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Resource pack to support workplace compassion March 2020 Publications Gateway Ref No. 000872

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Page 1: Resource pack - NHS England...C. Introductory slide set: Why workplace compassion matters Element 1: culture and values 1.1 Six word stories 1.2 Workplace compassion audit and action

Resource packto support workplace compassion

March 2020 Publications Gateway

Ref No. 000872

Page 2: Resource pack - NHS England...C. Introductory slide set: Why workplace compassion matters Element 1: culture and values 1.1 Six word stories 1.2 Workplace compassion audit and action

This set of resources has been designed to accompany the NHS England documentTowards Commissioningfor Compassion: A Support Guide published in October 2018.

You can access the guide here: https://www.england.nhs.uk/wp-content/uploads/2018/10/towards-commissioning-for-workplace-compassion-a-support-guide-v2.pdf

The guide was informed by ourresearch and insight programmeworking with a large number ofcommissioners and providers ofhealthcare services across theNHS. It includes a number of casestudies and practical examples ofgood practice of workingtogether to create and sustaincompassionate workplaces tosupport more dignified, caringand compassionate experiencesof care for patients and staff.

In the foreword to the SupportGuide, Neil Churchill, Experience,Participation & EqualitiesDirector for NHS Englandreminds us that “we know thathigh quality patient experiencecannot be achieved - ethically orsustainably - at the expense ofstaff and that it is only possiblefor health and care staff to staywell themselves and to deliverconsistently high quality,

compassionate care if they alsoexperience dignified,compassionate and practicalsupport in their workplaces.”The importance of doing all wecan to look after staff betterthan we ever have before hasnever been greater. One way ofdoing this is to pay specialattention to the practical actionsthat we can all take to createmore compassionate workplaces.

In the Support Guide we statedthat, “everyone can take actionnow, today, to create a morecompassionate workplace forthemselves and for others.”Using these resource materialscan support your organisation toachieve this. The resourcesinclude materials for teammeetings, for briefings to theexecutive team, video clips andpowerpoint slides for workshopswithin or across teams and

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Introduction to this resource pack

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departments, that you can use‘off the shelf’.

Just like the Support Guide thatthese Resource Materialsaccompany and support, thepractical actions within theseresources are not intended to bea single ‘one size fits all’offering. You may want to adaptand share the contents, slide setsand activities to suit your localplans, priorities andorganisations. Please feel free todo this and to add your logos orother identifiers where needed.But you don’t have to spendtime adapting them. Theresources have been developedso they are ‘good to go’ with noadditional effort from yourself.There are presenter notes ineach slide set to help you to getthe most from using them.

The resources are structured intoan introduction section and thenfour elements designed tosupport you to promote, developand sustain more compassionateworkplaces. The four elementswere identified through ourresearch and insight programme.

They are:

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The importance of doingall we can to look afterstaff better than we everhave before has neverbeen greater. One wayof doing this is to payspecial attention to thepractical actions that wecan all take to createmore compassionateworkplaces.

Element 1: culture and values

Element 2: actions and activities

Element 3: leadership and management

Element 4: policies and procedures

We anticipate that theintroductory resources may well be a good starting place but would encourage you toselect and use the resources andsets of activities in the mosthelpful and appropriate way foryour local setting. They can beused as standalone materials or employed flexibly incombination with otherresources that you haveavailable.

We hope you find theseresources helpful in enablingmore compassionate workplacesand that they will inspire you

too, to find and act on ways to create more positiveexperiences for staff withinservices that you provide andthose you commission.

We would love to hear abouthow you have used, adapted andshared the resources andparticularly to learn about waysin which they have enabled youto develop more compassionateworkplaces. Please do let usknow how you get on byemailing us [email protected]

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Materials in support of introducing workplace compassion

A. Shareable handout: Why workplace compassion matters

B. Shareable infographic reflecting the business case: Why caring forthe people who care matters

C. Introductory slide set: Why workplace compassion matters

Element 1: culture and values

1.1 Six word stories

1.2 Workplace compassion audit and action

1.3 Culture and Values for Workplace Compassion slide set

1.4 Culture and Values for Workplace Compassion Case Study. Hulland East Yorkshire Hospitals NHS Trust: Changing culture bydeveloping and living team values

1.5 Culture and Values for Workplace Compassion Case Study. NorfolkCommunity Health and Care NHS Trust: Using an online staffplatform to change values and culture

1.6 Culture and Values for Workplace Compassion Case Study.University Hospitals of Leicester NHS Trust: Showing workplacecompassion by saying thank you

1.7 Where to start with creating a culture of workplace compassionvideo clip

1.8 Contracting for workplace compassion video clip

1.9 Measurable benefits and outcomes of workplace compassionvideo clip

Element 2: actions and activities

2.1 Actions and Activities for Workplace Compassion Case Study.Imperial College Healthcare NHS Trust: Senior clinical leadershipafter a serious incident

2.2 Actions and Activities for Workplace Compassion Case Study.Northumberland, Tyne and Wear NHS Foundation Trust: Making iteasy to speak about things that matter

2.3 Actions and Activities for Workplace Compassion Case Study.North West Ambulance Service NHS Trust: Investing in peersupport for staff wellbeing

2.4 Actions and Activities for Workplace Compassion Case Study.Academy of Fabulous Stuff CIC and Lincolnshire CommunityHealth Services NHS Trust (LCHS): When staff feedback is fab

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Resources to support practical actions topromote workplace compassion include:

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2.5 Actions and Activities for Workplace Compassion slide set

2.6 Taking stock of actions and activities that support workplacecompassion: What do we do now that’s good? (or, “not throwingout the baby with the bathwater")

2.7 Tackling giants: Barriers to making a change to achieve workplacecompassion

2.8 Actions and Activities to Support Workplace Compassion ActionPlanning Exercise (or, “even Baldrick had a plan”)

Element 3: leadership and management

3.1 Leadership for Workplace Compassion Case Study. Leading a newdirectorate’s culture, building in workplace compassion: ImperialCollege Healthcare NHS Trust

3.2 Experience of Care: Patients and Staff Together IntroductoryWorkshop Agenda template

3.3 Experience of Care: Patients and Staff Together IntroductoryWorkshop Powerpoint slideset

3.4 Experience of Care: Patients and Staff Together Workshop CaseStudies

3.5 Experience of Care: Patients and Staff Together ImprovementPlanning Workshop Agenda template for participants

3.6 Experience of Care: Patients and Staff Together ImprovementPlanning Workshop Annotated agenda for facilitators

3.7 Experience of Care: Patients and Staff Together WorkshopFeedback Form

Element 4: policies and procedures

4.1 Policies and Procedures for Workplace Compassion Case Study.Surrey and Sussex Healthcare NHS Trust: The daily emergency callsafety huddle

4.2 Policies and Procedures for Workplace Compassion Case Study.NHS England and NHS Improvement Employee VolunteeringPolicy: A policy you can volunteer for

4.3 Workplace compassion as a business modelhttps://www.youtube.com/watch?v=qQNC1GtJ0RM

4.4 Policies and procedures for workplace compassion slide set

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1.1 Background

Given the centrality ofcompassion in the delivery ofcare, a key question for us all ishow can we createcompassionate cultures wherestaff can both delivercompassionate care and thrivethemselves? Part of the answerlies in recognising that we are allresponsible for shaping theculture in which we work.Everything we do, all of ouractions and interactions, shapethe culture of our teams and our organisations.

The cultures that support andpromote workplace compassionare embodied in theinterpersonal actions andbehaviours of colleagues, fromtaking the time to make a drinkfor a colleague, to appreciationof the wider context of a staffmember’s personalcircumstances. In this way,compassion towards staff, likecompassion towards patients,has a significant interpersonalbehaviour component.

1.2 Building compassionateworkplace cultures

Workplace compassion has someimportant characteristics and isdemonstrated particularlythrough peoples’ connectionswith one another. Theseconnections are ones wherepeople pay particular attentionto their shared and differentperspectives through empathyand deliberately seeking to

understand how one another seeand respond to their workplaceexperiences. These connectionsthen link with caring for oneanother that is embodied in theways that we communicate andact. In these ways, compassioninvolves a deliberate focus onothers along with a specificpurpose or intent to overcomeadversity or for others to havepositive experiences andoutcomes.

In essence, compassionateworkplaces are characterised bythe kinds of behaviours that areconsistently thoughtful andconsistently caring in ways thatdemonstrate empathy in action.While these actions are alsocharacteristic of compassionateleadership, we do not need towait for leadership or policy orpermission to be kind andthoughtful or to act with

empathy towards those we workwith. As we say in the NHSEngland guide “everyone cantake action now, today, to createa more compassionate workplacefor themselves and for others.”These resources are designedspecifically to inspire andsupport such practical every daythoughts and actions.

1.3 Learning

With regard to the features ofworkplace compassion thatrelate most strongly to cultureand values the followingemerged from our research:

n Very many of the staff wetalked to could readilydescribe the characteristics ofpositive staff experience;what it looked like and how itfelt to work in acompassionate workplace.

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1. Culture and values forworkplace compassion

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They were also familiar, ingeneral terms, with theevidence that good staffexperience correlates withgood patient experience.

n Some people expresseddiscomfort with referring tostaff as recipients ofcompassion. Typically staff areperceived as drivers ordeliverers of compassionrather than as its recipients.

n Our Twitter contributors toldus that workplace compassionand culture is embodied inthe interpersonal actions andbehaviours of colleagues,from taking the time to makea drink for a colleague, toappreciation of the widercontext of a staff member’spersonal circumstances. In thisregard, compassion towardsstaff, like compassion towardspatients, has a significantinterpersonal behaviourcomponent

n Many staff also told us abouta number of factors thatprevented them fromincorporating workplacecompassion into their regularactivities.

1.4 Resources

Here we reproduce the threeculture and values for workplacecompassion studies from thesupport guide in handoutformat. The case studies describeexemplary examples from NHSorganisations that haveinstigated change to their valuesand culture to supportworkplace compassion and aimto inspire other people workingin healthcare to find ways tocreate compassionateworkplaces.

We also share two workshopexercises with resources,handouts and slides to support

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workshops or improvementevents to enable staff to reviewand plan activities that supportthe development of cultures andvalues for compassion in theirworkplace. The resources havebeen piloted and refined withfeedback from NHS staff andorganisations and are providedin formats that enable you totailor them to your ownorganisation and your owncontext. The slide set haspresenter notes to supportdelivery of the exercises.

The case studies aim to inspirepeople working in healthcare tofind ways to createcompassionate workplaces. All ofthese examples are very light onthe resources required toimplement them. What all of thecase studies show is how culturescan be positively influenced byindividuals or small groups whowere motivated to make thingsbetter for themselves and their

colleagues, and found a way inwhich they could do that.

The set of resource materials wehave included are as follows:

1.1 Six word stories

Six-word stories exercise: This exercise borrows from astory associated with ErnestHemingway and the challengethat he undertook to write astory in just 6 words.Hemingway’s story was: ‘For sale,Baby shoes, Never worn.’ Thisexercise challenges you toconjure your own concisemasterpiece on the theme ofworkplace compassion.

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1.2 Workplace compassion auditand action

One technique used to supportpeople to develop self-compassion, is to suggest thatthey write to themselves about acurrent issue or situation thatthey face but to use the sameadvice, tone, and care that theywould use if they were advisinga close friend. This exercise takesthat basic premise and applies itto workplace compassion. Youcan do this exercise either inrelation to your own workplaceor a specific workplace that youcommission or work with.

1.3 Culture and Values forWorkplace Compassion slide set

1.4 Culture and Values forWorkplace Compassion CaseStudy. Hull and East YorkshireHospitals NHS Trust: Changingculture by developing and livingteam values.

1.5 Culture and Values forWorkplace Compassion CaseStudy. University Hospitals ofLeicester NHS Trust: Showingworkplace compassion by sayingthank you.

1.6 Culture and Values forWorkplace Compassion CaseStudy. Leading a newdirectorate’s culture, building inworkplace compassion: ImperialCollege Healthcare NHS Trust.

1.7 Where to start with creatinga culture of workplacecompassion film cliphttps://www.youtube.com/watch?v=fbrcPHtHJP0 Cherry Dale,previously Chief OperatingOfficer at Birmingham SouthCentral CCG, describes how hercommissioning organisationcreated a culture of workplacecompassion. This film clip is alsoembedded in the slide set above.

1.8 Contracting for workplacecompassion video cliphttps://www.youtube.com/watch?v=587gLXeJ5T8 Cherry Daledescribes why she commissionsfrom providers withcompassionate workplaces alongwith the activities thatcommissioners should expect tosee and how she incorporatesworkplace compassion intocontracts with service providers.

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1.9 Measurable benefits andoutcomes of workplacecompassion video cliphttps://www.youtube.com/watch?v=V1pa3SHsqAE Cherry Daledescribes examples of some ofthe changes that could be seenand measured in an organisationwith a culture and practice ofworkplace compassion.

