Doing a bad day’s work

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15 February 2013

I don’t believe people set out to do a bad day’s work.  I don’t think that anyone intends to be disruptive, to bully or to cause harm. Yet we know it happens and when it does, these negative behaviours can lead to a culture where poor leadership thrives.  The first Francis report in 2010 shines a spotlight on this very issue.

So the question I’ve had in my mind this week, is why do some people end up doing a bad day’s work?

The answer is, of course, many things and what I’m interested in is the role of leaders in this. One of the reasons, I think, is because people are not connected and they’re not engaged with their colleagues, their team or their organisation. More crucially, they’re not involved in decisions that affect them.

Both last year’s and 2010’s NHS staff survey results show us the evidence. Only 26% (27% in 2010) felt that their managers involved them in important decisions. That’s nearly three quarters of our workforce not helping to shape what happens to them and thereby, what happens to patients and their care.

When I look around for where there’s good practice, I see lots of initiatives in England where staff engagement takes centre stage, is applauded and is critical to success. The NHS Employers online engagement support device and Listening into Action approach being adopted by some NHS organisations spring to mind. But where I think there’s an approach that’s a bit different is across the Atlantic. In the States, there’s an accreditation process for hospitals that has nurse engagement in decision making as part of the pre-selection criteria. It’s run by the American Nurses Credentialing Center and is part of their Pathway to Excellence scheme. Evidence of staff being involved in decision making as part of an approval process takes the seriousness of engagement to a whole new level.

Where I’ve personally seen staff involved and properly engaged is when their team – usually subconsciously because the culture allows it – has an informal way of contributing. It’s often in a team discussion, it might be about a new staff rota or a seemingly insignificant discussion about where the staff lockers should go or where the Christmas ‘do’ is being held.

It needs to be on the big decisions too – such as moving more activity to a day case setting, putting in more outreach services, streaming elective activity away from emergency and so on. Whatever the level of decision, great leaders see engaged and involved staff as fundamental to how things run.

It’s also about how an organisation listens and talks with its staff. Again, there are fantastic examples of really great practice. Sandwell and West Birmingham Trust – winners of the HSJ Awards 2012 staff engagement category is a good place to start and you can also find examples of engaging with staff in our recognition awards winners.

The staff survey results for this year are due out at the end of this month and my guess is we won’t see a marked improvement on 26% of staff telling us they’re involved in decisions, though I hope I’m wrong!

My hope, and the reason I am so passionate about what the Academy does, is that the impact of our leadership development programmes will really start to make a difference in the future.