This report provides information on speaking up activity undertaken during quarter 2 2023/2024.
Executive summary: Key findings
- New FTSU cases increased by approx. 65% from Q1 to Q2 this year and by 19% in comparison to the same period last year. The increase can be attributed to the commencement of FTSU engagement visits and the impact of the change programmes which includes a tightening and increased accountability of processes and perceived negative behaviours attributed to change.
- Of the 89 concerns raised in Q2, the highest 3 categories have shifted:
- Application of systems and process
- Inappropriate attitude or behaviours
- 28 - 87% increase this quarter
- 18 - 29% increase this quarter
- Bullying and harassment
- 15 – 275% increase this quarter
- The application of Trust systems and processes in the main are process related to service changes, clarity in recruitment and feedback around investigation outcomes to the reporter.
The cumulative number of inappropriate behaviour or attitudes and bullying harassment has increased. There aren’t common themes, rather changes in people’s behaviour and manager responses to situations have been identified. Of these concerns:
- 46% are within our support services
- 21% within frontline operations
- 18% within EOC
- 12% within operations support
- 3% within PTS
- The anticipated rise cited in previous board reports for concerns raised from within the more administrative and corporate area of our support services has continued. Support to managers and staff within this area has been identified as a priority and will be included in the action plan of the National Guardians Office (NGO) reflection and planning tool.
- Concerns raised within administrative and corporate support services centre around normalised and expected professional behaviours which are cognisant with working within these environments. Breakdowns in communications have been regularly cited linked with the volume of work and associated pressures. The level of staff sickness and ER casework is anticipated to rise in line with this.
- 7 concerns have been raised regarding individuals within the wider trust leadership team. 6 were escalated to the appropriate level and addressed via CEO involvement. 1 has been logged with no further action at this point. 4 of the concerns cited a fear of suffering detriment which feels very real to them.
- The number of patient safety/quality concerns is higher than the total number of the previous year. It should be noted that these concerns were related to the behaviours of staff and the impact on patients and one was regarding the safety of patients on vehicles.
- There has been a reduction in the number of anonymous concerns raised to FTSU which is positive and suggests more confidence in the team. However, there has been an increase in the number of confidential concerns which means staff are still reluctant to have their concerns escalated more openly, which coincides with the percentage of staff stating they still fear suffering detriment if they raise a concern.
- The percentage of concerns resolved through FTSU facilitated interventions has positively increased due to the increased capacity within the team, the embedding of revised trust processes and the increase in understanding and support provided to staff by managers within the trust.
- FTSU concerns raised as a percentage of the number of staff for each area will be provided in the next board update and to the next Raising Concerns Forum.
FTSU priorities Q3 2023-24:
- Re-establishing quarterly engagement visits with a focus on students and support services.
- Trust completion of the NGO speaking up reflection and planning tool.
- Preparation for the NGO led board development session on the fear of speaking up and suffering detriment.
- Establishment of revised FTSU case management process.
Report and analysis of FTSU case work undertaken this year
1.Number and themes of concerns raised
1.2 Quarterly breakdown of concerns raised to FTSU Guardian.
|
Q1 |
Q2 |
Q3 |
Q4 |
Total |
2019/20 |
7 |
6 |
12 |
11 |
36 |
2020/21 |
8 |
13 |
117 |
77 |
215 |
2021/22 |
84 |
90 |
94 |
91 |
359 |
2022/23 |
84 |
75 |
47 |
75 |
281 |
2023/24 |
54 |
89 |
- |
- |
143 |
1.2 Theme of concerns*
|
2022/23 |
Q1 |
Q2 |
Q3 |
Q4 |
Total 2023/24 |
Patient safety / quality |
2 |
2 |
5 |
|
|
7 |
Bullying / harassment |
41 |
4 |
15 |
|
|
19 |
Behavioural / relationship |
6 |
0 |
1 |
|
|
1 |
System / process |
89 |
15 |
28 |
|
|
43 |
Staff safety |
12 |
4 |
4 |
|
|
8 |
Cultural |
3 |
0 |
1 |
|
|
1 |
Leadership |
1 |
2 |
7 |
|
|
9 |
Senior / middle management issue |
35 |
12 |
10 |
|
|
22 |
Infrastructure / environment |
1 |
1 |
0 |
|
|
1 |
Inappropriate attitude or behaviours |
14 |
14 |
18 |
|
|
32 |
Other / anonymous |
2 |
0 |
0 |
|
|
0 |
Total |
281 |
54 |
89 |
|
|
143 |
* Categories are suggested by the National Guardian’s Office; discussion with staff and judgement of the Guardian determines which category a concern is recorded against.