We also share twoworkshop exercises withresources, handouts andslides to supportworkshops orimprovement events toenable staff to reviewand plan activities thatsupport thedevelopment of culturesand values forcompassion in theirworkplace.

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2.1 Background

Workplace compassion exists inthe details of policies andprocedures but is enactedinterpersonally between staff,and not solely in interactionswith staff in hierarchicalpositions of authority and power.Workplace compassion isexperienced by staff as a resultof the thoughtful, caring, andempathetic actions of others.

Initiatives that supporthealthcare staff to becompassionate toward andbetween their colleagues,including at times of workpressure and when staff haveexperienced an emotional andphysical impact of their work,

could be as effective as thedevelopment of workplacepolicies and statements extollingthe virtues of compassion in theworkplace.

Our research and insight workshowed us that seemingly smalland simple actions made a realdifference to people’s experiencein the workplace. People told usthat small acts of kindness, such as“a note telling me to stay strongand some flowers”, “asking howare you today especially to juniorstaff”, that "a smile goes a longway”, and “taking a moment tomake a cup of tea, to share adifficult time” demonstratecompassion in the workplace andmake a big difference to staffmembers’ experiences at work.

2.2 Learning

n Compassionate leadership iskey to creating a culture ofcompassion in the workplace.The day to day experience ofstaff is though, in large part,determined by the actionsand activities of those aroundthem, their co-workers andfellow team members.

n Small-scale actions andbehaviours by staff towardseach other both reflect andfeed the culture of anorganisation. For leaders,supporting and modellingactions and activities thatshow compassion to staff iskey to culture change.

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2. Actions and activities for workplace compassion

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n Many of the actions andactivities that supportworkplace compassion areseemingly small and simpleyet have a powerful impacton staff experience.

n Organisations can ‘formalise’the occurrence ofcompassionate actions andactivities towards staffthrough specific initiativessuch as workplace peersupport programmes, orthrough provision of supportat key moments such asfollowing critical incidents.

2.3 Resources

Here we reproduce the fouractions and activities forworkplace compassion casestudies from the support guidein handout format. We alsoshare resources, handouts andslides to support organisationalimprovement workshops or teamimprovement events to enablestaff to review and plan activitiesthat support compassion in theirworkplace. The slideset haspresenter notes to supportdelivery of the exercises.

2.1 Actions and Activities forWorkplace Compassion CaseStudy. Imperial CollegeHealthcare NHS Trust: Seniorclinical leadership after a seriousincident

2.2 Actions and Activities forWorkplace Compassion CaseStudy. Northumberland, Tyneand Wear NHS Foundation Trust:Making it easy to speak aboutthings that matter

2.3 Actions and Activities forWorkplace Compassion CaseStudy. North West AmbulanceService NHS Trust: Investing inpeer support for staff wellbeing

2.4 Actions and Activities forWorkplace Compassion CaseStudy. Academy of Fabulous

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Stuff CIC and LincolnshireCommunity Health Services NHSTrust (LCHS) : When stafffeedback is fab

2.5 Actions and Activities forWorkplace Compassion slideset

2.6 Taking stock of actions andactivities that support workplacecompassion: What do we donow that’s good? (or, “notthrowing out the baby with thebathwater")

2.7 Tackling giants: Barriers tomaking a change to achieveworkplace compassion

2.8 Actions and Activities toSupport Workplace CompassionAction Planning Exercise (or,“even Baldrick had a plan”)

Compassionateleadership is key tocreating a culture ofcompassion in theworkplace. The day today experience of staff isthough, in large part,determined by theactions and activities ofthose around them, theirco-workers and fellowteam members.

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3.1 Background

The third domain in the cycle ofworkplace compassion isleadership and management.These two terms are often usedsynonymously but they doactually have differentmeanings. The HealthcareLeadership Model produced bythe NHS Leadership Academy1

describes nine dimensions ofleadership including inspiring asense of shared purpose andvision with others, engaging anddeveloping people, and holdingpeople, teams and organisationsto account. Managementconcerns the process of achievingan organisations objectives byorganising, planning, leadingand controlling human, physicaland financial resources.

Compassionate leadership hasbeen defined as “leadershipwhich is adaptive, shared, anddistributed”2. Compassionate,inclusive leadership is one of the capabilities identified in the national framework forimprovement for NHS-fundedservices ‘Developing People -Improving Care’3.

The framework states:

“Compassionate leadershipmeans paying close attention toall staff; really understandingthe situations they face;responding empathetically; andtaking thoughtful andappropriate action to help.Inclusive leadership meansprogressing equality, valuingdiversity and challengingexisting power imbalances Itmay sound a ‘soft’ and timelessleadership approach givencurrent urgent pressures. Butevidence from high performinghealth systems show thatcompassionate, inclusiveleadership behaviours plusestablished improvementmethods create cultures wherepeople deliver fast and lastingimprovement in quality andefficiency.”

Free resources to support anddevelop compassionate andinclusive leadership are availablefrom a number of sources,including:

n NHS Improvementhttps://improvement.nhs.uk/resources/culture-leadership/

n NHS Employershttps://www.nhsemployers.org/case-studies-and-resources/2017/01/inclusive-leadership-in-the-nhs

n NHS Leadership Academyhttps://www.leadershipacademy.nhs.uk

1. The Healthcare Leadership Model: The nine dimensions of leadershipbehaviour. NHS Leadership Academyhttps://www.leadershipacademy.nhs.uk/wp-content/uploads/2014/10/NHSLeadership-LeadershipModel-colour.pdf

2. de Zulueta P C. (2016). Developingcompassionate leadership in health care:An integrative review. Journal ofHealthcare Leadership, 8, 1-10.

3. National Improvement and LeadershipDevelopment Board (2017) DevelopingPeople - Improving Care: A nationalframework for action on improvementand leadership development in NHS-funded services.https://improvement.nhs.uk/documents/547/10591-NHS_-Improving_Care-Summary.pdf

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3. Leadership and managementfor workplace compassion

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4. NHS organisations that participated inthis scoping activity were: NHS LewishamClinical Commissioning Group, Royal FreeLondon NHS Foundation Trust, CornwallPartnership NHS Foundation Trust, MidYorkshire Hospitals NHS Trust, UnitedLincolnshire Hospitals NHS Trust,Lancashire Care NHS Foundation Trust,Worcestershire Acute Hospitals NHS Trust,Guy’s and St Thomas’ NHS FoundationTrust, Sheffield Teaching HospitalsFoundation NHS Trust.

National level support for NHSorganisations has tended tofocus on leadership capabilitiesand behaviours that supportcompassion in the workplace.Management approaches tosupport compassion in theworkplace and positive staffexperience have tended to takea backseat.

Given there are existingresources to supportcompassionate leadership in theworkplace, here we focus onresources to supportcompassionate management inthe workplace. In particular, wedescribe an improvementinitiative to supportmanagement for workplacecompassion and we shareresources which you can use todrive managementimprovements that supportworkplace compassion andpositive staff and patientexperience in your ownorganisation. We have reportedon this work since thepublication of the SupportGuide, so here we describe thebackground to the initiative indetail so that the context andunderlying concept is availableto users of these resourcematerials.

3.2 Exploring managementapproaches to supportpositive experience

This initiative arose from ourobservations that people in NHSorganisations with a staffexperience remit often workseparately from staff with apatient experience remit. Weobserved that staff experienceteams, where they exist, areoften located in differentdepartments to teams concernedwith improving patientexperience; have differentmanagement structures,objectives, and performance

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indicators. Given theinterconnectedness of staff andpatient experience, and theincreasing body of evidence thatsuggests staff experience andengagement is a key predictor ofpatient experience, we werecurious to explore why these twofunctions were not more alignedin many NHS organisations. Wewondered if NHS organisationsmight be ‘missing a trick’ withthis management structure.

We held a number of workshopsand telephone briefings withNHS provider organisations toexplore the management of staffand patient experience and testout whether joint managementof staff experience and patientexperience might both supportan NHS culture of compassion forall and improve productivity.4

Workshop participants describedthe striking organisationaldisconnect between what theyclearly knew and understoodabout the interconnectedness ofstaff experience and patientexperience, and the lack, and

sometimes the total absence, ofjoint planning of staffexperience and patientexperience activities. Thesedisconnects included dataanalysis and reporting, workingrelationships between teamsleading on staff and patientexperience programmes andimprovement initiatives withinNHS organisations. In seeking tobetter understand the rootcauses of this disparity betweenwell established knowledge andaction, workshop participantsnoted that capacity pressures,silo working, separate drivers,performance indicators andobjectives for staff and patientexperience teams, which wererarely co-located, served to keeppatient and staff experiencefunctions siloed. This situationwas reinforced by a moregeneral failure to explicitlyleverage staff experience inorder to improve patientexperience, despite the knownassociations between the two.

We held a number ofworkshops andtelephone briefings withNHS providerorganisations to explorethe management of staffand patient experienceand test out whetherjoint management ofstaff experience andpatient experiencemight both support anNHS culture ofcompassion for all andimprove productivity.

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In fact, workshop participantsdrawn from functions acrosstheir organisations, includingfinance and planning, patientexperience, staff experience,clinical directorates, and humanresources functions told us thatattending our workshop was thefirst time the members of thesemanagement teams had cometogether to focus collectively onstaff and patient experience. Theshared conversations thatorganisational team membersengaged in during ourworkshops had not beenexperienced within their ownorganisations. We were struck bythe fact that it had necessitatedtravel to an off-site workshop toget members of these differentteams from the sameorganisation to discuss staff andpatient experience with eachother. We learned thatdiscussions that had previouslytaken place between these keyindividuals within organisationshad tended to be sporadic andreactive. The infrequency withwhich such key components oforganisational systems cometogether, work together andagree action plans together fortheir organisation, was a keylearning point in our work.

It became clear that teammembers from across anorganisation benefited frompurposeful, shared dialogueabout patient and staffexperience in an improvementand transformation context.

We discussed the ways in whichimprovement activities in NHSorganisations are typicallyfocussed on a singular aspect ofpatient experience or staffexperience, the ramifications ofchanging one aspect of thehealthcare system on otheraspects of the system aresometimes not fully considered.For example, initiatives to attain

greater performance against atarget to improve patientexperience may be at theexpense of staff morale andincreased sickness absence.Whilst performance against thepatient experience indicator mayimprove, overall efficiencyactually reduces. We used theeconomic theory of productionpossibility frontiers toconceptualise this. Throughbetter understanding system-level trade-offs, and working tomaximise performance againstboth dimensions, rather thanproductivity targets alone, NHSservice providers may becomemore efficient in terms of bothpatient and staff experiences of care.

Some workshop participants toldus that they had experienced a

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moment of clarity, where theconnections between staffexperience and patientexperience, and crucially the wayin which these two factorsinteract and impact each other,came as a sudden realisation.Participants described feeling apowerful sense of theconnections between patientand staff experience in a waythat they hadn’t previouslyexperienced but that nowseemed entirely obvious to themonce this shift in perspective hadoccurred. The workshop hadcreated a paradigm shift inparticipants’ conceptualisation ofthe purposes and objectives oftheir roles in influencing andimproving patient and staffexperience. It no longer madesense to participants to considerpatient and staff experience

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functions as separate workprogrammes in NHSorganisations.

Following the workshops, severalNHS provider organisationsdecided to work with us to testout a new approach to serviceimprovement that we called“Experience of Care: Patientsand Staff Together”. Usingstandard improvementmethodologies (including:identifying a project team,securing executive support,developing a project aimstatement, fishbone diagrams,PDSA cycles, data collection andmeasurement of both patientand staff experience), this newimprovement approach hasseveral additional key features:

n Co-creation approach: Theproject team has to includepeople representing thefollowing managementfunctions: patient experience,staff experience, finance, IT &data analysis, clinicalgovernance, plus staff andpatient representatives, fromthe outset

n Adoption of a ‘scrap the silos’mindset

n Utilisation of data to measureany impact on both patientand staff experience

n Identification of a discreteimprovement initiative thatcan be completed in a shorttimeframe (maximum of 3months)

Examples of improvementinitiatives selected by the pilotTrusts using the Experience ofCare: Patients and Staff Togetherapproach included:

n Shifting towards the jointplanning, timing, andoperational delivery of thepatient and staff Friends andFamily Tests (FFT), previously

managed almost entirelyseparately. This also includeda specific aim of improvingstaff engagement throughincreasing participation in thestaff FFT.

n Improving an organisationalcomplaints managementsystem from a protracted andoverly complicated processwith multiple layers of sign-off and lengthy wait times forcomplainants, to anintegrated ‘Hearing Feedback’system able to respond toboth positive and negativefeedback. Quicker turnaroundof responses to feedback withlocal level ownership and signoff, in order to achieve earlierand better resolution forpatients and improved jobsatisfaction and ownership for staff.

n Improving two-waycommunication between staffand senior leaders on aspecific ward where staff hadself-identified a need toimprove compassion in theworkplace in order to reducethe risk of a reduction inquality of patient care.

