Health Service Focus

13.02.17

Driving quality improvement in healthy workplaces

Source: NHE Jan/Feb 17

Professor Gillian Leng, deputy chief executive and director of health and social care at the National Institute for Health and Care Excellence (NICE), talks to NHE’s David Stevenson about the work the organisation is doing around quality standards for healthy workplaces.

This year, NICE is due to publish quality standards and measures to improve the health and wellbeing of employees across the NHS. 

The quality standards, which are different from guidance, aim to provide a prioritised set of concise, measureable statements designed to drive quality improvements across a pathway of care. Although not mandatory, the quality standards can be used to plan and deliver services to provide the best possible care. NICE also notes that they “support the government’s vision for a health and care system focused on delivering the best possible health outcomes”. 

The first quality standard due to come out in this area is ‘Healthy workplaces: improving employee mental and physical health and wellbeing’, which aims to contribute to improvements in the wellbeing of employees and reducing sickness absence rates. 

“It aligns, of course, with the work coming out from the National Improvement and Leadership Development Strategic Framework,” said Professor Gillian Leng, deputy chief executive and director of health and social care at NICE. 

“NICE is a co-signatory to that work and, hopefully, that as a focus will be a mechanism for supporting this work. 

“But we also really need organisations and boards to take this up as well, in particular HR and directors of workforce, to really think about how this cascades through the system of line management so that leaders are displaying the attributes we have highlighted such as regularly consulting with staff, allowing flexible work scheduling, being accessible and praising for a job well done.” 

She added that these important qualities are nothing new and people would, on the whole, not object to them, “but, perhaps, in a busy environment, some of them might get forgotten”.

“But if there is a reminder, especially in times of extreme pressure, to support our staff, it can help improve the situation, because it can be pretty tough otherwise,” said Prof Leng. 

In the draft consultation on the quality standard, NICE proposed a number of statements such as plans for employers to have a named senior manager who is responsible for making employee health and wellbeing a core priority, and line managers’ job descriptions and performance indicators including supporting employee health and wellbeing.

 Prof Leng told us that in her ideal scenario organisations would be actively bought in to improving in this, “and to recognise what we’ve said in the quality standard and guidance and track themselves”. 

“A bit like when you do an audit. So people put mechanisms for measuring performance in place and regularly review to see what is happening or not and making changes to drive improvement at a local level,” she said. 

“Ideally we want trust boards to support this and monitor improvement, but alongside that using the NHS Staff Survey could be very useful.” 

However, Prof Leng admitted that while drawing the evidence together and making recommendations is relatively straightforward, “driving change is not so easy. And in this area it is less straightforward”. 

Discussing the quality standard and National Improvement and Leadership Development Strategic Framework implementation, she said: “I think it is better if boards take it in the round as a whole set of initiatives to improve the health and wellbeing of their staff. There will, inevitably, be different components, but as an umbrella it should be a focus on the staff.” 

STP support

One area of change in the media spotlight at the moment is sustainability and transformation plans (STPs) and their potential impact on organisations and staff. 

“I don’t think the STPs will impact particularly with regards to our workforce recommendations because they need to be driven within organisations, and at the moment STPs are not new organisations – they are collaborations/coalitions,” said Prof Leng. 

“However, I hope that they will be supportive of this work. One of the key themes of STP work is on prevention and these recommendations do support a healthy workforce both physically and mentally, and should be one of the strands they look. 

“A healthy, well-run workforce is going to be much better at delivering what needs to be delivered. I really hope that they will support the roll-out of this quality standard in driving improvement.”

For more information

W: www.nice.org.uk

Comments

Derek Mowbray   20/02/2017 at 11:33

My immediate reaction to these initiatives is that they are too soft. In the 2015 Staff Survey a result was that 3% of staff surveyed acknowledged that over a 3 month period they were unable to discharge their job to their satisfaction (I'm writing this from memory). We know from other studies the level of psychopresenteeism is high, and we know the cost is enormous (Twice or more than the combined cost of sickness absence and staff turnover attrbutable to stress). The problem of people not feeling well enough to perform at their peak is, arguably, the most serious problem the NHS has got - all the other massive problems are, arguably, the manifestation of the fact a large cohort of people cannot feel the buzz, thrill and excitement of working in the NHS that produces the innovation, energy, motivation, enthusiasm, persistence, and determination to find solutions to the major challenges, other than think of resources, make mistakes, repeat actions, work their hearts out, be inspected and face media criticism. We know that the application of psychological theories and principles is not something high on the NHS list of interests, but they will be when the current difficulties become really bad. A focus on developing managers to manage people by creating the cultural environment that provokes the workforce to feel consistently well is a vital starting point. That should be shouted from the rooftops and embedded into every training programme the NHS provides.

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