Staff voice

Accessibility: 

• Not having access to computers and equipment, ensuring formats are accessible. 
• Not having time to complete staff surveys or a desk to do so. 
• Assumptions around language can mean certain groups are missing information. 
• Encouraging underrepresented groups to contribute and ensuring all staff groups have an equal voice including staff from lower bandings and different backgrounds. 
• Some staff feel undervalued or might say ‘I’m just a...’. 
• Corporate staff feeling included in staff survey particularly when working offsite.

Not feeling encouraged or empowered to speak up: 

• Past experiences of speaking up but concerns have not been addressed or actioned. 
• A lack of support from within a team, fearing being blamed. 
• Cultural differences can be misinterpreted for example, passion mistaken for aggression, and prevents staff from talking to managers and more senior staff. 
• Lack of tolerance from listeners. 
• Safety to speak up – the risk of repercussions, personally or professionally. 
• Having the confidence to speak up can be intimidating, especially earlier in your career and so it can be harder to make suggestions. 
• People that come forward with suggestions can sometimes be made to feel humiliated and undervalued when giving ideas and suggestions. 

Lack of awareness around the pathways of speaking up: 

• It is not clear who to take ideas to or how to access them. 
• Raising awareness of ‘Speak Up’, some staff do not know what exists already. 
• Not knowing the process and therefore allowing behaviours to go unchallenged because ‘that is just what that person is like’. 

Communication challenges: 

• Ward handovers do not always have specific, structured operational key messages. 
• Information is often passed through managers and not always disseminated. 
• Communication is not always clear and does not always reach all areas of the organisation. 
• Some staff view remote working as a barrier to communication as things can be misinterpreted virtually. 
• Danger of making crisis mode of working the norm - lack of protected regular time to come together and have discussions and share ideas. 

Creating a culture to encourage speaking up and actioning feedback in a timely manner: 

• Acknowledging that it takes courage to speak up and thank people for doing so. 
• Creating a safe space that allows people the ability to feedback ideas anonymously. 
• Make it clear who to go to when rules are broken e.g., smoking; mask wearing. 
• Allowing space to challenge ideas, providing a clear escalation of issues. 
• Listening, be open to listening and implement feedback and suggestions, ensuring that responses and what happens is shared with staff. 
• Ensuring the Board listen to concerns and respond to them. 
• Human Resources processes can be long winded and don’t always see timely action. 
• Having designated representatives to participate in initiatives and encouraging team leaders to free up team members time to prioritise this. 
• Better publication of events through the trust in different formats and more expectation of participation. 

Improving communication and channels where information is shared: 

• Splitting communications into two channels – regular heartbeat and crisis. Emergency comms can be quick to go out, but the reversal is slow. 
• Ensuring communication that is shared is accessible and does not assume knowledge, technology or access. 
• Consistency with messaging and implementation of it e.g., no smoking on site. 
• Sharing positive staff stories more regularly. 
• Making people aware of communal computers and that they are for anyone to use. 
• Sharing information in communal areas e.g., a rolling monitor in the canteen so staff can access the weekly Q&A’s; lunchrooms; ashley board room. 

Providing training and access to support: 

• Develop training to improve IT literacy for those who need support. 
• Mandatory manager training for those with line management responsibilities. 
• Providing support for managers to create a space that encourages people to speak up and feel empowered to make changes and suggestions. 
• Switching from command mode to collaboration mode. 

Senior managers being visible and valuing everyone's voice: 

• More Back to the Floor Fridays including senior managers walking the floor in and out of uniform so they are not recognised. 
• Visibility from the exec team and senior managers on the floor, experiencing the challenges – seeing the problem is easier than hearing about it. 
• Senior managers acknowledging concerns rather than meeting them with silence. 
• Senior managers respecting every job role and valuing the staff in each team. 

Create opportunities for all your team to have a voice: 

• Everyone is different so people will need different ways to engage e.g., in team meetings; 1:1s; suggestion boxes. 
• All Teams meetings should have opportunities for everyone to contribute. 
• Asking the team ‘what do you think’ to empower them to be solution focused. 
• Share ways that staff can speak up on a regular basis. 
• Managers should speak on staff behalf if they cannot for themselves. 
• Stop the loudest voice getting their way. 
• Empower staff that they are part of the solution. They usually have the solutions to problems. 
• Have the confidence to say when you ‘don't know’ so that you can ask their team what they think – group/team thinking doing it together. 