People using the Experience ofCare: Patients and Staff Togetherimprovement approach told usthe following about theirexperience:

n All participants found thismethod to be a usefulapproach. Team membersreported that they nowbelieved it was important tolink staff and patientexperience improvementactivities as illustrated below:

‘I truly believe that linkingthe two is incrediblyimportant as patientexperience is a reflection ofthe organisation andengaged staff’

‘I’ve always believed there isa direct link between thetwo. If staff are ‘happy’productivity is increased - iegreater patient experience’

n Participants strongly agreedthat a ‘scrap the silos’collaborative approach is key,reflected in the followingcomments:

‘This is critical to achieveinnovation and change.’

‘We very often work in silosnot being aware ofcolleagues objectives andtargets. This can meanduplication of work. Workingtogether drives strongerobjectives and more joinedup working’

‘I found it informative andliked the structure. It alsogave me the opportunity towork with other colleagueson a project instead of in a silo’

n Participants reported changesthat have taken place as aresult of their involvement inthe pilot:

‘We have realised there aresome staff engagementactivities we need to stop andto develop our approach’

‘I am aware theOrganisational Developmentteam and patient experiencestaff are now workingcollaboratively. Huge change.’

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3.3 Learning

n Our conclusion, based on theexperiences of working withmembers of the NHSorganisations thatparticipated in this project, isthat staff and patientexperience and engagementteams do not typically workclosely together. Whilst somework is undertaken togetherand interactions betweenteams do occur, opportunitiesfor integrated, collaborativeworking, and particularly forthe planning anddevelopment of improvementactivities based on feedback,data, and perspectives of bothstaff and patients are typicallymissed.

n Different objectives,performance indicators,priorities, management,departmental or teammembership, and cultures ofsilo working, have led to andsustained the separate ratherthen integrated operation ofstaff engagement and

experience and patientexperience functions in mostNHS organisations.

n The Experience of Care:Patients and Staff Togetherworkshop was effective ingalvanising NHS Trust staff toactively and practicallyaddress the disconnectsbetween staff and patientexperience management.

n Some of the improvementinitiatives would either nothave happened, or would nothave been implemented ascollaborative activityinvolving both staff andpatients without using thisapproach.

n The Experience of Care:Patients and Staff Togetherimprovement approach canbe successfully applied acrossdifferent NHS sectors and caneffectively enable andsupport diverse improvementinitiatives from ward orservice to Trust-wide level.

n The Experience of Care:

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Patients and Staff Togetherworkshop acted as a catalystfor collaborative activities,and management changesfocussed on improvingcompassion for all andexperience of care for all.

3.4 Resources

Here we reproduce theleadership for workplacecompassion case study from thecommissioning for workplacecompassion support guide inhandout format.

We also share resourcesconcerning management andworkplace compassion to assistyou to run your own Experienceof Care: Patients and StaffTogether workshops andimprovement activities. Weinclude resources to run anintroductory workshop tointroduce this managementconcept and approach in yourorganisation or team. We theninclude resources (animprovement activity planningworkshop agenda) that can be

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used after the introductoryworkshop, should yourorganisation subsequentlydecide to utilise thisimprovement approach. Weinclude an annotated version ofthis agenda as a guide toworkshop facilitators in additionto the version for workshopparticipants. Using theseresources and implementing thisapproach is likely to involvemaking management changes tothe ways in which yourorganisation manages staffexperience and patientexperience functions. You mayeven instigate integrated staffand patient experience functionswith shared management,objectives and performancemeasurement. Our starting pointwas adjusting managementapproaches in order to improvecompassion in the workplace.The Experience of Care: Patientsand Staff Together approachacknowledges the inter-connectedness and wider contextof the healthcare setting whichcan impact the experience ofcompassion in the workplace.Consequently, using thisapproach may invoke broaderorganisational and managementchanges, to achieve greaterproductivity and positiveexperience for the organisationas a whole.

The resources provided here areintended to be used inconjunction with other standardimprovement approaches (PDSAcycles, etc) currently in use in theNHS. Consequently we wouldrecommend that they are usedby people with improvementand service developmentexperience. The resources havebeen piloted and refined withfeedback from NHS Trusts. Theresources are provided in aformat that enables you to tailorthem to your own organisationand your own context.

3.1 Leadership for WorkplaceCompassion Case Study. Leadinga new directorate’s culture,building in workplacecompassion: Imperial CollegeHealthcare NHS Trust

3.2 Experience of Care: Patientsand Staff Together IntroductoryWorkshop Agenda template

3.3 Experience of Care: Patientsand Staff Together IntroductoryWorkshop Powerpoint slideset

3.4 Experience of Care: Patientsand Staff Together WorkshopCase Studies

3.5 Experience of Care: Patientsand Staff Together ImprovementPlanning Workshop Agendatemplate for participants

3.6 Experience of Care: Patientsand Staff Together ImprovementPlanning Workshop Annotatedagenda for facilitators

3.7 Experience of Care: Patientsand Staff Together WorkshopFeedback Form

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Whilst some work isundertaken togetherand interactionsbetween teams do occur,opportunities forintegrated, collaborativeworking, andparticularly for theplanning anddevelopment ofimprovement activitiesbased on feedback, data,and perspectives of bothstaff and patients aretypically missed.

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4.1 Background

While a wide range ofemployers, across health, careand other sectors, have put inplace measures to support andpromote the health andwellbeing of their employees, itis becoming increasinglyrecognised that the nature ofwork in healthcare demandsspecial attention to theimportance and benefits ofcompassionate workplaces.

People working in health andcare experience a variety ofevents in the workplace in thecourse of their day to day work.There are many existing schemesto support health and care staffwho have experienced traumaticor critical incidents in theworkplace. These sit in thecontext of broader guidance forall employers to supportemployee physical health,mental health and wellbeing has

There is a significant amount of guidance related to this and we haveincluded links to some of this below:

https://www.local.gov.uk/sites/default/files/documents/health-work-and-health-re-904.pdf

https://www.nice.org.uk/guidance/settings/workplaces

https://wellbeing.bitc.org.uk/all-resources/toolkits

been and links to that guidanceis below. In this particular sectionhowever, we are placing asharper focus on compassion inthe workplace.

4.2 The importance ofpersonalised policies andprocedures

Leaders within organisations,and the ways in which theypromote, interpret and apply

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4. Policies and proceduresfor workplace compassion

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polices and procedures, canmake it harder or easier for staffto behave with the humankindness, thoughtfulness andempathy towards each otherthat these examples personify. Itis the compassionate use andpersonalisation of policies andprocedures that supportscompassion in the workplace.

Some of the structures that weset up in organisations whichthen become behavioural norms,supported by policies andprocedures, can lead us to focuson what went wrong or needs tobe improved, rather thanencouraging us to consider whatmight be happening with theindividuals involved5.

A recent study, conducted byRoffey Park6, identified two mainways in which policies andprocedures can impactnegatively on workplacecompassion even when that isexactly what they are intendingto support. These are:

n Too restrictive HR policies thatare difficult to adapt toindividual circumstances

n When policies and proceduresare followed to the letter, tothe point where you can nolonger see or becompassionate towards theperson involved.

Participants in our work todevelop the Support Guidehighlighted that althoughworkplace compassion can befound in the details of policiesand procedures, compassion isexperienced when policies andprocedures are made relevant tothe specific person concerned.

Our Twitter research campaignidentified that policies andprocedures contribute to positivestaff experience when they are

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5. Worline MC, Dutton JE Awakening Compassion at Work: The Quiet Powerthat Elevates People and Organisations McGraw-Hill Education 2017

6. Poorkavoos M Towards More Compassionate Workplaces Research PaperRoffey Park 2017

On the loss of his mumcolleagues bought myhusband a tree toremember her#ShowsWorkplaceCompassion

Space and time for staffto listen and talk aboutdifficult emotions#ShowsWorkplaceCompassion

Supporting colleaguesthrough mental healthcrisis and recognisingthat adverse behaviouris not misconduct#ShowsWorkplaceCompassion

Recognising whatmatters to one another#ShowsWorkplaceCompassion

applied to individual staff with compassion. When utilised andimplemented by line managers, policies can support them to showcompassion towards staff and demonstrate the compassionatenature of the employer. Below are some examples of thoughtfulcompassionate actions between colleagues that our Twitter studyparticipants told us about:

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4.3 Learning

With regard to the features ofworkplace compassion thatrelate most strongly topersonalising policies andprocedures the followingemerged from our research andinsights programme:

n Typically staff are perceived asdrivers or deliverers ofcompassion rather than as itsrecipients. This highlights theneed for policies andprocedures to enable andpromote enactment ofcompassion at aninterpersonal level between staff.

n The awareness of specificbehaviours, values andinitiatives that may besupportive or conducive toachieving workplacecompassion was negativelyimpacted by a sense thatthese may ‘reasonably’ besacrificed at times of pressure.

n Commissioners reportedlimited system drivers forcommissioners to commissionfor compassion, and activity

and progress in this directionwas reliant instead onindividual enthusiasts,advocates, and champions.

n For participants in our study,workplace compassion existsin the details of policies andprocedures but is enactedinterpersonally between staff,and not solely in interactionswith staff in hierarchicalpositions of authority and power.

4.4 Resources

Here we reproduce the twopersonalised policies andprocedures for workplacecompassion case studies from thesupport guide in handoutformat. The case studies describeexemplary examples from NHSorganisations that haveinstigated approaches topersonalising their policies andprocedures to support workplacecompassion. A central aim ofthese case studies is to inspireother people working inhealthcare to find ways ofbringing to life opportunitieswithin their policies andprocedures to improve their

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impact at a personal level, and indoing so to contribute to thecreation of more compassionateworkplaces.

The first case study describes aworking procedure that is criticalto patient safety that alsosupports workplace compassionby specifically creating a teamexperience in a complex,distributed network of staff. Thesecond case study showcases apolicy that recognises staff asindividuals with interests andpassions outside of theworkplace. The policy affordsstaff recognition and time forthose interests, benefiting theindividual concerned, theircommunity, and the employer.

We have also included a videoclip concerning policies andprocedures for workplacecompassion and a slide set foryou to adapt to facilitateexploration and discussion abouthow policies and procedures canbest support the creation ofcompassionate workplaces.

4.1 Policies and Procedures forWorkplace Compassion CaseStudy. Surrey and SussexHealthcare NHS Trust: The dailyemergency call safety huddle

4.2 Policies and Procedures forWorkplace Compassion CaseStudy. NHS England and NHSImprovement EmployeeVolunteering Policy: A policy youcan volunteer for

4.3 Workplace compassion as abusiness modelhttps://www.youtube.com/watch?v=qQNC1GtJ0RM

4.4 Policies and procedures forworkplace compassion slide set

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Introduction to workplacecompassion resources

Just like the guide that theseresource materials are designedto accompany and support, thepractical actions within theseresources are not intended to bea single ‘one size fits all’offering. We anticipate that youwill wish to adapt and share thecontents, slide sets and activitiesto suit your local plans, prioritiesand organisations. Please feelfree to do this and to add yourlogos or other identifiers where needed.

We anticipate that the introductory resources may well be a goodstarting place but would encourage you to select and use the resourcesand sets of activities in the most helpful and appropriate way for yourlocal setting. They can be used as standalone materials or employedflexibly in combination with other resources you have available.

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Appendix of resources

They are:

Element 1: culture and values

Element 2: actions and activities

Element 3: leadership and management

Element 4: policies and procedures

The resources are structured into an introduction section and then fourelements designed to support you to promote, develop and sustainmore compassionate workplaces. The four elements were identifiedthrough our research and informed through insights from our workwith provider and commissioner organisations.

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A. Shareable handout: Why workplace compassionand caring for the peoplewho care matters

Compassion has usually beenassociated with those served bythe NHS, with health and carestaff supporting and providingcompassionate care to others.While many health and care staffgain satisfaction from theprovision of compassionate care,their work is often emotionally,physically and mentallydemanding.

Given the increasing pressures onhealth and care staff, with 40%of NHS staff reporting feelingunwell due to stress (NHS staffsurvey, 2018), it is becominglyincreasingly important to lookafter staff much more effectivelythan ever before.

www.kingsfund.org.uk/blog/2016/1/creating-workplace-where-staff-can-flourish

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NHS staff are more likelythan the rest of theworking population tobecome patients(Michael West, 2016)

‘It is not enough simplyto aim to reduce staffstress levels. We shouldbe promoting the ideathat humans can flourishin the workplace.’(Michael West, 2016)

Workplace compassion mattersbecause we know that:

n The experience of staff inhealthcare organisations isstrongly connected with thequality of care provided topatients.

n Staff need to feel cared for inorder to care for patients.

n Organisations that prioritisestaff health and well-beingperform better, withimproved patient satisfaction,stronger quality scores, betteroutcomes, higher levels ofstaff retention and lowerrates of sickness absence.

n Healthcare organisations cantake action that improvessupport for staff and staffwellbeing.

