 34 26 22 25 34 47 48 57 18 44 41 35 48 28 36 38 43 - Overall staff engagement 3.70 3.77 3.70 3.61 3.55 3.77 3.63 3.67 3.83 3.61 3.63 3.64 3.49 Number of respondents 514 163 173 331 46 69 119 186 73 289 475 217 33 Due to low numbers of respondents, no scores are shown for the following occupational groups: Mental Health Nurses, Public Health / Health Improvement, Commissioning Staff, Ambulance Control Staff and Patient Transport Service. 28

Table 6.2: Key Findings for different staff groups Appraisals & support for development KF11. % appraised in last 12 mths 91 84 85 97 82 81 88 87 KF12. Quality of appraisals 2.81 3.03 2.74 2.94 2.25 2.71 2.75 3.09 KF13. Quality of non-mandatory training, learning or development Equality & diversity * KF20. % experiencing discrimination at work in last 12 mths KF21. % believing the organisation provides equal opportunities for career progression / promotion Errors & incidents * KF28. % witnessing potentially harmful errors, near misses or incidents in last mth KF29. % reporting errors, near misses or incidents witnessed in last mth KF30. Fairness and effectiveness of procedures for reporting errors, near misses and incidents KF31. Staff confidence and security in reporting unsafe clinical practice Health and wellbeing * KF17. % feeling unwell due to work related stress in last 12 mths * KF18. % attending work in last 3 mths despite feeling unwell because they felt pressure KF19. Org and mgmt interest in and action on health and wellbeing Working patterns KF15. % satisfied with the opportunities for flexible working patterns 3.94 4.02 3.84 4.20 3.58 3.87 4.07 4.16 7 12 6 11 8 11 11 10 78 83 82 88 77 88 91 87 46 33 14 36 25 35 48 42 94 91 85 87-100 93 93 3.54 3.67 3.43 3.52 3.21 3.46 3.30 3.52 3.50 3.56 3.43 3.53 3.09 3.30 3.46 3.64 38 37 31 38 38 44 38 44 50 54 51 52 58 65 32 56 3.40 3.57 3.58 3.43 3.06 3.40 3.25 3.38 34 36 54 47 29 32 31 44 * KF16. % working extra hours 76 60 59 80 61 86 89 87 Number of respondents 150 430 893 237 24 86 343 697 Please note that the staff groups classification was provided by Royal Cornwall Hospitals NHS Trust 29

Table 6.2: Key Findings for different staff groups (cont) Job satisfaction KF1. Staff recommendation of the organisation as a place to work or receive treatment 3.41 3.56 3.52 3.38 3.28 3.19 3.42 3.41 KF4. Staff motivation at work 3.82 3.87 3.79 3.91 3.49 3.67 3.81 4.01 KF7. % able to contribute towards improvements at work KF8. Staff satisfaction with level of responsibility and involvement 72 61 67 74 38 69 65 73 3.85 3.78 3.81 3.92 3.22 3.76 3.96 3.96 KF9. Effective team working 3.79 3.68 3.71 3.74 3.17 3.68 3.85 3.75 KF14. Staff satisfaction with resourcing and support Managers KF5. Recognition and value of staff by managers and the organisation KF6. % reporting good communication between senior management and staff 3.21 3.34 3.35 3.08 3.06 2.80 3.11 3.17 3.35 3.40 3.41 3.41 2.85 3.15 3.32 3.36 29 29 26 24 0 31 25 25 KF10. Support from immediate managers 3.80 3.80 3.73 3.76 3.01 3.52 3.54 3.85 Patient care & experience KF2. Staff satisfaction with the quality of work and care they are able to deliver KF3. % agreeing that their role makes a difference to patients / service users KF32. Effective use of patient / service user feedback Violence, harassment & bullying * KF22. % experiencing physical violence from patients, relatives or the public in last 12 mths * KF23. % experiencing physical violence from staff in last 12 mths KF24. % reporting most recent experience of violence * KF25. % experiencing harassment, bullying or abuse from patients, relatives or the public in last 12 mths * KF26. % experiencing harassment, bullying or abuse from staff in last 12 mths KF27. % reporting most recent experience of harassment, bullying or abuse 3.78 3.93 3.78 3.58 3.33 3.61 3.48 3.66 94 91 82 96 75 89 93 93 3.60 3.66 3.45 3.45-3.33 3.41 3.72 5 31 2 15 4 0 12 28 1 3 1 1 13 0 0 2-76 43 38 - - 39 74 14 28 15 34 13 9 29 43 28 30 24 22 26 28 25 31 32 53 37 38-37 20 47 Overall staff engagement 3.64 3.65 3.66 3.68 3.26 3.51 3.62 3.72 Number of respondents 150 430 893 237 24 86 343 697 Please note that the staff groups classification was provided by Royal Cornwall Hospitals NHS Trust 30

