Turning to staff for the answers

When 11 NHS trusts providing essential clinical services around the UK were delivered a negative rating from the Care Quality Commission (CQC) in 2014 – some even seeing their licences to operate revoked – they turned to their staff to find a solution.

Just five years later, all of them are now rated ‘good’ or ‘outstanding’, showing how, despite reductions in funding and manpower, organisations can harness the power of the workplace to turn their fortunes around.

A new report from NHS Providers details how these trusts did just that. While all took different paths, the key ingredient in all cases was a meaningful increase in staff engagement, through listening to and empowering employees. Bob Warnock, a senior clinical professional and physiotherapist at North Tees and Hartlepool Trust, says: ‘We realised the people on the frontline are our experts.’ North Tees – now rated ‘good’ – put this realisation into action by enabling frontline staff to make more of the decisions.

For example, it established a ‘frailty team’ to provide elderly patients with help at home, reducing the number of falls and, thus, the number of hospital admissions. The Trust also empowered staff when it came to telephone triage, allowing them to determine the most suitable support required before dispatching care providers. Overall, this resulted in a reduction of delays in patients leaving hospital from 1,000 days in October 2016 to just 200 two years later.

Similarly, London Ambulance Service’s decision to include a mental health nurse in teams attending 999 calls has reduced the number of patients being taken to A&E from 53 per cent to 19 per cent. Chelsea & Westminster chose an even more innovative route, launching a Dragons’ Den-style competition to give staff the opportunity to offer up their own solutions to the problems they were experiencing. This ultimately helped to reduce the amount the Trust spends on antibiotics by an incredible 79 per cent while cases of pneumonia contracted within the hospital fell by two-thirds.

Some trusts invested more in staff wellbeing, seeing the introduction of free yoga and Pilates classes, as well as free physiotherapy to help with the common musculoskeletal injuries suffered by staff, at Kingston Trust.

It has long been known that engaging staff in a meaningful way will have positive results when it comes to the quality of services provided by an organisation as well as its brand and reputation. Not only that, it can have a profound effect on a company’s bottom line. In 2009, the Government commissioned a report which found a solid correlation between profits and employee engagement.

The report Engaging for Success: enhancing performance through employee engagement, found that companies with low engagement scores earned an operating income nearly one-third lower than those with highly engaged workers. It also found that companies can boost their operating income by nearly 20 per cent in just 12 months if they engage properly with their employees.

Last year, the polling group Gallup reported that companies with highly engaged employees outperform others in their sectors by 147 per cent. It suggested employees who are engaged show up to work more, and are more committed to the quality of the services and products they are responsible for. The knock-on effect is better relationships with customers and, ultimately, an average 20 per cent uptick in sales.

Gallup also found that businesses with engaged workforces have earnings-per-share levels 2.6 times higher than those which do not actively engage their staff, as well as more than 40 per cent higher turnover at the top end. ‘This is not rocket science,’ says Sam Gilpin, managing director at leadership consultancy YSC. ‘If you talk to people and listen to their experiences, employees become more engaged.’ The knock-on effect of happy employees, particularly those at the front line, is, evidently, happy customers.

‘One of the ways to measure this is via Net Promoter Scores,’ says Alison Esse, director of culture change and leadership specialist The Storytellers. ‘It is amazing how NPS go up when employees are properly engaged.’

She cites the example of human resources services group ADP which had experienced a sharp drop in NPS – one of its key performance indicators – over a six-year period. A sharp rise in employee turnover had accompanied this. ‘Many channels had been used to connect and engage people in the strategy, but the messages were not landing. There was a lack of accountability, resistance to change and insufficient willingness to explore how things could be done differently,’ says Esse.

To change this, the group worked with The Storytellers to formulate a new vision for its staff – one of ‘every moment matters’ – which was formed via focus groups of staff from all areas of the business who went on to champion the message to the rest of the organisation.