High quality patient experiencecannot be achieved - ethically or sustainably - at the expense of staff.

Many healthcare systems aroundthe world are working tobalance two global phenomena:the growing demand, intensityand acuity for healthcare andthe associated risks of staffexperiencing stress, burnout andcompassion fatigue. Whilst manyNHS staff continue to live theirvalues and uphold the NHSConstitution in striving to delivercompassionate care, warninglights have been flashing morebrightly on issues like stress,bullying and the pressure tocome to work even when feeling unwell.

It is only possible for health andcare staff to stay well themselvesand to deliver consistently highquality, compassionate care ifthey also experience dignified,compassionate and practicalsupport in their workplaces.

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It is becoming critical that we doall we can to look after staffbetter than we have ever donebefore, both for their own andtheir patients’ health andwell-being.

In essence, compassionateworkplaces are ones wherepeoples’ actions are consistentlythoughtful, caring andempathetic towards one another.While these actions are alsocharacteristic of compassionateleadership, we do not need towait for leadership or policy orpermission to be kind andthoughtful or to act withempathy towards those we work with.

We can all, whatever our roles,find ways and take actions tocreate more compassionateworkplaces.

In addition to the range ofinitiatives that are implementedby a wide range of organisationsto support health and wellbeingof their employees in theworkplace, there are specificaspects of the nature of thework that health and care staffundertake, that meanscompassion towards andbetween health and care staffrequires particular attention andfocused action.

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The Point of Care Foundationpublication Behind Closed Doors(2017) stresses that ‘deliveringhigh quality care is only possibleif staff get the practical andemotional support they need’and recommends that ‘staffexperience should be givenequal priority to patientexperience at all levels of thehealthcare system’.

https:16682-presscdn-0-1-pagely.netdna-ssl.com/wp-content/uploads/2017/07/Behind-Closed-Doors-July-2017.pdf

‘having all the right businessphilosophies and managementpractices is meaningless unlessyou treat the person right infront of you, right now, the right way.’

Robert Sutton (2007) The NoAsshole Rule: Building a civilisedworkplace and surviving onethat isn’t. London: Piatkus

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B. Shareable infographic reflecting the rationale and business case:

Why caring for the people who care matters

C. Introductory slide set: Why workplace compassion matters

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Element 1: culture and values

Culture and values for workplacecompassion resource materials

1.1 Six word stories

1.2 Workplace compassion audit and action

1.3 Culture and values slide set

1.4 Culture and Values for Workplace Compassion Case Study. Hull and East YorkshireHospitals NHS Trust: Changing culture by developing and living team values

1.5 Culture and Values for Workplace Compassion Case Study. Norfolk CommunityHealth and Care NHS Trust: Using an online staff platform to change values and culture

1.6 Culture and Values for Workplace Compassion Case Study. University Hospitals ofLeicester NHS Trust: Showing workplace compassion by saying thank you

1.7 Where to start with creating a culture of workplace compassion video clip

1.8 Contracting for workplace compassion video clip

1.9 Measurable benefits and outcomes of workplace compassion video clip

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1.1 Six word stories

Six-word stories exercise: This exercise borrows from a story associated with Ernest Hemingway and thechallenge that he undertook to write a story in just 6 words. That’s right, not 140 characters, but a mere sixwords. Hemingway’s story was dark and sad: ‘For sale, Baby shoes, Never worn.’ This exercise challenges youto conjure your own concise masterpiece on the theme of workplace compassion.

Part 1: In six words, describe the worst healthcare workplace you have ever known.

Part 2: In six words, describe the best healthcare workplace you have ever known.

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Six word stories - examples

You may wish to share these examples to inspire your event or workshop participants or for tablediscussions.

n Overbearing boss, micro-management, increased resignations

n She survived to bully another day

n Bullying culture, unsupportive management, bureaucracy throughout

n Hitting targets, missing points, losing people

n Arrogant senior accusing, abandoning, lying, shouting

n Always negative. Low morale. High turnover.

n Intimidating, bullying and manipulating

n I'm trusted, I’m valued, I'm respected

n Gin and tonics, lots of laughter

n Commitment and competence. All working together.

n Valued, believed in, trusted, had fun!

n Management listen. Acknowledge excellence. Nurture staff.

n Smile, support, listen, open, together = team

n Laughing together makes difficult days better

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1.2 Workplace compassion audit and action

Step 1: Think about your workplace

Write a short description of this workplace as it is now; the values it has, what it feels like to work there, how the workplace and people working there responds when things get tough.

Step 2: Now think about the kind of workplace you would want for a close friend.

Write a short description of this workplace; the values it has, what it feels like to work there, how theworkplace and people working there respond when things get tough.

Step 3 How close was the workplace you pictured in Step 1 to your ideal workplace in Step 2?

1. 2. 3. 4. 5.

Not at all close Very close

Step 4. Make a change

What can YOU do, TO BE THE CHANGE, THIS WEEK, to move your workplace closer to your ideal workplace?

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1.3 Culture and values for workplace compassion slide set

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1.4 Culture and Values forWorkplace CompassionCase Study

Hull and East YorkshireHospitals NHS Trust:

Changing culture bydeveloping and living team values

Summary

We wanted to change our culturein the pathology department.Following a rather negativeresponse to a staff survey, weasked the staff what would help,and the answer was changing ourculture to a more inclusive one.We asked the staff what valuesthey thought representedpathology. Pathology staffsuggested a large number ofvalues which we put to a staffballot t determine a number ofkey values. It was important atthis stage that staff, and notmanagement, took ownership ofthe process, and defined theexpected behavioural values.Once selected we set aboutspreading these values usingposters which described what wewould expect from each otherand what would we challenge.We created an environmentwhich was inclusive and wherewe felt comfortable to stand upand challenge inappropriatebehaviour. We had lanyards madewhich we wear with pride whichdeclare ‘Pathology believes inEquality, Respect and Integrity’.

What we did

We changed our work basedculture from a negative one to apositive one, by defining our ownbehavioural values and agreedthat we would all benefit fromredefining our cultural values. We changed the way we allinteracted and sent the message out about what we

would support and what we donot accept.

Why we made this change

We recognised that the culturewithin the department was not agood one; that often due topressures we were less thanrespectful of each other andstaff felt disengaged. We wereproud of our work and ourprofession, but all felt that theculture needed to be changed tobenefit all.

How we did it

It was all about staffengagement and allowing staffto own the process. We allsigned up to it and our cultureand values are now included intoour departmental induction. Wesent out a clear message that weare an inclusive department andwill all tackle inappropriatebehaviour and we will all respecteach other.

What we hoped would change

We wanted the culture in thedepartment to change, to makeeveryone feel equally valued andenable everyone to tackleinappropriate behaviour. Wewanted staff to feel empoweredby the process, and to know they

have a voice, and wearing thelanyards makes us all feel part ofthe pathology team.

What changed

The culture changed. We allwear the lanyards and all groupsof staff feel empowered andthat they have a voice and thatthey matter. Everyone now feelsable to tackle issues moreconfidently. All new staff areautomatically enrolled into ourpathology values when theystart. The environment is nowmore inclusive.

What we are doing next

We have recently introduced achange to all our meetings.Before the meeting starts asentence about our values is readout: ‘This meeting is conductedunder the shared values ofpathology’. Wearing our values(on lanyards) and speaking ourvalues (at meetings) reminds usto act on our values. Otherdepartments in the Trust arelooking at what we have donewith interest.

For further information contact:

Chris Chase([email protected])

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1.5 Culture and Values forWorkplace CompassionCase Study

Norfolk Community Healthand Care NHS Trust:

Using an online staffplatform to change valuesand culture

Summary

Ensuring positive staff experienceand providing support for all staffis part of our annual priorities andis linked to the Trust’s strategicobjectives. We have put in placenumerous initiatives to supportthis objective. In staff surveys inprevious years though, many staffhave reported not feeling valuedand we wanted to find out why.During engagement sessions wewere disappointed to hear thatstaff felt that the Trust simply wasnot doing enough to look afterthem. We couldn’t ignore thefeedback we received from staff.

In June 2016, in collaborationwith Clever Together, welaunched ‘Your Voice Our Future’(YVOF), a dedicatedcrowdsourcing platform for staff,in which every member of staffcould log on and have open,honest discussions on varioustopics, and share their ideas,comments and votes. We aimed toensure all staff felt valued,listened to and involved inchanges within the Trust.

Staff have shared discussions on awide range of topics frominformation management,recognition, health andwellbeing, to leadership andbehaviours. As a direct result ofthe discussions on the staffplatform we have made furtherchanges in the Trust, such as arefresh of the Trust’s behaviourframework and the creation of a‘leadership promise’. More staff

now feel that the Trust islistening and communicating ona regular basis.

What we did

We realised we needed an onlinetool as staff are geographicallyspread across Norfolk, so that allstaff could contribute andparticipate in ‘conversations’. Wecreated the role of StaffEngagement Manager with a oneyear secondment to lead on thedevelopment of a culture ofpositive staff engagement andinvolvement, including thedevelopment of the onlineplatform. An important featureof this new role was an openrecruitment approach with anadvert to all staff in the Trust,with no grade banding attached.

We wanted to get the rightperson, their grade andsubstantive role wasn’timportant.

From discussions on the platformwe are able to gather moreinformation from staff abouttheir thoughts about leadershipand behaviours in the Trust.Comments received included:‘managers do not alwaysdemonstrate supportive, fair andcompassionate behaviours’;‘some of our leaders lack therequired skills to consistentlyensure we are happy and healthyat work’. We therefore created aLeadership Promise for all ourleaders to align to and ourbehaviour framework wasrefreshed and incorporated intoour appraisal system.

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Why we made this change

Our staff engagement score of3.71 in the 2016 NHS Staff Surveywasn’t where we wanted it to be.Engagement session conductedby the CEO had low attendancerates and other previous staffengagement events hadparticipation rates of less than10%. With the introduction ofYVOF participation has continuedto grow, with around 30% ofstaff participating in the onlineconversations.

How we did it

For the creation of the onlineplatform, we collaborated withClever Together and generatedinterest within the Trust using amulti-channel communicationapproach, created newengagement branding for socialmedia, and staff receivedinformation posted to their homesummarising our plans andinviting staff to get involved in apositive and constructiveconversation.

To make changes to thebehaviour framework, 700 staffparticipated in workshops torefine the framework. To embedthe behaviour framework acrossthe organisation to alldepartments, staff engagementhas become a mandatory trainingsubject for 2017-2018 with thecreation of a work-stationincluding a video, interactiveactivities highlighting the Trustbehaviour framework andinformation about support that isavailable for staff.

What we hoped would change

We hoped that staff would feel they always had a ‘voice’ and could always contributetowards improvements in their work place.

What changed

The value the organisationgained from just the first fewonline conversations alone couldnot have been predicted. Duringa 20 day campaign, more than900 staff posted 8,500 ideas,comments and votes. Staff fromevery corner of the Trust joinedin the online conversation –every band, directorate and staffgroup. In our latest staff survey(June-September 2017) staffengagement increased to 3.85(average) from 3.71 in 2016,which is above the nationalaverage for Community Trusts.

What we are doing next

The online campaign is now aregular event every quarterthroughout the Trust. Someteams have used the onlineplatform to have team specificconversations. For example, inone locality they continuouslyhave ‘Your Shout’ with whichstaff can voice ideas forimprovements. We are now re-launching the way in which werecognise and acknowledge staffin the workplace, with an annualawards ceremony, thank youcards and badges of recognitionamongst our latest changes.

For further information contact:

Laura Palmer([email protected])

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1.6 Culture and Values forWorkplace CompassionCase Study

University Hospitals ofLeicester NHS Trust:

Showing workplacecompassion by saying thank you

Summary

In November 2016 we launchedAbove and Beyond: a thank youscheme for staff which enablesany member of staff to thankanother. Staff send through theirmessage to the staff engagementteam, which is then copied into acard and then posted out to themember of staff with a pinbadge. In the first year we sent5,168 ‘thank you’s to staff.

We have received great anecdotalfeedback of the positive effect onstaff and teams within the Trustand we are continuing to see anincrease in nominations whichtells us how popular it is.

