The Hillingdon Hospitals NHS Foundation Trust took the exciting journey to review our values in November 2010 when it became apparent that there was the need to refresh and build on the existing culture and values. To capture learning from others a small working group visited other organisations to understand their culture and values and how they engaged staff. The learning from these organisations was used locally to make use of tried and tested methods.
In particular, a gap was identified around the underpinning behaviours expected of staff. We wanted to clearly define the minimum standard of behaviour that is expected across the Trust from our staff.
When consulting with staff it was reinforced that staff engagement in the refreshing of the culture and values was paramount to encourage ownership and buy in. The first stage of this engagement exercise was to gain staff input into the decision around which word would serve to remind staff what our values are. In view of this, and following further research, four acronyms (as below) were identified and put to staff vote.
- PRIDE – People, Responsibility, Inspire, Deliver, Educate
- ACT – Attitude, Communication, Teamwork
- CARE – Communication, Attitude, Responsibility, Equity
- PROUD – People, Responsibility, Outstanding, Understanding, Deliver
The acronym CARE received the highest votes and therefore represents our values. It was recognised that the word ‘Safety’ is a much needed addition to CARE, so it was added, thereby making the acronym ‘CARES’.
We then went on to develop a set of CARES behaviours that all Trust employees are responsible for demonstrating. To encourage full staff ownership of the behaviours small focus groups were arranged with staff from various areas and levels across the Trust. It is important that the behaviours whilst generic were meaningful and understood by all staff regardless of their role within the Trust or their area of work.
A total of seven events were held during June and July 2010 with a representative sample of staff from a variety of areas discussing the CARES acronym and the behaviours that they felt should underpin the acronym.
A session was also delivered to patients at the July 2010 Patients in Partnership forum to capture feedback, suggestions and thoughts from our service users. CARES was received positively and the feedback provided a more rounded set of behaviours that help incorporate the service user’s expectations.
Implementation of CARES and the expected behaviour
CARES has been and continues to be threaded through a number of initiatives, to ensure that our values embed the culture we want to create within the organisation and that it is at the heart of everything we do. We have been doing this through:
Developing our Experience and Engagement & Leadership strategies
CARES underpins the Trust Experience & Engagement and Leadership strategies. These two key strategies will provide a rounded approach to our commitment to embedding our culture through our values thus ensuring sustainability over time through developing supporting mechanisms. We wanted our commitment to improving staff and patient experience to expand into everything we develop so that it becomes ingrained as part of our transformational as well as transactional activities.
CARES will be incorporated into the development of the leadership framework and any leadership programmes. Existing leadership and management development programmes will be reviewed to incorporate CARES.
Retention and Recruitment
We have developed a set of generic questions incorporating the key behaviours within CARES for use at all interviews. The key behaviours will also be incorporated into our person specifications. We explore staff perceptions of how well CARES is embedded at Exit interviews, when leavers are more inclined to be open and honest with feedback.
Performance and Development Review (PDR) and Talent Management
We reviewed both our PDR and Talent Management processes and paperwork to incorporate the CARES behaviours in the format of a behavioural scale encouraging a more open discussion in a non-threatening manner about the individual’s demonstration of the values.
Reward and Recognition
Current reward and recognition initiatives are being reviewed and expanded to ensure they include assessment against the CARES framework so that staff who display the appropriate behaviours are recognised.
Customer Care Development Programme
The Trust has invested in an external provider to deliver a bespoke Customer Care programme which uses actor’s to present scenarios that have been taken from actual staff and patient feedback. These have been powerful as they bring emotion into the scenarios that bring feelings to life.
We have appointed CARES Ambassador’s who have a responsibility for demonstrating the CARES values in practice, inspiring others to demonstrate the values and to want to be an Ambassador. They will reinforce the importance of our values and the commitment of the organization to making the embedding of them a success.
They will capture good practical examples of CARES in action and good news stories, communicating these so that we deliver positive messages about how we are making progress.
The Ambassadors will give feedback to others who demonstrate the CARES values and will challenge others whose attitude and behaviour is contrary to our values.
The road ahead…….
We recognize that we have made some progress but know that we still have a long way to go but through our multi targeted approach we are confident that we will see improvements over the coming years.
We will be asking staff about their understanding of the values through bespoke questions in the National Staff Survey and will continue to use it to measure the impact through the varying stages of implementation from understanding through to applying.