Following a one-day event for leaders and champions, the new vision was cascaded through the workforce through a series of local team meetings and town halls where the focus was on how every employee can make a difference. Within one year, ADP had achieved an 11 per cent increase in employee engagement, a six per cent increase in employee retention and a whopping 48 per cent increase in its Net Promoter Scores. Customers were happier.

While the benefits of engaging with staff may seem obvious, however, it is easy to sideline such issues when times are tough. ‘Because of the stress and pressure organisations are under, leaders spend time focusing on the wrong things,’ explains Gilpin. Leaders often default to ‘tried and tested’ methods of managing people, even when they are not particularly effective.

‘There is often a ‘received’ way of interacting within an organisation; this is the way we do it. We need to encourage leaders to change the way things are done. It takes courage to do it differently because you risk looking stupid.’ Change is often a trigger for things to turn sour in the workplace, particularly if leaders are inflexible about moving with the times. ‘You can have a set of leaders who are very successful, then the context changes but they are not flexible about how things need to evolve,’ says Gilpin.

If an organisation is in real crisis, however, this can create a window of opportunity to issue the rallying cry. ‘Change becomes a matter of survival,’ says Gilpin. ‘It is easier to explain to staff why it matters to them.’

To make the most of this opportunity, the message you wish to convey must be a strong one. It needs to state the purpose and why it is valuable for individuals. Why it matters and why they should care. ‘This is a huge part of any change initiative – how to instill hope for the future,’ says Gilpin. ‘People often need a good reason to believe again.’

Leaders must listen and ask for ideas so that employees feel valued. If they feel valued, they will go the extra mile. You need a sense of dialogue.

This was precisely the position that Dorset Healthcare University NHS Foundation Trust, for example, found itself in 2014, three years after it had gone through a merger of three different healthcare providers which had left staff reeling and very much divided across the county.

The first thing the Trust did was to find a new message that would unite employees. It did so by asking all staff the same three questions What do you do? How do you do it? Why do you do it? This resulted in its new vision and mission of Be better every day, which laid the foundation for real staff engagement resulting in the Trust being rated outstanding in 2018, just four years after being in breach of its licence.

To get the message home, it is essential that communications are more than just a one-way flow of information. ‘Leaders must listen and ask for ideas so that employees feel valued,’ says Esse. ‘If they feel valued, they will go the extra mile. You need a sense of dialogue. If you continue to lead with a show-and-tell attitude, then you are not giving people the space to explore and socialise ideas.’

Gilpin adds: ‘One of the biggest mistakes organisations make is the assumption that they already know the answer. You get very smart people in leadership roles, but they often think their ideas are the only right ones. Bright people are used to being right and become uninterested in other ideas.’

When it comes to talking to people, how you do it will vary by organisation and by what has been done in the past. If a company has used surveys to carry out ‘tick-box’ exercises, then another survey will not cut it. If it is bureaucratic and impersonal, it will reinforce the idea that people are not being listened to.

At the other end of the spectrum, just asking for ideas and sitting back isn’t enough, says Lynne Arrowsmith, co-founder of brand and communications agency Goldbug. ‘The concept of the classic corporate ‘idea scheme’ – a glorified suggestions box – is dead. It can take up so much in terms of resources and, in 20 years of working in this area, I have not seen one thing changed as a result of this type of scheme.’ As Henry Ford once said: ‘If I’d asked customers what they wanted, they would have told me A faster horse.’

‘If you just ask people in a big corporate business what will make the business better, you risk just getting a lot of low-level ideas and you risk disengagement if my idea is not implemented. ‘The You said, we did programme can easily become You said, we didn’t.’ Face time with employees is crucial.  ‘Senior leaders will do their best work by being connected to people who speak to customers every day,’ says Arrowsmith. ‘They should prioritise time with those people.’

‘I am always surprised by how many companies do not have regular team meetings, especially where teams are scattered,’ adds Esse. ‘Human beings need to get together. People are good at finding solutions, but they need a forum in which to do it.’ This doesn’t have to be formal meetings – some people may not want to speak up in such a gathering – there is a multitude of ways to accomplish this.

