hsj conference january 2010
DESCRIPTION
Presentation to HSJ Conference in London on 20th January, 2010 on Wellbeing and Performance in the NHSTRANSCRIPT
Wellbeing and performance in the NHS –an outcome of a Positive Work Culture
Derek Mowbray
Health and wellbeing – where to start
Nutrition
Genetics
Behaviour
Influences on health and wellbeing
After Thomas McKeown in:The Role of Medicine:
Dream, mirage or nemesisNPHT. 1976
The ‘big idea’
People who feel well perform better than people who feel ill
Wellbeingfeeling wellbeing well and feeling wellbeing ill but feeling wellbeing alertconcentratingmotivatedengagedhaving energy
Performanceclear aimsappropriate aimsclear timetableefficacious actionno deviationeffective actionno repetitionefficient actionsno hesitation
Wellbeing and Performance
Just a Minute Performance Model
Work improves our health and wellbeing
Working days a year
Holidays
Weekends
WorkWork
Psychological distress
Defining psychological distress
Pressure – Strain - Stress
Stimulant (pressure)
Diversion (strain)
Impairment (stress)
The impact of stress at work
Individualmisery
The Law and
Tribunals
Insurance premiums
Sickness absence,
staff
turnover.
HSE Management
Standards
5
10
15
20
25
30
0-5 6-10 11-15 16-20 21-25 26-30 Over 35
Numberof
companies
Percentage of all staff turnover pa
7
14
31
22
11
4
8
Turnover of staff 2006, 2007 and 2008
‘Top 100 Companies to Work For’Source: Sunday Times March 2007, 2008 and 2009
5
13
40
14
17
1
7
2006
2007
31-35
2
6
2008
42
9
11
23
30
15
Organisations are controlled communities
It is the manner in which they are controlled that is important.
Costs of the ‘Iceberg Effect’ as a percentage of total costs of psychological distress at work
sickness absence
staff turnover
reduced productivity at work
58%‘Iceberg effect’
32%
10%
High personal wellbeingGood business performance
Average personal wellbeingPoor business performance
Poor personal wellbeingAverage business performance
Poor personal wellbeingPoor business performance
Characteristics:Clear purposeCommitment, Trust, EngagementEffective recruitment practicesGood terms and conditionsTeam working; staff involvementAdaptive leadership and managementCustomer and staff focusLow sickness absenceLow staff turnoverLow costs/high profits
Characteristics:Ambiguous purposePoor recruitment practicesAverage terms and conditionsMismatched skills to jobsLaissez-faire management practicesFew company wellbeing programmesAverage company benefitsAverage sickness absenceHigh staff turnoverHigh costs/ low profits
Characteristics:Clear purposeAverage terms and conditionsLimited alternative employmentTransactional managementIncentive and bonus schemesHigh levels of sickness absenceHigh number of tribunalsLimited wellbeing programmesAverage staff turnoverVery high costs/Minimal profits
Characteristics:Ambiguous purposePoor terms and conditionsLack of Commitment, Trust, EngagementCoercive, competitive and bullying cultureHigh level of presenteeismHigh numbers of tribunalsHigh levels of sickness absenceHigh staff turnoverHigh costs/Low profits
Tackling the problem of psychological distress at work
Prevention
Prevent
deterioration
RestorationPalliation
Next
Generation
Strategic framework
A Positive Work Culturebased on wellbeing and performance
Culture
Self
Support services
To promote a Positive Work Culture based on wellbeing and performance
To manage threats to wellbeing and performance
To prevent personal deterioration in wellbeing and performance
To restore people back to their normal level of independent life and beyond
To support people with chronic psychological distress
To prevent psychological distressin support workers/carers
Prevention
Prevent deterioration
Restoration
Palliation
Next generation
Strategic framework Focus Purpose
© Derek Mowbray 2009
Wellbeing and Performancestrategy
Culture
Derek Mowbray 2009
•a clear, unambiguous purpose, expressed as a simple ‘big idea’, an idea which all the staff relate to closely, and are proud to discuss with friends and colleagues.
•an atmosphere of confidence, where all the staff are interested in each other, supporteach other, and project this confidence towards clients and customers.
•staff who behave respectfully towards each other, value each other’s views and opinions, work in teams which are places of mutual support, where anything is debated without a hint of humiliation, where the critique of individual and team work is welcomed, discussed and where lessons are learnt and implemented.
•staff who ‘go the extra mile’ by providing unsolicited ideas, thoughts, stimulus to each other, and where their interest in their customers offers something more than is expected, beyond courtesy, and beyond service, offering attentiveness and personal interest.
•challenges for their staff, that provide opportunities for personal development through new experiences, and which treat everyone with fairness and understanding.
•staff who are personally driven towards organisation and personal success - intellectually, financially, socially and emotionally.
Characteristics of a Positive Work Culture
We all act
We are all actors
We act according to context
We are influenced by the cultural foundations
We act in ways expected of us (stereotypes)
We behave according to the meaning we place on specific situations
Trust, commitment and engagement
Building trust and commitment leads to engagement
Organisation purpose
Organisationarchitecture
Organisation‘rules’
Organisation‘how to play the game’
Organisationdevelopment
Organisation Development
Derek Mowbray 1994
The ‘Big idea’
Purpose
Architecture
Rules of the game
How to playthe game
Structure
JobRecruitmentPayChallenge Secure
Teamwork InvolvementOpennessCommunication
Work life balanceResponsiveness
Training and development
Career opportunity
Management encouragement Leadership abilityPerformance appraisal
Manager – employeerelationshipEmployee attitudeManager discretionEmployee discretionAttentiveness
Factors that influence trust and commitment
CitizenshipBehaviourProceduresPolicies
Personal attributes andbehaviours
PeopleLeaders
Managers
Personal attributes
AttentivenessTrustworthiness
Demonstrate wisdomAssertive
Intelligence with humourPassion
Direction with committed ambition
Address individual needsNurture
Behaviours
AttentivenessPolitenessCourtesy
Personal communicationBody language
Addressing needsEmpathetic
Intellectual flexibilityEmotional intelligence
NegotiationSharing
ReliabilityHonesty
ClarityFairnessHumility
Conflict resolutionEncourage contribution
EngagementCommitment
TrustResilienceTolerance
Attentiveness
Intellectual flexibility
Reliability Resolve conflicts
Encouragement
Behaviours that inspirecommitment, trust and engagement
In others
Return on Investment
Costs
Performance
Engagement
Inspiration and Innovation
Trust
Commitment
Further information
Draft Code of Conduct for Healthcare Management – www.ihm.org.uk
Brief guide to a Positive Work Culture – www.orghealth.co.uk
White papers on: The Wellbeing and Performance AgendaPrevention of stress at workA Positive Work Culture – http://webcommunities.hse.gov.uk/