We are EEAST Briefing 25th February 2021

Chief operating officer Marcus Bailey and Director of Workforce, John Syson with this executive briefing recorded on February 25th.

I think this briefing is a big focus really on us talking more about culture, and us really talking about where we are and the ability for us to share some thoughts with you throughout the session, and then from our point of view, to open it up for those questions and answers as well. So, without further ado, I’m going to hand over to John to take us through the first bit, John.

Thank you Marcus and good afternoon everybody, my name is John Syson, Director of Workforce here at the Trust. As Marcus said, one of the key things of today’s Exec Q&A is going to be around the organisational culture, the work that has happened and the work that will be happening to look to improve some of the elements of culture at EEAST.

I think it’s probably worth going a little bit back to the start with this one. So, I’m sure many of you who are currently listening to this will have been at the Trust when we had our CQC inspection back in the summer, so in June and July. Then we had the CQC report that came out in the Autumn, and then very quickly following that the Trust has taken a number of actions to try and get under the skin and understand a lot of the issues that were highlighted in the CQC reports, because there were a lot of very serious concerns raised around both what happens at EEAST and how as an organisation we look to deal with those things.

I think it is worth reiterating, because I know some of you have tuned in to previous ones of these, we have talked about the importance of the whole organisation, including the Executive team very deliberately taking ownership of the report and accepting the content of it and what it says around how EEAST has been and what EEAST is like as a place to work for staff and volunteers, and the affect that has on people and on our patients.

So, as part of trying to get under some of that, we did the harassment survey which went out in October and into November, and we had a really fantastic response to that survey. I think over 50% of staff responded to some element of it, and that gave us a huge number of data points, but of information, of free text, and that has been very helpful in shaping what has come afterwards, and I think it also has really, really reinforced that some of the key things that we saw in the CQC report were genuine and were backed up with other information.

So, thank you for anyone who is on the call who filled out that report. It has been looked out, and we appreciate the anonymity of everyone that filled that in has been very important, but it has been a very useful data set to combine with other bits of information to try and understands the what’s and the where, and how we can try and look to address that.

One of the big changes that has come out from that has been the Speak Up, Speak Out and Stop It campaign. So, this is something which I know people have been looking on East24 or on Need to Know, or hopefully if you’ve listened to these sessions previously, there is a theme that has been coming out. I’m very pleased to say that we have had fantastic engagement from out staff side colleagues around supporting that message and publicising the importance of it.

I think we have seen that people are more willing to speak up and speak out that they have been previously, and how we can evidence that is that we have seen significantly more queries coming through to our Freedom to Speak Up Guardian. So, Janice Scott, who some of you may know, started with the Trust in the summer, and I think, and I may get my percentages slightly wrong, but something like a 500% increase in queries and questions and concerns being raised with the Freedom to Speak Up Guardian.

We’ve also seen a significant increase in number of concerns that are coming up, either through a formal or informal route. So, whether that is a concern that’s formally escalated through either a dignity at work or disciplinary or grievance process, we’ve seen a substantial increase ever since that campaign and the CQC report came out, and that continues at the moment.

I think it’s important to reflect and to acknowledge that the volume of new case work that has came through has posed some really significant challenges for the Trust in general, and very specifically for my directorate in the workforce team. We have been working hard both with recruiting additional resources to HR, but also working with Get Real HR in terms of bringing in some additional investigatory support, so that we can look to progress those cases more quickly.

Although, now we’re in February, we are starting to see some of the fruits of that, I absolutely acknowledge that we still have a long way to go, and I also understand how important it is that good transactions, whether that’s recruiting people, paying people or resolving employee relations issues when they come up, is a really core foundation part of beginning to build the Trust and the change in culture that we want to see in EEAST.

So, I think one of the other things around that campaign is giving people the confidence and the tools with which to try and challenge some poor behaviour if they see it, and recently we have started some bystander intervention training, so if people see something either with a colleague or as part of their work, that they think ‘that’s not right, that’s not how it should be’ giving people the confidence to know how to intervene in that situation appropriately, and safely and fairly.

I think that is an important part of looking to change the organisational culture overall, is people having a really good understanding of what good looks like and giving them the confidence to point out to people, and it doesn’t always need to be in a formal situation but give the confidence for people to speak out and say, ‘I’m not sure how that looked’. Later on, both Marcus and I will talk about some of the good, and some of the maybe the not so good things that we have seen through some of the culture work that has already started in the organisation.

