Royal Bolton Hospital NHS Foundation Trust

Royal Bolton was one of the biggest improvers. Nicky Ingham, Director of Workforce and OD at Royal Bolton Hospital NHS Foundation Trust, says some of the 2008 feedback was damning, and some HR colleagues found it difficult to take. Particular issues were time to recruit, inconsistency in HR advice, and insufficient communication. According to Nicky: ‘Recruitment is only a small part of what we do in HR but it was clear that our credibility is based on getting the basics right so that became a priority. It was a wake-up call. We knew we could do better.’

The 2010 survey showed significant improvements in HR customer perceptions on six world class factors, when compared to 2008. In 2010, 60 per cent of management and clinician respondents rated their HR/OD function as ‘better’ or ‘much better’ than before. People indicators across the Trust (attendance, sickness etc.) also improved during the same period.

A sign of the department’s success came in June when Nicky was named as Human Resources Director of the Year in the Healthcare People Management Association awards – having been nominated by the chair of the hospital’s staff side.

So how did they do it? The team was set the challenge of changing customer perception. The realigned team structure was further embedded to provide more support for managers. The employee services centre team used lean methodology its processes including increased communication about recruitment. Discussions with the executive board and staff side, plus peer support from Morecombe Bay NHS Trust, gave them confidence they were going in the right direction. But shifting the culture of the HR staff was the key, especially their ownership of issues at local level and keeping the patient perspective in mind.

The Trust HR believes it is now in a much stronger position to show how it makes a difference. ‘Given the challenges ahead across the NHS our main priorities moving forward are providing support to managers. We will be helping them in leading with confidence and conviction to help sustain organisation performance and ensure stability within the local health system,’ says Nicky.

Central Manchester University Hospitals NHS Foundation Trust

Central Manchester is a large city centre teaching hospital which, over the past few years, has had an extremely challenging workforce agenda building new hospitals, closing established hospitals, moving services across the city and transferring services into and out of the Trust.

The Human Resources function consists of the following departments:

• Operational HR
• Medical Staffing
• Organisational Development & Training
• Recruitment & Workforce
• Occupational Health & Safety

In 2008 CMFT first became involved in World Class HR and in 2009 took part in the initial questionnaire. The results were very disappointing for the function. However, more detailed feedback was needed to provide the Trust with the detail to really tackle specific areas of concern within the different HR departments.

The HR Directorate therefore developed an overarching action plan which aimed to address all aspects of the WC-HR model, in particular focussing on:

• Portfolio of policies, procedures and guidance being up to date and accessible.
• HR Skills Training for new, middle and senior managers
• Workforce Strategy Review
• Recruitment Processes
• HR KPI's and information provided to the Divisions
• Training Needs Analysis and links to training programme
• Occupational Health support
• Further development of the Business Partner model
• Communication and cross departmental working within the HR directorate
• Communication of new HR processes and initiatives across the Trust
• Divisions' knowledge of different HR departments and key contacts

It was crucial to ensure that World Class HR was not seen as a separate project. Work was undertaken to ensure that WC-HR was perceived as a practical and integral tool to ensure that the HR function within CMFT delivers a quality and efficient service to the Trust. The key themes of the model were therefore woven into the HR Directorate Objectives and fed down into the HR Department objectives.

In November 2009 the Trust teamed up a local Acute Trust to undertake a Peer Review and in January 2010, Trusts within the NW again undertook a WC-HR questionnaire. This time CMFT developed its own questionnaire so that it could receive more detailed information with regard to the specific services within the HR Directorate. The questionnaire particularly focused upon the first two factors of the WC-HR model 'getting the basics right' and 'supporting people management'.

The results from both the Peer Review and the Questionnaire were very encouraging and the following areas were particularly good:

• Managers generally understand the role of the HR Directorate and think that the structure is right in some departments such as OD & T and HR Operations
• Managers are generally happy with the level of support they receive to manage and develop their staff
• Good portfolio of policies & procedures
• Managers generally feel they receive good support from the HR Operations team which enables them to make informed decisions about staff and service
• Fast track Physiotherapy & osteopath through OH
• Managers feel they receive sufficient data to support the management of sickness absence

The feedback has enabled the HR department to develop a more detailed action plan for each specific area. The feedback from the questionnaire was also communicateed through the Trust's meeting and management structure as part of the HR Directorates Quality Campaign.

A further questionnaire is planned for April / May 2011 and this will explore the areas of concern identified during the last questionnaire to ensure improvements are being made. The questionnaire will also ask for feedback on factors 3 & 4 'achieves results for the business' and 'has a compelling business proposition' and again this information will be fed into HR directorate & department action plans.

WC-HR within CMFT is seen as a very practical way of assessing whether the HR directorate is providing a quality 'value for money' service. Ultimately, it will provide the HR directorate with a tool to demonstrate to the Trust how it is adding value to the organisation, aligning itself to meet the business objectives and proactively leading the people agenda.

Cheshire HR Shared Service

Cheshire HR Service was a newly established shared service for three NHS organisations in October 2007: one Acute Trust and two PCTs. The project offered the opportunity to gather soft perceptions about how the recent changes were going as well as to ensure the expected cost-savings and service improvements were delivered. The HR Service scored well overall on the first survey but still managed to improve on all seven factors in 2010 including a 50 per cent improvement on perceptions about recruitment.

Judy Watson from Central and Eastern Cheshire Primary Care Trust (one of the organisations served by the HR Service) says: ‘we found that improving the people management capability of line managers is key to improving staff experience.’ DoH research already shows that good staff experience leads to good patient experience.

So what is the secret of their success? Examples of good HR operations practice introduced at Cheshire include:

• monthly briefings for line managers on HR admin services and payroll to manage expectations and make sure they understand what they need to be doing and when
• working with finance function to deliver more accurate monthly reports for line managers (and ensure ESR structures fit for purpose)
• making two-way communication more bespoke to the three different business situations, eg twice monthly ‘balcony briefs’ by CEO/Director at one organisation to update and answer staff questions – recorded and placed on intranet so the same message goes out consistently
• introducing HR business partner teams and more recently an HR Consultancy ‘hub’ and ‘People Coaches’ to support high performance team working across the 3 organisations served
• Service Level Agreements with customer organisations includes KPIs, soft and hard, for all functions within the Cheshire HR service.