Give team members protected time to prioritise events and feed back to the team: 

• Protected time to engage in events and look at shared information. 
• Protected time for teams to come together. 
• Things come up at short notice and staff may be rostered. More notice the better to support team members. 
• Shift mindset from ‘if anyone’s interested’ to ‘we need someone to attend’ - permission and value on engagement. 
• Be clear of the expectation of attending and engagement. 
• Nominate a team member to condense and share information with the team. 
• Have a communication champion for the team. Team could take it in turns. 
• Sharing the responsibility of disseminating information means inclusivity. 
• Be intentional and take responsibility to ensure someone attends. 

Give and receive constructive feedback, take action and celebrate successes: 

• Give more feedback to staff – positive as well as impact of unaware behaviours. 
• Managers to ask for 360 feedback. 
• Open to feedback or invite more feedback. 
• Take time to really talk with your staff, not at them. More time! 
• Invite people to spend time with your team. 
• Take action based on the problems you hear. 
• Cultural bias training. 
• Role model CARE by behaving the right way. 
• Taking a moment to stop and celebrate wins. 
• Inviting senior execs/ non-execs to meetings where you are celebrating successes.  

Clear communication and transparency: 

• Share how staff can be kept up to date with Trust changes, so they know how they can be included. 
• A lot of emails are chunky with lots of text - ‘please read’. Really difficult to see. Highlight key points, in a shareable format, top 3 points. 
• Transparency within the team from management all the way down. 
• Some agreed principles around how we do email subject lines (e.g., action/ urgent). Some messages are at the bottom of an email thread. Some shared words which flag so that people can see what needs to happen. 

Share information: 

• ‘This is me’ folder of managers with photos and profiles; for staff to learn about their managers, so they know them to feel able to talk to them. 
• Share what people actually do – as job titles do not explain that fully. 

Speak up, make suggestions and provide feedback: 

• When a problem is shared, ask for a solution at the same time, to get people thinking they are part of the solution and managers do not do everything – empowerment. 
• Come with a solution to a problem. 
• Call out non-CARE behaviours from managers and colleagues. 

Training and events: 

• Introduce compulsory banding of each event. Need to have representation. 
• TRIM training 

We heard you share that it is not always clear how to share your feedback, opinions and suggestions and that when you do, it does not always appear to be actioned. There are lots of ways to share your views at HHFT including: 

• Access the Raising Concerns page on TrustNet to access further information on our Freedom To Speak Up guardians, our whistle blowing policy and the Speak in Confidence service.   
• The annual national Staff Survey and the People Pulse survey give staff a chance to provide their thoughts on what it's like to work at HHFT.  The People Pulse survey runs three times a year and the July instalment is now live until July 31st. Click here to fill it in or visit www.nhspeoplepulse.com. 
• Our Freedom To Speak Up Guardians (FTSU) provide an additional route to support staff to speak up. They are impartial and aim to ensure that the issues raised are responded to, and make sure that the person speaking up receives feedback on the actions taken. They have recently started a quarterly newsletter which provides more details on themes of cases raised and available speaking up training. 
• You can report an incident or near miss using the DATIX reporting system. 
• Trade unions are organisations that represent you at work. Local representatives are based at HHFT to offer help and advice. Contact Liz Collings, Staffside Chair, or Steve Rolfe, Staffside Secretary. 
• Chaplains are available 24/7 to provide pastoral, emotional and spiritual support to all patients, relatives, carers and the staff who support them. Contact them at chaplaincy@hhft.nhs.uk.   
• In February 2022 Improving Human Factors for Patient Safety (iHuPs) launched as a brand-new programme to implement human factors understanding throughout HHFT. Human Factors is a scientific discipline that ‘makes it easy to do the right thing and difficult, or ideally impossible, to do the wrong thing’. You can access it on Green Brain by searching for ‘Human Factors Module One’. 
• You can raise concerns and access support by contacting your staff governor. 
• Managers can join the virtual manager drop-ins every Thursday from 14:00 – 15:00 where key members of the HR department can provide guidance and support on HR queries. Access them here. 
• HHFT's inclusivity network provides a compassionate, safe and supportive place for staff to discuss and express their views, lived experiences and concerns. As part of the network, we have LGBT+, BAME, Disability and International Workforce champions groups. Contact inclusivity@hhft.nhs.uk if you would be interested in joining the inclusivity network or one of the LGBT+, BAME, Disability or International Workforce champions groups as a member or an ally.   
• Schwartz Rounds provide a structured forum where all staff, clinical and non-clinical, come together regularly to discuss the emotional and social aspects of working in healthcare. 
• Contact culturechange@hhft.nhs.uk if you would like to become a Culture Champion. 
• By listening to the staff at HHFT, we feel we have developed a Behaviour Framework which reflects what we have heard and will help to develop an inclusive, happy, safe and compassionate working environment for everyone. 
• TRiM is a way of supporting people after exposure to trauma whilst at work. Find out more information here.  
• Ways to make your voice heard locally include providing and asking for feedback, asking for or suggesting solutions at the same time as raising problems and celebrating successes.  
• We are committed to providing information on the local pathways for speaking up – coming soon. 
• Our staff wellbeing hub is here for all staff with skilled advisors available to help. Contact them on 01962 824119 or by emailing staffwellbeing@hhft.nhs.uk.  

