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

2. Context

3. What would you like to learn from this session?

4. 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?”

5. 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

6. Background (2)

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

8. The effect of a positive workplace culture on motivation and on health and wellbeing.

9. 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:

10. 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:

11. 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:

13. What factors do you think are linked to attrition?

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

15. 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

16. 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

17. 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

18. 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

19. 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

20. Effect of Health on Work – Improving Personal Resilience

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

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

23. The key role of managers in supporting those with health problems to sustain them in work
Guidance for managers provided by Mind at:

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

25. 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

26. HSE guidance – work related stress
HSE guidance on work related stress at:

27. 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:

28. 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

30. 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

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

32. 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