Organisational values of National Health Service trusts in England: semantic analysis and relation to performance indicators

BMJ Leader ◽  
2021 ◽  
pp. leader-2021-000512
Author(s):  
Amina Waheed ◽  
Edward Presswood ◽  
Gregory Scott
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Sickness Absence ◽  
Language Processing ◽  
National Health ◽  
Semantic Analysis ◽  
Care Quality ◽  
Positive Effects ◽  
Universal Sentence ◽  
Organisational Values

BackgroundOrganisational values are widely assumed to have positive effects on performance and staff. National Health Service (NHS) trusts in England have accordingly chosen their own organisational values. However, there has been no survey of the values adopted, and there is little evidence that the choice of values per se has consequences for outcomes. We comprehensively described trusts’ organisational values, using natural language processing to identify common themes. We tested whether the choice of themes was associated with outcomes for patients and staff.MethodsWe collected data on trusts’ values (from their websites), performance (Summary Hospital-level Mortality Indicator (SHMI) statistics, Care Quality Commission (CQC) ratings), sickness absence rates (SAR) and staff opinions (NHS Staff Survey responses). We first characterised values based on lexical properties then progressed to semantic analysis, using Google’s Universal Sentence Encoder, to transform values to high-dimensional embeddings, and k-means clustering of embeddings to semantically cluster values into 12 common themes. We tested for associations between trusts’ use of these themes and outcomes.ResultsOrganisational values were obtained for 221 of 228 NHS trusts, with 985 values in total (480 unique). Semantic clustering identified themes including ‘care’, ‘value respect’ and ‘togetherness’. There was no significant association between themes and SHMI or CQC ratings. However, themes predicted trusts’ SAR (p=0.001, R2=0.159), with use of ‘care’, ‘value respect’, ‘aspirational’ and ‘people’ all significant predictors of increased sickness absence; themes also predicted staff opinions on ‘Equality, diversity and inclusion’ (p=0.011, R2=0.116), but with ‘supportive’ and ‘openness’ predicting more negative responses.ConclusionA trust’s adoption of individualised organisational values does not seem to make a positive difference to its patients or staff. These findings should give NHS managers pause for thought, challenging them to reconsider their reliance on value-defining initiatives, and to seek evidence that a focus on values has measurable benefits on outcomes.

How do explicitly stated hospital trust values relate to their CQC ratings?

BMJ Leader ◽  
2018 ◽  
Vol 2 (2) ◽  
pp. 68-70
Author(s):  
Nathan Hamnett ◽  
Naomi Patel ◽  
Kathryn Nelson ◽  
Tom Harrison ◽  
Nicholas White
Keyword(s):  
Quality Improvement ◽  
National Health Service ◽  
Health Service ◽  
Service Delivery ◽  
National Health ◽  
Care Quality ◽  
A Value ◽  
Care Quality Commission ◽  
Organisational Values ◽  
Range Of Values

IntroductionFor National Health Service(NHS) Trusts in the process of setting internal organisational values, it would be useful to see if there was a correlation between certain organisational values and Care Quality Commission (CQC) ratings to enable quality improvement.MethodsTo examine this, we identified the CQC ratings of the NHS England provider trusts and identified and listed the trust’s values. These values were then categorised and a comparison made of well-performing and underperforming trusts.ResultsA total of 43 different values were identified, with a total of 800 values being used across all 188 trusts. In the reviewed hospitals, a broad range of values were found with some not meeting common definitions of what a value is. All trusts included some aspect of behaviour in their values.ConclusionWell-performing hospitals are more likely to be open and honest with aspirational values, whereas those which are not are more likely to be focused on day to day service delivery with operational or proscriptive values. There was considerable variation from the published NHS constitution values with outstanding and good trusts having more variance from the values in the NHS constitution than trusts rated requiring improvement or inadequate.

scholarly journals Improving the Usefulness and Use of Patient Survey Programs: National Health Service Interview Study (Preprint)

2017 ◽  
Author(s):  
Kelsey Flott ◽  
Ara Darzi ◽  
Sarah Gancarczyk ◽  
Erik Mayer
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Patient Experience ◽  
National Health ◽  
Care Quality ◽  
Barriers And Facilitators ◽  
Care Staff ◽  
Health Care Staff ◽  
Service Improvement ◽  
Patient Reported

BACKGROUND A growing body of evidence suggests a concerning lag between collection of patient experience data and its application in service improvement. This study aims to identify what health care staff perceive to be the barriers and facilitators to using patient-reported feedback and showcase successful examples of doing so. OBJECTIVE This study aimed to apply a systems perspective to suggest policy improvements that could support efforts to use data on the frontlines. METHODS Qualitative interviews were conducted in eight National Health Service provider locations in the United Kingdom, which were selected based on National Inpatient Survey scores. Eighteen patient-experience leads were interviewed about using patient-reported feedback with relevant staff. Interviews were transcribed and underwent thematic analysis. Staff-identified barriers and facilitators to using patient experience feedback were obtained. RESULTS The most frequently cited barriers to using patient reported feedback pertained to interpreting results, understanding survey methodology, presentation of data in both national Care Quality Commission and contractor reports, inability to link data to other sources, and organizational structure. In terms of a wish list for improved practice, staff desired more intuitive survey methodologies, the ability to link patient experience data to other sources, and more examples of best practice in patient experience improvement. Three organizations also provided examples of how they successfully used feedback to improve care. CONCLUSIONS Staff feedback provides a roadmap for policy makers to reconsider how data is collected and whether or not the national regulations on surveys and patient experience data are meeting the quality improvement needs of local organizations.

