The Royal Wolverhampton NHS Trust Trust Board Report Meeting Date: 28 th October 2013 Title: Executive Summary: ChatBack 2013, Results and Next Steps Overall the Trust results were encouraging: 14 out of 19 results that were able to be bench marked against ChatBack 2012 showed an improvement in performance. The Trust s overall summary score was green with the index score showing an increase of 55 points. Key areas of improvement include: Overall satisfaction with job up by 2% to 69% Recommending Trust as a place to work up by 2% to 64% Care of patients being a top priority for the department up by 7% to 82% Satisfaction with quality care they give up by 5% to 88% Awareness of Trust values up 8% to 79% Knowing what the values mean to them in their role up by 9% to 71% On a more concerning note the question regarding recommending the ward/dept. to friends and family was 77% which is a decline of 1%. This result when calculated in line with net promoter formula is however up from 4 to 14% and also is an improvement on the national survey result for 2012 which was 66% (although not a direct comparison as it refers to the organisation not the specific ward etc.) Action Requested: Report of: Author: Contact Details: Results have been cascaded to the Divisions and Directorates and action plans are being developed. The purpose of this update is to provide an overview of the key results of this round of ChatBack and to outline next steps in terms of the communication and action planning approach. Director of HR Caroline Marshall, Deputy Director of HR Caroline.Marshall5@nhs.net Resource Implications: Public or Private: (with reasons if private) References:
(eg from/to other committees) Appendices/ References/ Background Reading NHS Constitution: (How it impacts on any decision-making) In determining this matter, the Board should have regard to the Core principles contained in the Constitution of: Equality of treatment and access to services High standards of excellence and professionalism Service user preferences Cross community working Best Value Accountability through local influence and scrutiny TB : 28/10/2013 Page 2
1. Introduction As part of the Organisational Development Strategy we have utilised ChatBack as a vehicle to enable us to baseline key metrics. The tool has primarily focused on key priority areas highlighted through the National Staff Survey, previous ChatBack surveys as well as metrics to support assessment of the culture of the Trust. In light of the Francis report Chatback was refined to enable monitoring at a department level of these specific areas of interest e.g. culture, engagement, sharing concerns, confidence in quality of patient care etc. The results will act as a cultural barometer for the organisation. The purpose of this report is to provide an overview of the key results of the 2013 round of ChatBack and how they compare with 2012 results and the 2012 national staff survey results. In addition, to outline next steps in terms of the communication and action planning. 2. Background ChatBack 2013 was conducted over a 4 week period in July. The mechanisms employed to ensure that we accessed all staff (community and acute) were two-fold: access to an on line survey hard copy questionnaires distributed via management cascade. The response from staff was excellent with 2037 staff (30.5%) responding (up from 1766 in 2012). 3. Key Findings a. Trust Level Overall the Trust results were encouraging with the majority of results that were able to be bench marked against ChatBack 2012 showing an improvement in performance see appendix 1 for details of Trust results. The Trust s overall summary score was green (basically an aggregate result for all statements an average of 70% agreement of staff with each statement, previously amber, at 64%). Of the 19 results that could be bench marked against ChatBack 2012 results 14 had improved, including: Overall satisfaction with job up by 2% to 69% Recommending Trust as a place to work up by 2% to 64% Care of patients being a top priority for the department up by 7% to 82% Satisfaction with quality care they give up by 5% to 88% Awareness of Trust values up 8% to 79% Knowing what the values mean to them in their role up by 9% to 71% Effective communications between senior management and staff up by 3% to 53% On a more concerning note the question regarding recommending the ward/dept. to friends and family was 77% which is a decline of 1%. This is, however, an improvement on the national survey result for 2012 which was 66% (although not a direct comparison as slightly different question wording, one refers to the organisation and one the specific ward). TB : 28/10/2013 Page 3
Further details of the answering profile for this question are outlined later in this report. In addition, 2 other questions showed declines in performance: My manager tells me how I m doing on a regular basis down 6% to 51% My manager takes my work related views seriously down 4% to 60% b. Net Promoter Question The raw score for this question which relates to how likely it is that the individual would recommend the service to their friends and family was 77% as mentioned above, however, when calculated in line with net promoter formula the result is up from 4 to 14%. An analysis of the answering pattern for this question indicates a shift in responses to a more polarised position in 2013, on both the negative and positive aspects, with some Likelys becoming Extremely Likely, but increased negativity too. See appendix 2 for breakdown of answers. There were some notable variations at a department level in the responses for this question that may be worthy of