Promoting partnership working in the NHS

Partnership Working the DCHS Way

Derbyshire Community Health Services NHS Trust (DCHS) agreed an ambitious, transformational five-year strategy in order to develop more community-based services and deliver quality care closer to home against a backdrop of required financial savings, increased productivity and estate rationalisation.

The workforce implications of the strategy were, and remain, challenging, requiring a significant change in the way in which services are delivered and how the Trust’s workforce is configured. The Trust employs around 4,500 staff across 133 sites in Derbyshire and Leicestershire.

In recognition of the scale of these challenges, DCHS restructured its People and Organisational Effectiveness Directorate and established a dedicated Staff Partnership Team to build on the Trust’s existing partnership working and engagement with staff. Clearly, good staff engagement would be a pre-requisite for success.

The Staff Partnership Team is comprised of appointed trade union representatives for the Trust and is funded via annually-agreed facility time arrangements. The team coordinates and engages with other locality-based lay trade union representatives.

A Staff Partnership Committee (the DCHS negotiating and consultative committee) meets monthly and reports through to the Trust Board and its Quality People Sub-Committee. The Trust recognises six different trade unions and professional organisations and has a high density of union membership.

During 2013, a series of ‘Big Conversation’ events fronted by management and staff partnership colleagues were held with over 1,000 DCHS staff to enage directly on key elements and implications of the strategy.

For example, staff were asked how they felt DCHS could best deliver the required efficiency savings (£39 million over the life of the strategy) whilst maximising employment opportunities. Based on the feedback from these events, a number of potential changes to local terms and conditions were identified and the Staff Partnership Team was heavily involved in assessing the impact of the proposed changes. The proposed changes included:

  • Revisions to pay protection policy
  • Increased flexibility and mobility within the contract of employment
  • Early implementation of the linking of incremental progression with a values and behaviour based appraisal system

DCHS Deputy HR Director Paul Boustead said: “In addition, the Trust worked with the Staff Partnership Team to assess the impact of the nationally agreed changes to mileage rates. The impact assessment showed that the nationally agreed changes were detrimental to DCHS employees.

“We therefore worked with our staff partnership colleagues to engage our staff and create a mandate to develop and negotiate a local mileage scheme that remains affordable but at the same time better meets the needs of our employees.”

Latest staff survey results revealed the positive impact the engagement work has had on the workforce in the context of recent transformation.

  • 79 per cent staff satisfied with quality of work and patient care they deliver against the national average of 75 per cent
  • Staff recommendation as place to work or receive treatment - DCHS 3.78 (out of 5); national average 3.59
  • Work pressure felt by staff at DCHS 3.03 (out of 5); national average 3.13
  • Overall, the Trust score for staff engagement was above average for community trusts

Alongside the formal engagement mechanisms, regular informal meetings between the Chief Executive, Senior HR representatives and the Executive Team with trade unions was key. This allowed the Staff Partnership Team fully to represent the staff voice to influence and negotiate revisions to local terms and conditions.

Where there was broad initial agreement with staff and their representatives, DCHS moved to implement those at pace and demonstrate the benefits.

The biggest challenge was how meaningfully to engage with a multi-disciplinary, disparate and flexible workforce, 65 per cent of whom were part-time employees based at 133 sites.

The Trust delivered a number of ‘webinars’ alongside the face-to-face engagement events, holding them at a variety of times to allow employees to dial in/log in and interact with the process and to express their views.

They used a range of other methods such as focus groups, surveys and team meetings to collect information and feedback from staff.

Management and trade union representatives also needed development to assist them to undertake  negotiations and “collective bargaining” around local flexibilities to what are nationally negotiated core terms and conditions.

Based on the detailed understanding and analysis of the staff feedback, the Staff Partnership Team managed successfully to negotiate modifications, which lessened the impact of the proposals whilst still ensuring the overall aims of the reforms were delivered – i.e. a win-win was secured.

The combined impact of the negotiated proposals saved in excess of £2 million, which may have saved over 100 jobs. In addition, the locally-negotiated mileage scheme, although cost neutral, delivered productivity, staff morale and engagement benefits, which the Trust expects ultimately to have a positive impact on patient care.  

Paul Boustead added: “The primary lesson learnt was just how important it is to engage our partnership colleagues from the outset and ensure they co-create the solution to the problems presented. There are also key lessons about being bold and brave enough as an organisation and not being afraid to do what’s right for your staff, even if it bucks the national or regional trend.”

The approach taken has been recognised, commended and disseminated to others by ACAS and the DCHS Unison branch was shortlisted for the Branch of the Year Award.

For more information please contact:

Mrs Jennifer Guiver, Deputy Director of People & Organisational Effectiveness:  Jennifer.Guiver@dchs.nhs.uk