Staff engagement the Leeds Way

Anna Edgren-Davies (@edgren_anna) is Senior HR Manager at Leeds Teaching Hospitals NHS Trust where she has overseen work to improve staff engagement since 2014. She has also recently been made Director of Business Development at Leeds Cares. Anna tells us how building a sense of community has been at the core of the trust’s strategy to ensure people are happy and engaged at work, and how that makes the difference between an okay experience and a great experience for patients.

What is staff engagement and why does improving it lead to better patient outcomes?

The NHS staff survey gives every organisation a staff engagement score, based on levels of motivation and satisfaction, involvement, and willingness to be an advocate of their service. What we have realised is that staff engagement also has a broader scope. Our staff tell us it’s not just about being part of the trust, but also about how it feels to be part of their team. And that’s a big part of what we focus on now, ensuring that people are happy and engaged and part of a strong community at work. 

The way people feel at work has a massive impact on the quality of care they are able to give to patients. If staff feel happy, supported, and clear about what’s expected of them, they can put all their energy into caring for other people. 

As we’ve changed our culture, our scores across the whole survey have changed. People at the trust also talk really positively about the Leeds Way and how it feels to work here. 

Tell us more about the Leeds Way and the approach you’ve taken to improving staff engagement. 

Back in 2014, our regulators were telling us we had work to do organisationally, financially we were in deficit, and our waiting times weren’t great. Those were strong drivers for change and combined with a change in leadership, the momentum was there to really try and transform things.

We co-created the Leeds Way with our staff using a crowdsourcing platform. Around 4,000 people joined a conversation about what our organisation’s values, behaviours and goals should be. We created a definition of our culture – the way things are done around here – which everyone could sign up to and feel part of. So now everyone knows what our vision and values are, they form part of our appraisal system, staff induction and our recruitment process.

Embedding the Leeds Way has been led from the top and it’s been important for our staff to see that commitment. Our leadership team are out in the organisation, role modelling the values, sharing positive stories, listening to staff, and taking action based on what they’re told. 

How have you gone about creating a sense of community? 

When I came into post, I wanted to look at how we could create positivity and energy and make people feel proud to be part of Leeds Teaching Hospitals. Being so big (we have 17,800 employees), people often feel part of their local team, but don’t necessarily feel part of the organisation. 

We have a ‘sense of community’ workstream that consists of non-traditional wellbeing activity. We look for things people can do together, based on our values, that make them feel good and connect them back to their sense of vocation. We started with teams collecting gifts for our local homelessness charity and it really brought people together. 

Then we looked at how we could work with our hospital charity, Leeds Cares, which was underutilised. We now really encourage staff to get involved, find ways to raise money or volunteer, and to think about using the charity funds to solve issues. For example, one patient was worried about how her little girl was going to get to school while she was in hospital. Staff were able to arrange a taxi service funded through the charity, so the patient could focus on getting better. 

How are you linking the work into increasing improvement capability in the organisation?

The ability to make improvements at work strongly links to staff engagement and patient experience. When our staff survey results came out in 2016, they showed we had some work to do in this area. We made it a key theme during 2017: finding lots of ways to tell staff that they have permission, authority and autonomy to make improvements. We also trained over 600 members of staff in our Leeds improvement method. 
We asked staff how they want to be supported to make improvement and some of the top ideas were easy to implement: asking for people’s ideas as part of ward handovers and sharing ideas being developed by other teams. 

Another thing that really worked was iFactor, a scheme where we invited staff to submit innovation and improvement ideas. We had over 800 entries and the top 12 were given an executive sponsor to help take them forward. One of the winning projects ‘Get up, get dressed, keep moving’, was an idea that came from the national End PJ Paralysis campaign. It encourages elderly and bedbound people to get out of their pyjamas, put clothes on and move around the ward. Another project is about non-clinical staff working as volunteers within the hospital – befriending patients, doing drink rounds in outpatient clinics, or helping patients find their way around the hospital. It’s helping non-clinical staff have more contact with patients and feel part of the hospital team. 

What have you learnt while introducing these changes?

We’ve found that putting energy into addressing specific elements of the staff survey findings leads to more of an impact than trying to do everything at once. After a year of focusing on how staff can make improvements, we saw a 4.5% bump in results for the ‘I am able to make improvements at work’ statement in the survey. 

We’ve also realised that staff engagement doesn’t belong to HR. If ward managers aren’t living the values and modelling the behaviours, whatever you do centrally won’t make much difference. 

How are things better now, for staff and for patients?

Compared with other trusts, we’ve seen the biggest improvement in our staff engagement scores between 2012-17. People working at the trust say the energy in the organisation feels different, it’s a more positive place to work and people are more connected. 

For patients, that shift in energy and positivity is felt in the care they receive. Our staff put that little bit of extra effort into the service they deliver because they feel happier at work. It makes the difference between an okay experience and a great experience.