scholarly journals Changing patterns of sickness absence among healthcare workers in England during the COVID-19 pandemic

2021 ◽  
Author(s):  
Rhiannon Edge ◽  
Diana A van der Plaat ◽  
Vaughan Parsons ◽  
David Coggon ◽  
Martie van Tongeren ◽  
...  
Keyword(s):  
Mental Illness ◽  
National Health Service ◽  
Health Service ◽  
Sickness Absence ◽  
National Health ◽  
Healthcare Workers ◽  
Disease Occurrence ◽  
Changing Patterns ◽  
Delays In Diagnosis ◽  
Working Populations

Abstract Background Patterns of sickness absence shed useful light on disease occurrence and illness-related behaviours in working populations. Methods We analysed prospectively collected, pseudonymized data on 959 356 employees who were continuously employed by National Health Service trusts in England from 1 January 2019 to 31 July 2020, comparing the frequency of new sickness absence in 2020 with that at corresponding times in 2019. Results After exclusion of episodes directly related to COVID-19, the overall incidence of sickness absence during the initial 10 weeks of the pandemic (March–May 2020) was more than 20% lower than in corresponding weeks of 2019. Trends for specific categories of illness varied substantially, with a fall by 24% for cancer, but an increase for mental illness. A doubling of new absences for pregnancy-related disorders during May–July of 2020 was limited to women with earlier COVID-19 sickness absence. Conclusions Various factors will have contributed to the large and divergent changes that were observed. The findings reinforce concerns regarding delays in diagnosis and treatment of cancers and support a need to plan for a large backlog of treatment for many other diseases. Further research should explore the rise in absence for pregnancy-related disorders among women with earlier COVID-19 sickness absence.

scholarly journals Relationship between employee engagement scores and service quality ratings: analysis of the National Health Service staff survey across 97 acute NHS Trusts in England and concurrent Care Quality Commission outcomes (2012–2016)

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e026472 ◽  
Author(s):  
Mark Wake ◽  
William Green
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Employee Engagement ◽  
National Health ◽  
Care Quality ◽  
Cross Sectional ◽  
Quality Ratings ◽  
Service Staff ◽  
Care Quality Commission ◽  
Receive Treatment

ObjectiveThis research explores measures of employee engagement in the National Health Service (NHS) acute Trusts in England and examines the association between organisation-level engagement scores and quality ratings by the Care Quality Commission (CQC).DesignCross-sectional.Setting97 acute NHS Trusts in England.Participants97 NHS acute Trusts in England (2012–2016). Data include provider details, staff survey results and CQC reports. Hybrid Trusts or organisations affected by recent mergers are excluded.Outcome measuresAnalysis uses organisation-level employee engagement and CQC quality ratings.ResultsEmployee engagement is affected by organisational factors, including patient bed numbers (β=−0.46, p<0.05) and financial revenue (β=0.38, p<0.05). CQC ratings are predicted by overall employee engagement score (β=0.57, p<0.001) and financial deficit (β=−0.19, p<0.05). The most influential employee engagement dimension on provider ratings is ‘advocacy’ (λ=0.54, p<0.001). Analysis supports the notion that employee engagement can be predicted from advocacy scores alone (eigenvalue=4.03). Better still, combining advocacy scores from the previous year’s survey or adding in motivation scores is a highly reliable indication of overall employee engagement (95.4% of total variance).ConclusionsNHS acute Trusts with high employee engagement scores tend to have better CQC ratings. Trusts with a high financial deficit tend to have lower ratings. Employee engagement subdimensions have different associations with CQC ratings, the most influential dimension being advocacy score. A two subdimension model of engagement efficiently predicts overall employee engagement in NHS acute Trusts in England. Healthcare leaders should pay close attention to the proportion of employees who would recommend their organisation as a place to work or receive treatment, because this is a proxy for the level of engagement, and it predicts CQC ratings.

scholarly journals Impact of workplace discrimination and harassment among National Health Service staff working in London trusts: results from the TIDES study

BJPsych Open ◽  
2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Rebecca D. Rhead ◽  
Zoe Chui ◽  
Ioannis Bakolis ◽  
Billy Gazard ◽  
Hannah Harwood ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
National Health Service ◽  
Health Service ◽  
Sickness Absence ◽  
National Health ◽  
Turnover Rates ◽  
Physical And Mental Health ◽  
Cross Sectional Survey ◽  
Service Staff ◽  
The Impact