Another way to engage with staff is to support and invest in steering committees. Narda Shirley, managing director of PR agency Gong Communications, has been working with Lloyd’s Insurance Market groups to improve diversity and inclusion among workforces in a bid to improve relations with staff and, by extension, with customers. ‘You have to be at the coal face and walk in the shoes of your customer – be able to see things from their perspective,’ she says. ‘The people at the coal face must reflect the people you are serving. If everyone is from just one socio-economic perspective, you will not be able to do this.’

Senior leaders will do their best work by being connected to people who speak to customers every day

Cross-company groups, properly harnessed to form steering committees, can help with best practice. ‘There frequently already exist informal employee groups – often just people giving up their own time; for example, youth groups or gender groups. It is saying to them Why don’t we help to promote your group by giving you resources and publicising events and making you look as official as possible? Give them funding to pay for events and speakers. This is a really effective grassroots-up approach.’

Gilpin agrees: ‘Don’t just leave it up to the leadership team to find solutions. Form a team of influential people from a level or two below the leadership teams to interact with the executive – to tell them You are missing x, y, z. Get diversity in terms of skill set and identity. It can be really developmental for people to be part of a team like this. Find people that others listen to.’

Employees also respond well when you share in their successes. ‘Whether people are managers, chambermaids or working on reception, you should be celebrating the small ways in which they all make a difference,’ says Esse. ‘Encourage people to feel they are part of the story and have a part to play in the success of the organisation.’  There are lots of ways to do this – notably using videos on the staff intranet and making use of social media. ‘Storytelling can be highly motivating and a great way to keep the momentum going. It is all about recognition and acknowledgement of the effort and contribution people have made.’

Arrowsmith adds: ‘You need to make the content sing so you need to look for employees to create the content for employees. Train people to be content gurus and get them telling stories. If you are talking to each other, it is like a conversation you have on your break. You can open up conversations across the organisation.’

This is the main way in which leisure group Resorts World Genting achieved a higher level of engagement with its staff and, as a result, made significant inroads in its plans to double visitor numbers to 40 million per year. Under the banner of the message Above + Beyond, the group’s 12,000 staff were encouraged to share real-life, emotive stories from across the business at PowerUp! events and storytelling workshops.

Don’t just leave it up to the leadership team to find solutions. Form a team of influential people from a level or two below the leadership teams to interact with the executive – to tell them You are missing x, y, z.

More than 100 stories are now recognised each month within the company. Drop-out rates from its induction programme have fallen by 20 per cent and, most significantly, customer service scores have risen by 80 per cent in two years and continue to rise. None of this is possible unless leaders put in the work to show they are serious about staff engagement

‘Where it all goes wrong is when leaders are just paying lip service,’ says Esse. ‘They must walk the talk. Often leaders say one thing, then forget all about it when they move on to the next thing. ‘Leaders need to role model. If you want people to behave in a particular way, you need to behave that way too or trust is eroded and you lack credibility. If you say your door is open, you must put in the work to make sure it is open.

‘If you say you want to hear from people, you must give the time for them to be heard. If you are going to tell people they need to be innovative, then you cannot go and micromanage your teams.’

Show staff you are serious by measuring the results of what you implement. ‘In the insurance industry, for example, KPIs are now being linked to diversity,’ says Shirley. ‘Really linking recruitment practices to appraisals and bonuses gives a clear incentive and clear signals from leadership that they are taking this seriously.’

One way to be visible in the dialogue with staff is to use a social media-style intranet platform, says Arrowsmith. Be active on it to show you are listening. ‘Being able to participate and be heard is very important and a social media platform is ideal. You need a multi-channel platform which creates opportunities for employees to talk to each other. The ways we access information in the outside world have changed – we want it quick and bite-sized. We want to scroll and move on to the next thing. The same rules apply for internal communications – people should be consuming it in the same way. ‘If you want to solve a problem, you can invite people in to solve it and you can do that in a targeted way. There will be loads of ideas and small ideas can make a big difference.’