Steven Weeks, policy manager at NHS Employers, takes a look at how technology is being used to improve staff engagement within the NHS, what it means for employers and things to consider.
Over the past 18 months, the NHS has found itself carrying out a massive real-time experiment in using technology for staff engagement. Over the past two months colleagues have shared their experiences with myself and colleagues on using a range of tools to support engagement during the pandemic. In this blog, I consider the questions: what are the main lessons of this experience? And, how can we make most effective use of technology in the next period?
Pre-pandemic, a small number of trusts had extensive experience in this area, but for most the restrictions on interaction created by COVID-19 were the catalyst for rapid change. For a majority of organisations, the initial focus was to find a way to effectively communicate rapidly changing information with as many staff as possible. When face-to-face methods became impracticable, this generally took the form of MS Teams replacing team briefings and tea trolley chats. Other organisations overhauled their intranets and looked into using other tools to share information rapidly with staff.
The starting point for most organisations was how to broadcast information, but this soon shifted to a focus on feedback from staff on the frontline. Trusts arranged online meetings with senior leaders, where staff could share concerns and raise questions. Despite being resource intensive, these meetings helped to improve the visibility of senior leaders. There was also a growth in online forums such as closed discussion groups (which the NHS has traditionally been very cautious about). A small number of trusts also organised large-scale online consultation meetings.
The main lessons appear to be that high levels of online participation are possible if meetings convey relevant information, and there are responses to issues raised for instance 'you said, we did'. Closed, staff-led online groups have operated successfully in NHS during this period, although ground rules for comments need to be clear.
Ensuring all staff participate has been a challenge, especially as pressures have continued. Large-scale online meetings are challenging to run in an interactive way, and the richness of face-to-face interaction may be lost through the technology. Screens have not been a substitute for the relationship between teams and line managers, nor have they been a solution for all staff engagement challenges.
Online engagement also needs to be complemented by more formalised collective input, for example, from staff networks and via partnership working with staff side.
- There has been some further development of real-time staff feedback tools. Examples from Northumbria Healthcare will be discussed at an upcoming staff experience event and via forthcoming NHS Employers case studies.
- Most surveys carried out during this period have been undertaken online, for example, via the NHS England and NHS Improvement People Pulse, Quarterly Pulse Survey and in most cases the current NHS Staff Survey.
- Technology can assist in more frequent assessment of staff opinion to support rapid response, but there are risks of digital exclusion and survey overload.
- Technology has the potential to help analyse free text comments, though we are still in the early stages of doing this effectively.
- As organisations seek to find new ways to provide services post pandemic, there has been renewed interest in crowd sourcing tools. These have been shown to add value to quality improvement processes as long as they are properly resourced and part of overall quality improvement (QI) strategy. These tools are most helpful at the initial ideas generation stage, with other methods needed for assessment and implementation.
In 18 months, the NHS has moved from relatively low adoption of technology for engagement, to a place where its use is widespread. Making the best use of technology to enhance engagement will be a key challenge for the next period. The People Promise says we will ensure everyone has a voice that counts, and in future that voice may very well be heard virtually.