Creating healthy, motivating workplaces Robin Cordell MBA FRCP FFOM SWOT 21 Nov 2018

Context

What would you like to learn from this session?

Agenda Introduction Background on workplace health The effect of a positive workplace culture on motivation and on health and wellbeing The impact of NHS staff experience on patients’ experience Personal factors that might be linked to attrition Organisational factors that might be linked to attrition Key messages – “so what will we do now?”

Background (1) – Occupational Health Social, technical, economic and political context Effect of health on work Effect of work on health Individual physical, psychological and social factors Organisational culture

Background (2)

Background (3) RSM Occupational Medicine Section at: https://www.rsm.ac.uk/events/events-listing/2018-2019/ sections/occupational-medicine-section/ omm01-ethics,-the-law-and-data-protection-in-work-and-health.aspx and at: https://www.rsm.ac.uk/events/ events-listing/2018-2019/sections/food-health-forum/fhm02-menopause-in-the-workplace.aspx

The effect of a positive workplace culture on motivation and on health and wellbeing. https://www.rsm.ac.uk/events/events-listing/2017-2018/sections/occupational-medicine-section/omk01-creating-healthy,-motivating-workplaces.aspx

In his 2013 report on the NHS, Don Berwick led the call to “let pride and joy in work, not fear, infuse the NHS”. A positive working environment, where all are valued for their contribution and feel empowered to contribute, is strongly associated with improved health of the workforce, motivation and business performance, and thus business success. Conversely, controlling environments lead to demotivation, reduced business performance and ill-health within the workforce. Berwick report into patient safety (2013) at: https://www.gov.uk/government/publications/berwick-review-into-patient-safety

Jocelyn Cornwell, Chief Executive and Founder, Point of Care Foundation …. the latest evidence on NHS staff, their experience at work, the pressures they face and the consequences for patients. The Point of Care Foundation believes that it’s critically important that NHS employers pay attention to staff and their experience at work because when staff feel positive and engaged with work it has a positive impact on patient experience. Point of Care Foundation (2017) at: https://www.pointofcarefoundation.org.uk/evidence/behind-closed-doors/

We would like to see organisations encouraging frontline staff to look after themselves, to pay attention to their own and their colleagues’ wellbeing, to alert their managers to pressures that can be alleviated, and to let them know when they need support. At the top of organisations we believe that boards and senior leaders can do much to support staff by acknowledging that their intrinsic motivation to care for patients and making line managers accountable for creating environments that enable staff to be at their best with patients and satisfied with their ability to care. We would also like to see more staff in more organisations being able to access psychosocial support and forums for reflective practices. Point of Care Foundation Schwarz rounds at: https://www.pointofcarefoundation.org.uk/our-work/schwartz-rounds/

What factors do you think are linked to attrition?

Factors linked to 30% attrition rate (2017) Rota gaps  More out-of-hours working  Poor work–life balance  Less supervision  Fewer training experiences 

Possible ways to manage attrition Flexibility in training programmes Support and career development for specialty doctors Addressing implications of rota gaps and resident consultants on call Maintaining workforce skills through use of retiring consultants Welfare of the Workforce group including support returning to work Future models of care Supporting Our Doctors Task Group to prevent, minimise and manage workplace stress

Occupational Health Social, technical, economic and political context Effect of health on work Effect of work on health Individual physical, psychological and social factors Organisational culture

The relationship between performance and demand/pressure/arousal point at which performance declines performance point at which ”fight or flight” may occur capacity resilience demand/pressure/arousal After Yerkes and Dodson

Effect of reduced resilience point at which performance declines performance point at which ”fight or flight” may occur capacity resilience demand/pressure/arousal After Yerkes and Dodson

Improved capacity through improving resilience point at which performance declines performance point at which ”fight or flight” may occur capacity resilience demand/pressure/arousal After Yerkes and Dodson

Effect of Health on Work – Improving Personal Resilience

NHS information on Mindfulness at: https://www. nhs

Mental Health First Aid England at: https://mhfaengland.org

The key role of managers in supporting those with health problems to sustain them in work Guidance for managers provided by Mind at: https://www.mind.org.uk/workplace/mental-health-at-work/taking-care-of-your-staff/useful-resources/

Effect of Work on Health - work related risk factors for common mental health problems

Occupational uncertainty Imbalanced job design Job insecurity High job demand Role ambiguity Job control Lack of a sense of procedural justice Organisational change Effort- Reward Imbalance Temporary employment status Low social support at work Low relational justice Lack of value and respect Bullying http://oem.bmj.com/content/74/4/301

HSE guidance – work related stress HSE guidance on work related stress at: http://www.hse.gov.uk/stress/what-to-do.htm

Management Standards Demands – this includes issues such as workload, work patterns and the work environment Control – how much say the person has in the way they do their work Support – this includes the encouragement, sponsorship and resources provided by the organisation, line management and colleagues Relationships – this includes promoting positive working to avoid conflict and dealing with unacceptable behaviour Role – whether people understand their role within the organisation and whether the organisation ensures that they do not have conflicting roles Change – how organisational change (large or small) is managed and communicated in the organisation HSE Management Standards at: http://www.hse.gov.uk/stress/standards/index.htm

Effective leadership and management of organisations is directly related to motivation and the health of the workforce. A positive workplace culture promotes motivation, and health and wellbeing Including, enabling and empowering

Possible ways to manage attrition (2017) Flexibility in training programmes Support and career development for specialty doctors Addressing implications of rota gaps and resident consultants on call Maintaining workforce skills through use of retiring consultants Welfare of the Workforce group including support returning to work Future models of care Supporting Our Doctors Task Group to prevent, minimise and manage workplace stress

Key messages – “so what will we do now?”

Robin Cordell MBA FRCP FFOM SWOT 21 Nov 2018 Creating healthy, motivating workplaces - good for organisational performance, retention and the health of the workforce Robin Cordell MBA FRCP FFOM SWOT 21 Nov 2018