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People and their Development:

Human Resources Strategy 2007-12

North Staffordshire Combined HealthcareNHS Trust

Running Things Your Way

Our Plans for Becoming an NHS Foundation Trust

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Note about the terms and language used in this document

Patients, service users, clients, consumers, customersThe terms above are used throughout the foundation trust strategy documents. Itshould be understood that all have equal meaning to the terms patient and client thatare traditionally used in health and social care settings. In this document we haveattempted to use them in a context-specific way.

North StaffordshireThe term North Staffordshire is used to describe the areas of the City of Stoke-on-Trent, Newcastle-under-Lyme Borough (including its urban villages) and theStaffordshire Moorlands District. All these areas fall within the North of StaffordshireCounty and are traditionally served by the Trust. Where the terms Staffordshire andStoke on Trent have been used simultaneously or individually this will be to makespecific reference to populations within the City and County boundaries.

Membership communityThe term membership community is used to refer to people on our Register ofMembers from the local communities of Staffordshire and Stoke on Trent, service

users and carers, whether these individuals are local or come from outside of theStaffordshire and Stoke on Trent area, and the staff of the foundation trust.

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CONTENTS

Chapter Section Content Page

1 Introduction

1.1 This document 1 1.2 Our purpose 1 1.3 Our values 1 1.4 Our principal objectives 1

1.5 Why apply for foundation status? 31.6 The benefits for staff of a membership trust 41.7 Our success to date 4

2 Service Development Strategy

2.1 A period of change 72.2 Core services 72.3 Current services not part of the medium term

future7

2.4 Service modernisation 82.5 Workforce plan 8

3 Governance arrangements

3.1 Membership 113.2 Council of Governors 11

3.3 Staff governors 113.4 Management capacity 124 Developing this strategy

4.1 Purpose 134.2 Three key themes 134.3 Structure 13

5 Your employer

5.1 Accreditation for Improving working Lives and

Investors in People

15

5.2 Work life balance 155.3 Health and safety 165.4 Staff involvement 165.5 Partnership with trade unions 175.6 Equality and diversity 175.7 Pay modernisation 185.8 Communications 185.9 Best practice in HR 195.10 Management of change 195.11 Increasing productivity through new ways of

working19

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6 Your career

6.1 Learning strategy 216.2 Leadership 216.3 Appraisal 226.4 Skills development 226.5 Career development 236.6 Partnerships in learning 23

7 Your team

7.1 Developing teams 257.2 What difference will our approach make? 267.3 Support 267.4 Evaluation 26

8 Performance Management Framework

8.1 Balanced scorecard and management informationpack

27

8.2 Key performance indicators 27

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North Staffordshire Combined Healthcare NHS Trust - March 2007

Human Resources Strategy 1

1.1 This document

1.1.1 This strategy document has beendeveloped to support ourapplication to become a NHSfoundation trust in June 2007.

1.1.2 The original document wasproduced in 2005 and wentthrough various drafting stages asa result of a detailed process ofboth internal and external

consultation.

1.1.3 Following deferment of theapplication we have continued toengage with staff through anonline survey, a workshop andthrough attendance at teammeetings. Details of the processof engagement and the commentsreceived are available in aseparate document.

1.1.4 The overall strategy has not

changed from the originalsubmission, but this documenthas been refreshed to take intoaccount progress since theprevious version.

1.1.5 The workforce planning sectionhas been rewritten to reflectchanges in service provision andcommissioner requirements.

1.2 Our purpose

1.2.1 Our purpose is:

To improve the health andwelfare of local communities

1.2.2 This has driven our philosophyand culture for the last 12 years.The statement is supported by aset of values and principalobjectives which are set outbelow.

1.2.3 Central to achieving this purposeare the concepts of both user andcarer involvement and staff

engagement and we have beenevolving our practices andsystems to this end. More recentlywe have introduced anorganisational developmentprocess which seeks to realise thefull potential of frontline clinicalteams through self direction withina framework and to involve usersand carers as team members inorder to achieve improvements inthe quality of services. A fuller

description of the approach canbe found in Section 7 of thisdocument.

1.3 Our values

1.3.1 We have developed a set ofo rgan isa t iona l va lues inconsultation with our staff Thepurpose of these values is toguide and influence not only theway that we work with our serviceusers, but also the way that we

work with each other in the Trust.These values are shown in Figure1.1 and are reflected in thisstrategy.

1.4 Our principal objectives

1.4.1 We have developed a number ofprincipal objectives for the Trustunder 5 broad headings

customer focus;

business development;

governance;

workforce; and

finance.

CHAPTER 1Introduction

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2 Human Resources Strategy

Figure 1.1: Our core values

Courtesy and Dignity

Treat people with courtesy and dignity by listening

and checking if what we are doing is the best way orif things can be done differently.

Communication

Ensure that people have access to information thatis relevant and timely and in a way that they can beeasily understood and do our best to make sure thatwhere ever possible people are not asked for thesame information more than once.

Flexibility and Responsiveness

Write our policies with patients, service users,carers and staff in mind and try not to let our policies

and procedures reduce our flexibility orresponsiveness.

Efficiency

Spend money wisely and ensure that the care weprovide is both cost effective and value for money.

EffectivenessAim to provide the highest standard of care byensuring that through continuous professionaldevelopment we all have the most up to date andmost appropriate skills and knowledge to do ourjobs effectively.

Equality and DiversityRecognise individuality and respect differences,needs and choices by talking with, listening andresponding appropriately to everyone who comesinto contact with us.

