Promoting partnership working in the NHS

A new attendance policy: a new approach to people management - Norfolk and Norwich University Hospitals NHS Foundation Trust

The organisation

The Norfolk and Norwich University Hospitals NHS Foundation Trust is one of the largest NHS trusts in the United Kingdom providing first-class acute and specialist services. Every year more than 7,000 staff provide acute hospital care to more than 822,500 people from Norfolk, North Suffolk and from further afield. Patients are referred to the hospital by around 100 local GP practices and also from other acute hospitals around the country. The hospital provides a full range of acute clinical services, including more specialist services such as oncology and radiotherapy, neonatology, orthopaedics, plastic surgery, ophthalmology, rheumatology, paediatric medicine and surgery. They also work closely with the University of East Anglia’s Faculty of Medicine and Health Sciences to train health professionals and undertake clinical research. 

Trust management have worked in partnership with staff side colleagues to agree and implement a new attendance policy and associated toolkits.

The challenge

In April 2015 the trust welcomed a new Deputy Director of Workforce, Ashley Judd, who met with the staff side chair and lead for the hospital’s Pay and Conditions of Service Committee (PACS). Ashley’s aim was to share his ethos for people management - know your staff – and to discuss the importance of trust, relationships, engagement and empowerment. Staff side were initially sceptical - a negative relationship between staff and management had developed due to challenging consultations, reviews and time-consuming appeals. They raised serious issues, such as some staff reporting that they felt pressured to attend work when unwell, and also highlighted that they had tried for several years to revise the sickness policy but with no success. Ashley was tasked with addressing concerns around the policy, he also had to re-build trust and positive relationships between staff and management. In order to move forward, a significant leap of faith was required from both sides.

The process

Much of 2015 was spent speaking with staff at all levels of the trust. Ashley met many staff who were particularly unhappy with how sickness procedures were handled. He made a point of attending every PACS meeting and appointed a HR manager to chair so he could be more involved in the process. Over time, it became noticeable that PACS meetings were becoming more open and honest, with both sides listening and valuing the feedback they received. Managers became increasingly aware of the negative impact the existing sickness process was having on staff, and both sides came to the agreement that radical change would be necessary for the benefit of both staff and management. All PACS members worked in partnership to agree and develop a new attendance policy and toolkits. In the months leading up to the policy launch, over 30 briefings were held and attended by over 400 managers in order to address wider managerial concerns.

The aim

The aim was to promote the new approach to people management as widely as possible within the trust. It had become clear that the existing sickness process was ineffective and viewed negatively by staff, so the aim was to develop a policy that was person centred and valued outcomes over processes. By doing so, it was believed that not only would staff have a more positive experience of the attendance process, but managers would feel empowered to make appropriate decisions based on individual cases.  

The outcome

Since the new policy has been introduced the trust has seen a reduction in instances of sickness absence amongst staff. In the six months to January 2017, sickness figures for each month have been lower than the comparable months from 12 and 24 months previous. Fewer staff are being sanctioned as managers begin to know their staff and undertake qualitative assessments. They are becoming more comfortable with making decisions which focus on the wellbeing of both staff and organisation, rather than being fixated on the sickness process. Alongside these improvements, PACS has agreed to keep the policy under regular review, to reflect the changing needs of the organisation and its staff. The process has provided confidence in embedding change for the future – the trust’s special leave and grievance resolution policies have already been reviewed.

The success of the new policy and change in management approach has highlighted that positive changes can be made against all odds when working in partnership. This was reflected in the positive reference made by UNISON at their AGM, who expressed their pride at being associated with the process and outcome.

Top tips

  • Meaningful consultation and negotiation is important and should not be viewed as a barrier to change.
  • The greater the engagement with colleagues, the greater opportunity to understand others’ perspectives and seek improvement.
  • The change in approach is more important than the change in policy – the key principle is know your staff.

Further information:

Ashley Judd, Deputy Director of Workforce & Harry Seddon UNISON

Ashley.judd@nnuh.nhs.uk