What we did

We designed a card and pinbadge and developed a form thatcan be emailed or posted back tothe staff engagement team sothat it is accessible for all staffincluding those that don't havean email address or have limitedaccess to a computer. Welaunched the initiative at ourannual leadership conferencewith approximately 300 leadersfrom around the Trust. Wepromoted the scheme at localmeetings and give a report onthe number of thank you’s thathave been sent in the chiefexecutive briefing every month.We have given examples ofpositive feedback from staff thathave both sent and received athank you, and also some top tipsabout sending them. The positive

effect that the scheme has onstaff has helped with itspopularity and spread.

Why we made this change

Feedback given in our NHS StaffSurvey and our quarterly 'pulsecheck' results were telling us thatstaff didn’t feel recognised forthe great work that they do,and. as with many NHSorganisations, these arechallenging times. We felt thatstaff deserved to be thanked fortheir work, their commitmentand the times when they goabove and beyond what is askedof them and we thought that itis important for any member ofstaff to be able to do this.

What we hoped would change

The change that we want to seeis that staff feel thanked andsupported for the work that theydo and that they feelappreciated. We also hope thatby implementing Above andBeyond we have provided a toolto help managers thank theirstaff. This fits into a larger staffengagement plan for the trustand we hope this will help toimprove engagement with staffwhich then benefits all patientsand staff as a result.

What changed

We eagerly await our NHS StaffSurvey results to see if there hasbeen any measurable impact inan improvement in engagementscores and particularly in positiveresponses to give and receivingthanks at work.

Until then, we can see change inthe popularity of the scheme: inthe first three months we sawmonthly submissions of 98 - 186;the last three months rangedbetween 508 and 723. Anecdotalfeedback has been really positiveand our testimonials areincreasing.

What we are doing next

We plan to change the colour ofthe balloons and badge for thenext year hoping that this willkeep up the momentum that wehave created.

We have consideredimplementing a team 'thank you',however we have decided to stickwith individual cards and badgesonly as our feedback has told ushow good this individual messageof thanks makes staff feel.

For further information contact:

Linsey Milnes ([email protected])

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1.7 Where to start with creating a culture of workplacecompassion video clip

https://www.youtube.com/watch?v=fbrcPHtHJP0

1.8 Contracting for workplace compassion video clip

https://www.youtube.com/watch?v=587gLXeJ5T8

1.9 Measurable benefits and outcomes of workplacecompassion video clip

https://www.youtube.com/watch?v=V1pa3SHsqAE

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Element 2: actions and activities

Actions and activities for workplacecompassion resource materials

2.1 Actions and Activities for Workplace Compassion Case Study. Imperial College HealthcareNHS Trust: Senior clinical leadership after a serious incident

2.2 Actions and Activities for Workplace Compassion Case Study. Northumberland, Tyne andWear NHS Foundation Trust: Making it easy to speak about things that matter

2.3 Actions and Activities for Workplace Compassion Case Study. North West AmbulanceService NHS Trust: Investing in peer support for staff wellbeing

2.4 Actions and Activities for Workplace Compassion Case Study. Academy of Fabulous StuffCIC and Lincolnshire Community Health Services NHS Trust (LCHS) : When staff feedback is fab

2.5 Actions and Activities for Workplace Compassion slideset

2.6 Taking stock of actions and activities that support workplace compassion: What do we donow that’s good? (or, “not throwing out the baby with the bathwater")

2.7 Tackling giants: Barriers to making a change to achieve workplace compassion

2.8 Actions and Activities to Support Workplace Compassion Action Planning Exercise (or,“even Baldrick had a plan”)

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2.1 Actions and Activitiesfor Workplace CompassionCase Study

Imperial College Healthcare NHS Trust:

Senior clinical leadershipafter a serious incident

Summary

As a team, we have worked hardto improve the ways we feedback to staff after a seriousincident. We have a multi-pronged approach that includes:

n personal feedback toindividuals

n a dedicated grand round slotin paediatrics to feed back onthe serious incident and learnfrom the case

n a paediatric focussed SchwartzRound (with plans to holdmore) to provide a safe space for staff to talkabout the impact of being partof a serious incident.

This facilitated conversationbetween staff including nurses,junior doctors and other staffmembers who normally wouldnot feel able to talk about theirexperience because of worry andfear about what happened. I toldthe story of a serious incident forthe NHS England DNA of CareDigital Storytelling project,describing how the incidentaffected myself and our team.

This story 'pieces' can befound here:

http://www.patientvoices.org.uk/flv/ 1039pv384.htm

We have used this story in theTrust to facilitate discussion andopen up communication about avery difficult issue.

What we did

As a senior clinician, I ampassionate about advocating formembers of the wider team,who may not have a voice andmay be disadvantaged becauseof this. I speak up. I contribute toevents that help learning,understanding and bettercommunication (such as being apanel member on a recentSchwartz Round and anupcoming one on the topic of‘burn-out'). My 'Pieces' storyhelps staff to talk about difficultissues. We have now startedsessions in our department,specifically focusing on beingcompassionate with ourselvesand each other - a project we hope to roll out through our Trust.

Why we made this change

In medicine, as a doctor for mypatients, but also as a leadconsultant, I am passionateabout having open, honest andgood relationships within ourmultidisciplinary team.Increasing pressure on NHS staff,NHS space and increasedreporting rules were affectinghow we talked and behavedtowards each other. We were nottalking well about seriousincidents and we were nottalking well about difficultissues. Empathy at work for eachother has diminished since I wentinto medicine. I try to makethings better where I can.

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How we did it

‘Address the obvious’ has beenmy motto from childhood. TheDNA of Care Project opened myeyes to how common distress andpoor communication are. I startedby using my own stories tofacilitate conversations andrapidly found other passionatesenior nurses and clinicians toproduce a snowball effect.Together, we organised theSchwartz Rounds, are workingspecifically on compassion withsmaller groups and have struckup a tighter relationship with ourin-house counselling service tosupport distressed individuals. Ithas become easier to “addressthe obvious”.

What we hoped would change

I wanted us to feel morecomfortable about talking toeach other when things aretough.

I do not want anybody to everfeel exhausted, distressed, burnedout - and then also isolated,because they don’t feel they canspeak up.

I hoped for:

n open, safe and compassionateconversations between us

n compassionate senior staffmembers to support juniorcolleagues

n compassion across staffboundaries (i.e. to facilitateconversations between e.g. doctors and nurses, nurses andmanagers, etc.)

n our institution to be a kinder,happier place in the long run.

What changed

We talk more openly and itallows empathy to be expressed(and probably people givethemselves permission to

feel it again). Moreconsideration and compassion isspreading through all types ofmeetings and conversations.There are now regular sessions,to allow safe spaces for this(although physical space to dothis remains a very real problem).Relationships between clinicaland non-clinical staff areimproving. There is simply betterrecognition that we have to lookafter each other.

What we are doing next

I will continue to work with mycolleagues on creating safespaces to talk about difficult,often 'hidden' issues. e.g. burn-out being the next one. I willapply for a grant to helppromote staff compassion with

the aim to create in-house staffstories with a dedicated story-bringer to continue thecompassion roll-out across ourvarious hospital sites.

Alongside this, I will continuework on my “Terrific Teens &Fabulous Families” project,giving patients and familiesaffected by chronic conditions avoice - and getting their storiesout there to engendercompassion in society.

For further information contact:

Claudia Gore ([email protected])

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2.2 Actions and Activitiesfor Workplace CompassionCase Study

Northumberland, Tyne andWear NHS Foundation Trust:

Making it easy to speakabout things that matter

Summary

In early 2015, to improve staffengagement, we set up a Trustwide initiative know as SpeakEasy. Speak Easy is a place wherewe can: get together to talkabout things that matter; listento each other, hear each otherand learn from each other; talkabout what we do well; talkabout what might need tochange; talk about what wemight do to help us moveforwards, together. It is not asubstitute for talking about issuesregularly and routinely in teams,but rather a forum where we canlook at the big picture across theTrust. In the spirit of collectiveleadership it enables andfacilitates local solutions to issuesrather than a top downapproach.

We have now had eight rounds ofSpeak Easy over the past twoyears and management of SpeakEasy has moved from the centreof the organisation to bedevolved to and run within thelocalities. Whilst a Trust Widetheme might be discussed - forinstance the health and wellbeingof staff - each of the threelocalities approached the issue indifferent ways.

What we did

The Executive Team arepassionate about theircommitment to improving staffengagement, supported by solidevidence that says that when weare valued, listened to and

respected, we are more effective,healthier, productive and lesslikely to make errors.

Historically, we have not alwaysgot this right, which led to newthinking about how we might goabout having local, honestconversations with staff. As anexecutive team we wanted tolisten to staff. If anything can bedone Trust wide to address issuesthat are raised then we will, butwe also want to give otherspermission to fix what needsfixing, supporting andencouraging others to makedecisions.

Why we made this change

We have wanted to improve ourapproach to staff engagementfor some time. This was the startof a process that led the Trustfrom a culture where control wasfrom the centre to one, twoyears on, that is flatter in its’structure, devolved from thecentre, making decisions as closeto our service users as possible.For this to happen, effectiveengagement was essential

How we did it

Meetings take place 3 times ayear across the Trust. Meetingsare two hours in duration andeach one has a theme. Trustexecutives attend part of eachmeeting but in a listening role.

What we hoped would change

We wanted to hear how thingsare for staff and for teams. Wewanted to ensure that the needsof service users are at the heartof how we make decisions. Wewanted to hear about what wedo well, to share our successstories and promote what we aregood at doing, and we wantedto have honest, two-way, andsometimes uncomfortableconversations. We wanted tobuild mutual trust and respect.

What changed

For the past two years we haveseen improvements in staffsurvey scores in the areas thathave been the focus fordiscussions at the Speak EasyEvents. Each Speak Easy event iswritten up and results are widelyshared. The initiative has startedto be used at local level to dealwith local issues and it’s widelyrecognised as an organisationaldevelopment intervention withinthe Trust.

What we are doing next

The initiative will continue,though the focus continues toshift from the centre of theorganisation to the localities.Speak Easy will continue to havea central theme but how thattheme is explored will be locallydetermined.

For further information contact:

Mark Spybey([email protected])

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2.3 Actions and Activitiesfor Workplace CompassionCase Study

North West AmbulanceService NHS Trust:

Investing in peer supportfor staff wellbeing

Summary

The Trust launched an ‘Invest inYourself’ brand to raise awarenessand encourage staff to tell uswhat we can do as a Trust tosupport staff with personalwellbeing. This has threeworkstreams of ‘Happy,’ ‘Healthy’and ‘Fit.’ An ‘Invest in Yourself’microsite was launched which isaccessible for staff whilst they areout and about.

As part of the ‘Invest in Yourself’brand a number of Health andWellbeing initiatives were intro-duced. These included PTS(Patient Transport Service) PeerSupport, Blue Light Champions,TRiM (Trauma Risk Management)and taking part in GlobalChallenge. PTS Peer Supportersand Blue Light Champions arenetworks led by operational staff(not management), who have awealth of experience, both work-related and personal, who arekeen to create a mentally healthyworkplace for staff. In relation toBlue Light Champions, NWASsigned the MIND Blue Lightpledge in January 2016 to showcommitment in improving themental health and wellbeing of staff.

TRiM is a score based assessmentoffered to staff by their peers,following traumatic exposure.NWAS also took part in the GlobalChallenge in 2017 which wasaimed at staff getting healthier,feeling more energised, losingweight and being part of a team.

The overall aims of the Invest inYourself brand together with theinitiatives are to help to improvethe Health and Wellbeing of staffand the culture that surrounds itby promoting, engaging andcommunicating innovatively andeffectively with staff regardingHealth and Wellbeing.

What we did

An ‘Invest in Yourself’ micrositewas launched featuring facts,staff stories and information onsupport available to all staff.There is a specific page for allsupport networks within theTrust. For PTS Peer Support andBlue Light Champions, welcomepacks were created to embedthese Peer Support Networks.

Mental Health Awarenesstraining was made mandatory forall managers and a pilot schemeto offer staff access to CognitiveBehavioural Therapy was trialledin addition to the counsellingservices that is available. A Health and Wellbeing workinggroup was also created to meetquarterly with a range of Trustrepresentatives.

Why we made this change

NWAS already has support inplace for staff, however due tothe nature of the work and thefact that staff are so busy, staffdo not always have theopportunity to access thissupport. Sometimes staff feelthat they cannot speak to theirmanager and would find it much

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easier to chat to a peer abouttheir concerns whilst on shift. AsPeer Supporters work amongsttheir colleagues, they are easilyaccessible and approachable. Onthe whole it was hoped that theInvest in Yourself brand wouldfacilitate engagement and raiseawareness of Health andWellbeing across the Trust.

How we did it

‘Invest in Yourself’ was launchedin August 2017 to create a uniquebrand and platform for Healthand Wellbeing at NWAS. Theconcept was agreed and amicrosite was launched as a wayto communicate and engageeffectively with staff. Training wasimportant and peer supporttraining for Blue Light Championswas undertaken. Both the BlueLight Champions and TRiMassessors attended 'train thetrainer' courses to enable themto cascade the training to other staff.