Leadership and Partnership

Lead through vision, inspiration and collaboration toensure all who have a stake in our organisationwork together to achieve our goals.

Professionalism

Endeavour to be open and honest and respectconfidentiality as well as behave with integrity at all

SAFE

SOUND

SUPPORTIVE

Excellence

Aim to achieve the best outcomes for our serviceusers by delivering up to date evidence-based carethat is agreed in partnership with the service userand carer.

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1.4.2 The objectives relating to theworkforce are set out in Figure1.2.

1.4.3 Whilst this strategy is influencedby all of the principal objectives, itparticularly aims to drive forwardthe 3 that specifically relate to theworkforce. Although there isinevitably some overlap betweenthem:

Chapter 5 - Your employeraddresses our need tomaximise our attractivenessas an employer;

Chapter 6 - Your careerdescribes our approach tolearning and development;and

Chapter 7 - Your teamdescribes how we work with

teams to maximise individualcontribution and to developleadership capacity.

1.5 Why apply for foundationstatus?

1.5.1 In 2004 and 2005 we were ratedas a 3 star trust and so wereeligible to apply for foundationtrust status along with other trustsproviding Mental Health andLearning Disability services; albeitwe currently provide an extendedrange of services includingassessment and rehabilitationservices for physically frail olderpeople with complex needs. In2006 we were assessed by theHealthcare Commission as goodfor the quality of services and fairfor use of resources.

1.5.2 We see the creation of afoundation trust as a naturalevolution for us rather thansomething that requires a radicalchange in culture. It provides an

opportunity to take the conceptsof user and carer involvement andstaff involvement to a further level.The philosophy and thinking thatlay behind our organisationaldevelopment approach sits verycomfortably with the concept of afoundation trust. The applicationprocess has also provided a driverfor significantly improving ourbusiness focus and processes.

1.5.3 Foundation trusts have the

following key characteristics:

part of the NHS and subjectto NHS standardslegal constraints ensure theyremain in the NHS, cannot beprivatised, remain focussedon core services, restrictprivate income and cooperatewith other local partners;

Workforce

1 Maxi mise the Trust sattractiveness as an employerin all relevant labour markets.

2 Develop and implementsystems that ensure that theknowledge and skills of theworkforce fully supportachievement of its purpose,

including compliance with allm a n d a t o r y t r a i n i n grequirements.

3 Develop strong leadership toensure that the Trustsworkforce is organised in themost efficient and effectiveway.

Figure 1.2: Workforce principal objectives.

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established as PublicBenefit Corporationsgreater local ownership andinvolvement of patients thepublic and staff following them o d e l o f m u t u a lo r g a n i s a t i o n s o r cooperatives;

more democraticlocal people and staff willelect governors to sit on a

Council of Governors whichwill help to determine thedirection of the Trust; and

different accountabilitystructureauthorised and monitored byan Independent regulator forNHS Foundation trusts(Monitor).

1.5.4 We are able to embark on thesechanges because we have a

stable base both financially and interms of our staff. There isenormous loyalty and commitmentfrom all staff and an enthusiasmfor innovation and serviceimprovement. We have been ableto recruit and retain highly skilledclinical and managerial staff,frequently against national andlocal shortages.

1.6 The benefits for staff ofmembership of afoundation trust

1.6.1 We believe that as a foundationtrust staff members would see arange of benefits:

through membership agreater opportunity to identifywith the aims of the Trust;

a means of demonstratingpride in the work that we do;

through electing staffgovernors onto the Council ofGovernors, a greaterengagement in the decisionsof the Board;

developing a stronger senseof belonging to and servinglocal communities;

enhanced communicationsystems;

greater involvement indecision making at teamlevel;

closer working with users andtheir carers;

a stronger voice in shapingour future strategies; and

greater freedom to innovateand develop services.

1.6.2 We will establish systems toensure that we regularly work withstaff to identify further benefitsand improvements that we canmake to working lives.

1.7 Our success to date

1.7.1 Our confidence about deliveringfurther benefits to staff is basedon our track record to date. Thiswas set out in more detail in our

preliminary application forfoundation trust status. Some ofour key achievements have beenverified through both internal andexternal assessments whichmeasure the quality of ourmanagement of people:

holding Investors in People(IIP) for the last 8 years;

gaining Practice Plus level inImproving Working Lives

(IWL);

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winning many nationalawards for health and safety;

scoring highly in both localand national staff surveys asa good employer;

scoring highly in the last 2national Staff Surveys for thequality of our seniormanagement leadership;being in the top 20% of

Mental Health/ LearningDisability Trusts;

scoring in the best 20% ofMental Health trusts in 16 outof 28 measures in the 2005staff survey;

being commended for ourstrong leadership by the,then, Commission for HealthImprovement (CHI) andscoring well in their

a s s e s s m e n t o f o u r performance on staffing andstaff management; and

gaining Learning and Skillsbeacon status from theDepartment of Education andSkills for our Nursing Cadetscheme.

