Organisation

Berkshire Healthcare NHS Foundation Trust

What was the aim/problem?

To reduce the number of unwarranted disciplinary and grievance investigations and make Berkshire Healthcare an ‘outstanding place to work for everyone’.

What was the solution?

We reviewed our casework policies, using the principles of just culture, and developed three new policies which were published in May 2021:

• Early resolution – focusing on informal resolution of issues at an early stage, using mediation and facilitation, and aims to reduce the need for formal investigations. We are developing a pool of trained mediators to support with this new approach.
• Performance improvement – supporting and developing people to perform at their best and sustain any improvements that are needed.
• Disciplinary – greater emphasis on the initial ‘fact-find’ step of the procedure, with more focus on understanding and reviewing the incident/issue in more detail and in a more holistic way, and less on the behaviour or actions of one individual. The focus is not about attributing blame, but about the learning and making changes. Any decision to suspend should only be taken once all other options, including temporary redeployment, have been considered and discounted.

We secured fixed term funding from the integrated care system to recruit a team of investigating officers who have been supporting our investigations since May 2021. This team has consistently provided high-quality investigation reports, with reduced resolution times and a reduction in the time commitment from our service managers. The independence of investigating officers provides a reassurance about objectivity.

What were the challenges?

We didn’t roll out training across the trust for our managers but instead coached our managers as they became involved in individual cases.

We have been successful in coaching managers with a change in their approach and their thinking, but initially we encountered resistance from some.

By working with managers and guiding them through the new policies and approach, we are slowly beginning to embed the new ways of working.

What were the results and the impact?

In 2021/22, 48% of potential disciplinary issues were closed following the fact-find stage. Half of the new complaints received via the early resolution policy were closed informally without the need for further investigation. No early resolution cases proceeded to a full investigation.

One case involved a drug error; previously this would have led to a formal investigation and possible suspension. The revised fact-find process quickly identified learning for the whole team and a change in processes, and was concluded in a few days without the need for any formal disciplinary investigation.

In another case, a fact-find into a safeguarding concern concluded that a full investigation was warranted. Historically, the seriousness of the allegation would have included a suspension; however, using the new policy, we became aware that the person had a qualification (unrelated to their job role) which meant that they could be redeployed to work in an alternative role whilst the investigation was completed.

The work of the investigating team has so far saved our service managers 650 hours.

The average resolution time for disciplinary cases managed by this team is 10 working days lower than the overall trust average.

Feedback from our commissioning managers is very positive about the timeliness and quality of the investigation work and the reports.

What were the learning points?

The decision to coach managers on the new policies helped – we believe a more usual approach of asking manages to attend a training course about the just and learning culture approach would not have brought the success that individual coaching with live cases has. However, this did and continues to require significant input and expertise from the HR team.

Next steps and sustainability?

Through working with our new policies in practice, we have already identified further refinements to the wording of the policies, and we will be developing an associated suite of template letters.

We are extending the just culture approach to our new supporting attendance policy and the development of a toolkit for managers to support with managing absence.

Want to know more?

Joanne Evans, HR Lead – policy & transformation: joanne.evans@berkshire.nhs.uk