Active Hospital Toolkit

Active Hospital Toolkit

Staffing and Staff Management

Good staff and staff management underpin all good clinical governance systems and are vital to our ability to provide high-quality care.

This section will help you to:

  • recruit highly skilled staff
  • create an efficient team
  • provide a well supported environment
Setting up...

Look at the Trusts existing recruitment procedures, mandatory training and whistle blowing policies. This will give you the information you need when building a team for the Active Hospital Project. Here is a  Checklist for this.

Next Steps...
There are important specific staffing decisions that should be made for each of the Active Hospital pathways.

Workforce planning

Workforce planning is a continual process used to align the needs and priorities of the project with those of its workforce to ensure it can meet its requirements and organisational objectives.

We used Physical Activity Champions within our pathways, who are responsible for delivering the intervention and assisting with development and improvement of the service. These clinical champions came from a variety of different backgrounds –  in the maternity pathway, our Physical Activity Champion was a midwife whereas in the TAVI pathway, we used an exercise physiologist.

Educational background and previous experience will vary between Physical Activity Champions and depend on the needs of each specific pathway. Job analysis for a Physical Activity Champion should be analysed to identify the right person for the role. Here is an example job advert for one of our Physical Activity Champions.

Job descriptions should move beyond education and experience to include work and character traits that can impact a person’s ability to thrive in your organisation. Aligning with your Trusts vision and values is an important consideration. It is also important to identify potential future evolution of the pathway to ‘future-proof’ recruitment of Physical Activity Champions.

 

Staff Retention

Staff retention is crucial to the success of services.

There are number of factors that have been identified as important in increasing staff retention:

  • Induction: supporting new starters with induction and introducing mentoring programmes with pastoral support from more experienced staff.
  • Flexibility: offering a range of flexible working options for all staff to support their work-life balance and life needs.
  • Long term planning: mapping out how current duties and their Personal Development Plan will fit into new starters long-term career plans and aspirations.
  • Conflicting demands: making new starters aware of any conflicting demands between stakeholders and consider how these can be managed.
  • Opportunities: promoting roles and opportunities within the dynamic Active Hospital project will allow retention of the staff and expertise.
  • Training and skills development: ensuring staff receive adequate training and support to develop in their roles.

Specific Training

It is NHS policy that all staff who are new to each NHS trust undergo a structured induction and successfully complete a probationary period (subject to limited exceptions).

All new employees should be provided with initial training (including mandatory training) and explanation of required standards and set objectives for the probationary period. This should include overview to key elements of their work by having an opportunity to learn basic facts and skills associated needed to fulfil their role. Those usually include:

  1. Induction to the clinical pathway
  2. Review of basic concepts of behavioural framework
  3. Training in motivational interviewing

Monitoring Activity

A structured probationary period of six months for all new employees helps to introduce them to the main duties and responsibilities of their post and to allow the opportunity for both the individual and the line manager to objectively assess whether or not the employee is suitable for the role.  For employees with a fixed term contract the normal probation process should be followed for the duration of employment. If employment is subsequently extended, the probation period will be extended up to the standard period.

The line manager is responsible for explaining the performance standards required of the new employee and service standards relating to their area of work. This includes but is not limited to:

  • Expectations professional behavioural standards
  • Quality and quantity of output
  • Skills that must be acquired or developed
  • Protocols that must be learnt
  • Deadlines which must be met and how any changes to deadlines will be communicated
  • Working relationships/networks to be developed with other staff, students, external contacts, etc.

It is expected that the line managers will hold regular one-to-one meetings with all new employees, to provide information, support them in their new role, set standards, provide feedback on performance and progress and to address any concerns from the employee. These meetings should be held as frequently as deemed necessary but no less than once a month.

Summary of Line manager planned activities related to new employees before and after starting the employment:

Planning appraisals

Monitoring performance with a clear framework for addressing any concerns, offering support and training to address perceived unsatisfactory conduct at an early stage helps to support early development.