1.7.2 There are other notableachievements to date:

successful management ofs i g n i f i c a n t c h a n g eprogrammes, including theclosure of Stallington Hall andSt Edwards Hospital, thecreation of modernisedservices to take their place,and the t ransfer o f approximately one third of ourservices to Primary CareTrusts;

a stable workforce with

turnover below 10%;

successful recruitment toposts in shortage disciplines,i n c l u d i n g c o n s u l t a n tpsychiatrists, and overseasrecruitment of nurses;

a wide range of servicemodernisation projectsinvolving new ways ofworking;

a track record of improving

staff productivi ty, forexample, increasing activityin older peoples servicesthrough enhanced communitysupport with fewer wards;

a strong record of partnershipworking with trade unions,strengthened further throughthe joint implementation ofAgenda for Change. TradeUnions have had a seat onthe Trust Board for many

years;

a full range of modern flexibleemployment policies andpractices;

an excellent Staff Supportand Counselling service hasbeen in place for the last 10years; and

scoring above the nationalaverage in the majority of

areas covered by the StaffSurvey run by the HealthcareCommission.

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2.1 A period of change

2.1.1 Over the next 2 years we will befacing a period of extensivechange as local services arerealigned, and the local healtheconomy addresses seriousfinancial deficits. However we facethese changes with confidence,drawn from our successfulmanagement of significantstrategic changes in recent years.

2.2 Core services

2.2.1 The trust is developing its corebusiness in the areas of mentalhealth and learning disabilities,particularly those which complywith national policy and localcommissioning intentions. Ourexpertise is in providing care forindividuals over long periods oftime, where many agencies areinvolved in caring and where

informal and self care areimportant. These services will beprovided by us on our own, and inpartnership with a wide range ofbodies including social services,other NHS organisations,voluntary organisations, andindependent sector organisations.

2.2.2 We wish to further develop anumber of specialist areasincluding, but not limited to,repatriation of clients currently

receiving services out of area,i n c r e a s e d d e l i v e r y o f psychological therapies, servicesfor people with personalitydisorder and interventionsdesigned to reduce unnecessaryadmission to University Hospital ofNorth Staffordshire.

2.2.3 We also recognise the importanceof business systems, that the trusthas a growing profile inestablishing; recognising thatexpertise and innovation is notlimited to staff with clinical

backgrounds and including thosewho support, advise and manageclinical services. Achievingfoundation trust status will provideus with an opportunity to furtherdevelop and market thesesystems for the greater good ofthe trust and the NHS generally.

2.3 Current services not partof the medium term future

2.3.1 The service development strategyand local commission ingintentions mean that there aresome of the services that wecurrently provide for older peoplethat will be managed by otherorganisations within the localhealth economy. In each case thetransfers will be managed in asensitive way and through aprocess which involves both thestaff themselves and their tradeunions.

2.3.2 We will be reviewing the extent towhich we are a provider of sharedservices to other organisations aswell as the extent to which we area receiver of such services. Thisreview will need to be undertakenin the context of PCTreconfiguration arising fromCommissioning a Patient LedNHS and be carried out withpartner organisations.

2.3.3 The effect of these changes willbe a reduction in the overallnumbers of staff employed by usas a result of staff transferring toother organisations.

CHAPTER 2Service development strategy

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2.4 Service modernisation

2.4.1 In parallel with these changes, theTrust will be continuing theprocess of modernising its mentalhealth and learning disabilityservices, and sees significantscope for expanding andimproving these. We recognise,however, that the pace of changewill be significantly dependent onthe ability of our local PCTs to

fund any developments and onour ability to think creatively aboutwe can improve productivitylevels.

2.4.2 The Trust is confident of its abilityto deliver improvements inservices through a number ofapproaches. We will continue toseek innovation through roleredesign and new ways ofworking. We will work with users,informal carers and partner

organisations to identify who isbest placed to meet specificneeds; whether these are ourstaff, those in the statutory orvoluntary sector or informalcarers. We are confident of ourability to recruit and retain thespecialist staff we will need, basedon our success to date. We willcontinue to use existingapproaches and where necessaryto use innovative ways to attractstaff to the area.

2.5 Workforce plan

2.5.1 Workforce profile

Trust currently employs a total of2000 wte staff. Figure 2.1 showsa breakdown of the workforceprofile.

2.5.2 Absence rates

Staff absence through sickness is

5.2% having reduced over the last2 years from a level of 6.5%

2.5.3 Turnover

Annual turnover is 8.6% which isbelow average in benchmarkingwith Trusts across the WestMidlands

2.5.4 Age profile

The age profile for the trust as a

whole shows that 12% of theworkforce are under 30 years ofage, 58% are aged 30 to 49 and30% are 50+. Within the largeststaff group, nursing, 25% areaged 50+

Staff Group WTE

Medical 83

Nursing 1241

Allied Health Professionals 206

Admin & Estates 363

Support staff 77

Managers & Senior Managers 30

Total 2000

Figure 1.2: Workforce profile.

12%

58%

30%

Below 30 yrs

30 - 49

50 and over

Figure 1.3: Age profile.

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3.1 Membership

3.1.1 Foundation trusts have beendeveloped as Public BenefitCorporations based on the modelof mutual organisations andcooperatives. The key conceptbehind this model is the notion ofmembers of the public and staffbecoming members of thefoundation trust; thus ensuringgreater ownership and control of

the organisation, through electingrepresentatives to serve asgovernors.

3.1.2 We have proposed that all staffwil l automatically becomemembers unless they specificallyopt not to be, and have written toeveryone to explain what thismeans and provide a mechanismfor opt-out, should this be thecase. This mechanism has soughtto ensure that there are no

difficulties for staff who do wish toopt out. To date only 2 membersof staff have decided to opt outand so we are confident that theapplication for foundation truststatus has the overwhelmingsupport of our workforce.

3.2 Council of Governors

3.2.1 The Council of Governors will bemade up of members of the publicand staff who have been elected

to serve as governors. Additionallywe have identified partnerorganisations such as PrimaryCare Trusts, Local Authorities,Universities and others who maythen appoint governors on to theCouncil.