A bespoke EOC Programme waslaunched in January 2018 for ourEmergency Operations Centreswith specialists in nutrition,personal resilience, traumamanagement and individualwellbeing techniques.

What we hoped would change

By having Peer Supportersavailable for staff to talk to it washoped this would reduce sicknessabsence levels relating to stressand anxiety and make staff feelmore supported during anydifficulties they may beexperiencing. It was hoped thatthe Peer Support Networks wouldhelp to reduce the stigma aroundmental health to create amentally healthy workplace.

On the whole it is hoped that the‘Invest in Yourself’ brand andinitiatives would help to improveHealth and Wellbeing of staffand provide an engagement toolwhich promotes a positiveculture by helping staff to be‘Happy,’ ‘Healthy’ and ‘Fit.’

What changed

It is still a bit early to tell butverbal feedback suggests the‘Invest in Yourself’ brand andinitiatives have been positivelyreceived so far. Analysis andevaluation of the Peer SupportNetworks is ongoing and will becompleted once the Networksare fully rolled out across the Trust.

What we are doing next

We will continue to build uponthe ‘Invest in Yourself’ brand tokeep it refreshed and up to date.We aim to implement andenhance support networkoptions for all staff to ensurethey remain relevant and staffare engaged with the ‘Invest inYourself’ initiatives.

For further information contact:

Laura Dean([email protected])

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2.4 Actions and Activitiesfor Workplace CompassionCase Study

Academy of Fabulous StuffCIC and LincolnshireCommunity Health ServicesNHS Trust (LCHS):

When staff feedback is fab

Summary

In 2017 The Academy of FabulousStuff CIC developed and launchedthe Fab-O-Meter (www.fab-o-meter.com), a real time means ofmeasuring the morale of staff inhealth and social care. Based onan app, the Fab-O-Meter recordshow staff’s morale has beenduring their shift using a green /amber / red system. Anonymiseddata from the app can be used byhealthcare providers tounderstand how different cohortsof staff are feeling and take anysubsequent actions that they seefit. Data can be viewed over timeand trends over time can beanalysed. Lincolnshire CommunityHealth Services NHS Trust startedusing the Fab-O-Meter inNovember 2017.

What we did

People told the Academy thatwhilst the annual staffengagement survey is useful, itcan take ages to manage andgives what is actually a historicalpicture of how staff feel. The FabO Meter was created to provideup to date information abouthow staff feel that could be usedas the basis for understandingfactors that influence staff moraleand to take action when needed.LCHS introduced the app in ourservices in Lincoln and alreadynearly half of all staff have usedthe app.

Why we made this change

Poor staff morale is often aprecursor to poor standards ofcare. Equally, good moralegenerates high performance inorganisational outcomes. Theannual NHS staff gave us a ‘pointin time’, but the data was oftentoo slow for it to be meaningfuland the complexity ofinformation was often lost onstaff. No system was availablethat could reliably and quicklymeasure staff morale andunderpin Trust decision making.

From a strategic perspective, wechose to adopt the Fab-O-Meteras it really aligned with one ofour organisational objectives ofengaged, motivated, skilled,productive and supportedworkforce, and, importantly,

modelled our organisationalvalues of ‘We Listen, We Care,We Act, We Improve’.

In addition, the ability to collectstaff feedback through an appsupported a drive to usetechnology more and gopaperless. We have also beenworking with our LCHS Leadersto better understand what‘people’ KPIs would be useful tosupport how they manage theirteams and ultimately improveoutcomes for patients. While wehad the usual metrics ofattendance, FFT, turnover, wewere looking for a moremeaningful metric of how staffwere feeling.

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How we did it

We were really keen that thischange was going to be ‘bottomup’ and not ‘top down’. Werecruited ‘Morale Innovators’ byan invitation to all staff interestedin joining a team to improvepatient outcomes by improvingstaff morale. We had volunteersfrom admin staff, AHP, supportworkers, staff side reps,community staff, managers,leaders, corporate staff - startingwith a group of 25-30 innovators.We then used this group to startto get the message out; we didsome ‘soft’ launching, butformally launched during NHSChange Week in November.Among the things we did: ourInnovators briefed our executiveteam and gained their buy-in,staff side briefed our Staff SideConsulting Forum, we usedinternal comms to get messagesout, our CEO championed theplan in his weekly email, wedeveloped posters and pull-upbanners for our HQ and trainingrooms, we adopted it in our staffinduction and mandatorytraining, we used our closedfacebook site, set up a twitteraccount, briefed leaders throughour leadership programme, andused our weekly staff comms.

All these ideas were developedand delivered by our innovators.One of the things we wereabsolutely passionate about wasthat morale was everyone’sresponsibility, not just thepreserve of management, sowe’ve recently released theMorale Dashboard to all 1700staff so staff can see theorganisation morale anddepartment morale.

What we hoped would change

We wanted to make it easy forstaff to reliably and safely conveytheir morale to Trust leadership.We also wanted Trust leadership

to be able to both positivelyrecognise excellence in moraleand identify where challengesare present so that action couldbe taken.

What changed

LCHS has always believed thathappy staff deliver betteroutcomes for patients. It’s earlydays for us with the Fab-O-Meterwhich was launched just a fewmonths ago. We already feel itgives us a much more dynamicway of knowing how our staffare feeling, so we can dosomething about it. Giving staffaccess to the Fab-O-Meterdashboard has helped shift theresponsibility of morale from justbeing the preserve ofmanagement to everyone. Thesimplicity of the Fab-O-Meter apphas been well received by staffand has supported a cultural shiftof ‘say it not think it’.

What we are doing next

Our Trust executive team arealready starting to use Fab-o-Meter information in theirrespective areas and we plan tocelebrate progress so far with acelebration event. We’ll also belooking to start to case studywhat leaders are doing with theFab-o-meter data. The long termaim is that the Fab-o-meterbecomes business as usual and isa morale indicator that gets asmuch attention as our patientquality measures.

For further information contact:

For Academy of Fabulous StuffCommunity Interest Company,Jon Wilks([email protected])

For Lincolnshire CommunityHealth Services NHS Trust(LCHS), Dusty Millar([email protected])

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2.5 Actions and Activities for Workplace Compassion slide set

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2.6 Taking stock of actionsand activities that supportworkplace compassion:

What do we do now that’sgood? (or, “not throwing out thebaby with the bathwater")

Before starting a spring clean, it’soften a good idea to take a lookin the cupboards, and do astocktake of those things youwant to keep and those thingsthat you need to throw away. To make sure that you don’t missanything when you do yourstocktake, you might find ituseful to use the table shownhere as a prompt. This is takenfrom a research study that usedTwitter to identify the actionsand activities that showworkplace compassion.7

n Together, make a big list of allthe things that currently goon in your workplace, big orsmall, that show workplacecompassion. This is your‘Things to keep’ list.

n Agree between you thosethings that you definitelywant to keep and don’t wantto throw out in your springclean. Put a * next to these.

n When you do this exercise,you might find that you alsothink about those things thatgo on in your workplace thatdo not support workplacecompassion. On a separatepiece of paper make a big listof ‘Things to take to the tip’

Leadership and Management

Embedded organizational culture of caring for one another

Speaking openly to learn from mistakes

No blame/no bullying management

Inspiring leaders and collective leadership

Financial investment in staff

Recognize humanity and diversity

Values and Culture

Common purpose in a team

Feeling valued

Being heard

Engaged

Use of caring language

Personalized Policies and Procedures

Recognition of the emotional and physical impact of healthcare work

Recognition of nonwork personal context

Work/life balance is respected

Respecting the right to breaks

Being treated well when unwell

Activities and Actions

Small gestures of kindness

Provision of emotional support

7. Clyne W, Pezaro S, Deeny K, Kneafsey R Using Social Media to Generate and CollectPrimary Data: The #ShowsWorkplaceCompassion Twitter Research Campaign JMIR PublicHealth Surveill 2018;4(2):e41. DOI: 10.2196/publichealth.7686

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2.7 Tackling giants: Barriers to making a change to achieve workplace compassion

For this exercise you will need:

n A group(s) of willing participants

n A large piece of paper, as big as you can get, to either pin up on the wall or put in the centre of a table

n A selection of magazines to cut out images and words

n Scissors, glue sticks

n Lots of different pens/markers in a variety of colours

n Stickers, glitter, other arts supplies that you can access.

As a group, discuss the things that get in the way (the ‘giants’) of making changes at work to take action toachieve a more compassionate workplace. Find a way to represent these giants visually using the materialsthat you have assembled.

You have 40 minutes. Have fun!

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2.8 Actions and activities to support workplace compassionAction Planning Exercise (or, “even Baldrick had a plan”)

We invite you to consider how you/the team can contribute to creating a compassionate workplace.

We suggest that you set yourself one goal; one plan that you/the team will carry out in a specific timeframeto work towards a more compassionate workplace.

We suggest you set yourself a SMARTER goal, using the table below as a guide. Don’t neglect the last twocomponents; make sure that you choose an enjoyable goal that you reward yourself for achieving.

It’s often the case that we are more likely to achieve goals that we have voiced and shared with otherpeople, so you might want to consider telling one of your colleagues about what you plan to do next, or, ifyou are planning this as a team, tell another team what you are planning.

Element Question to ask yourself

Specific Am I clear exactly what my goal is?

Measurable How will I know when I have completed my goal? What does it look like?

Achievable Can I really, currently achieve the task? (Don’t set yourself up to fail!)

Relevant Is the goal important to you?

Time-bound When do I achieve my goal?

Enjoyable Is my goal enjoyable?

Reward What reward will I give myself when I am successful?

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Action Plan for workplace compassion

Our/my goal is

......................................................................................................................................................................................

......................................................................................................................................................................................

......................................................................................................................................................................................

......................................................................................................................................................................................

(Remember to be specific e.g. say thank you to at least one colleague a day)

Frequency

I/we will do this every

......................................................................................................................................................................................

(Remember your goal needs to be measurable e.g. 4 times in the week, twice a day)

When

I/we will do this when

......................................................................................................................................................................................

(e.g. every day, Tuesday and Friday)

Barriers

I/we might experience these barriers:

......................................................................................................................................................................................

......................................................................................................................................................................................

(e.g. lack of time, lack of motivation)

How confident are you that you will complete your SMARTER goal? Circle a number.

Not at all Very

0 1 2 3 4 5 6 7 8 9 10

Achieving Your Goal: Now let's think about ways to help you achieve your goal.

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Overcoming Barriers

To overcome the barriers listed above I/we will

......................................................................................................................................................................................

......................................................................................................................................................................................

......................................................................................................................................................................................

......................................................................................................................................................................................

......................................................................................................................................................................................

(e.g. put aside specific time to do this, set a reminder alarm on your phone)

Enablers

Things that will help me/us to achieve this goal are

......................................................................................................................................................................................

......................................................................................................................................................................................

......................................................................................................................................................................................

......................................................................................................................................................................................

......................................................................................................................................................................................

(e.g. tell a colleague about your goal and ask them to encourage you, ask a colleague you think has goodskills in this area to help you)

Reward

As a reward, when I/we achieve our goal I/we will

......................................................................................................................................................................................

......................................................................................................................................................................................

......................................................................................................................................................................................

......................................................................................................................................................................................

......................................................................................................................................................................................

Now how confident are you of achieving your goal?

Has thinking about ways you can increase success and planning a reward helped with this? Circle a numberbelow.

Not at all Very

0 1 2 3 4 5 6 7 8 9 10

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Element 3: leadership and management

Leadership and management forworkplace compassion resource materials

3.1 Leadership for Workplace Compassion Case Study: Leading a new directorate’s culture,building in workplace compassion: Imperial College Healthcare NHS Trust

3.2 Experience of Care: Patients and Staff Together Introductory Workshop Agenda template

3.3 Experience of Care: Patients and Staff Together Introductory Workshop Powerpointslide set

3.4 Experience of Care: Patients and Staff Together Workshop Case Studies

3.5 Experience of Care: Patients and Staff Together Improvement Planning Workshop Agendatemplate for participants

3.6 Experience of Care: Patients and Staff Together Improvement Planning WorkshopAnnotated agenda for facilitators

3.7 Experience of Care: Patients and Staff Together Workshop Feedback Form

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3.1 Leadership andManagement for WorkplaceCompassion Case Study

Imperial College Healthcare NHS Trust:

Leading a new directorate’sculture, building inworkplace compassion

Summary

The senior leadership team of anew directorate were keen tomeet as many staff as possibleduring the first year of operation.We invited groups of 10 front lineand managerial therapy anddischarge staff to "tea & biscuits"sessions with one of the membersof the leadership team on arolling 6 week basis. The sessionsare based on the theory of‘commensality' (eating together)as there is good evidence thatthis builds a sense of trust andbelonging in a team.