One of the biggest barriers to staff voice was said to be accessibility and assumptions around knowledge, technology and access. 

• We heard your feedback that information is not always shared in an accessible way, and we are going to explore how we can share the outcomes and actions from the big conversations in a more accessible way. 
• One of the suggestions was to improve training and development including IT literacy to improve accessibility. We offer fully funded Functional Skills training in English and Maths to help learners of all ages and levels, supporting them to develop and demonstrate the practical skills needed in real-life situations. 
• Our A-Z of courses on TrustNet provides the details of lots of the courses we offer. 
• Our organisational development team is working with the HR Business Partner for the Corporate division to explore how we can make the staff survey more inclusive to home workers. 
• Our Quality Improvement Academy has bronze, silver and gold levels, and focuses on improving quality by giving the people closest to problems affecting care quality the time, permission, skills and resources they need to solve them. 
• This useful guide from the UK Government provides advice on how to make communication accessible and includes best practice on which format to use and why it is so important. 

We had lots of feedback on the channels used for communication and a feeling that these may not always be the best methods to reach staff. We have shared this feedback with the communications team to consider how best to incorporate this going forward.

• One suggestion was for Ward handovers to include key operational messages as well as patient handovers. 
• Emails were reported as being too long, with it difficult to find key information. We will develop some email guidance soon. 
• One of the suggestions was for managers to create protected time for their team to attend events, for example choosing a ‘communication champion’ who can then feedback the key themes to the rest of the team. 
• Understanding each other's job roles can create a better understanding of each other and improve communication. The HR team offer a ‘shadow and share’ scheme to job shadow, could this be something you introduce in your team? 
• Based on your feedback from previous Big Conversations we are looking for examples of where flexibility, recognition or staff voice work well in your area so we can share these positive stories across the organisation. Get in touch at culturechange@hhft.nhs.uk if you think this is you. 

There was feedback that staff would value visibility among senior managers including more Back to the Floor Fridays from the exec team so that problems are seen and acknowledged. 

• Our exec team would love to come and visit your department and meet the staff in your team. Whether it is to celebrate successes or see what it’s like in your team. Please get in touch with the management offices if you would like to arrange a visit. 
• We will be sharing with the Board that staff would value visibility from senior managers walking the floor in and out of uniform, so they are not recognised. 
• Managers have a responsibility to create opportunities for their team to have a voice. Ways you might do this are in team meetings, one to ones, suggestion boxes or simply asking ‘what do you think?’  
• Although many decisions rest with managers, that does not mean managers have to make them alone. Be inclusive. Create the conditions that allow every individual in your team the space and confidence to have a voice. Do not assume that the most senior, most experienced individual in the room has the best plan. 
• There was a suggestion for a ‘This is me’ folder on TrustNet of managers with photos and profiles for staff to learn about their managers, so they know them to feel more able to talk to them – watch this  
• Map to Management provides a framework for a consistent approach to leadership development and progression irrespective of profession, or seniority, as well as facilitating the development of aspiring managers.