Appraisals should be a regular process, timetabled into working hours. It creates a dialogue between the two parties with both having equal opportunity and freedom to input and express their views.

An effective appraisal system improves performance and patient outcomes. Review of performance and previous objectives is only one part of the process. Objective setting through Personal development planning is a key element of a good appraisal.

Objectives should be set for both performance objectives and for personal development. Performance objectives should be set using the SMART objectives (specific, measurable, achievable, realistic, time constrained). Personal development objectives should be set to consolidate or broaden performance in current role or to prepare an appraisee deemed to have the ability to move to another role to do so. All objectives should be traceable to contributing to strategic and operational objectives, either directly or indirectly. A template for an appraisal meeting can be found here.

Mentorship and Leadership development

Mentoring is an informal, confidential and supportive process: the mentor does not have a management role in relation to the probationer and should not therefore be a Head of Department or an appraiser.

The ways in which the mentor mentee relationship will function will vary according to the individuals concerned and the kind of working relationship they build together. At the beginning of the process the mentor and mentee should discuss how and when discussions and meetings will be arranged, as a pattern of regular meetings may be useful. However, both parties may agree to an ad hoc arrangement, to allow the mentee to initiate meetings whenever necessary, so any queries or concerns they have in connection with their work or departmental routines and procedures can be discussed as soon as they arise.

Mentors should aim to be a source of support to the mentee, an access point for information about the department and a channel for contact with others. In this way, they can provide a means of entry to a useful network of contacts and support for a new member of staff. One of the mentor’s key responsibilities is to observe mentee in working environment and give constructive and confidential feedback. In those setting, a peer Physical Activity Champion from another pathway might be the most appropriate.

The best way to learn to lead is through experience, so giving potential leaders challenging assignments can be helpful (1). In that sense, the Active Hospital project is a great way of obtaining leadership skills. This process is based on a regular analysis of the developmental needs and linked to a formal or informal gap analysis between desired capacity to lead, and the leader’s actual capacity to do so.

Reference:

  1. McCauley CD, McCall Jr. MW. Using Experience to Develop Leadership Talent: How Organizations Leverage On‐the‐Job Development. First published:17 March 2014. John Wiley & Sons, Inc. DOI:10.1002/9781118829417

Workforce planning is a continual process used to align the needs and priorities of the project with those of its workforce to ensure it can meet its requirements and organisational objectives.

We used Physical Activity Champions within our pathways, who are responsible for delivering the intervention and assisting with development and improvement of the service. These clinical champions came from a variety of different backgrounds –  in the maternity pathway, our Physical Activity Champion was a midwife whereas in the TAVI pathway, we used an exercise physiologist.

Educational background and previous experience will vary between Physical Activity Champions and depend on the needs of each specific pathway. Job analysis for a Physical Activity Champion should be analysed to identify the right person for the role. Here is an example job advert for one of our Physical Activity Champions.

Job descriptions should move beyond education and experience to include work and character traits that can impact a person’s ability to thrive in your organisation. Aligning with your Trusts vision and values is an important consideration. It is also important to identify potential future evolution of the pathway to ‘future-proof’ recruitment of Physical Activity Champions.

 

Staff retention is crucial to the success of services.

There are number of factors that have been identified as important in increasing staff retention:

  • Induction: supporting new starters with induction and introducing mentoring programmes with pastoral support from more experienced staff.
  • Flexibility: offering a range of flexible working options for all staff to support their work-life balance and life needs.
  • Long term planning: mapping out how current duties and their Personal Development Plan will fit into new starters long-term career plans and aspirations.
  • Conflicting demands: making new starters aware of any conflicting demands between stakeholders and consider how these can be managed.
  • Opportunities: promoting roles and opportunities within the dynamic Active Hospital project will allow retention of the staff and expertise.
  • Training and skills development: ensuring staff receive adequate training and support to develop in their roles.

It is NHS policy that all staff who are new to each NHS trust undergo a structured induction and successfully complete a probationary period (subject to limited exceptions).

