1. Insert logo RAISING CONCERNS: Outline presentation

2. Today’s presentation What is raising concerns Raising concerns post Francis Our organisation’s policy Our challenges and gaps How to influence culture change Why we need board/or other appropriate governance structure buy in Tips and resources

3. The Francis Inquiry and subsequent reports have reinforced the need for organisational culture change. Organisations need to: be more open and transparent in relation to reporting respond and share information about complaints and concerns encourage a culture of openness and transparency – prevention is better than cure Gaps still exist: confidence – don’t feel safe raising a concern fear/perception of consequences negative experiences The need for culture change

4. Raising concerns is not exclusive to the NHS Clapham rail crash - an inspector failed to report loose wiring because ‘he didn’t want to rock the boat’. Zeebrugge Ferry tragedy - it had emerged that staff on five occasions had raised concerns that ferries were sailing with their bow doors open. Collapse of Barings Bank - it was found a senior manager had failed to blow the whistle loudly or clearly.

5. Progress v challenges Many employers are actively working to improve staff confidence to raise concerns Workforce challenges impact on staff motivation and confidence Historical negative perceptions Lack of clarity

6. National staff survey trends – where are we? % staff (strongly agree/agree) 201120122013 Organisation encourages the reporting of errors, near misses or incidents 80%86%85% Know how to report concerns 89%90% Reported an error, near miss or incident 97%96%

7. Our statistics Use this slide to insert local staff survey information ACTION! SPARE SLIDE FOR YOUR INFORMATION

8. Importance of getting it right RightWrong Increased patient safety x Harm to patients and staff Good organisational reputation x Poor organisational reputation Financial savings x Financial implications Organisational wide awareness and open culture x Lack of staff awareness Increase in morale, productivity and positive staff survey results x Low staff morale, productivity and staff survey results Stakeholder and regulator confidence in good governance x Regulatory response/Crisis management Lower rates of sickness absence and stress x Increased sickness absence and stress x Poor working relationships Staff feel supported and valued x Reduced productivity Low turnover x High turnover

9. Benefits for patients and staff Supportive, open and transparent culture Confident and empowered staff – improved morale Improved staff engagement – improved productivity & lower sickness levels Reduction in incidents – early prevention Improved patient care – better experiences

10. Our raising concerns policy Use this slide to outline your organisation’s current position. For example: When was the raising concerns policy last updated? Who has responsibility for championing raising concerns? How do we communicate with and engage our staff o Any promotional materials? o Regular channels (intranet, posters, etc.) ACTION! SPARE SLIDE FOR YOUR INFORMATION

11. Our challenges and gaps Use this slide to outline your organisation’s challenges and highlight any gaps ACTION! SPARE SLIDE FOR YOUR INFORMATION

12. Drivers for positive culture change Robust communications and staff engagement Strong organisational values: embedded through values based recruitment, induction and appraisal Clear understanding of all supporting policies and procedures Clarity – understanding the difference between a concern or a grievance Openness and transparency Early intervention Effective training for managers Having an ambassador or champion All need board/or other appropriate governance support.

13. Influence culture change  Know how to deal with a concern  Embedding values and leading by example  Be visible to staff  Continually improve policies and mechanisms for reporting concerns  Ensure managers are trained and supported to deal with concerns, difficult conversations and any associated emotional impact  Ensure feedback is provided

14. Raising concerns ambassadors/champions Are regularly reported on and discussed at board level Become embedded in your staff engagement strategy Contributes to the safety and quality of patient care Are seen as a normal part of employment Benefits: Raise awareness amongst staff Instil confidence that concerns will be listened to and addressed Offer staff an alternative reporting route to their line manager Help ensure the voice of staff is heard at a senior level Provide feedback at senior level to ensure constant development of policies and procedures Champions can help ensure raising concerns:

15. Tips from other organisations Make raising concerns an integral part of your staff engagement strategy Encourage openness and transparency Think about implementing a tool/model/forum which allows all staff to report genuine concerns directly to the chief executive/senior management Recruit an ambassador for cultural change who autonomously reports directly to the senior management team Develop and support a network of raising concerns champions Work with staff and provide appropriate training Use the tools and resources available to promote raising concerns

16. Information, tools and resources Legislation and policy Draw the line logo, assessment tool, manager’s guide, presentation and how to use guide Draw the line logoassessment toolmanager’s guidepresentation and how to use guide Values based recruitment mapping tool – map your organisational values to that of the NHS Constitutionmapping tool Model process flow chart – raise awarenessflow chart Raising concerns at work: Whistleblowing Guidance for Worker and Employers in Health and Social Care – guidance for you and your staff Raising concerns at work: Whistleblowing Guidance for Worker and Employers in Health and Social Care National Whistleblowing Helpline – free confidential advice for all health and social care staff National Whistleblowing Helpline Public Concern at Work – helps you give staff confidence to speak up early Public Concern at Work Raising concerns posters – help raise awarenessposters Ten top tips for reporting concerns – can be used a pay slip insert or posted on your staff intranet Ten top tips NHS Employers Staff Engagement Toolkit – improve staff engagementToolkit NHS Employers DoOD toolkit – ensure your staff are working as a team, towards a common culturetoolkit List of prescribed bodies where concerns can be escalatedprescribed bodies Frequently asked questions

17. 5 Boroughs Partnership NHS Foundation Trust has committed to taking a transparent approach with patients, carers and staff as demonstrated in its ‘Let’s Talk’ initiative. Read more about the success of their ‘afternoon with the chief executive’ sessions and transparency in the trust. Read the case study. Read the case study Read how Staffordshire and Stoke On Trent Partnership NHS Trust have created an open and transparent environment to ensure that individuals have the support they need when they raise a concern. Read the case study. Read the case study East London NHS Foundation Trust have developed a framework for listening which aims to support culture change. Dr Amar Shah, Quality Improvement Lead & Consultant Forensic Psychiatrist at the trust shares their ideas. Read the case study.Read the case study. Birmingham and Solihull Mental Health NHS Foundation Trust thinks it is important that all staff have a number of mechanisms to raise their concerns early, and anonymously if they prefer. Find out about ‘Dear John’ an informal tool devised and implemented to enable staff to raise their concerns. Read the case study.Read the case study. Learn from success… Gateway number 02948