Lincolnshire Partnership NHS Foundation Trust’s cultural journey continues

Nurturing a collective and compassionate environment

Lincolnshire Partnership NHS Foundation Trust (LPFT) is a mental health and learning disability trust serving a local population of over 756,000 people in the East Midlands. It started its cultural journey in 2015 when the CQC rated it “requires improvement”, in 2020 this was upgraded to “good overall” and “outstanding” for well-led.

The organisation’s cycle of continuous improvement started with the introduction of NHS England’s Culture and Leadership Programme. The progress they made in the first few years is shown in this earlier case study.

The trust’s Executive Team are actively engaged with its programme of continuous improvement, keenly asking for their NHS Staff Survey results as soon as they are available. The ethos of the ‘LPFT family’ runs throughout the organisation, with engagement and collaboration between all staff across departments and levels at the heart of its culture and values.

Challenges

Despite major improvements within its NHS Staff Survey results and CQC ratings, a few areas remain that still require focus from the trust. LPFT wanted to use the NHS Culture and Leadership Programme to develop a leadership support framework that included structured guidance on how to support staff and how to have effective wellbeing conversations.

Additionally, the pandemic in 2020 brought about a generalised decline in health and wellbeing as well as a dramatic and immediate shift in working practices. There was an associated increase in muscular skeletal conditions, high-stress levels, and a reduction in team effectiveness.

Actions

The trust’s vision is articulated in the people strategy focusing on four key areas: recruitment and retention, staff wellbeing, reducing processes and learning lessons, and culture and leadership. Using these four pillars, values and behaviours were co-designed with staff, ensuring buy-in from all levels within the organisation.

The close and consistent contact with an engaged Executive Team, including the Chief Executive, sets a strong cultural tone across the organisation. The management team and Board are keen to hear from and respond to staff. They want to analyse the survey feedback as soon as it is available, especially the free text, which can provide deep contextual insight.

The Organisational Development (OD) team look at the trends and create insights and actions from the data to help improve staff experience. The OD team share NHS Staff Survey (NSS) results, along with the National Quarterly Pulse Survey (NQPS) results, with the Associate Directors (each responsible for four clinical divisions) at quarterly meetings. The Associate Directors are further connected to staff experience by insights shown on their NQPS dashboards and by taking part in engagement and listening events.

The OD team and leadership team have been focused on team development, setting up a series of leadership development programmes as part of the LPFT Collective OD and Leadership Offer 2022. Within the programmes are courses to help manage the road to recovery post-Covid and ‘Team Time’ to help teams connect, share experiences, and process high levels of stress.

Additional activities introduced to teams to improve cohesion and wellbeing included:

• Road to recovery initiative – equip leaders for a return to normal.
• Leadership Support Circles – offer time and a reflective safe space, and include short themed and interactive online sessions.
• Team Time – adapted Schwarz rounds (conversations with staff about the emotional impact of their work) reflecting on experiences over the last two years.

To fully support each staff member’s wellbeing, the team reviewed their form called the Management Supervision Agenda, to gear it towards wellbeing, and prompt conversation about responsibilities, discuss the challenges that staff face both in and outside of work, and provide support for both. This is complemented by “Walking in your shoes”, a series of engagement events to understand the reasons that people stay and are tempted to leave.

The Staff Wellbeing Service provides access via line managers, self-referral, or the Emotional Wellbeing helpline to a range of therapies, discounted fitness activities and wellbeing workshops. Calls to the helpline identified that some people were feeling lonely or were fearful about working during the pandemic. In response to their feedback, LPFT bolstered its existing coaching assistance programme by provided extra support to help them work through their worries.

To demonstrate to staff that people beyond the trust care about their welfare, the staff wellbeing team coordinated the dissemination of gifts from other organisations during COVID. This was well-received by local businesses who were eager to show support and appreciation for the NHS staff’s efforts. Items collected included Easter eggs, Chilly’s bottles, and even hot meals for ward staff provided by one local hospitality company, which was unable to operate as usual because of lockdown rules.

All of these initiatives demonstrate how seriously the trust (and local community) value staff experience and wellbeing. At LPFT, they talk about the ‘LPFT family’ and they’ve worked hard to keep the family feeling with people working from home. They use the motto “Live and not laminated” to ensure everyone feels the effect of the support work and the initiatives are not reduced to motivational posters.

Impact

LPFT’s multi-faceted approach to wellbeing has led to exceptional results in the 2021 NHS Staff Survey, achieving a 64% completion rate, up from 61% in 2020, while the average response rate for similar organisations was 55%.

This approach has helped them to score (2021 survey) in the top 5 vs Picker average for:

And improved the most in these areas:

Going forward

Whilst LPFT performs well above the Picker average; the team remain committed to continuing their upward trajectory of improving culture and wellbeing. They have mapped out their People Plan Priorities into 2023 to build on their current strong performance.

“Fast access to insights about our staff experience have enabled us to put wellbeing at the centre of the LPFT family”

Jane McLean – Associate Director of People (OD, Leadership and Culture), LPFT.