Background Harassment and discrimination in the National Health Service (NHS) has steadily increased over the past 5 years with London being the worst performing region. There is a lack of data and research on the impact this is having on staff health and job satisfaction. Such data are necessary to inform the development of effective workplace interventions to mitigate the effects these experiences have on staff. Aims Examine the impact of harassment and discrimination on NHS staff working in London trusts, utilising data from the 2019 TIDES cross-sectional survey. Method In total, 931 London-based healthcare practitioners participated in the TIDES survey. Regression analysis was used to examine associations between the sociodemographic characteristics of participants, exposure to discrimination and harassment, and how such exposures are associated with physical and mental health, job satisfaction and sickness absence. Results Women, Black ethnic minority staff, migrants, nurses and healthcare assistants were most at risk of discrimination and/or harassment. Experiencing either of the main exposures was associated with probable anxiety or depression. Experiencing harassment was also associated with moderate-to-severe somatic symptoms. Finally, both witnessing and experiencing the main exposures were associated with low job satisfaction and long periods of sickness absence. Conclusions NHS staff, particularly those working in London trusts, are exposed to unprecedented levels of discrimination and harassment from their colleagues. Within the context of an already stretched and under-resourced NHS, in order to combat poor job satisfaction and high turnover rates, the value of all healthcare practitioners must be visibly and continuously reinforced by all management and senior leaders.

scholarly journals Perception, experience and knowledge of early physiotherapy in intensive care units of Rome: a survey

2020 ◽  
Vol 90 (4) ◽  
Author(s):  
Simone Salvitti ◽  
Elena Repossini
Keyword(s):  
Intensive Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Public Hospitals ◽  
Fundamental Aspect ◽  
Full Potential ◽  
Hospital Organization ◽  
Positive Effects ◽  
Clinical Instability

Early physiotherapy (EP) programs on critically ill patients in the intensive care unit (ICU) have proven to be safe, feasible and effective. However, despite being considered by all the professionals involved as a fundamental aspect of integrated care, in most cases they are inadequately applied or not performed at all. The main objective of this study is to evaluate the knowledge, perceptions and activities related to EP among physician, nurses and physiotherapists who practice in ICUs of Rome. Obstacles to its application and possible strategies to overcome them are also examined. The study was conducted according to the CHERRIES recommendations. Two questionnaires with 29 questions were created on the Google Form platform and were sent by mail to all the ICUs of public hospitals or accredited private hospitals with the National Health Service in Rome. Thirty (60%) of the contacted ICUs responded. The physiotherapist is present in 76.7% of ICUs and carries out its activities mainly during daytime hours (60.9%), for less than 3 hours in 39.1% of cases and only after a request for specialist advice (65.2%). Only in 4.3% of cases the service is guaranteed even at weekends but only after a request. All 29 professionals interviewed consider both the presence of a physiotherapist within the interdisciplinary team of the ICU and the implementation of an EP program to be necessary, supporting the positive effects of this program. The most frequently obstacles to the implementation of an EP program are clinical instability (69%), low priority to EP practice (62.1%), cardiovascular instability (58.6%) and lack of experience (58.6%). The most frequently indicated strategies to overcome these obstacles are to organize interdisciplinary briefings (86.2%), to avoid excluding patients from treatment without specific motivation (75.9%), to invest in staff training (75.9%), to use protocols and guidelines (58.6%). EP is not currently exploited to its full potential due to lack of funds, culture, experience, training and a hospital organization that limits the provision of effective patient care and efficient service to the National Health Service.

scholarly journals Impact of COVID-19 pandemic on sickness absence for mental ill health in National Health Service staff

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e054533
Author(s):  
Diana A van der Plaat ◽  
Rhiannon Edge ◽  
David Coggon ◽  
Martie van Tongeren ◽  
Rupert Muiry ◽  
...  
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Sickness Absence ◽  
Outcome Measures ◽  
National Health ◽  
Ethnic Origin ◽  
East Midlands ◽  
Occupational Characteristics ◽  
Service Staff

ObjectiveTo explore the patterns of sickness absence in National Health Service (NHS) staff attributable to mental ill health during the first wave of the COVID-19 epidemic in March–July 2020.DesignCase-referent analysis of a secondary dataset.SettingNHS Trusts in England.ParticipantsPseudonymised data on 959 356 employees who were continuously employed by NHS trusts during 1 January 2019 to 31 July 2020.Main outcome measuresTrends in the burden of sickness absence due to mental ill health from 2019 to 2020 according to demographic, regional and occupational characteristics.ResultsOver the study period, 164 202 new sickness absence episodes for mental ill health were recorded in 12.5% (119 525) of the study sample. There was a spike of sickness absence for mental ill health in March–April 2020 (899 730 days lost) compared with 519 807 days in March–April 2019; the surge was driven by an increase in new episodes of long-term absence and had diminished by May/June 2020. The increase was greatest in those aged >60 years (227%) and among employees of Asian and Black ethnic origin (109%–136%). Among doctors and dentists, the number of days absent declined by 12.7%. The biggest increase was in London (122%) and the smallest in the East Midlands (43.7%); the variation between regions reflected the rates of COVID-19 sickness absence during the same period.ConclusionAlthough the COVID-19 epidemic led to an increase in sickness absence attributed to mental ill health in NHS staff, this had substantially declined by May/June 2020, corresponding with the decrease in pressures at work as the first wave of the epidemic subsided.

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