Table 6.3: Key Findings for different directorates Appraisals & support for development KF11. % appraised in last 12 mths 89 88 85 82 91 KF12. Quality of appraisals 2.85 2.87 2.95 2.80 3.06 KF13. Quality of non-mandatory training, learning or development Equality & diversity * KF20. % experiencing discrimination at work in last 12 mths KF21. % believing the organisation provides equal opportunities for career progression / promotion Errors & incidents * KF28. % witnessing potentially harmful errors, near misses or incidents in last mth KF29. % reporting errors, near misses or incidents witnessed in last mth KF30. Fairness and effectiveness of procedures for reporting errors, near misses and incidents KF31. Staff confidence and security in reporting unsafe clinical practice Health and wellbeing * KF17. % feeling unwell due to work related stress in last 12 mths * KF18. % attending work in last 3 mths despite feeling unwell because they felt pressure KF19. Org and mgmt interest in and action on health and wellbeing Working patterns KF15. % satisfied with the opportunities for flexible working patterns 4.01 3.96 4.08 4.01 4.14 9 7 11 10 9 86 78 87 85 87 33 15 42 36 30 92 86 92 89 95 3.51 3.35 3.49 3.41 3.73 3.48 3.46 3.52 3.49 3.68 35 31 43 39 40 51 49 53 52 48 3.46 3.65 3.40 3.35 3.44 41 59 40 39 41 * KF16. % working extra hours 68 65 82 75 82 Number of respondents 924 489 530 590 327 Please note that the directorates classification was provided by Royal Cornwall Hospitals NHS Trust 31

Table 6.3: Key Findings for different directorates (cont) Job satisfaction KF1. Staff recommendation of the organisation as a place to work or receive treatment 3.38 3.54 3.46 3.45 3.56 KF4. Staff motivation at work 3.82 3.74 3.93 3.93 3.95 KF7. % able to contribute towards improvements at work KF8. Staff satisfaction with level of responsibility and involvement 68 75 64 66 69 3.84 3.82 3.85 3.89 3.95 KF9. Effective team working 3.75 3.77 3.65 3.76 3.75 KF14. Staff satisfaction with resourcing and support Managers KF5. Recognition and value of staff by managers and the organisation KF6. % reporting good communication between senior management and staff 3.21 3.34 3.17 3.24 3.17 3.34 3.50 3.34 3.30 3.44 27 29 24 21 34 KF10. Support from immediate managers 3.72 3.82 3.75 3.67 3.78 Patient care & experience KF2. Staff satisfaction with the quality of work and care they are able to deliver KF3. % agreeing that their role makes a difference to patients / service users KF32. Effective use of patient / service user feedback Violence, harassment & bullying * KF22. % experiencing physical violence from patients, relatives or the public in last 12 mths * KF23. % experiencing physical violence from staff in last 12 mths KF24. % reporting most recent experience of violence * KF25. % experiencing harassment, bullying or abuse from patients, relatives or the public in last 12 mths * KF26. % experiencing harassment, bullying or abuse from staff in last 12 mths KF27. % reporting most recent experience of harassment, bullying or abuse 3.73 3.68 3.57 3.83 3.64 91 84 90 91 93 3.42 3.55 3.67 3.54 3.75 8 3 39 20 8 1 1 2 2 1 46 75 78 61 68 21 8 45 32 32 25 26 28 29 28 36 43 48 39 39 Overall staff engagement 3.62 3.70 3.66 3.66 3.73 Number of respondents 924 489 530 590 327 Please note that the directorates classification was provided by Royal Cornwall Hospitals NHS Trust 32

Table 6.4: Key Findings for different work groups Full time / part time a Appraisals & support for development KF11. % appraised in last 12 mths 86 88 KF12. Quality of appraisals 2.89 2.88 KF13. Quality of non-mandatory training, learning or development Equality & diversity * KF20. % experiencing discrimination at work in last 12 mths KF21. % believing the organisation provides equal opportunities for career progression / promotion Errors & incidents * KF28. % witnessing potentially harmful errors, near misses or incidents in last mth KF29. % reporting errors, near misses or incidents witnessed in last mth KF30. Fairness and effectiveness of procedures for reporting errors, near misses and incidents KF31. Staff confidence and security in reporting unsafe clinical practice Health and wellbeing * KF17. % feeling unwell due to work related stress in last 12 mths * KF18. % attending work in last 3 mths despite feeling unwell because they felt pressure KF19. Org and mgmt interest in and action on health and wellbeing Working patterns KF15. % satisfied with the opportunities for flexible working patterns 4.03 4.04 9 10 84 86 33 26 92 89 3.48 3.51 3.52 3.49 38 34 52 48 3.46 3.45 41 55 * KF16. % working extra hours 75 65 Number of respondents 2206 552 a Full time is defined as staff contracted to work 30 hours or more a week 33