How to use guide for Raising Concerns: Outline presentation - PDF document

How to use guide for Raising Concerns: Outline presentation

FEBRUARY 2015 The outline presentation is part of a new online toolkit, designed to improve the raising concerns experience amongst staff in the NHS. Empowering staff to raise concerns requires them to feel confident in using local policies and procedures and this forms part of a wider cultural change programme. The board or other appropriate governance structure has a key role in influencing culture change and the presentation describes their role and ways in which they can make this happen. Aims of the presentation The key aims of the outline presentation is to help you facilitate an open conversation, in particular to: ✓ support you to describe the crucial role leaders have in relation to raising concerns ✓ describe the consequences of not having good policies and processes in place ✓ outline the key benefits of a positive raising concerns culture ✓ provide you with background information and outlines the importance of continually championing raising concerns ✓ highlight effective practice adopted elsewhere ✓ describe the role of the freedom to speak up guardian, and ways to support them ✓ signpost leaders to various information, tools and resources to be used locally when championing raising concerns. Speaker notes You may use these notes to provide you with information and context around the slides in the presentation. These slides are for guidance only and you may want to adapt and change them to include local messaging. Slide 3 – Raising concerns is not exclusive to the NHS The Clapham rail disaster, Zebrugge ferry disaster and collapse of Barings bank all had the same thing in common – people witnessed errors but either failed to mention them in fear of rocking the boat, their concerns weren’t taken seriously or the whistle wasn’t blown loudly or clearly enough. Slide 6 – Progress v challenges There is a lot of work being done by organisations to improve raising concerns however challenges continue to present themselves. This slide briefly outlines some of them. 2 February 2015 How to use guide for Raising Concerns: Outline presentation Gateway number 02948

Slide 8 – National Staff Survey Trends – where are we? This slide provides some key statistics to help show the picture across the country. The NHS Staff survey shows the majority of staff do feel safe raising concerns however more work needs to be done to ensure this is the case for all staff. The 2014 NHS Staff Survey includes, for the first time, questions relating to raising concerns about unsafe clinical practice. This is intended to give us a more accurate reflection about how staff feel about whistleblowing concerns. Nine in ten of staff responding to the survey (93 per cent) said they would know how to report concerns about unsafe clinical practice. Seven in ten staff (68 per cent) said they would feel ‘secure’. While the percentage of staff responding to this question has remained pretty static over the last four years, the results remain subjective and can be interpreted in a number of ways. To put this into context, 20 per cent of staff responded saying that they neither agree or disagree, with 10 per cent stating that they would not feel secure. It may be helpful to include within any local staff surveys a question to gain a better understanding of why staff don’t feel strongly one way or another – perhaps they don’t feel they need to know about how to report a clinical concern because it’s not relevant to their job. Improving lines of communication and seeking engagement with staff, where appropriate, to help mitigate any identified risks and make service improvements will be key in instilling staff confidence in local systems and will go a long way towards building staff morale when things go wrong. Slide 13 – Influence culture change This slide highlights some very simple ways of ensuring that the raising of concerns becomes recognised and accepted as a normal part of employment within an organisation. The key point is that improvements do not need to be onerous or complicated. Slide 14 - Drivers for change From spending time with managers and staff to issuing a statement on raising concerns, there are lots of ways the board or other appropriate governance structure can show commitment: ✓ lead by example ✓ demonstrate strong organisational values ✓ ensure raising concerns is an integral part of induction, training, staff appraisal, objectives ✓ ensure managers have access to training where needed ✓ ensure managers are aware of other supporting policies. February 2015 3 How to use guide for Raising Concerns: Outline presentation Gateway number 02948

FEBRUARY 2015 Slide 15 – Achieving a positive culture For raising concerns to be effective throughout organisations, it needs to be visible and championed from the top down. Culture change does not happen overnight and must be seen as a wider part of continual review and improvement. Sir Robert Francis, in his recent Freedom to Speak Up report, covers how organisations can create the right culture, how concerns should be handled and what is needed to make the system work. Slide 16 – The link between staff engagement and values — The Francis report called for an ‘emphasis on and commitment to common values throughout the system by all within it’ — A CIPD survey showed only 46% of employees believe chief executives always or mostly act in line with organisational values* — When it comes to embedding values, senior leaders have an important role to play. Sir Robert Francis outlined ‘the common culture and values of the NHS must be applied at all levels of the organisation, but of particular importance is the example set by leaders’. * Meeting the Challenge: Successful Employee Engagement in the NHS Slide 17 – The benefits of good staff engagement Good staff engagement has a positive impact on absence rates, improves staff and patient experience along with the quality of care. Slide 18 – Championing raising concerns — In the Freedom to Speak Up report, Francis makes specific reference to requiring employers to appoint a ‘freedom to speak up guardian’ to ensure staff are trained in receiving and handling concerns. — Some organisations already have a designated raising concerns cultural ambassador whose role is to work with staff promoting raising concerns. — Local champions or guardians should have complete autonomy and act as a route for concerns to be raised directly with senior management. — Champions or guardians can be anyone at manager level and have a key role in signposting staff to further information and resources. Important information The statistics provided in this presentation were correct at the time of publishing. Employers are encouraged to use local statistics where possible to evidence and influence local improvements. 4 February 2015 How to use guide for Raising Concerns: Outline presentation Gateway number 02948

Background and other useful resources You can access the rest of the Draw the Line toolkit by visiting the NHS Employers website. Resources include the Draw the Line logo, self-assessment tool and manager’s guide. Following the failings at Mid Staffordshire, the Francis Inquiry and subsequent reports including the Freedom to Speak Up review have, and continue, to highlight raising (whistleblowing) concerns as an issue. Whilst there have been improvements and there is generally better understanding, work still needs to be done to empower staff and instil confidence in local systems. — people know about it but don’t always feel safe raising a (whistleblowing) concern — perception around becoming a troublemaker or fear of consequences often prevent people speaking up — lack of feedback — people tend to raise a concern twice internally before going to another external body (not always the right body which adds to their frustration), or the media — well communicated processes and testing how well they are understood by staff will be key in giving you the opportunity to carry out the appropriate investigation and any follow up action. Information about the various reports following the Inquiry can be found on the NHS Employers website: — Berwick report — Cavendish report — Keogh report — Clywd – Hart report Targeted research with employers in February 2014 with Robertson Cooper, identified some of the issues and barriers that typically prevent staff from raising concerns. The research and employer engagement with HR Directors, staff and managers, identified that a resource to help facilitate conversations between managers and the board/or other appropriate governance structure in relation to improving staff confidence would be useful. February 2015 5 How to use guide for Raising Concerns: Outline presentation Gateway number 02948