All new employees should be provided with initial training (including mandatory training) and explanation of required standards and set objectives for the probationary period. This should include overview to key elements of their work by having an opportunity to learn basic facts and skills associated needed to fulfil their role. Those usually include:

  1. Induction to the clinical pathway
  2. Review of basic concepts of behavioural framework
  3. Training in motivational interviewing

A structured probationary period of six months for all new employees helps to introduce them to the main duties and responsibilities of their post and to allow the opportunity for both the individual and the line manager to objectively assess whether or not the employee is suitable for the role.  For employees with a fixed term contract the normal probation process should be followed for the duration of employment. If employment is subsequently extended, the probation period will be extended up to the standard period.

The line manager is responsible for explaining the performance standards required of the new employee and service standards relating to their area of work. This includes but is not limited to:

  • Expectations professional behavioural standards
  • Quality and quantity of output
  • Skills that must be acquired or developed
  • Protocols that must be learnt
  • Deadlines which must be met and how any changes to deadlines will be communicated
  • Working relationships/networks to be developed with other staff, students, external contacts, etc.

It is expected that the line managers will hold regular one-to-one meetings with all new employees, to provide information, support them in their new role, set standards, provide feedback on performance and progress and to address any concerns from the employee. These meetings should be held as frequently as deemed necessary but no less than once a month.

Summary of Line manager planned activities related to new employees before and after starting the employment:

Monitoring performance with a clear framework for addressing any concerns, offering support and training to address perceived unsatisfactory conduct at an early stage helps to support early development.

Appraisals should be a regular process, timetabled into working hours. It creates a dialogue between the two parties with both having equal opportunity and freedom to input and express their views.

An effective appraisal system improves performance and patient outcomes. Review of performance and previous objectives is only one part of the process. Objective setting through Personal development planning is a key element of a good appraisal.

Objectives should be set for both performance objectives and for personal development. Performance objectives should be set using the SMART objectives (specific, measurable, achievable, realistic, time constrained). Personal development objectives should be set to consolidate or broaden performance in current role or to prepare an appraisee deemed to have the ability to move to another role to do so. All objectives should be traceable to contributing to strategic and operational objectives, either directly or indirectly. A template for an appraisal meeting can be found here.

Mentoring is an informal, confidential and supportive process: the mentor does not have a management role in relation to the probationer and should not therefore be a Head of Department or an appraiser.

The ways in which the mentor mentee relationship will function will vary according to the individuals concerned and the kind of working relationship they build together. At the beginning of the process the mentor and mentee should discuss how and when discussions and meetings will be arranged, as a pattern of regular meetings may be useful. However, both parties may agree to an ad hoc arrangement, to allow the mentee to initiate meetings whenever necessary, so any queries or concerns they have in connection with their work or departmental routines and procedures can be discussed as soon as they arise.

Mentors should aim to be a source of support to the mentee, an access point for information about the department and a channel for contact with others. In this way, they can provide a means of entry to a useful network of contacts and support for a new member of staff. One of the mentor’s key responsibilities is to observe mentee in working environment and give constructive and confidential feedback. In those setting, a peer Physical Activity Champion from another pathway might be the most appropriate.

The best way to learn to lead is through experience, so giving potential leaders challenging assignments can be helpful (1). In that sense, the Active Hospital project is a great way of obtaining leadership skills. This process is based on a regular analysis of the developmental needs and linked to a formal or informal gap analysis between desired capacity to lead, and the leader’s actual capacity to do so.

Reference:

  1. McCauley CD, McCall Jr. MW. Using Experience to Develop Leadership Talent: How Organizations Leverage On‐the‐Job Development. First published:17 March 2014. John Wiley & Sons, Inc. DOI:10.1002/9781118829417

Downloads

Staffing and Staff Management Matrix

You can use this matrix as a guide and checklist to help you with your Governance framework.

Personal Development Plan template

Appraisal Template

Physical Activity Champion Example Job advertisement

Staffing Checklist

Checklist to help you review existing recruitment procedures, mandatory training and whistle blowing policies

Active Hospital Staff Induction Template