1.3 NGO Professional Groups* 2023-24
|
2022/23 |
Q1 |
Q2 |
Q3 |
Q4 |
Total 2023/24 |
Additional clinical services |
98 |
18 |
32 |
|
|
50 |
Administrative and clerical |
56 |
13 |
32 |
|
|
45 |
Allied health professionals |
103 |
17 |
17 |
|
|
34 |
Estates and ancillary |
11 |
3 |
5 |
|
|
8 |
Students |
8 |
1 |
0 |
|
|
1 |
Other |
5 |
2 |
3 |
|
|
5 |
Total |
281 |
54 |
89 |
|
|
143 |
Please note as of April 2022 all professional groups were updated by the NGO as follows.
Additional clinical services - Staff directly supporting those in clinical roles. In addition, support to nursing, allied health professionals and other scientific staff are included. Have significant patient contact as part of their role.
Administrative and clerical - non-clinical staff, including non-clinical managers, administration officers, executive board members who do not have significant patient contact as part of their role.
Allied Health Professionals - Registered clinical staff providing diagnostic, technical and therapeutic patient care, including dieticians, radiographers and physiotherapists. Includes qualified ambulance staff such as paramedics.
Estates and ancillary - non-clinical support and maintenance staff, including gardeners, plumbers, cooks and housekeepers who do not have significant patient contact as part of their role.
Students - Directly employed staff undertaking formal education, including student nurses and midwives
Other - Used to encompass anonymous, third-party contacts along with other areas of the Trust that do not fit the NGO reporting categories.
2. Quarterly service area breakdown of concerns
A&E Sectors |
2022/23 |
Q1 |
Q2 |
Q3 |
Q4 |
Total |
Bedfordshire and Luton |
8 |
3 |
3 |
|
|
6 |
Cambridgeshire and Peterborough |
43 |
1 |
7 |
|
|
8 |
Hertfordshire and west Essex |
27 |
9 |
4 |
|
|
13 |
Mid and south Essex |
14 |
2 |
2 |
|
|
4 |
Norfolk and Waveney |
15 |
1 |
3 |
|
|
4 |
Suffolk and north east Essex |
18 |
5 |
0 |
|
|
5 |
AOC including ECAT and SPOC |
Bedford |
24 |
4 |
4 |
|
|
8 |
Chelmsford |
19 |
4 |
0 |
|
|
4 |
Norwich |
16 |
3 |
13 |
|
|
16 |
PTS |
Bedfordshire and Luton |
13 |
1 |
1 |
|
|
2 |
Cambridgeshire and Peterborough |
13 |
1 |
6 |
|
|
7 |
Hertfordshire |
2 |
1 |
4 |
|
|
5 |
North Essex |
0 |
0 |
0 |
|
|
0 |
West Essex |
1 |
1 |
0 |
|
|
1 |
|
|
|
|
|
|
|
Operations Support and Estates |
11 |
6 |
7 |
|
|
13 |
Support Services |
53 |
10 |
34 |
|
|
44 |
Anonymous |
4 |
3 |
1 |
|
|
4 |
Total |
281 |
54 |
89 |
|
|
143 |
3. Progression towards FTSU KPI’s
CQC exit criteria |
Aim |
Metric |
2022/23 baseline |
Target |
Previous quarter |
Current quarter |
Strengthening FTSU and making speaking up business as usual |
Staff, managers and leaders complete the relevant mandatory speak up training modules |
0 |
85% |
- |
Speak Up - 342 Listen Up - 82 Follow Up - 21 % report to RCF, update next report |
Q21e – I feel safe to speak up about anything that concerns me in this organisation |
46% |
48% |
- |
Data unavailable until staff survey Nov 23 |
Less than 5% of anonymous concerns raised to FTSU |
3% (9/281) |
2% |
6% (3/54) |
3% (5/143) |
Reduction in the percentage of staff in fear of or suffering detriment |
44% (123/281) |
40% |
52% (28/54) |
49% (70/143) |
Increased number of FTSU ambassadors |
16 |
40 |
16 |
15 1 left the trust |
Cultural Oversight Group |
Aim |
Metric |
2022/23 baseline |
Target |
Previous quarter |
Current quarter |
Key objective 1 - To ensure that EEAST has a culture of belonging and inclusivity |
A reduction in the number of staff reporting bullying and harassment to FTSU |
21% (59/281) |
20% |
7% (4/54) |
13% (19/143) |
A reduction in the number of staff reporting inappropriate attitudes and behaviours to FTSU |
7% (20/281) |
7% |
28% (14/54) |
22% (32/143) |
Key objective 1 - To ensure that EEAST has a learning culture embedded |
Percentage of cases resolved through FTSU facilitated interventions |
- |
40% |
43% (23/54) |
64% (91/143) |
A reduction in the percentage of confidential concerns raised to FTSU |
65% (88/281) |
60% |
72% (39/54) |
75% (107/143) |
FTSU feedback question - From your experience with the Freedom to Speak up team, would you speak up again - Yes |
- |
40% |
Not yet available |
Await outcome of revised feedback process |
|