Solent NHS Trust

Key focus:

Belonging in the NHS

• Freedom to speak up
• Culture

 

Background

In the 2020 NHS staff survey results, Solent NHS Trust was rated in the top three organisations for positive speaking up culture for the third year in a row and was the top performing trust in the newly added freedom to speak up specific question. Solent are also currently shortlisted for the Health Service Journal employee engagement award. This is all evidence of a huge turnaround across five years – 2015 staff survey results indicated that in order to improve the experiences of Solent staff, the culture needed to be changed. At the time, the trust's CQC rating was requires improvement; now it is rated outstanding in caring, and good overall.

The key to this turnaround has been the trust’s great place to work strategy, building a values-based and people-centred organisation in which staff can thrive. This strategy is one of the three organisational priorities:

• provide great care
• be a great place to work
• deliver great value for money.

Jasvinder Sohal, the trust's chief people officer, has only been in post for a year and is struck by the fact that there's "something about Solent where we really are values-led".

Values-led

Being values-led is a key ambition for many trusts but making it a reality can be challenging.

As a first step, Solent ran listening exercises with employees and members. Feedback from these exercises was collated and used as the basis for a values refresh. This bottom-up approach helped to secure staff buy-in when the new ‘HEART’ values were announced:

• Honesty
• Everyone counts
• Accountability
• Respect
• Teamwork

These form an important part of the annual appraisal process for staff, who are asked to reflect on what the values mean to them personally and how they bring them to work. Recruitment and leadership practices have also been overhauled in order to embed the trust's values into their daily culture. In conjunction with two psychologists, Solent developed a Leading with HEART programme, which earned the psychologists the British Psychological Society's 2019 Award for Excellence in Professional Practice by the Division of Occupational Psychology. The training was expanded to middle managers in 2020 and continues to have excellent take up.

The focus of the training is to enable inclusive and compassionate leadership, which in turn creates an environment where people are supported to be at their best. Jasvinder is clear on the importance of this being modelled from the top, and praises Solent’s chief executive, Sue Harriman, for being "so approachable" with "an authentic presence where people do see our values being lived and breathed. Because she does that, everybody else does that."

 

Speaking up culture

Compassionate, approachable leadership has clearly been key to the positive speaking up culture at Solent. Dan Winter-Bates, Solent’s freedom to speak up (FTSU) guardian and wellbeing lead for the ICS, has undertaken extensive work on the interplay between leadership and FTSU. His recent project, pulling together all the avenues which staff can take when speaking up (including the FTSU guardian, wellbeing champions, the executive team, people partnering teams, and others) is testament to the trust’s approach. As he summarises: "there are all of the different areas where you have the opportunity to talk to people about whatever you need to, and equally the different routes you can go down to do it." This is clear evidence of an organisation which has done extensive work to embed cultural improvement at every level.

It’s all related to speaking up, it’s all related to staff voice, and that is something that we shine on in all aspects.

Dan Winter-Bates    Solent's Freedom to Speak Up Guardian (FTSU) and wellbeing lead for the ICS

By moving away from the concept of FTSU as a specific department's responsibility, sponsored by specific people and embedding it into the wider work on culture and careers, it is truly enabled. When people feel psychologically safe, they will speak up and be able to express their concerns. A good speaking up culture, which is evident in Solent, therefore makes for a safer environment for staff and for service users.

 

Keeping track

Solent continues to put staff voice at the heart of its decision making, with regular listening and engagement practises. Local surveys and innovative engagement activities are carried out across the trust’s services to ensure that corporate-led initiatives are working and appropriate. For example:

• team barometers and weekly huddles in adults specialist services
• monthly morale and wellbeing questionnaires in estates and facilities during transformation programme
• stress audit carried out by adults Portsmouth
• monthly how are you doing? survey conducted by adults Southampton
• wellbeing days –particularly successful in children’s therapies in Portsmouth
• health and wellbeing champions, and mental health first aiders, embedded across the trust.

In areas where engagement in listening tools, such as the staff survey, is lower, the trust takes targeted action. Over a number of years, they have been working to increase engagement levels with Solent’s facilities team by holding conversations to understand their disengagement, values and needs. The focus on this team has been successful, with an increase in their NHS Staff Survey response rate from 40% in 2019, to 67% in 2020.

Investment has been key to Solent’s culture transformation. Resources have been refocused, and the team expanded, to deliver on leadership and development, the core leadership offer, and embedding a culture of growth and development, all in line with the trust's values. Staff buy-in has also been a vital enabler to this work, supported by bottom up engagement and the modelling of values from the top down.

Moving forward

In the 2020 NHS staff survey results, Solent showed improvements in seven out of ten themes, and the highest national score in three themes. The trust’s response rate in the NHS staff survey was also the highest for trusts of its type at 66% – a marked increase from 44.4% in 2015. Turnover in nursing staff has also fallen from 18.76% in April 2017 to 14.1% in 2020. All of these indicators suggest that the culture has improved dramatically, and the workforce is more engaged. This was noted in Solent's most recent CQC inspection: "The trust's strategy, vision and values underpinned a culture which was patient-centred. The culture was very positive, open and honest, staff were listened to and heard. We found everyone we spoke with was extremely happy working at the trust."

who work in Solent elements of staff experience, the trust remains alive and responsive to concerns, while the organisational values give a clear direction for the work as whole.