Improving retention through staff engagement: a Do OD case study

Key benefits and outcomes

• The organisation saw a significant reduction in turnover and sickness rates.
• Improved benefit and development offer around key areas of concern identified in a scoping exercise.
• The implementation of various wellbeing initiatives, including a compassionate leadership circle and an allyship toolkit.
• Recognition through the Capsticks Award for Innovation at the HPMA Awards 2023.
• Improved scores on flexible working in the NHS Staff Survey.

What the organisation faced

Employer-employee relations experienced changes as a direct result of COVID-19 at a global level, and this had an impact on team dynamics within LPFT.

In response, the trust decided to conduct research to learn more about the factors that attracted people to the organisation so that these could be further enhanced. The organisation also wanted to explore the causes that led staff to leave, and how these could be mitigated. Additionally, it was interested in finding out what staff thought about the trust's benefits and reward package, and whether they felt anything of importance was missing.

This was a crucial piece of work for the trust due to the ongoing workforce issues facing health and social care, as well as the widespread concerns about attraction, recruitment, and retention.

What the organisation did

At the start of the process, the trust asked itself three key questions:

• What makes staff want to stay?
• What tempts them to leave?
• What does good reward and recognition look like?

To begin to answer these questions, the trust determined which areas had the highest turnover and vacancy rates. The OD team then conducted engagement sessions within those areas and organised drop-in sessions within different departments. The sessions were well attended, with 101 staff taking part.

A further sense-check exercise was carried out using Survey Monkey and Facebook polls to ensure the findings applied to the wider organisation. This generated over 100 responses - extending the scope of the exercise helped to double the number of participants. Other ways for staff to participate included sending suggestion postcards and contacting the generic email inbox, both of which were well used.

The team successfully gained a clear understanding and, based on the most popular keywords that were fed back, concluded that the main reasons that made staff want to stay within the organisation were:

• teamwork
• LPFT as an employer
• job purpose and satisfaction
• flexible working (60 per cent of staff surveyed said they were satisfied with the working from home opportunities).

It also learned that the main reasons why staff considered leaving were:

• lack of flexibility in some areas
• pay and cost of living
• workload and wellbeing.

Taking into consideration the feedback received, the trust implemented a number of changes and took on board various pieces of work in order to improve the experience of staff in the organisation.

Further flexible working policies were put in place, such as the piloting of a  team-rostering system within some adult inpatient areas (with plans to extend this year on year) and the introduction of NHS England’s flexible working guides.

With the aim to improve pay and support staff with the cost of living, the trust uplifted all clinical posts from Band 2 to Band 3 roles and created a competency framework to encourage development for Band 6 roles. It has also developed a wage stream app for all employees and set up a hardship fund. Additionally, the trust has rolled out a bespoke leadership programme for ward managers and clinical leads in areas with the highest turnover and sickness rates.

Results and benefits

The organisation received outstanding results in the 2023/2024 Q2 National Quarterly Pulse Survey. LPFT was ranked first out of 180 providers in the motivation and engagement category. It also received a joint first place in the involvement category and a joint second place in advocacy.

The trust’s turnover rates have decreased significantly, from 15.3 per cent in August 2022 to 12.9 per cent in May 2023. The same can be said for sickness rates, which have dropped from 5.9 per cent in August 2022 to 5.4 per cent in May 2023.

The scoping exercise also allowed the trust to enhance its benefit and development offer around key areas of importance and concern. For example, with the introduction of an assessment and development tool for team leaders offered a more consistent approach to team effectiveness.

Following the review of Band 2 and 3 roles in inpatient areas, the organisation has improved the financial wellbeing of many employees while also resolving a conflict over the lack of differentiation between Band 2 and 3. The organisation has also managed to improve scores around flexible working in NHS Staff Survey.

The staff wellbeing service introduced more workshops into its health and wellbeing offer around burnout, moral injury, emotions and what they do for us, sleep, boosting wellbeing, becoming more assertive, men-o-pause, and improving self-esteem.

Working with system partners, the trust reviewed staff benefits offer, commissioning an external provider to support its approach to flexible working and, with the support of the people exemplar programme, identified the highest turnover of staff group in order to target offers to retain.

Overcoming obstacles

The staff engagement exercise was carried out during the COVID-19 pandemic and some of the areas identified by the OD team experienced outbreaks, which delayed the project slightly. The team felt it was important to conduct the engagement sessions face-to-face to maximise attendance, and because clinical staff often have difficulty accessing MS Teams.

Moving forward

The trust's OD team has been working on changing people's attitudes towards flexible work, including discussing the possibility of reviewing long-shift patterns in inpatient and urgent care settings.

The organisation is working to ensure that wellbeing offers are equitably accessed by all employees in need and conducting an ongoing review of workloads and capacity in the services. It has developed several wellbeing initiatives, including a compassionate leadership circle and a Lincolnshire system-wide allyship toolkit that encourages staff to report instances of bullying and harassment. This toolkit was awarded the Capsticks Award for Innovation at the HPMA Awards 2023.

Takeaway tips

• Provide multiple ways for staff to get involved in the process.
• Make sure the loop is closed by taking action based on the feedback received.
• Engage with the key stakeholders early on to address any concerns and ensure executive sponsorship is in place from the beginning.
• Make sure the OD team and the interviewees have agreed on what can be shared with other parties, given the nature of the content being raised.
• Allow OD colleagues to debrief after the sessions, as sensitive topics are often discussed.