What we did

The groups of 10 were carefullyselected to ensure a mix ofgrades, professions and clinicalspecialties. The objectives wereto: 1) give staff and theleadership team an opportunityto get to know each other asindividuals, 2) give staff theopportunity to get to knowcolleagues they don't usuallywork with, 3) provide a safe,informal space to share ideas,good news, questions orconcerns. Over 12 months, nearly100 staff (30% of the directorate)have had the opportunity toparticipate and a number ofconcrete changes in practice haveoccurred as a result.

Why we made this change

As a new directorate with over300 staff from AfC band 2 to 9,and spanning a range of AHP,nursing and medical groups, theleadership team wanted toquickly embed a culture ofopenness, communication andpersonal connection.

We are also aware that access toand visibility of the leadershipteam is a direct driver of staffengagement and a sense ofconnection to their work.

How we did it

Groups of 10 were carefullyselected to ensure a mix ofgrades, professions and clinicalspecialties. Attendance isvoluntary, but managerscascaded the message that staffwere encouraged to prioritisethese sessions. Hot drinks andbiscuits were provided and onsome occasions, staff bought inhomemade cakes to share withcolleagues. There is no definedtopic for discussion as the goal isto create an open forum wherefront line staff drive the agenda.Over the months a wide range oftopics have come up, fromchanges in the executive team tophysical working conditions insome office areas.

What we hoped would change

Staff feeling personallyconnected to each other and tothe directorate team; stafffeeling listened to and positiveabout the team culture of thedirectorate; staff feeling valued,understood and connected tothe Trust's goals and direction oftravel.

What changed

Regular access to the directorateleadership team has contributedto improved staff engagement asevidenced by our staff surveyresults. Staff report feeling ableto raise concerns, ask questionsand celebrate success in anappropriate forum.

What we are doing next

We will continue "tea & biscuits"sessions with the rest of thedirectorate staff until all

300+ have received an invitation.We will consider moving towardsmore thematic sessions asconsistent themes start to arisee.g. joy in work, personaldevelopment, work/life balance,team building plans.

For further information contact:

Anna Bokobza([email protected])

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3.2 Experience of Care: Patients and Staff Together

Workshop Agenda Template

Experience of Care: Patients and Staff Together

Introductory Workshop

Date

Venue

Agenda

09.30 Arrival, registration and coffee

Introduction and welcome

Icebreaker

Plan for the day

10.00 The relationship between staff and patient experience:presentation and table discussion

11:15 Break

11.30 Case studies (small group work followed by whole groupdiscussion)

12.15 Experience of Care: Patients and Staff Together takeaway

13.00 Next steps and thank you

13.15 Workshop close

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3.3 Experience of Care:Patients and Staff TogetherPower Point Slide set

3.4 Experience of Care:Patients and Staff TogetherWorkshop Case Studies

Experience of Care: Patients andStaff Together Case Studies

These light-hearted case studies,featuring 3 fictitious NHS Trusts,can be used to stimulate groupdiscussion about the ways in NHSprovider organisations can planand improve the experience ofcare for patients and workforcetogether. Discussion shouldconsider ways in which the Trustscan maintain and/or improveexperience of care for all,patients and staff, avoiding anynegative ‘unintendedconsequences’ for the experienceof care of either group.

The 3 case studies are:

A Patients First Acute Trust

B Reconfigurations R Us Trust

C “Outstanding” Trust

Group task for each case study:

1. Discuss the extent to whichthe Trusts are currentlydelivering compassion for alland the potential challengesand opportunities that lieahead

2. Agree a strategy to improvethe experience of care forpatients and staff together

3. Agree actions to improve theexperience of care forpatients and staff together

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Case A: ‘Patients First Acute Trust’

The organisation:

‘Patients First’ is a city-basedAcute Trust with approximately8,000 staff. It serves a diverseurban geography, includes a largehospital with a long, proudhistory and a reputation in someareas for national excellence.

It’s a busy place to work and abusy place to be a patient. Likemany other acute Trusts, PatientsFirst strives to do more forpatients, but waiting times aresteadily rising, the financialposition is ‘challenging’, staffsickness levels and staffrecruitment continue to be aconcern. Several improvementinitiatives have taken place in

recent years, always with theintention of putting the patient first, hence the name of the Trust.

Current situation:

The results of the recent NHSStaff Survey were described by amember of Patients First staff as‘horrendous’. The staff Friendsand Family Test (FFT) tells asimilar picture: Patients Firstscored 43% and 54% respectivelyfor the Staff FFT questions aboutrecommending their organisationas a place to work andrecommending the organisationto friends and family in need ofcare/treatment, against anational average in the mostrecent quarter of 62% and 79%.

The Patient FFT results suggests a

better picture but one that stillincludes plenty of room forimprovement. The latest figuresfor A&E Patient FFT at PatientsFirst show 68% of patients wouldrecommend the service, against a national average for A&E of 85%.

Aims and aspirations:

Patients First have just initiated aconsultation exercise aboutpriorities and strategy. The Boardgenuinely want to hear fromstaff and patients about plans forthe future. Given the latestfeedback about A&E, the Board s particularly keen to hearsuggestions about the A&E service.

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Case B: Reconfigurations RUs Trust

The organisation:

This organisation has beenthrough quite a number ofchanges of late and is now aboutto embark on a majorreconfiguration. The short versionof the re-structure is that servicesare about to be centralised in onelocation (maintaining severaloutlying services and sites butwith a reduced range and scale ofservices at these sites). To achievethis, two separate NHS Trusts willmerge into 1 large new Trustcalled ‘Reconfigurations R USTrust’. The new Trust came intoexistence in earlier this year, andthe majority of activity tocentralise services will take placeover the next 2 years.

Current situation:

The two pre-merger Trusts thattogether now compriseReconfigurations R Us Trustgenerally have good reason tofeel satisfied with the quality ofcare and service provided forpatients and their families, andproud of how their staff feelabout their employer. By andlarge, both organisations havescored either in the top or thesecond quartile on a range ofperformance indicators forpatient and staff well being.However, one of the pre-mergerTrusts has always consistentlyscored more highly than theother for both patient and staff welfare.

Aims and aspirations:

The aim of the new managementof Reconfigurations R Us is forpatients to receive a seamlessservice during all the changesthat have taken place and areplanned. There is an expectationthat the Trust’s standing on someindicators and league tables mayexperience a short, slight fall.The hope is that any dip inperformance is short and shallow.

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Case C: “Outstanding” Trust

The organisation:

“Outstanding” Trust is a successfulTrust, where patients speak of theexcellent care they receive andstaff feel proud to tell others thatthey work at “Outstanding” Trust.It is not uncommon for staff thatleave the Trust to return to workthere again later in their careers.

Current situation:

“Outstanding” Trust has all thechallenges, including financialchallenges, you would expect ofa busy, urban Trust with severalacute sector hospitals and anumber of specialist services. CQCrecently rated the Trust as ‘good’and the care it provides as‘outstanding’. In addition CQCnoted that the Trust had severalareas of outstanding practiceincluding ‘engagement of staff ina culture of improvement andcompassionate care.’

Aims and aspirations:

“Outstanding” Trust is delightedwith the recognition it hasreceived for the service itprovides to patients and thesupport it gives to staff.“Outstanding” Trust wants notonly to maintain currentperformance but to improve on it.

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3.5 Experience of Care: Patients and Staff Together Improvement

Planning Workshop Agenda template for participants

Experience of Care: Patients and Staff Together

Improvement Planning Workshop

Date

Venue

Agenda

09.30 Arrival, registration and coffee

Introduction and welcome

Icebreaker

Plan for the day

09.50 Refreshing Patients and Staff Together (aka “What are we allhere for again?!”)

10:20 Defining our focus

11.20 Where are we and where do we want to be

12.15 Break (45 minutes)

13.00 Ideas generation: options for improvement

14.00 Finalising our action plan

14.45 Checking roles, responsibilities, timelines, next steps

15.15 Workshop close

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3.6 Experience of Care:Patients and Staff TogetherImprovement PlanningWorkshop Annotatedagenda for facilitatorsExperience of Care:Patients and Staff Together

Improvement PlanningWorkshop

Date

Venue

Annotated Agenda (annotations in bold)

09.30 Arrival, registration andcoffee

Introduction andwelcome

Icebreaker

If you have a different audiencefrom the introductory workshopthen you might want to use thegratitude icebreaker again.Alternatively, use an icebreakerof your own.

Plan for the day

09.50 Refreshing Patients andStaff Together (aka“What are we all herefor again?!”)

To refresh your audience,consider showing slides 7 and 8(the infographics) and slides 13and 14 (“Is there another way?”and “Experience of Care:Patients and Staff TogetherImprovement Approach in a slide”).

10:20 Defining our focus

Use your usual improvementapproach for generating aspecific focus for improvementthat everyone can agree uponand that can potentially beaddressed within the time andresources you have available.

We have found a generaldiscussion works well perhapsstarting with known issues forthe team concerned, or usingany evaluation or experiencedata for the relevant service orteam that is available. Examplesof improvement topics and aimsstatements from our previoususe of this approach include:

Improving an organisationalcomplaints management systemfrom a protracted and overlycomplicated process withmultiple layers of sign-off andlengthy wait times forcomplainants, to an integrated‘Hearing Feedback’ system ableto respond to both positive andnegative feedback. Quickerturnaround of responses tofeedback with local levelownership and sign off, in orderto achieve earlier and betterresolution for patients andimproved job satisfaction andownership for staff.

“Our aim is a care plan that usup to date, proportionate,makes patients feel empowered,heard and involved. Staff feelempowered and that they havedone their best."

Shifting towards the jointplanning, timing, andoperational delivery of thepatient and staff Friends andFamily Tests (FFT), that hadpreviously been managedalmost entirely separately. Thisincluded a specific aim ofimproving staff engagementthrough increasing participationin the staff FFT.

Improving two waycommunication between staffand senior leaders, by a specificdate on a specific ward, wherestaff had self-identified a needto improve staff experience inorder to reduce the potential risk of reduction in quality ofpatient care.

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11.20 Where are we andwhere do we want to be

In this part of the day, developconsensus about the size andscale of the ‘problem’, usingperformance data whereavailable. Discuss what kind andscale of change you are aimingfor with your improvementactivity. Begin to consider whatexisting data or evidence youcould use to track change, orplan and discuss new datacollection if necessary, and howyou will know that change hasoccurred. You will likely need torevisit this when you developyour action plan.

12.15 Break (45 minutes)

13.00 Ideas generation:options forimprovement

Use your standard improvementapproach for exploring theoptions that are available formaking a change. We havefound fishbone plans to beuseful for identifying the rootcauses of the issue in order tothen generate specific optionsfor change. Throughout (as withall aspects of the discussion inthis workshop) ensure yourefocus participants onconsidering both patients andstaff experience together, andthe impact that each has on theother. By the end of this session,you need to have:

n a specific idea for animprovement initiative

n understand why you wouldmake such a change

n understand how the changeis intended to impact staffand patient experience

n have consensus within theTogether Team for theinitiative.

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14.00 Finalising our action plan

With the remainder of the timeavailable, draw up an actionplan; a list of the specific tasksthat are needed in order todeliver your initiative andachieve your aim. Werecommend you include someform of measurement (usingexisting data and resourceswhere possible) so that youknow whether any change hasoccurred. If you are using a PDSAapproach you will likely plan justthe first PDSA cycle at this point.

14.45 Checking roles,responsibilities,timelines, next steps

Make sure you ensure all taskshave been assigned to a personbefore everyone leaves! If theco-ordinator of the initiative isnot going to be you, make sure someone is assigned a co-ordination role. Make a plan for how you will allcommunicate and/or meet againto review your activity.

15.15 Workshop close

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3.7 Experience of Care: Patients and Staff Together feedback form

This survey concerns your experiences of using the Experience of Care: Patientsand Staff Together improvement approach

For each question, we would like you to mark the corresponding box that bestrepresents your response. There are no right or wrong answers. It is your opinionwe are interested in. You might also like to write a few words about your answerin the text boxes provided.

Please begin when you are ready.

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Statement Please mark the response that best represents your opinion

Very useful UsefulModerately

usefulSlightlyuseful

Not usefulHow useful did you find it to use the Experienceof Care: Patients and Staff Together improvementapproach when planning and conductingimprovement activity?

Why did you choose this response?

Veryimportant

ImportantModeratelyimportant

Slightlyimportant

Notimportant

How important do you believe it is to follow aspecific model for improvement (like theExperience of Care: Patients and Staff Together) when planning and conductingimprovement activity?

Why did you choose this response?

Veryimportant

ImportantModeratelyimportant

Slightlyimportant

NotimportantHow important do you now believe it is to link

staff experience and patient experience whenplanning and conducting improvement activity?

Why did you choose this response?