So, I’m just going to pause there and hand back to Marcus who is going to cover a few more things, and just a reminder that people are absolutely welcome, and we welcome any questions to come into the Q&A box. So, I’ll hand over to Marcus and I’ll see you again in a few minutes.

Thanks John, a really good introduction. I guess I just wanted to just follow up on that and just share a few thoughts really about taking what looks like taking what looks like some key headlines, and slogans/banners, things we talk about, special measures, culture and some really practical bits, actually the kind of thing that – and I think while I’m not going to name areas – just to play back some of the stuff that has happened and continues to happen at this moment in time, some of the bits that we get to review now.

So if I use, and these are generic examples, so please don’t draw in to any area’s or anything that you may have heard. But actually, some really good examples of the speak up, speak out bit here is the use of social media, whatsapp groups created to support and inform the work of colleagues. Absolutely fine, this is exactly what it intends to do, but then actually being told that people are coming forward about the type of conversations, that workplace banter that goes on within these social media groups. When you them and people come forward to speak up, actually they’re not acceptable.

They’re either discriminatory against race, sexual preference or orientation, against people. And some of it is just as basic as inappropriate name calling, labelling people because of their size, their looks, their shape, actually is not acceptable, and that is some of the things that are happening. They happen today, they are happening now in our workplace that we are working really hard where people are able to come forward, we are supporting that around education, around development, around talking through, because actually for us this is the fundamental basic changes that we need to be looking at together.

If you think about that, and we have, and in the background of my slide bit here is about our values as an organisation, teamwork and respect, to be able to sit there in a group chat nobody call out or work through calling somebody fat because of their size. Actually, that is just not acceptable. That is just so basic being so disrespectful to colleagues.

These are the kinds of things that say this is not about having to work and focus on really big-ticket items all the time, because some of this is absolutely within our gift, some of this is a choice that we make. Then our step behind it, in terms of calling that out, stopping it, not making it and not allowing it to happen, is then also about how do we encourage others to speak up, to be able to then challenge each other.

Actually, we are a professional organisation, we have professional people. Doesn’t matter whether you’re in HR, whether you’re in finance, doesn’t matter with regards to if you are registered as a healthcare professional or not, everyone in this organisation is a professional person. I guess I look at that and play that back because for me, this is all within our gift to change, and it really is, and I think we have to reflect on those as well.

Other examples about how just in crew rooms or across corridors, about his notion of banter and what does that mean. But actually, where that is aimed at somebody, where it is identifiable, where is about how people react, where it is about a sexual preference or because of a gender, where we refer to girls in the work place, all of that creates a different level of culture, and all of those are the kinds of things that says looks people will challenge us and say oh we’re going to become politically as an organisation.

No, this is about values as an organisation, this is about civility in the workplace, this is about being respectful to each other, this is about working together to actually say nobody should be in fear coming in to this organisation, to be subject to ridicule conversation, to be subject to inappropriate behaviours and language, nobody should be subject to being discriminated because of the way they look, because of their sexual preference, the orientation, because they’re from a BAME background. These are just some really basic bits, and I guess in a way this is my thought process here which is actually speaking out, to say actually we need to stop it.

This is the way I view being able to share because what I don’t want us to do is I don’t want us to get lost behind the big headlines, some of this is practical, some of this is within our gift and some of this is happening, and we are either part of it because we are joining in, or we are part of it because we are not saying anything. I appreciate that it is really difficult, and I appreciate that it takes a really brave thing to be able to do that, but actually these are the fundamental bits that we are dealing with, these come across Tom’s, John’s, myself’s desk every single day, and actually I want to share with you because this is about making it real.

I don’t want you to think about this as a campaign that doesn’t mean something to me. And, I guess I pose the question before I hand back to John, is actually for me as an individual as I ask you to think about what and where is our role in all of this as we move forward. Where am I historically, where am I now, where do I want to be moving forward, and how can we have those conversations with colleagues. How can we work through that, and how can we have those conversations with colleagues, how can we work through that, and how can we really start to challenge each other to be the best we can be, whether we’re with patients, whether we’re without patients, whether we’re at work or out of work.

 Because those particularly holding a professional registration, it’s about that totality of what being a professional means, and actually when we talk about values and we talk about behaviours, it’s really about bringing those to life and it’s really about how does that land with me, what kind of professional person do I want to be, how can I demonstrate that and how can I support others to do it.  

Thanks, and I’m going to pass back John to continue with that theme.

