CPD work pressure: finding solutions together (part 2)

This article focuses on Amanda Fraser-Gray, a rotational band 6 physiotherapist and CSP steward based at Royal Lancaster Infirmary. Here is Amanda’s account of what she and fellow steward Victoria Eden, along with safety reps Elizabeth Barber and Alex Bush, did with their colleagues to pinpoint the pressure, and what she’s learnt from the experience. 

As part of the CSP campaign, we surveyed members at the end of 2016. That was an exceptionally busy time of the year due to the demands of ‘winter pressures’. We were aware that there were some vacancies in the department, but I don’t think we realised at the time how stretched the department was.

 

Our ‘Pinpoint the pressure’ survey was based on a template prepared by CSP. We loaded this into Survey Monkey. Responses were anonymous which I think is one reason we got a much higher response rate (73 per cent) than the trust gets to its annual NHS staff survey. 

 

The first question asked ‘do you feel stressed at work?’ Knowing that every respondent answered ‘yes’ meant we had a responsibility as CSP reps to take action with and on behalf of staff. The survey data led us to look in more detail at workload and whether we had enough staff to meet demand. 

 

Our review uncovered a shortfall in staffing. We found a number of unfilled vacancies and posts where the post-holder was on leave with no back-fill. We also saw that some posts had evolved so that staff in them had less time available for hands-on clinical work. Members also raised concerns about a lack of training opportunities available at that time. 

 

We shared our findings with staff, and with their agreement approached management to raise our concerns. We approached the therapies manager but got no response. We knew that she was involved in a service reorganisation and was under considerable pressure at that time. So rather than adding to that pressure, we took advice and approached the managers in the next layer up and got an immediate response. 

 

Meetings were set up for us to discuss the evidence we had collected and what could be done to address the staffing issues we uncovered. Our trust has a set of behavioural standards and values in place that informed our communication with management. We took care to ensure that our presentation of the evidence did not become a “finger-pointing exercise” and emphasised our commitment to working together to find solutions.

 

Having that direct channel of communication with management made a real difference – ‘if information is not filtering up you don’t get actions cascading back down’. Our trust has since emphasised its commitment to partnership working with staff side. 

The combination of information from the survey and data about staffing levels allowed us to be objective. The timing helped management recognise how addressing physiotherapy staffing levels would help the trust meet the demands of winter pressures. Management agreed to increase our staffing levels. Locums were employed to plug the staffing gap while we negotiated the number and scope of posts needed. We agreed to work with members to collect capacity and demand data that supported management in making the case to over-recruit. That outcome confirmed that management heard and recognised our concerns.  

 

The trust recruited a cluster of new band 5 posts and a band 6 post, as well as a band 7 post in paediatrics that had been vacant and uncovered for a considerable time. Management were able to make the case for the band 7 post by showing that we needed someone to lead the delivery of in-patient physiotherapy services for children, and support staff training and development in this specialised area of practice. 

 

It’s still too early to know how the changes have impacted on the service. Now that staffing levels are more closely aligned with service demands, the sense of the department ‘being all at sea’ is fading - staff feel that their voices have been heard and acted on by management. The process of plugging the gaps has changed the balance of activity for colleagues who are involved with training and development of new staff and students in the short-term. We’ve re-introduced the work-based continuing professional development sessions that were lost to create time to meet the winter pressure targets. That’s also having a positive impact on morale and confidence in our practice. 

 

We’ve shared the outcomes and learning from our action with colleagues on staff side and hope that other unions will undertake similar anonymised surveys of their members. We plan to repeat the member survey over the next few months – it will be interesting to see how that data compares with where we were at the end of 2016. 

The campaign has been an empowering experience. Conversations with colleagues through the campaign has helped me recognise how our work and how it is organised impacts on how we feel – about ourselves and our practice. I’ve learnt how to manage two different ‘hats’ (CSP steward and band 6 physiotherapist) and how to modify my practice to fit with the ‘hat’ I’m wearing. The campaign has increased the visibility of workplace reps – members have been able to see first-hand what their membership achieves. I’ve come to see the CSP as an enabler – a body that offers guidance and direction that allows workplace reps and staff to work together to pinpoint an issue and take action to change practice. And I’ve also learnt how to use Survey Monkey!  

The first article in the series (21 March 2018) invited you to take time out to pinpoint the pressure in your practice by describing the issue and what was causing it.  Use your notes from that activity and the insights shared by Amanda to develop an action plan to address the pressure you highlighted in your practice.