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What makes a winning work place

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For the last two years, Sunderland PCT has been voted by nurses the top employer of nurses, in NT’s annual Top 100 survey. Emma Wilkinson asks nurses there what makes the trust such a good employer

In recent years the NHS has been in a constant state of flux, with staff all too easily left behind when managers are pulling in new directions. But those at Sunderland Teaching PCT are among the lucky ones.

The PCT has won Nursing Times’ annual Top 100 survey – run in conjunction with NHS Employers – for two years in a row. In the survey, trusts are rated by nurses on a host of criteria ranging from staff benefits and family-friendliness to morale and training opportunities.

And the pretty consistent message from staff at Sunderland PCT is they feel ‘supported and involved’. Not that there haven’t been some fairly big upheavals.

Over the past 18 months, the PCT has become integrated with two neighbouring trusts, while retaining some independence – a far from straightforward process.

Joy Akehurst, assistant director of nursing, says there was a point last year when they thought they had lost the support of staff and it was a big worry, but when they won the award again they realised they must be doing something right.

‘It’s all about the patients, and when you’ve got everybody concentrating on that one thing you feel united – you don’t get lost in all the bureaucracy. The staff are really valued and if the staff are happy, the patients are going to feel that.’

Open Dialogue

She explains they have a very structured one-to-one cascade system to make sure everyone gets to know what changes are happening and a two-monthly forum to encourage debate between frontline staff and management.

‘All the managers do at least one clinical session a month, which can be a bit of a challenge but it’s a sign to staff that we’re there with them,’ she adds.

There are 590 nurses at the PCT, which serves a population of 283,000.

Joy Gibson is a staff nurse working at the local day hospice. She moved from the acute sector around 18 months ago, attracted to the position by the opportunities for career development.

‘Very quickly when I joined, I had the opportunity to do a foundation course in palliative care and then the chance to do a lymphoedema course. It was really good to do that so early on and get the theory as well as the practical experience.’

Training Opportunities

Ms Gibson says the opportunity for continuing education is one of the key reasons for the incredibly low turnover among the nurses.

An online booking service for training run by the PCT speeds things up even further – staff are encouraged to put themselves up for training and an email then goes to their line manager for approval.

In addition to the options for career development, a pilot project the hospice was chosen to take part in by the National Innovation Centre had really caught the nurses’ imagination, she explains.

The task was to come up with a blueprint for the gold standard service, looking at issues such as the speed of the referral process.

“We were just supported so well from all levels to take on the challenge and there was quite a bit of extra work.

“The project is now finished but we have been encouraged by the PCT to carry on with what we’ve been doing – we had more ideas than we had time to do them in, but we wanted to keep going with them.”

Ms Gibson says the feedback they’ve had from patients has been incredibly positive and she feels very privileged to be part of such an important service.

Work-life Balance

In 2006, the PCT also won the NT Top 100 special category for being the best family-friendly employer. Making sure staff have a good work-life balance is built into the culture of the trust, explains Margaret Kennedy, who has worked as a nurse at the trust for 30 years.

In her role as business manager, she is responsible for modernisation of the district nursing service as well as tissue viability, dermatology, minor surgery and is the clinical lead for infection control.

‘There’s a lot of support around flexible working, rather than looking at things as a problem, trying to look for a way around it. Childcare is a big thing to organise and they support that.

‘Staff can come and say I have a problem without feeling threatened, it makes a huge difference.’

The PCT has a dedicated childcare coordinator who also now takes on the role of offering support for nurses who are carers for older relatives.

As a long-term member of staff, Ms Kennedy says Sunderland PCT has always been a good place to work but admits there’s been a real culture change in the past three or four years.

‘Without any doubt the leadership culture is embedded in the organisation – it’s everybody’s business, not just the manager’s, and it’s demonstrated in the retention figures.’

A lot of services have been redesigned in this time but Ms Kennedy believes the approach of including the staff at every stage has led to success.

‘We acknowledge staff need to be involved and there’s often not the opportunity unless it’s facilitated by the organisation. We have to enable staff to come up with their own solutions rather than telling people what to do.’

The latest project is the modernisation of the district nursing service, which has in itself seen a raft of changes in recent years with the introduction of schemes such as community matrons, through which many staff have developed new skills.

‘The community is a very political place to work and there’s a lot of very challenging relationships. Staff have to feel they’re valued and part of the plan,’ says Ms Kennedy.

‘With the example of district nursing, we have a huge care service that needs modernising. We are holding a number of events with staff and we’ve had a lot of positive feedback and some negative things that staff felt need to be addressed, which can be hard to listen to but it’s important.

‘We’re starting some project work in the next few weeks, looking at how we can free up more of nurses time; if we didn’t listen, we wouldn’t succeed.’

The PCT is often overwhelmed with applicants whenever a job is advertised, both through those seeking internal promotion and outside interest. Gareth Johnson joined the PCT in 2003 because he could see the trust was ‘forward-thinking’.

In 2004 he became manager of the newly set-up nurse-led minor injuries service.
‘It’s developed my role as a nurse. That’s one of the things that attracted me to the trust, the fact they were starting up new services.

‘I feel I am able to get on with my job and I’m supported in that rather than having to worry about lots of targets.

Flexibility in career and working hours make for good staff morale, low turnover and in turn makes for better patient care, he says.
‘It’s hard work but the atmosphere is satisfying.’

NT TOP 100 - How organisations are rated

• Equality and diversity
• Benefits and remuneration
• Family-friendliness
• Flexibility of working
• Job satisfaction
• Reward and recognition
• Culture and values
• Morale
• Healthiness of workplace
• Training and development

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