Promoting partnership working in the NHS

‘See Something, Say Something’ – Somerset Partnership NHS Foundation Trust

The organisation

Somerset Partnership NHS Foundation Trust provides a wide range of integrated community health, mental health, learning disability and social care services to people of all ages, employing more than 4,000 staff with a turnover of £158 million. The trust provides services from 13 community hospitals across the county and mental health inpatient services on eight mental health wards. It runs seven minor units and four dental access centres, including on the Isle of Wight, Dorset and in prisons in Bristol and Gloucestershire. 

The See Something, Say Something campaign has been developed in partnership, with the aim of giving staff the tools and language to empower them to challenge poor behaviour and to tackle low level concerns. The project allows staff to identify and celebrate good and positive behaviour.

The challenge

Following the publication of the Francis Report in 2013, Somerset Partnership NHS FT wanted to make sure they would never find themselves in a similar situation. The board felt the organisation as a whole needed to be involved in making sure this didn’t happen. The trust wanted to introduce a set of behaviours so that staff felt supported and enabled to  provide excellent care for both patients and colleagues, while continuing to maintain high standards.

In partnership with staff side, an organisation-wide engagement exercise was started. A key message which came through during the exercise, was that staff at all levels should be able to say something to each other if they see something of concern. A major challenge was enabling and empowering staff, particularly in lower bandings, to have the confidence  to speak up when they see something that's not right, particularly when it involved more senior colleagues. From this, the See Something Say Something campaign was born.

The process

A volunteer group made up of staff side and strategic and operational staff, was set up to look at how frontline staff could be trained to have these potentially difficult conversations. The group was led from the bottom up by the staff side chair, working with a cross section of staff at all levels. All business areas were represented, including administration clerical, estates and hotel services, as well as frontline health and care staff. A key element of the project was that all staff owned the process while having strong executive team support.

The group came up with a role play scenario model to demonstrate situations in a range of settings involving staff and/or patients. The scenario was played out and then discussed and critiqued to establish if it could have been handled better. In November 2013, the training model was piloted at a Nursing and Allied Health Professional (AHP) strategy event, with a group of 120 healthcare professionals who provided extensive feedback. Following this, a revised version of the training was delivered to a ward team and further evaluated. A key theme emerging from the feedback was the need to identify and comment on positive behaviours, together with suggestions about how to give staff the tools to do this.

Following sign off by the executive team in February 2014, the project was developed further and included a toolkit made available on the staff intranet which explained what the training would deliver. Scenario booklets and conversation triggers were developed to support staff who found it difficult to find the right words to start conversations, particularly when it involved more senior people. The accepted opening line for colleagues has become: ‘In the spirit of see something say something, can I say.....’. A great suggestion was the development of a badge with the symbol for See Something Say Something, to be awarded to staff following completion of the training. This badge proved to be key in the successful uptake and roll out of the project. Ambassadors for the project were identified, who then received extra training to drive and deliver the change throughout the organisation.

From July 2014, the training was rolled out across the organisation, carried out by two staff side representatives and a bank of multi-disciplinary operational staff, beginning with train the trainer events and board training. Whole teams were then trained together so that everyone was at the same starting point. The programme was robustly evaluated following each session, creating valuable data for future learning.

Outcomes

Since the project was implemented, there has been a significant reduction in recruitment and retention difficulties at the trust. Teams are working closely together and there has been an increase in staff speaking up, identifying both positive and less than ideal behaviours. Patients and families also started to notice the badge and have commented on the benefits of the campaign in their family and friends feedback. The See Something, Say Something campaign has also received a number of recognition awards, including:

  • Trust Recognition Award - Winner Compassion in Practice category in 2014
  • Community Hospitals Association - Winner Innovation and Best Practice Award 2015
  • Advancing Healthcare Awards - Finalist Unite the Union award for working together 2015
  • NHS South West Leadership Recognition Awards - Finalist NHS Innovator of the Year 2015.

See Something Say Something has become part of everyday business at the trust. The chairman introduces the project to new starters as part of the induction day, and it is woven into all training so that it becomes part of the organisational DNA for staff.

This programme is just one strand of a wider piece of work around staff engagement, which aims to bring about culture change in the organisation. The Care Quality Commission (CQC) provided positive feedback on the project following their inspection.

Both staff side and management colleagues have been invited to speak at various national events and there has been interest from a number of outside organisations keen to develop similar programmes. These include the Royal College of Nursing, CCG’s, social services, NHS Scotland, and several mental health and community trusts.

Prior to the setting up of the project, partnership working had been seen as very one-sided, rather than a way of working collaboratively to achieve something meaningful. Since the project commenced, there has been a real change in working relationships, with staff side and management at Somerset Partnership now working closely to deliver some very difficult and challenging organisational changes.

Top tips

  1. The project has to be owned by the staff to achieve engagement - at all levels.
  2. Partnership working with staff side colleagues is critical from the outset.
  3. Identify outcome measures and baseline measures to evaluate results.
  4. Executive team buy-in is essential.
  5. Allow time! The programme grew much quicker than anticipated and involved a lot of staff time.

Contact details:

Dawn Dawson Acting Director of Nursing & Patient Safety, Somerset Partnership NHS FT - Dawn.Dawson@sompar.nhs.uk

Denyze Harris, Speech and Language Therapy Service Manager, Somerset Partnership NHS FT - denyze.harris@sompar.nhs.uk

Vanda Squire, Staff Side Representative, Somerset Partnership NHS FT - Vanda.squire@sompar.nhs.uk