Thank you Marcus, and I think actually there are a couple of good points that you brought up there that may be worth looking at a little bit further. One of which is about the professionalism and the civility. So, we’ve recently started a Professional Standards Group at the Trust, which has really good input from both the HCPC and the College of Paramedics.

But I think it’s important to emphasise that it’s not just about those staff who may have a professional registration. The way of behaving and the way of being in important for everybody, and not just those that are in front line positions. It’s AOC to frontline, it’s how the support services, my own service helps and supports the organisation, that’s like information technology colleagues, and how we interact with patients and colleagues from other organisations. All of that comes into it, and it’s all about those standards.

I think the other point that is probably really useful to get across is the… Marcus mentioned about people being concerned are we becoming or are we turning in to some overly politically correct organisation. There is some really good research, and I would encourage people to go out and have a look, there are some good YouTube videos on the importance of civility in clinical teams, and how it’s such a fantastic driver of clinical performance. It’s not necessarily do you have the best or the most qualified or the most educated or the most experience experts in the team, it’s around are people civil to each other? and do people have the confidence, whoever that is in the team, whether it’s the most junior member or the most senior member, to be able to say ‘hang on, is this working properly’? It’s that confidence and it’s that ability to raise concerns without fear of the consequences of doing so, is a real hallmark of teams that can provide excellent clinical care.

As well as being morally the right thing to do in terms of everybody in our organisation deserves to work in a place where they are respected for who they are and can feel safe in who they are in the workplace. There are very good clinical and organisational performance reasons for this as well, and it reinforces that mutual reinforcement of good culture reinforces good culture that reinforces good outcomes for patients, and it reinforces a good working place for staff in the organisation.

Marcus has already alluded to that we absolutely have a hell of a long way to go in this, this is not a project that is going to be completed in a couple of months, it is a much longer term thing, but I think there are some real benefits for our patients and everyone, all of us who work here in EEAST and hopefully these sessions and the materials that are being produced around Speak Up, Speak Out and Stop It and the other things are all part of making that more visible and making that commitment clearer.

So, I would encourage people if they haven’t already read the leadership message this week to have a look there. There is a very good video and some additional materials which explain a bit more about where we’re coming from and where we’re looking to go. And also, if anyone does fancy a bit more interesting reading or YouTube video watching, do have a look at Professor Michael West, he has some very interesting videos around just culture, and I think that is quite a helpful guide to something that has been tried and tested in lots of other places in the NHS, which speaks to some of the work that we’re looking to do.

So, some of the other bits I wanted to talk about is maybe an example of where, and I’m absolutely not going to release any confidences, but an individual – Marcus talked about banter – had been let’s say bantering with some colleagues, and thought ‘this is fine, everyone is having a laugh and a joke, and this is part of that, we’re building a good team’ and they were approached by somebody who was in the room who did not feel that that was a particularly good subject for a laugh and joke, felt that was very much targeted to them, and that individual was brave enough to raise it, the person who got that feedback had the insight and the maturity, and the bravery to realise and understand the effect that, not intentionally, but had unintentionally had, and had the bravery to both apologise but also to take that on and try and inform their colleagues around how behaviour that may not be intended could have quite a detrimental affect on a colleague, and looked to take some very practical steps to make sure that they understood what might happen and what the consequences of that may be.

We talk a lot about all of us having a responsibility to work with and engage with culture and we are absolutely seeing both individuals and teams really taking on and running with some of the changes that we’re looking to see, and that’s fantastic to see that. I’ve heard this cultural change described as a series of little fires that start off in an organisation and they build and build and build and eventually you have that overwhelming sense of cultural change. I’m hopeful that after a couple of months we are starting to see some of those fires building and we have certainly seen some teams and individuals really engage in what have sometimes been really tough conversations for teams to have.

Again, some of that we’ve been able to facilitate using the external resource we’ve had, or sometimes with some of the internal resource that we’ve had, and we’ve seen some positive outcomes from that. But it is going to be a long journey, journey is used a lot when it comes to cultural things, but we are starting to see some of the positives from that and I would encourage people listening to this either live or if you are listening to it later on videoed, to have a consideration around how what we do and how we behave, the impact that can have on our colleagues. Because, certainly from the employee relations cases we see, sometimes there maybe isn’t the intent but there isn’t that understanding of how people may be coming across, and that is something that we are looking to address in terms of giving people that insight helping them to get that insight.

Published 1st March 2021