investigation: Beynon short stay - 43% Deansely ward 44% Health Visiting 57% Virtual Ward 58% Stroke inc Ward 1 at West Pk 48% Anaesthetics 54% Detailed reports for these areas have been provided to relevant managers to enable analysis and action planning. c. Comparison to National survey results (2012) 14 of the ChatBack questions can broadly be compared to the 2012 National staff survey results (note there are some wording variances between questions). Of these, 12 show an improvement on the 2012 results, including: I am satisfied with the quality of care I give to patients/service users in my department 88% agreed in ChatBack cf. 74% in 2012 National staff survey Within my department, care of patients/service users is the top priority 82% cf. 69% in 2012 National staff survey. Further detailed results are shown in appendix 3. d. Directorate level The majority of directorates showed an improvement at an aggregate scoring level with the following notable exceptions: Hotel Services went from green to red Commercial services went from amber to red Rehabilitation and Ambulatory went from green to amber. Notable improvements at an aggregate level were seen for: Division 1 Amber to green (+96 points) TB : 28/10/2013 Page 4
o o o Radiology from red to green (+118 points). Theatres and Critical Care from red to amber (+167 points) Obstetrics and Gynaecology from red to amber (+115 points) Division 2 stayed at amber but up by +56 points o Medical group from amber to green (+124 points) o Adult community services went from red to amber (+72 points) o Emergency Services stayed at amber but improved (+72 points) Detailed reports for these areas have been provided to relevant managers to enable analysis and action planning. 4. Next Steps A communication cascade is underway. Results have been cascaded to the divisions and directorates to enable local level action plans to be developed. Trust level communications are also planned through all user bulletins, senior manager forum, JNC etc. HR Managers are working with line managers to review the effectiveness of the actions implemented in response to 2012 results as well as developing action plans to address any new areas of concern. TB : 28/10/2013 Page 5
2013 All responses Total of 2,037 Trust responses (30.5% response rate). Figures are representative of the entire trust to ±1.8% at a 95% confidence level. +55 +96 +17 +118 +56 +167 +59 +22 +53 +115 n/a +56 +55 +38 +129-1 -22 +21 n/a +107-42 -22-158 +77-83 Aggregate Index Score is derived from the % of respondents agreeing with relevant questions. Maximum of 1,000. 'Change' is relative to August 2012. Overview 1. The Trust meets the threshold level for a Green overall rating (scoring broadly equivalent to an average of 70% agreement in each question), with an increase of 55 points from 2012 (with some amendments to the question set) 2. Responses to all questions received 12 Green ratings, 8 Amber ratings and 4 Red ratings 3. Historic review shows that 14 broadly comparable questions have increased from 2012 with 3 declining and 2 scoring the same (other questions were new for 2013 and consequently no 2012 data exists) 4. Of these scores, largest gains relate to role clarity and awareness of/adherence to Trust values 5. Declines from 2012 are relatively minor, but two of the three relate to line manager behaviours 6. Additional 'drill-down' insight is available in separate spreadsheet format 1
7. How likely are you to recommend your ward or unit to friends and family if they needed similar care or treatment? Net Promoter Score of +14%. Calculated by subtracting the proportion of 'Neither agree nor disagree', 'Disagree' and 'Strongly Disagree' responses from the proportion of 'Strongly Agree' responses. No specific targets have been applied to question 7, given its scoring. This question is not included in the overall index calculation on p.1. 77% 69% 2013 1. Taking everything into consideration, I am satisfied with my job in my department 6. I feel that my role makes a difference to patients/service 87% users 2. I would recommend my 64% department as a place to work 5. I am satisfied with the quality of care given to patients/service users in my department 81% 88% 3. Within my department, care of patients/service users is the top priority 4. I am satisfied with the quality of care I give to patients/service users On or above target (70%+ agreement) D Close to target (60% - 69.9% agreement) Below target «60% agreement) Strengths 1. Questions 3 and 4 have increased by 7 and 5 percentage points respectively, relative to 2012 Areas for enhancement 1. Question 7 has declined 1 percentage point from 2012 levels: however, the Net Promoter Score (based on a different scoring approach) has increased from +4% to +14% 2
[Chat~ (d~ 2013 15. My manager takes my workrelated views seriously 60% 8. In my directorate, communication between senior management and staff is effective 53% 14. My manager tells me how I'm doing on a regular basis 9. I am made aware of what is going on in my department 13. I understand what the Trust's values mean for me in my role 10. I am made aware of what is going on in the Trust 79% 12. I am aware of the Trust's values 11. I know how my role contributes to what my department is trying to achieve On or above target (70%+ agreement) D Close to target (60% - 69.9% agreement) Below target «60% agreement) Strengths 1. Questions 11, 12 and 13 all receive Green ratings and have increased by 13, 8 and 9 percentage points respectively from 2012 levels Areas for enhancement 1. Question 14 has declined by 6 percentage points relative to 2012 levels and receives a particularly ambivalent score across the trust 2. Question 15 has declined by 4 percentage points relative to 2012 levels 3. Aspects of communication (9 and 10) do not fully meet respondent expectations 3
