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Dual Site NHS Foundation Trust


Case Study: NHS Trust London

Two large general hospitals based in London. The Trust provides acute and tertiary care and also offers a range of community based services, including an award winning sexual health and HIV clinics across London.

Dearden were originally appointed to provide consultancy support to the HR function and provided this support for an extended period. Mark Gammage as Managing Director of Dearden HR worked as the interim HRD for 3 years before becoming substantively employed three days a week for the another 2 years. His role included acting as Deputy CEO and COO for 10 months during this period.

The Trust had significant issues with high turnover and poor staff engagement, its services to patients were largely unexceptional and the Trust had just lost 2 stars in the then national star rating system being moved from 3 stars to 1 star. Through a widespread programme of staff engagement, realising staff benefits and improvements to communication, leadership and management, the Trust’s performance substantially improved.

What We Did

● A values programme in partnership with the Medical Director and Chief Nurse, with values agreed by staff and stakeholders and these then forming the basis of objectives throughout the organisation and in all the Trust’s systems and processes.
● Implementation of an engagement methodology whereby HR and a cadre of line managers were trained to work with staff to find local solutions to local problems and issues. This began the process of inculcating a culture of staff empowerment.
● Development of a staff benefits strategy, ‘selling’ what the Trust did in a consistent and uniform way and also providing additional benefits such as fast-track musculo-skeletal services, and a contract with Optima-life to provide education and training sessions for over 200 staff on exercise, diet, mental well-being and stress and for 20 staff to undertake more rigorous heart rate monitoring the same as provided to the England Rugby and Cricket teams.
● Introduction of ways of capturing Innovative solutions to problems and challenges such as the Directors Den with investment in excess of £200k as pump-priming in projects diverse as the first NHS organisation to recruit doulas to support women in childbirth, DVDs to reduce the need for administrative and clerical staff attending face to face mandatory training and an interactive website for the Trust’s younger patients.
● A new cohesive education and training structure which bound all aspects of education and training together and the creation of an Education Strategy Board and appointment of a Director of Multi-Professional Education who helped to steer the generation of the Trust’s education strategy
● Running regular wellbeing events including mini-health MOTs, stress testing, dietetics and innovative events such as cake-making, Zumba classes and Pilates. This generated ongoing support for physical exercise classes such as the running club and yoga classes.
● Widespread improvements to staff communication including an effective Team Briefing process

Delivery Outcomes

Staff Survey

The Trust received an outstanding staff survey in 2012 with 70% of Key Findings showing an improvement on the previous year and over 80% better than the average for an acute Trust, including:

● staff recommending the Trust as a place to work or receive treatment (4.05 in 2013 on a 1-5 likert scale; the previous year was 3.88, and national average 3.57)

● staff job satisfaction (3.71; national average 3.56)

● the Trust was placed in the top 20% for staff ability to contribute to improvements

● the Trust scored the best score nationally for KF21; % of staff reporting good communication between management and staff

● the Trust’s engagement score was 3.87 (on a Likert scale of 5) which placed it in the top 20% of acute trusts nationally

The Trust scored better than acute Trusts in 18 KFs (out of 28) with 14 KFs in the top 20%. Over half of the Trust’s KFs were in the top quartile of London Trusts.

Most significantly, 80% of staff replied that they would be happy with the standard of care provided to friend/ family as compared to a national average of 60%.

Other Staffing
● turnover reduced from over 17% in 2008 to 13%;
● vacancy rates went down from 16% in 2008 to 8% and active vacancies were at under 3%;
● sickness absence was constant at 3.7%;
Patient Care

The Trust met and/ or surpassed all of its performance quality standards including waiting times for treatment and achieved the highest level of A&E performance in the country. The Trust was also voted the safest Hospital by Dr Foster in 2012.

The Trust achieved a ‘double excellent rating’

The Trust also earned independent national recognition as an outstanding employer, being named Best Employer for Carers and in the top 30 employers in the UK by the Top Employers for Working Families Awards 2010, 2011 and 2012, and voted as having the Most Effective Benefits strategy amongst all UK organisations in the HR Excellence Awards 2011.