3.2.2 The Council of Governors hassome key roles in helping to steerthe direction of travel of the Trust.These can be termed advisory,guardianship and strategic. Theyhave specific powers to:

appoint or remove thechairman and other nonexecutives who form part ofthe Trust Board;

approve the appointment ofthe Chief Executive; and

appoint or remove the trustsauditor.

3.2.3 The Council of Governors must be

consulted on forward planning bydirectors and must meet at leastonce a year to receive the annualaccounts and report.

3.3 Staff governors

3.3.1 We very much welcome the ideaof staff governors and see it as anatural progression from ourcu r ren t pa r tne rsh ip andinvolvement processes. We havehad a Trade Union representative

as a member of the Trust Boardfor many years now and throughour organisational developmentprogramme are developing whatwe call distributed leadershiproles in all of our teams.

3.3.2 We therefore have many people inthe organisation who have thes k i l l s , c o m m i t m e n t a n denthusiasm to become staffgovernors. A crucial part of ourstrategy will be to ensure that

these staff (and other governors)are supported, by the use ofprotected time with appropriatetraining and development toundertake their role.

3.3.3 As a result of consulting staffthrough a series of staffawareness and involvementsessions we have increased thenumber of staff governors from 3to 5 and are proposing that thisconstituency should be broken

down into 5 classes representing:

CHAPTER 3Governance arrangements

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medical;

nursing;

therapies;

a d m i n i s t r a t i v e a n dmanagement roles; and

support services and estates.

3.3.4 As our original application was

deferred we have already beenthrough the process of electionsfor staff governors and, with theexception of one category wherewe have a vacancy, they are inplace and have been operating inshadow form.

3.3.5 We are also in discussion withtrade unions about how ourcurrent strong Partnershiparrangements can best be carriedforward into a foundation trust.

3.4 Management capacity

3.4.1 In the last year we have made anumber of changes to ourmanagement and governancearrangements designed tostrengthen our managementcapacity.

3.4.2 At Board level we have appointed3 new non Executive Directorswith a range of skills and

experience specifically focussedon the needs of a foundation trust.We have appointed a newDirector of Operations with wideacute sector experience in theNHS and Canada to bring adifferent perspective to the Trust.We have a Board DevelopmentProgramme designed to furtherequip the Board with the skillsneeded to operate as afoundation trust.

3.4.3 Below Board level we haverealigned our operating units,have significantly strengthenedour Finance Team and support forthe business developmentfunction. We have commenced adevelopment programme forgeneral managers and recognisethe need to equip managers at alllevels with additional businessrelated, financial and commercialskills through cascading thisprogramme.

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4.1 Purpose

4.1.1 The purpose of the People andTheir Development Strategy is toensure that we have:

a quality workforce, in theright numbers, with the rightskills and diversity, withshared values and organisedin the right way to deliver theTrusts service development

strategy.

4.2 Three key themes

4.2.1 We have had a People and TheirDevelopment strategy for the last7 years and have based it on thenational HR strategy, using manyof its key concepts. We haveindicated that we see the move tofoundation trust as an evolutionand so it follows that we do notsee the need to move away from

many of these concepts that haveserved us well. CombinedHealthcare has a unique cultureand ways of doing things, whichwe want to reflect in our strategyfor the future.

4.2.2 Our plans are therefore groupedunder 3 key themes:

your employer;

your career; and

your team.

4.3 Structure

4.3.1 Under each of our 3 themes, weset out a series of strategicintentions through which we seekto describe the essential nature ofthe Trust.

4.3.2 These statements are thensupported, where appropriate, byevidence that our staff haveprovided of our current position.

This evidence has come from themost recent staff survey, fromImproving Working Lives feedbackand from comments made at ourfoundation trust staff awarenessand involvement sessions.

4.3.3 Finally we set out some next stepsthat we propose to take.

CHAPTER 4Developing this strategy

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5.1 Accreditation forImproving Working Livesand Investors in People

5.1.1 We were awarded Practice Plusunder Improving Working Lives in2006, We will seek to improve onthe standards that we achieved.

5.1.2 We will also aim to maintain ouraccreditation under IIP as wehave done for the last 8 years andwill be assessed for re-accreditation in April 2007.

5.1.3 Current position:

awarded IWL Practice Plus in2006;

in the 2005 Staff Survey wewere in the best 20% ofMental Health/LearningDisability Trusts in 16 areas,better than average in 5,average in 5 and belowaverage in only 2; and

the 2005 Staff survey showedimprovements in the majorityof areas compared to 2003and 2004;

5.1.4 Next steps:

we will receive the results ofthe 2006 survey in early 2007and will develop an actionplan to address any issuesthat arise from this;

we will undertake the worknecessary for assessment forIIP in April 2007; and

we will address any issuesthat may arise from theassessment.

5.2 Work life balance

5.2.1 We will continue to develop aculture in which everyone isvalued not only for theircontribution to our Trust, but alsoas individuals with lives outside ofwork. We will ensure that policiesand systems are in place toenable everyone to balance thesometimes competing pressuresof work and home life. This will

include policies to address issuesof childcare and care of olderdependents and tackling anyremaining areas where a longhours culture may exist.


scored above the nationalposition for the quality of worklife balance;

but slightly below the national

position on the percentage ofstaff saying that they useflexible working options;

IWL resource bookletproduced, giving moreinformation to staff;

flexible working policyproduced;

5.2.3 Next steps:

we will monitor the take up offlexible working;

we will continue to promotethe benefits of flexibleworking to teams; and

we will integrate questionsabout work life balance intoour appraisal system.