2013 26. We are given feedback about changes made in response to reported errors, near misses and incidents 60% ~---,---- 70% 16. I am able to make suggestions to improve the work of my team I department 25. We are informed about errors, near misses and incidents that happen in the department 60% 17. I am able to make improvements happen in my area of work 24. When errors, near misses or incidents are reported, my department 78% takes action to ensure that they do not happen again 61% 18. I am involved in decisions that affect my daily work 23. My department encourages us to report errors, near misses or incidents 19. My colleagues treat me with dignity and respect 22. The last time you saw an error, near miss or incident that could have hurt staff or patients I service users, did you or a colleague report it? 96% 78% 65% 21. I have adequate materials, supplies and equipment to do my job 20. Team work in my immediate group of colleagues is effective No specific targets have been applied to question 22, given its scoring. This question is not included in the overall index calculation on p. 1. On or above target (70%+ agreement) o Close to target (60% - 69.9% agreement) Below target «60% agreement) Strengths 1. Question 21 has increased by 7 percentage points from a comparable question in 2012, although does not yet merit a Green rating Areas for enhancement 1. None speciflcally noted, although Questions 17, 18 and 26 are close to minimum levels for an Amber rating 4
2013 Historic review Scores show the percentage of positive responses in the '2013' column, with change in percentage points from 2012 in the final column. The table only includes questions asked in both years. Change Question-statement 2013 from 2012 1. Taking everything into consideration, I am satisfied with my job in my department* 69% 2% 2. I would recommend my department as a place to work* 64% 2% 3. Within my department, care of patients/service users is the top priority 82% 7% 4. I am satisfied with the quality of care I give to patients/service users 88% 5% 6. I feel that my role makes a difference to patients/service users 87% 1% 7. How likely are you to recommend your ward or unit to friends and family if they needed similar care or treatment?** 8. In my directorate, communication between senior management and staff is effective 77% -1% 53% 3% 9. I am made aware of what is going on in my department*** 59% 7% 10. I am made aware of what is going on in the Trust 55% 0% 11. I know how my role contributes to what my department is trying to achieve*** 77% 13% 12. I am aware of the Trust's values 79% 8% 13. I understand what the Trust's values mean for me in my role 71% 9% 14. My manager tells me how I'm doing on a regular basis 51% -6% 15. My manager takes my work-related views seriously 60% -4% 16. I am able to make suggestions to improve the work of my team / department 70% 1% 18. I am involved in decisions that affect my daily work 61% 0% 19. My colleagues treat me with dignity and respect 80% 1% 20. Team work in my immediate group of colleagues is effective 78% 1% 21. I have adequate materials, supplies and equipment to do my job**** 65% 7% Changes from 2012 wording. *2012: 'Trust' not 'department' ** 2012: 'recommend your service', not 'recommend your ward or unit' *** 2012: 'directorate' not 'department' **** 2012: 'The Trust provides the resources necessary for me to work effectively (e.g. equipment, supplies, etc.)' 5
Appendix 2 Net Promoter Answering Profile 2013 Response Profile 1,713 respondents in 2013 (306 opted for Don t know or n/a): Extremely Likely: 629 (37%) Likely: 697 (41%) Neither likely nor unlikely: 204 (12%) Unlikely: 78 (5%) Extremely unlikely: 105 (6%). So you have the 37% for the Extremely Likely, then subtract the 12%, the 5% and the 6% to give 14%. 2012 Response Profile 1,756 respondents in 2012: Extremely Likely: 466 (27%) Likely: 903 (51%) Neither likely nor unlikely: 282 (16%) Unlikely: 74 (4%) Extremely unlikely: 31 (2%). The calculation is therefore 27 Extremely Likely, then subtract 16, 4 and 2 to get 5 due to rounding this was actually 4%. In short, it looks like there s more polarisation in 2013. TB : 28/10/2013
Appendix 3 Comparison to 2012 National staff survey results Question ChatBack 2013 result Would recommend my department as a place to work Within my department, care of patients is the top priority I am satisfied with the quality of care given to patients in my department I feel my role makes a difference to patients How likely are you to recommend your ward or unit to friends and family if they needed care or treatment In my directorate, communication between senior management and staff is effective I am able to make suggestions to improve the work of my team/department I am able to make improvements happen in my area of work I am involved in decisions that affect my daily work The last time you saw an error, near miss or incident that could have hurt staff or patients did you or a colleague report it My department encourages us to report errors, near misses or incidents When errors etc. Are reported, my department takes action to ensure they do not happen again We are informed about errors, near misses and incidents that happen in the department We are given feedback about changes made in response to reported errors, near misses or incidents. 64% 59% 82% 69% 88% 74% 87% 81% 77% 66% 53% 39% 70% 76% 60% 54% 61% 55% 96% 92% 85% 87% 78% 65% 67% 51% 60% 47% National staff survey result (2012) * * * * * TB : 28/10/2013