The NHS must engage its employees if it is to improve

Wednesday, October 28, 2009

Cary Cooper suggests that far from being soft issues, employee engagement and wellbeing are vital tools that can be used to secure improvements in performance

Whatever your political persuasions, you can't help but feel a bit sorry for the NHS at the moment. If it's not someone criticising the very raison d'etre of the NHS, particularly in relation to President Obama's proposed health reforms in the US, it's headlines about the salaries of medical staff, levels of bureaucracy, cruel nurses or confusion over swine flu advice. One way or another, it is seldom positive.

A headline that caught my eye recently cried out that NHS staff are: "Fat, unfit and top of the sick league". This referred to the recent interim report from the large-scale review by Dr Steve Boorman and his team looking at the health and wellbeing of NHS staff.

As with any review of staff health and wellbeing, there are likely to be some results which will not make particularly pretty reading, and that require attention, management and investment.

However, this is not a reason to avoid carrying out such reviews. The research base and business case for improving employee engagement and well-being is well-documented and, in my view, impossible to ignore – a healthy, engaged and resilient workforce translates into higher productivity and therefore better outcomes all round.

The very fact that the government has commissioned a report like this, amid all the talk of budget cuts, speaks volumes for its commitment to the NHS, as well as the influence that staff can have on the overall health and wellbeing of the nation – and, in particular, that of patients. Aside from the medical treatment that the NHS provides, it has another role, which is to set and promote a good example for the rest of social and corporate Britain to follow.

We shouldn't be focusing on the few attention- grabbing headlines that describe a horror story. Boorman has set out a series of recommendations and the final report will be delivered by the end of the year – we now need to give strategic health authorities and trusts a chance to consider and implement that advice and make change happen in a planned and meaningful way.

One key aspect of the changes required was discussed in the MacLeod Report – Engaging for Success: Enhancing Performance through Employee Engagement.

The task of changing the culture of the NHS to one that sees staff wellbeing as a valuable resource has a much better chance of success if the workforce is engaged and involved. Management cannot risk presenting a done deal to staff – the future of the NHS needs to be a co-creation between management and workers.

The definition of engagement I like best, by the Chartered Management Institute, has particular resonance for the NHS: "Engagement is about creating opportunities for employees to connect with their colleagues, managers and wider organisation. It is also about creating an environment where employees are motivated to want to connect with their work and really care about doing a good job...it is a concept that places flexibility, change and continuous improvement at the heart of what it means to be an employee and an employer in a 21st century workplace" (Gatenby, Rees, Soane and Truss, 2009).

Engagement is not some soft issue but a major opportunity to improve NHS leadership, management, key processes and outcomes. There is a great deal of research showing the benefits organisations can reap when they get it right. Employee engagement and wellbeing can be seen as the glue that needs to be at the heart of any large and complex organisation – and there are few that are larger and more complex than our NHS.

However, the strategic decision to create a new market-based infrastructure within the NHS that consists of commissioning (PCTs) and provider (NHS acute, mental health trusts etc) organisations has created a great opportunity to change the culture.

As NHS organisations start to see themselves in commercial terms, standards and aspirations in all areas have risen and this includes those relating to employee engagement and wellbeing.

In the new world, as the NHS starts to conceptualise itself as a flotilla of ships rather than a giant tanker, it is creating the flexibility for providers to make their own plans to achieve their objectives.

Above all, they are free to find new ways to engage their employees. As they do this new cultures will be created and we have a good chance of getting the health service that we, the consumers, want and deserve in return for our taxes.

Sure, there may have been some gory headlines in recent reports about NHS staff, but based on the experiences of my university spin-off company, Robertson Cooper, I know that there is some serious commitment to improving employee engagement and wellbeing out there in the NHS – both in effort and financial terms. The change has already started – so watch this space, because I'll be following this one very closely.

• Robertson Cooper will be hosting the second annual Business Wellbeing Network Conference on 11 November in London – Dr Steve Boorman will be presenting his interim findings. For more information call 0161 2324910 or email: sophie.armond@robertsoncooper.com

Cary L Cooper is professor of organisational psychology and health at Lancaster University Management School and director of Robertson Cooper Ltd. Read his blog at http//carycooperblog.com