CHAPTER 5Your employer

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5.3 Health and safety

5.3.1 We will continue to improve thequality of life whilst at work. Thiswill include further work to reduce,wherever possible, the number ofaccidents and violent incidents,reducing the incidents ofharassment and bullying, reducingthe effects of organisational stressand improving the physicalworking environment.


in the 2005 staff survey 69%of staff had Health & Safetytraining in previous 12months (below nationalscore);

66% of staff work extra hoursand 57% due to pressuresand demands of job ( belownational levels and a

reduction from 2004);

11% of staff suffered workrelated injuries compared to17% in 2003 (below thenational figure of 19%, butaverage for MH/LD Trusts);

38% of staff suffered workrelated stress (compared to39% in 2004, but worse thannational position of 35%);

25% of staff experiencedphysical violence frompatients/relatives ( no changefrom 2004 and worse thannational position); and

s t a f f e x p e r i e n c i n gharassment, bullying orabuse from patients/relativesreduced from 27% in 2004 to25% ( below the nationalfigure) whilst thoseexperiencing the same from

staff showed a much betterposition at 12% compared to15% nationally.

5.3.3 Next steps:

we will be monitoring theresults of the 2006 survey;we will publicise the data andexisting groups working inthese areas will review theiraction plans;

we will continue to extend theuse of the Stress Audit Toolas a means of encouraging

all clinical and non clinicalteams to address the causesof stress; and

we will continue with our jointtraining programme inconjunction with trade Unionsto address the issues ofbullying and harassment.

5.4 Staff involvement

5.4.1 Through the expansion of

organisational developmentprogramme and through ourmembership scheme and otherinitiatives, we will ensure that stafffeel able and encouraged tocontribute their ideas both to thefuture direction of our servicesand to their day to daymanagement. We will continue tocreate a culture in which staff areencouraged and feel able to voicetheir concerns.


in the 2005 Staff Survey wescored above the nationalscore for the quality of jobdesign which measures clearjob content, feedback andstaff involvement and were inthe best 20% of MH/LDTrusts;

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we scored above the nationalscore for the extent ofpositive feeling within theo r g a n i s a t i o n , ( w h i c hmeasures communication,staff involvement, innovationand patient care); butfeedback from awareness/involvement sessions indicatethat there is still more work tobe done.

5.4.3 Next steps:

we will be continuing with theroll out of our organisationaldevelopment programme todevolve decision making toteam level, and are extendingit to non clinical teams; and

we will be developing furtherideas on how membership ofa foundation trust willenhance participation and will

work with our staff governorson this aspect.

5.5 Partnership with tradeunions

5.5.1 We will continue to see tradeunions as key partners indeveloping and delivering thisstrategy and all strategies withinthe Trust. The partnership hasbeen worked on over the last 10years and has been significantly

strengthened through the jointworking on the implementation ofAgenda for Change.

5.5.2 We will work closely with TradeUnions to ensure that anyindividual or collective issues thatthey raise are dealt with promptlyand effectively.


Trade Unions have had aseat on the Trust Board forthe last 8 years;

joint management of theAgenda for Change project;

Trade Union representationon a range of standinggroups/committees; and

partnership agreement inplace.

5.5.4 Next steps:

we are discussing with TradeUnions how best to ensurethe continued partnershipworking under the foundationt r u s t g o v e r n a n c earrangements; and

we look forward to theintroduction of UnionLearning Representatives asa further extension ofpartnership working.

5.6 Equality and diversity

5.6.1 We will continue to promoteequality and diversity as keyvalues of the Trust and will workwith key partners to promotegreater representation from blackand minority ethnic staff in ourmental health and learningdisability services.


in the 2004 Staff Survey(questions not included in2005 national survey) 72% ofstaff felt we are committed toequal opportunities for allstaff, compared to 67% in2003;

64% said that we act fairlywith regard to careerprogression compared to61% nationally;

we have undertaken trainingon impact assessment; but

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feedback suggests moreneeds to be done foradministrative support staff.

5.6.2 Next steps:

the Equality and DiversityGroup will further developtheir action plan;

we wi l l ex tend our programme of training on

equality and diversity and onimpact assessments; and

we will review our policiesa n d p r o c e d u r e s i np r e p a r a t i o n f o r t h ei n t r o d u c t i o n o f a g ediscrimination legislation.

5.7. Pay modernisation

5.7.1 We will continue to foster andpromote new and more effective

ways of working and deliveringservices, and will use the flexibilityof Agenda for Change to developappropriate rewards for new rolesas they emerge.

5.7.2 We will use Agenda for Change toensure that staff are appropriatelyrewarded for the responsibilitiesthey carry.

5.7.3 We will continue to extend thecoverage of the new consultant

contract


51% of the consultant bodyare on the new contract with90% projected to be on it in 5years;

completed assimilation toAgenda for Change andprogressing with reviews;

5.7.5 Next steps:

we will be reviewing theopportunities to realise thebenefits offered by Agendafor Change.

5.8 Communications

5.8.1 We will conduct annual staffsurveys and use the Trade Unionrepresentatives, staff governors

and team leads as soundingboards to identify any furtherenhancements that we can maketo our communication systems.