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How important was it to use a collaborative ‘anti-silo’ approach to planning and conductingimprovement activity?

Why did you choose this response?

Veryimportant

ImportantModeratelyimportant

Slightlyimportant

Notimportant

How important was it to measure and collect datawhen planning and conducting yourimprovement activity?

Why did you choose this response?

Veryimportant

ImportantModeratelyimportant

Slightlyimportant

Notimportant

Using the Experience of Care: Patients and StaffTogether approach influenced the aim of ourimprovement activity.

Why did you choose this response?

Stronglyagree

AgreeNeitheragree ordisagree

DisagreeStronglydisagree

Using the Experience of Care: Patients and StaffTogether improvement approach influenced theactions of our improvement activity.

Why did you choose this response?

Stronglyagree

AgreeNeitheragree ordisagree

DisagreeStronglydisagree

Statement Please mark the response that best represents your opinion

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Using the Experience of Care: Patients and StaffTogether improvement approach influenced theeffectiveness of our improvement activity

Why did you choose this response?

Stronglyagree

AgreeNeitheragree ordisagree

DisagreeStronglydisagree

How likely are you to use the Experience of Care:Patients and Staff Together improvementapproach again?

Why did you choose this response?

Can you describe what actions you have taken using the Experience of Care: Patients and Staff Together improvement approach?

What (if anything) has changed as a result of these actions?

Very likely LikelySomewhat

likelyUnlikely

Veryunlikely

Statement Please mark the response that best represents your opinion

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What did you find most challenging about using the Experience of Care: Patients and Staff Together and why?

What did you find most useful about using the Experience of Care: Patients and Staff Together and why?

What future actions (if any) do you plan to take?

What (if anything) would you do differently next time you are planning or conducting new activities?

What (if anything) has changed as a result of taking this collaborative ‘anti silo’ approach?

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Element 4: policies and procedures

Policies and procedures forworkplace compassion resources

4.1 Policies and Procedures for Workplace Compassion Case Study. Surrey and SussexHealthcare NHS Trust: The daily emergency call safety huddle

4.2 Policies and Procedures for Workplace Compassion Case Study. NHS England andNHS Improvement Employee Volunteering Policy: A policy you can volunteer for

4.3 Workplace compassion as a business modelhttps://www.youtube.com/watch?v=qQNC1GtJ0RM

4.4 Policies and procedures for workplace compassion slide set

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4.1 Policies and Proceduresfor Workplace CompassionCase Study

Surrey and SussexHealthcare NHS Trust:

The daily emergency callsafety huddle

Summary

We introduced daily EmergencyCall Safety huddles in October2016. The on call bleep holdingteam who respond to thehospital’s medical emergenciesand cardiac arrests now meetevery morning. This team is multi-disciplinary and includes a criticalcare outreach nurse, medicalregistrar, FY1 and 2, resuscitationofficer, coronary care nurse,anaesthetist and operatingdepartment practitioner. Once atime and venue had been agreedfor the daily huddle, we used thehospital communications team toshare the information. Wearranged for the hospital switchboard to put out a reminderbleep every morning five minutesbefore the huddle is due totake place.

We initiated the huddles becausewe wanted to improve patientsafety, improve team dynamicsand leadership and make theteam responding to the hospitalemergencies as effective andefficient as possible. Prior tointroducing the safety huddles,the first time the team met wasat the bedside of a deterioratingpatient. It was often unclear as towho was who, who was runningthe emergency and what ourroles were.

All members of the emergencycall team have noticed animprovement in communicationand leadership, and a reductionin staff stress. A qualitative studyshowed that the huddle is viewed

as an integral and very positivecomponent of the on-call shift.Doctors like that their roles areclearly defined, and that theyknow who they are going to beworking with in advance shouldan emergency occur. They felt ithelped alleviate stress byallowing them to plan foremergencies in advance.

What we did

We use a standard workproforma so the huddle runs thesame each day. We start byintroducing ourselves to eachother. We then allocate roles(e.g. who will lead theemergency, who will do bloods,who will document, who willdefibrillate etc.). We then discussany training requirements (e.g.

FY2 needing to lead anemergency with support frommedical registrar, anyone needIntra osseous insertion practiseetc). Finally we discuss anythemes for the week/lessonslearnt. The safety huddle takesno longer than ten minutes.

Why we made this change

The multi-disciplinary on callemergency team membershipchanges every day and everynight. There is a 400 million: 1 chance of exactly the same

team ever working togetheragain. In the past the first timethe emergency response teamwould meet was at the bed sideof a rapidly deterioratingpatient. We would not always

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know who each other are, eachother’s capabilities, roles, or evenwho was leading the emergency.Now, all this is planned inadvance at our ten minuteshuddle each morning. We are alot more efficient, effective andthere is better leadership andcommunication. Staff stress hasbeen reduced too. This willimprove patient safety, patientexperience and staff experience.

How we did it

Firstly we got agreement that‘another meeting/ huddle’ wouldbe of benefit to all concerned.Getting the key stake holders onboard was vital. Luckily, we wereat the point where we werelooking to make changes to ourmedical handover, so this tied innicely. A huddle proforma wasagreed as to how the ten minutesmeeting would run. The KentSurrey and Sussex AHSN hadsupported this initiative atanother local hospital, and putdetails on their website as a goodquality improvement initiative, sowe followed that. The meeting isled by the critical care outreachteam as they are the one regularmember of the team (doctors’change throughout the year,resuscitation officers are oftenteaching, etc.)

What we hoped would change

We wanted the relationshipbetween the multi-disciplinary oncall emergency team members toimprove. We wanted the team tobe more efficient and effective.Ultimately we wanted patientsafety to improve.

What changed

A qualitative study has shownthat we have reduced staff stress(particularly for the junior doctorswho were unclear of their roles inan emergency), improved teamdynamics, communication and

leadership. We work better as ateam. We always know who isleading the emergency. We nowhave a designated lead for asecond/simultaneous emergency.The junior doctors report feelingless stressed when attending anemergency, as they know whattheir role is and what’s expectedof them. The medical registrarsreport less stress as they knowwho else will be attending theemergencies and that the roleshave already been allocated inadvance. If one of the teamdoesn’t turn up for the 10minutes meeting, this is pickedup very early in the day andmanaged.

What we are doing next

We plan to introduce this intoour hospital at night meeting.We also plan to introduce hotdebriefing following emergency

calls. Together with the criticalcare outreach nurse from theother local hospital (Brightonand Sussex University Hospital)we have presented the huddle atthe Resuscitation Council (UK)annual scientific symposium tohelp raise the profile of thesuccess of the changes we haveput in place. We would like theResuscitation Council torecognise this huddle in theirguidelines as good practice. Itreally is such a quick, easy, freeinitiative that has such positiveeffects on team working andstaff experience.

For further information contact

Claire Rowley([email protected])

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4.2 Policies and Proceduresfor Workplace CompassionCase Study

NHS England and NHSImprovement EmployeeVolunteering Policy:

A policy you can volunteer for

Summary

NHS England and NHSImprovement has an EmployeeVolunteering Policy, which allowsall colleagues up to five days paidleave per year to volunteer forgood causes. The policy is alignedto our aims and objectives, andEmployee Volunteering activitycomplements what we areworking to achieve as anorganisation.

We know that volunteersexperience a number of benefits:enjoyment, satisfaction andachievement, meeting peopleand making friends, broadeninglife experience, boostingconfidence, reducing stress,improving physical health andlearning new skills.

Our Employee VolunteeringPolicy is one of the ways NHSEngland and NHS Improvementpromotes positive staffexperience. We want to enablecolleagues to engage in activitiesthat they enjoy, for organisationsthat they care about andcontribute to the wider healthand social care system andcommunities more generally. Wealso want to support them todevelop skills that can contributeto career progression and gainsatisfaction from working outsideof their day job.

What we did

We developed a policy for allemployees, which allows peopleup to five days paid EmployeeVolunteering leave each year.The policy gives a framework forpeople to use EmployeeVolunteering leave to supportwork in other organisationswhich complements the work ofNHS England and NHSImprovement.

We have set up informationpages on the intranet, wherepeople can access:

The policy

Frequently Asked Questions

Links to volunteer databases

The intranet is also a placewhere employees can:

Record their Employee VolunteerLeave

Read and share case studies

Give their feedback on theirEmployee Volunteeringexperience.

Why we made this change

The Employee VolunteeringPolicy was in development rightfrom the beginning of NHSEngland’s inception. Werecognise the value of volunteersto the NHS and wider health caresystem as well as the mutualbenefit of employer-supportedvolunteering for staff and NHSEngland and NHS Improvementas an employer.

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How we did it

Creating the EmployeeVolunteering Policy was acollaborative effort, bringingtogether colleagues across theorganisation to develop a policythat was fit for purpose and easyto understand. Having a goodrepresentation from across theorganisation also helped us makesure that we aligned the policy toour vision and values, and thatwe had the correct supportmechanisms in place to make it assmooth as possible for colleaguesto access Employee Volunteerleave and for us to monitoruptake and impact.

What we hoped would change

We wanted to implement thepolicy as soon as possible - notwith any specific change in mind,but so that we started out with aculture that was supportive ofemployee volunteering and thebenefits it can bring toemployees, communities and NHSEngland and NHS Improvement.

What changed

Of the colleagues who used someor all of their EmployeeVolunteering leave:

53% say it helped them performbetter in their job

37% say it made them betterable to apply for more seniorpositions

93% said it gave them anawareness of wider social issues

82% said it gave themunderstanding ofothers/empathy

76% said it improved theircommunication

76% said it made them feel more motivated

73% said it improved team-working skills

64% said it improved jobsatisfaction

60% said it improved their self-confidence

53% said it improved theircommitment to their employer

What we are doing next

We are looking at ways toexpand uptake for EmployeeVolunteering by creatingstronger links with the voluntarysector, creating toolkits for staffand making opportunities morevisible to colleagues.

We intend to create moreopportunities for staff to useEmployee Volunteering leave tosupport wider determinants ofhealth. These are particularlylinked to global and nationalgoals for SustainableDevelopment and will beincluded in our next SustainableDevelopment Management Plan.

For further information contact

Michelle Mazzotta([email protected])

Page 73: Resource pack - NHS England...C. Introductory slide set: Why workplace compassion matters Element 1: culture and values 1.1 Six word stories 1.2 Workplace compassion audit and action

73R E S O U R C E P A C K T O S U P P O R T W O R K P L A C E C O M P A S S I O N

Written and developed by theFlourish team at Hope for TheCommunity CIC (h4c.org.uk)

This resource pack was writtenby Dr Wendy Clyne and Dr KarenDeeny for NHS England and NHSImprovement. Thanks to thestaff experience team at NHSEngland and NHS Improvement(Kate Milton, Michail Sanidas,Sara Latham and Susan Shears)for their input. We would alsolike to acknowledge the input ofthe following people andparticipating NHS organisations:

Introductory resources forworkplace compassion: Dr Sally Pezaro.

Element 1: Cherry Dale, Lorna-Collingwood-Burke, Sam Holden,Hull and East Yorkshire HospitalsNHS Trust, Norfolk CommunityHealth and Care NHS Trust andUniversity Hospitals of LeicesterNHS Trust, NHS NEW Devon CCG.

Element 2: Imperial CollegeHealthcare NHS Trust;Northumberland, Tyne and WearNHS Foundation Trust, NorthWest Ambulance Service NHSTrust, Academy of Fabulous StuffCIC and Lincolnshire CommunityHealth Services NHS Trust.

Element 3: Dr Sally Pezaro,Professor Darrin Baines, Lorna-Collingwood-Burke, Sam Holden,Imperial College Healthcare NHSTrust, NHS Lewisham ClinicalCommissioning Group, RoyalFree London NHS FoundationTrust, Cornwall Partnership NHSFoundation Trust, Mid YorkshireHospitals NHS Trust, UnitedLincolnshire Hospitals NHS Trust,Lancashire Care NHS FoundationTrust, Worcestershire AcuteHospitals NHS Trust, Guy’s and StThomas’ NHS Foundation Trust,Sheffield Teaching HospitalsFoundation NHS Trust, 2getherNHS Foundation Trust, and NHSNEW Devon CCG.

Element 4: Cherry Dale, Surreyand Sussex Healthcare NHS Trust,NHS England and NHSImprovement EmployeeVolunteering Team.

Author details andacknowledgements

4.3 Workplace compassion as a business model video clip

https://www.youtube.com/watch?v=qQNC1GtJ0RM

4.4 Policies and procedures for workplace compassion slide set

Page 74: Resource pack - NHS England...C. Introductory slide set: Why workplace compassion matters Element 1: culture and values 1.1 Six word stories 1.2 Workplace compassion audit and action

Written and developed by the Flourish team at Hope For The Community CIC - www.h4c.org.ukDesigned by Create Onsight - www.createonsight.co.uk