See how Imperial College NHS Trust responded to being near the bottom of the NHS staff engagement league tables with an employee engagement program that’s already delivering results in its first year. Engagement and Talent Lead at the Trust, Nathaniel Johnson talks through the set up of the program and gives his tips for success in staff engagement.

1. #QualtricsConverge
Employee engagement in a
high-pressure environment

2. +
#QualtricsConverge
Imperial College Healthcare NHS Trust
Nathaniel Johnston
ENGAGEMENT AND TALENT LEAD // TWITTER: @n8_tweets

3. #QualtricsConverge
Who we are

4. #QualtricsConverge

5. #QualtricsConverge

6. #QualtricsConverge

7. #QualtricsConverge

8. #QualtricsConverge
In a health context…

9. #QualtricsConverge
“There is a clear relationship between the
wellbeing of staff and patients’ wellbeing”
- The Kings Fund, 2012
Engagement = better healthcare

10. #QualtricsConverge
Additional evidence shows that healthcare organisations with higher levels of staff engagement have:
FEWER HOSPITAL
ACQUIRED
INFECTIONS
SIGNIFICANTLY
FEWER MISTAKES
BETTER OUTCOMES LOWER
MORTALITY
RATES
A BETTER
PATIENT
EXPERIENCE
Engagement = better healthcare

11. #QualtricsConverge
• Bottom 20% of NHS organisation for our engagement score
• Lowest scoring hospital Trust in London
• Low response rates
• Fatigue at frequency of surveys
• Lack of input from staff on survey design and sharing results
• No “you said, we did” output from surveys
Where were we?

12. #QualtricsConverge
OUR TRUST
OUR VOICE
6
What did we do?

13. #QualtricsConverge
This is our overall outcome measure. Going forwards, it will enable us
to track engagement levels over time. It is calculated from a
combination of three factors:
• Advocacy: How likely people are to recommend Imperial
Healthcare NHS Trust to friends and family as a place to work
• Motivation: How motivated people self-report feeling motivated to
give their best effort at work
• Satisfaction: Overall how satisfied people say they are with their
job
Overall
engagement
OUR TRUST
OUR VOICE

14. #QualtricsConverge
Creating more good days for staff…
1. Staffing
2. Leadership
3. Culture
5. Teamwork
6. Efficiency
8. Pay and CPD
4. Working
conditions
7. Capacity
0 20 40 60 80 100 120 140 160 180 200 220 240 260 280 300 400 500
Support & understanding Line-management
Organisational
management
Senior leadership Direction
10. Change
9. Well-being
MORE STAFF! Adequate staffing levels
Recognition, appreciation & praise Value staff
Respectful and
friendly culture
Positive
attitudes
No
bullies
Improved environment Improved facilitates
(fix the lifts)
Provision of food
and drink for staff
Not 3
sites
Control
aircon
Teamwork & teambuilding Communication across & within teams
Accountable
and
responsible
A good IT system Efficient processes Pro-active planning
Admin
support
Less
paper
work
Resources & equipment Decreased workload / more time
Reduce waiting.
Manage bed / room
capacity.
Training & development Higher, fairer pay
Career
progression
Shift flexibility Improve staff morale.
Social / well-being activities
Time for breaks /
finish on time
Empower staff Listen
Staff
voice
Research &
innovation
Address
issues
TOP 10 over-
arching themes
OUR TRUST
OUR VOICE

15. #QualtricsConvergeOUR TRUST
OUR VOICE
Top reasons for high overall job satisfaction

16. #QualtricsConverge
1. Staffing
2. Demands
3. Efficiency
5. Support
6. Culture
8. Invest in staff
4. Teamwork
7. Management
0 20 40 60 80 100 120 140 160 180 200 220 240 400
Resources & equipment Manageable workload
Less patients /
not overbooking
Admin time or
support
Patient
flow
Less
pressur
e
10. Empowerment
9. Work conditions
Address staff shortages – enough staff to work with
A better IT system Less inefficiencies
& time wasting
Less paperwork
& bureaucracy
More planning,
less chaos
Easier
processes
Communication (less emails) Teamwork & team building
Can do
attitudes
Support & understanding Good management
Safety
/
speak
up
Strong
leaders
Recognised & valued Respectful attitudes
Address
bullying
Positive
attitudes
Less
blame
Shift flexibility
Performance
management
Fairness &
equality
Role clarity
& direction
Provide
feedback
Focus
on
care
Training & development Work-life balance Fair pay Care
about staff
Better environment Improve facilities
Temperature
control
Food &
drink
Less
travel
Consulted & listened to
Empowered, not
micro-managed
Change &
innovation
More
transparent
TOP 10 over-
arching themes
OUR TRUST
OUR VOICE
Creating fewer bad days for staff…

17. #QualtricsConvergeOUR TRUST
OUR VOICE
Top reasons for low overall job satisfaction

18. #QualtricsConverge
Recognition
& Value
Contribution
& Control
Safety &
Wellbeing
Connection
& Support
Direction
& Purpose
OUR TRUST
OUR VOICE
Our Engagement drivers...