5.8.2 We will ensure that we havee f f e c t i v e s y s t e m s o f communication throughout theorganisation to both passinformation to staff and to receivefeedback and ideas from them.


in the 2005 Staff Survey wescored above the nationalposition for the extent ofpositive feeling within theorganisation. This takesaccount of communicationsand staff involvement;

we have introduced changesto the team briefing systemand improved the staffmagazine; but

in awareness sessions stafftell us that communicationscould be better.

5.8.4 Next steps:

we will be exploring how wecan enhance communicationswith staff through ourmembership scheme; and

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we will be seeking views fromstaff on how to improve ourcommunication processes,and acting on them.

5.9 Best practice in HR

5.9.1 We will regularly review our HRpractices and policies to ensurethat they remain at the leadingedge of employment practice.


the Personnel team networkswe l l w i th o ther HRpractitioners locally and theDirector of Personnel is thecurrent Chair of theShropshire and StaffordshireHR Network and is also amember of the WestMidlands PCT and MentalHealth Trust HR DirectorsNetwork, The team will be

regularly reviewed to ensurethat it has the capacity andcapability to address theagenda.

5.9.3 Next steps:

in 2007 we will complete theintroduction of the ElectronicStaff Record that willsignificantly enhance thequality of our data and dataprocesses;

we will integrate HR metricsinto the Trust balanceds c o r e c a r d a n d t h emanagement informationpack ( see section 8); and

we wi l l cont inue tobenchmark with other similarorganisations.

5.10 Management of change

5.10.1 We will manage the process ofstrategic change in a way that issensitive to individuals needs andwishes and involves both theindividual and their Trade Union inthe decision making process.


a track record of successfully

managing major strategicchange.

5.10.3 Next steps:

we w i l l rev iew ou r Management of Changepolicy with staff and tradeunions to ensure that itcontinues to reflect bestpractice.

5.11 Increasing productivitythrough new ways ofworking

5.11.1 We will continue to look forinnovation and ways of addingvalue to the services we provide.

5.11.2 We have a track record ofimproving productivity throughnew ways of working.


increasing patient activity inolder peoples services byenhanc ing commun i tys u p p o r t a n d b e dmanagement processesleading to the need for fewerwards;

introduction of advancednurse practitioner and nurseconsultant roles;

enhancing the role of nursingsupport staff;

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we have established andappointed to a post ofGeneral Manager ServiceRedesign to lead on thiswork; and

expenditure on medicallocums has reduced from1.8m in 2003/4 to 0.8m in2006/7 and is projected toreduce to 0.5m in 2007/8

5.11.4 Next Steps:

we will utilise NIMHEsdocument 10 high impactchanges in mental healthservices to focus work onservice modernisation andredesign;

we will continue to focus on

reducing sickness levels;

we will enhance productivitythrough further skill mixreviews; and

we will work with the Deaneryon the Modernising MedicalCareers process.

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Human Resources Strategy 21CHAPTER 6Your career

6.1 Learning strategy

6.1.1 We have developed a LearningStrategy, which sets out our keyaims. It is based on the followingvalues:

fairness and equity (access,identification and selection);

flexibility (flexible learningopportunities);

effectiveness (patient focusedand learner led); and

partnership (multidisciplinary,multi-organisational learning).

6.1.2 This strategy is supported by aTrust learning plan through whichwe will continue to address thetraining and development needsof our staff to ensure that we havea workforce that has the

confidence, skills and flexibility tomeet the needs of thecommunities to whom we providea service.


in the 2005 Staff Survey 98%of staff had received trainingin the last 12 months;

responsibility for training anddevelopment has been

transferred to the PersonnelDirectorate;

st reng thened systemssuppo r t i ng manda to rytraining; but

in awareness sessions stafftell us that there needs to bebetter access to training forsome groups

6.1.4 Next steps:

the introduction of theKnowledge and Skil lsFramework will greatlyenhance our ability toundertake training needsanalysis and to target ourresources to key learningobjectives; and

implementation of ESR in

2007 will improve our trainingrecords system.

6.2 Leadership

6.2.1 We recognise the importance ofleadership skills at all levels of theorganisation and will developthese skills through a range ofinternal processes and the use ofaccredited external programmes.


2004 Staff Survey (noequivalent question in 2005survey) in the top 20% ofmenta l heal th / learn ingdisabilities trusts for thequality of senior managementleadership;

leadership and managementdevelopment strategies underreview;

360 degree appraisal beingintroduced for leadershiproles utilising the LeadershipCentre assessment tool;

cohorts of staff have attendedClinical and non clinicalleadership programmes; and

leadership programmes beingdeveloped.

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6.2.3 Next steps:

we will further develop ourleadership programmes andextend the use of theL e a d e r s h i p Q u a l i t i e sFramework; and

we will introduce a range ofdevelopment programmes forthe Board, senior managers,governors and other key

groups of staff.

6.3 Appraisal

6.3.1 We will continue to ensure thateveryone has a regular PersonalReview which utilises theKnowledge and Skills Frameworkto deve lop a Persona lDevelopment Plan linked to theteams plans and those of theTrust.


in the 2005 Staff Survey 74%of staff had been appraised inthe previous 12 months(compares to 60% nationallyand placed us in the best20% of MH/LD Trusts);

45% said it was wellstructured (compared to 32%nationally and placed us inthe best 20% of MH/LD

Trusts); and

61% said they had aPersonal Development Plan(compared to 47% nationally,again in the best 20% of MH/LD Trusts);

6.3.3 Next steps:

we will continue theprogramme of training tosupport the integration of the

Knowledge and Skil lsFramework, into the appraisal

system; and

we will continue with thedevelopment of job outlinesfor the Knowledge and SkillsFramework and work toincrease the coverage andquality of appraisal.

