Staying Connected

Like all Boards across NHSScotland, Ayrshire and Arran experienced unprecedented challenges during the Covid-19 pandemic, resulting in considerable pressure on our workforce. The Nurse Directorate was not exempt from this and our teams required to evolve in response to frequently changing service needs.

During the emergency response stage, there was of course a need to prioritise patient care and many of our staff were deployed around the system to support rising clinical pressures. This understandably had an effect on the health and wellbeing of individuals, our ability to connect as a team and the delivery of team objectives. In addition, this necessitated a more light touch approach to other, non-essential activities, including staff engagement.

This is our story of how we did our best to stay connected and balance staff engagement with service delivery during this challenging time.

Staying Connected

Our main focus during the early stages of the pandemic was on communication; ensuring that our workforce remained connected, that they could be agile and responsive in terms of decision making, and importantly, staff had access to the support they needed.

The “Everyone Matters” Pulse Survey carried out in 2020 identified that staff gain the majority of their support from Work Colleagues, (Teams and Family being close seconds) and it was clear just how important our colleagues are in terms of our personal wellbeing.

From the outset, positive use of MS Teams was promoted and training provided to ensure that staff were comfortable with the system. Informal check-ins, lunch dates and virtual team events (including Christmas Party Nights over Zoom!) helped us keep that sense of team and camaraderie. A structure of virtual team huddles and 1:1 sessions was established to give staff the space to participate and contribute their views both in a team setting, and to provide a forum for support and professional supervision. By keeping connected and having a shared understanding of objectives and priorities, teams were able to be agile and proactive in their response, to maintain service quality, and for those of us who were redeployed, this helped with the transition back into substantive roles. Page 2 of 5

Furthermore we made sure that important guidance and information relating to the pandemic was shared effectively through directorate communications and structures; Health and Social Care Wellbeing sessions were promoted and staff were made aware of and, where appropriate, encouraged to access support such as peer support, staff listening service, occupational health and Project Lift Wellbeing Coaching. We found that sharing information and clear communication was so important, particularly for those staff who were working remotely.

Whilst our teams engaged well in this and feedback was positive, this did not negate the fact that staff were under extreme pressure and this was impacting on morale and job satisfaction.

Staff Engagement

When iMatter was restarted in 2021, perhaps unsurprisingly our results demonstrated a downward turn from the 2019 results across most areas. We were keen to use this as an opportunity to hear from staff, learn from our experiences during the early stages of the pandemic and strengthen our approach to good staff governance. With support from our local iMatter team, staff and managers were supported to use the system and the importance of iMatter as an improvement cycle was reinforced through team meetings and directorate communications. This resulted in 80% of our teams coming together to explore feedback, listen to the opinions, ideas and concerns of team members, and develop plans for improvement during the 2021 iMatter run.

In parallel to this, we took part in the Health and Safety Executive (HSE) Talking Toolkit Pilot which aimed to test a new method of carrying out Departmental Stress Risk Assessments and promote this as a tool for managing stress positively in the workplace. The toolkit was tested in two of our teams. We decided to utilise coaching methodology to set the ground rules and create the conditions for psychological safety. Creating this safe space resulted in open and honest conversations where staff felt able to explore the issues that were contributing to workplace stress, and was found to be a positive team building experience in and of itself. This approach was shared both as part of the HSE Pilot, and within the Directorate Staff Governance Action Plan, as a ‘Good News Story’ that could be replicated in sessions such as iMatter action planning and other Departmental Stress Risk Assessments.

“So What?”

Creating the right space and opportunity for staff to speak up within a culture of psychological safety is vital for our staff to learn, grow and thrive. The iMatter survey is an excellent tool for gathering this important staff feedback, and the action planning process gives our teams the opportunity to explore this and create their own improvement plans. There is a wealth of knowledge, diversity and creativity in our teams and by creating psychological safety within this space, this has been captured in the valuable contributions to team improvement plans; a few examples of which we are pleased to share below.

Value Management Approach (VMA) – Directorate Improvement Plan

A Value Management Approach (VMA) engages clinical and nonclinical teams to apply Quality Improvement (QI) methods with combined cost and quality data to deliver improved patient outcomes, experience and value.