19. #QualtricsConverge
Our
Engagement
drivers Engagement increases when people feel respected for who
they are, and that their efforts are noticed and valued.
Recognition & value
The Harvard Business Review says successful teams receive five times as much
appreciation as criticism.
Focus on ensuring:
• Recognition and appreciation
• How we want to recognise good work or efforts
• Specifically, what would people like to notice and appreciate in the team?
OUR TRUST
OUR VOICE

20. #QualtricsConverge
Our
Engagement
drivers Engagement increases when people are able to develop their
skills, strengths and ideas and put them to good use.
Contribution & control
Gallup research shows people whose managers focus on their strengths are twice as
likely to be engaged as people whose managers focus on their weaknesses
Focus on ensuring:
• People know what each other’s strengths are in the team
• Managers know what skills or areas people want to develop
• People know how to help each other to do their best work
• We nurture more ideas
OUR TRUST
OUR VOICE

21. #QualtricsConverge
Our
Engagement
drivers Engagement increases when people feel safe from poor
behaviours, and that their work contributes to their wellbeing.
Safety & Wellbeing
A BMJ article showed rude or bullying behaviours make patient safety errors much
more likely to happen.
Focus on ensuring:
• We reduce bullying at work.
• Identifying behaviours teams want less of and reducing them
• Identifying how teams can support each other when things are really busy
• How we make it safer to ‘speak up’
OUR TRUST
OUR VOICE

22. #QualtricsConverge
Our
Engagement
drivers Engagement increases when people feel a good sense of
teamwork and support in their team, with other teams and from
leaders.
Connection & support
In an NHS study, a 5% increase in team-working scores in staff surveys correlated with
a 3.3% fall in mortality rates
Focus on ensuring:
• People know what a ‘real team’ looks like and what support they want from each other
• Teams know what other teams want from them and how they could change how they work
• Teams get what they need from other teams and are clear what they need from them
OUR TRUST
OUR VOICE

23. #QualtricsConverge
Our
Engagement
drivers Engagement increases when people find meaning in their
work, understand what’s expected of them, and see that in
others too.
Direction & purpose
Studies have shown that managers can increase engagement by setting challenging
SMART goals. 1
Focus on ensuring:
• People are clear about what’s expected of them – individually and as a team
• Individual objectives help to meet the team’s objective
• People are clear about their expectations of each other
• People are positive about what we are doing?
Refresh of the Trusts corporate objectives that are cascaded during the
appraisal process so all staff have a “line of sight” to how their role delivers the
organisation’s mission
OUR TRUST
OUR VOICE

24. #QualtricsConverge
How did we take this further?

25. #QualtricsConverge
“I have worked in the Trust
for 15 years and after this
session, I feel like I’ve been
really listened
to and heard”
- Advanced Nurse Practitioner
Photo: HIV/Sexual Health team meeting, Nov 2016
In the shoes of our people

26. #QualtricsConverge
You said, we did

27. #QualtricsConverge
• Gone from “worst 20%” and jumped two levels to “average”
• 9% response rate increase
• Highest engagement score since 2012
• Action plans received from all directorates (first time ever!)
• Over 700 staff participated in an “In our Shoes” workshop
• Renewed energy and motivation around engagement
“Following changes to the work environment, we have seen improvements in our
patient “friends and family experience tracker”- so that is a real pat on the back for
the MRI Scanning Team”
Where are we now?

28. #QualtricsConverge
• Gearing up for the second year of the Our Voice, Our Trust survey
• New development programme educating managers on their role in employee
engagement currently in design
• Toolkit resource on engagement and retention activities for managers
• Continued roll out of the In Our Shoes listening exercises
• Moving forward on our journey towards being a great place to work, for all
Future…

29. #QualtricsConverge
Thank you
@n8_tweets