6.4 Skills development

6.4.1 We will continue to ensure that we

use the concept of the skillsescalator to ensure thatresponsibilities rest at the mostappropriate level of staff and thatthey receive appropriate trainingand support to carry out anyenhanced roles.


track record of a range ofprojects focussing onchanging working practices;

wide range of new roles andteams introduced such asintegrated mental healthteams; and

e x a m p l e s o f r o l eenhancement such as nurseprescribing.

6.4.3 Next steps:

through or organisational

development processes ourteams will continue to reviewtheir working practices andthrough the involvement ofusers and carers will identifynew ways of working. Skillsprogrammes will support anychanges;

we will use the NIMHE10high impact changesdocument as the basis forfurther reviews of working

practices; and

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in particular we will developthe level of business andcommercial skills within theorganisation.

6.5 Career development

6.5.1 We will encourage staff to developtheir careers. We will completeour current nursing cadet schemewhich encourages young peopleinto nursing and will promote ourown lifelong learning scheme andthe NHS Learning Accounts asways of encouraging staff backinto learning.


NVQ Centre supports a widerange of NVQs across staffgroups;

basic skills programmes inliteracy and numeracy offeredin conjunction with StokeCollege;

lifelong learning schemeoffers financial support forpersonal learning not linkedto work; and

sponsorship scheme forHCSWs to enter nursetraining.

6.5.3 Next steps:

we will review the range ofbasic skills and NVQ coursesavailable to staff; and

we will continue to exploreways of opening up access toNHS careers throughappropriate training schemestargeting mature students aswell as younger people.

6.6 Partnerships in learning

6.6.1 We will continue to work withpartner organisations such asneighbouring trusts, the strategichealth authority, universities andother education providers toensure that learning anddevelopment is delivered in themost effective way.


formal partnership agreementwith local PCT;

working col laborativelyacross the health economy todevelop training facilities; and

actively involved in localPartnership Board.

6.6.3 Next steps:

we will undertake further workwith partner organisations tosecure improved trainingfacilities; and

we welcome the opportunityto work in partnership withU n i o n L e a r n i n gRepresentatives when thefirst group have been trained.

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7.1 Developing teams

7.1.1 Our development work with teamsis built on evidence basedresearch. It is designed to developself directed teams within aframework where the frameworkensures that we work and act inaccordance with NHS standardsand professional codes

7.1.2 It is a dynamic process that

ensures that Trust requirementsaround service improvement andclinical effectiveness are achievedat team level; where teamsworking in partnership with thecustomer are given the knowledgeand power to make decisionswithin clear boundaries.

7.1.3 It recognises that clinical teamshave the knowledge and skillsneeded to improve services andgives them the tools and

responsibilities to make adifference. Pursuing this managedapproach to healthcare delivery isconsistent with the ethos ofdecentralisation and localaccountability that underpins theconcept of NHS foundation trusts

7.1.4 It is designed to help teams,including service users andcarers, agree a shared vision forthe future, and identify areas fordevelopment and work together to

make it happen.

7.1.5 The approach brings togetherthree key areas:

team developmentgiving teams, including usersand carers, the permission,freedoms and support to usetheir knowledge, skills andexperience to create andprovide better services byworking more effectively and

innovatively together;

quality and governanceenabling teams to safeguardquality by developing theirability to deliver safe andeffective services based onna t iona l l y recogn isedstandards; and

performance managementand assuranceensuring that all teamsd e l i v e r r e a l s e r v i c e

improvement by monitoringtheir own progress towardsagreed objectives andproviding assurance at teamand Trust level.

7.1.6 We expect, and researchsuggests, that this way of workingwill improve our customersexperience of care and supportfrom the Trust. A bottom up, topdown dynamic will in turn meanthat this experience will contribute

t o s h a p i n g c o n t i n u o u simprovement and help to informand meet the Trusts strategy,objectives and ensure the safetyand quality of services. It supportsan integrated approach toeverything we do.

7.1.7 So far local research by theClinical Effectiveness ResearchUnit (CESU) has highlighted someencouraging results, specificallyaround a renewed sense of team

working and greater flexibility toinnovate.

CHAPTER 7Your team

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7.2 What difference will ourapproach make?

7.2.1 The strong framework created byNHS standards and professionalc o d e s o f p r a c t i c e i scommunicated and understood,enabling teams to have clarity onthe freedoms open to them

7.2.2 Increased shared learning andinnovation where exceptional

good practice can be exploitedthroughout the Trust

7.2.3 More sophisticated and effectivemethods of involving the customerwhere services respond toexpressed need and thereforeimproving the customersexperience.

7.2.4 The key objectives of the Trustincluding compliance withStandards for Better Health are

met at team level and thereforee m b e d d e d a c r o s s t h eorganisation.

7.2.5 Staff will feel more positive aboutworking for the Trust, evidencedby greater retention and lowersickness and absence rates, morepositive staff to staff and staff tocustomer relationships and staffperforming at their best.

7.2.6 A synergy between the Trusts

direction and activities with that ofteams direction and activitiescreated by bottom up, top downinvolvement processes

7.2.7 Effective leaders that inspire andbuild confidence across the Trust.

7.28 A culture that positively enhancesthe success of the Trust.

7.3 Support

7.3.1 Our team development portfolio is awritten guide to the variousprocesses involved in theprogramme. Additionally, support willbe provided to teams from thefollowing areas:

Organisational DevelopmentTeam and systems;

Performance ManagementTeam and systems;

Delivering Health system andtraining in its use;

Clinical Governance Team;

P u b l i c a n d P a t i e n tInvolvement Team;

S t a f f S u p p o r t a n dCounselling Service.