We decided to develop a Directorate level Improvement Plan through the principles of VMA, giving all teams the opportunity to contribute to the plan which considers the Four Pillars of Quality, Service, People and Finance, and measures improvement against our Workforce and Financial Metrics.

‘What Matters to Me’ sessions were held by all teams, and this feedback was collated, analysed and themed. This process identified some ‘quick wins’ that could be taken forward at a team level, for example several teams have completed or are planning team develop sessions, team building sessions or away days.

This exercise also highlighted some common themes, both positive and negative, and included areas for improvement such as duplication of effort, conflicting priorities or at times unpredictable workload. A small team has now been identified to lead on an improvement plan that will seek to address any common themes, and help to spread learning and improvement throughout the directorate.

Staff Governance Group

Previously, the Nurse Directorate Staff Governance Committee was largely attended by senior members of the team who also attended directorate Business meetings. As such, there was duplication of Agendas and at times a lack of capacity to attend. In keeping with the Staff Governance Standards and in particular “Involved in Decisions” we had an ambition to create a new Group, with members who could provide a perspective from across teams and disciplines and represent the interests of the wider staff group.

The new Staff Governance Group is open to all Nurse Directorate Staff. It is a forum which brings together members from a variety of specialities and backgrounds who have a common interest in enhancing and continually improving Staff Governance, together with our Partnership and HR representatives.

The group had its first meeting in February 2022 and since then, members have participated in the development of the directorate Staff Governance Action Plan, collating feedback from teams, and actively promoting and raising awareness through team meetings and engagement with colleagues.

Managers Training Programme

The past 1-2 years has been a time of significant change for our Directorate with enhanced services and additional corporate responsibilities. This brought with it opportunities for succession planning and career development, with some staff members moving into new management positions. In partnership with our HR and Staff Side colleagues, a bespoke Managers Training Programme was designed and offered to all Nurse Directorate Managers during Summer 2022. This included training on the new ‘Once for Scotland’ policies and partnership working. The course is currently being evaluated and this will inform future sessions, with consideration given to a rolling programme of training and support.

Directorate Newsletter – “Heartbeat”

In the spirit of keeping our teams informed and connected, a small editorial group was formed to produce our new style Newsletter - “Heartbeat”. This was designed using feedback from iMatter and “What Matters to us” sessions – with a focus on staff wellbeing, staff governance standards, developments that are taking place across our Directorate, and featuring articles such as a message from our Nurse Director, ‘The Luckiest girl in Ayrshire’ - an insight into our new Chief Executive, the role of the NonExecutive Director, Meeting the need for Long-Covid, and a regular ‘Wellbeing Space”.

The newsletter is designed with staff, for staff, and it is hoped that this First Edition – issued in September 2022, will be the first in an ongoing conversation with staff and teams across the Directorate.

Buddy System

Staff feedback highlighted that when employees are new to the organisation or directorate; ours is a complex system and it can be daunting to find information and make connections. A Buddy system has been put in place to ensure that all new starts are allocated a Buddy, and receive at least weekly ½ hour sessions for the first 4 weeks or however long they require, plus support and signposting, in addition to standard training, induction and supervision processes.

In Summary……..

We continue to learn from our teams and listen to feedback, and more recently have started to explore new ideas such as a Staff Quiet room within our Eglinton House offices as a space for staff to relax and reflect on their day or the tasks ahead, informal lunch meets to bring together team members who would not normally otherwise have met, creating the opportunity for new connections, and Director “Ask me anything sessions” which are now taking place across all our sites. Most importantly we want to create the culture within our directorate where staff feedback is valued, and where we can create the conditions for our teams to thrive. We want all staff to join the conversation, to get involved with work that is going on across our Directorate, the wider organisation and beyond. iMatter has been and will continue to be a key part in this. We hope that this story might prove helpful for colleagues across the system and would invite you to connect with us – we would love to hear from you, learn from you and share our experiences.

Laura (on behalf of all Nurse Directorate Colleagues, NHS Ayrshire and Arran)

Laura Parker, Business Manager