7.4 Evaluation and research

7.4.1 Our organisational developmentprogramme is being supported bya research and evaluationprogramme to ensure that itachieves the expected benefitsand to provide an evidence basefor further development. Weintend to train users and carers tocarry out some of this research.

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Human Resources Strategy 27CHAPTER 8Performance Management Framework

The Trusts Performance ManagementFramework (PMF) plays a key role in theTrusts drive for excellence, providing ameans to review and improveorganisational performance by linking andaligning individual team and organisationalobjectives and results.

8.1 Balanced scorecard andmanagement informationpack

8.1.1 During 2006, the PerformanceManagement Framework hasbeen further enhanced following acomprehensive review and theintroduction of a Trust specificba lanced scorecard andmanagement information pack.The main purpose of thisimproved system is to support theTrust in delivering its PrincipalObjectives, track performance,understand the balance betweeno u t c o m e s a n d t a r g e timprovement.

8.1.2 The balanced scorecard has beeni n c re m e n t a l l y i n t r o d u c e dthroughout 2006/7 and wasformally approved by the TrustBoard in December 2006 andimplemented at quarter 3 2006/7reporting. The balancedscorecard and managementinformation pack contain a seriesof metrics designed to target

improvement and measureperformance.

8.1.3 For the workforce business priorityarea, a series of key performanceindicators (KPIs) have beenagreed, which both targetimprovement and measureperformance, against each of thethree principal objectives.Performance against the KPIs isassessed on a quarterly ormonthly basis, as appropriate, and

reported to the Trust Board aspart of the balanced scorecard ormanagement information pack.

8.1.4 The Workforce section of thebalanced scorecard has beendeveloped with a focus on thenational HR Metrics and the keyaims are to:

review performance against arange of HR measures;

measure the impact of HR onthe performance of theorganisation and the balance

between priority areas; and

compare the trust over timewith other organisationst h r o u g h c o n s i s t e n tbenchmarking.

8.2 Key performanceindicators

8.2.1 A number of key performanceindicators are already operationalwithin the balanced scorecard andwill continue to be monitoredregularly with a view to targetingimprovement. Whilst strategicplanning has been strengthenedthrough the development andintroduction of our strategicplanning cycle there is a need tomake further improvementsthrough an integrated approach toplanning at service level,corporate planning, workforce,activity and financial planning andtheir links to strategic planningcycle. The KPIs within thebalanced scorecard designed totarget improvement are listedbelow. The KPIs will be furtherdeveloped as progress is made ineach of these key areas:

KPI 12.2 - alignment offinance and workforcesystems;

KPI 14.1 - effectiveIntegrated workforce planningarrangements;

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KPI 14.2 - implementation ofthe ESR; and

KPI 15.1 - implementation ofthe KSF

8.2.2 The balanced scorecard andmanagement information packcontain a number of workforcerelated Key PerformanceI n d i c a t o r s t o m e a s u r eperformance. The following areas

are already fully operational:

KPI 12.6 - total staffing costsincluding agency, bank,locum and temporary staffspend;

KPI 14.4 - level of staffsatisfaction: Individuals whoare thinking of leaving theTrust as they are unhappywith their current job role;

KPI 14.5 - full staff surveyresults;

KPI 14.6 - IIP accreditation ;

KPI 15.2 - staff attendanceagainst the mandatorytraining programme;

KPI 16.1 - sickness absence;and

KPI 16.2 - turnover of

workforce

8.2.3 Additional Key PerformanceIndicators are contained in thebalanced scorecard but arecurrently under development. It isplanned that reporting will beimproved, with improved statisticaldata with drill-down capability,although this reporting will bef i n a l i s e d f o l l o w i n g t h eimplementation of the ESR whenthere will be additional data quality

and assurance checks to ensurethat data is robust:

KPI 12.5 - vacancy controls;

KPI 12.7 - total staffingnumbers (wte & headcount);and

KPI 14.3 - establishmentcontrols

8.2.4 Other areas that are regularlyreviewed include the number ofConsultants who have received an

annual appraisal and have a PDP;the number of other staff withinclinical teams who have an annualappraisal and the number ofclinical teams which havecompleted a Training NeedsAnalysis. When all KPIs listedabove are fully in place, there willbe a development programme tofurther develop indicators in theareas o f : lea rn ing anddevelopment; all staff with a PDP;increasing productivity through

new ways of working; equality for,and diversity of staff and staffprofiles.

8.2.5 A final area for development is theneed to ensure that there is arigorous system of benchmarkingto the staffing establishments andoutcomes of other mental healthtrusts. This will continue to bedeveloped throughout 2007/8.

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We have developed a Human Resources strategy that will ensure that the proposed newfoundation trust has the staff and skills it needs to deliver high quality services.

Our systems and processes ensure that staff are fully involved in planning anddeveloping services.

We have a performance management process that will ensure that we deliver against the

strategy.

HUMAN RESOURCES STRATEGYKey Points

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Head Office:

North Staffordshire Combined Healthcare NHS Trust

Bucknall Hospital

Eaves Lane

Stoke on Trent

Staffordshire

ST2 8LD

Tel: 01782 273510 Web: www.nsch-tr.wmids.nhs.uk

Documents

Hr Strategy 2007