The Leeds Teaching Hospitals NHS Trust

Learning from COVID-19 Wayfinder Conversation

In the summer we asked you for your feedback on our response to the COVID-19 pandemic; what’s worked well, what we still needed to improve, and also, what we wished to make ‘the norm’ going forward. Your 362 ideas, 731 comments, and 11,888 votes meant that we were able to make some key Trust decisions which have been helping us to continue our battle against COVID-19, whilst also looking to the future in ultimately making LTHT the best place to work and to receive care. We wish to share the fantastic work that has taken place in response to your feedback.

Watch this introductory video: Director of HR & OD, Jenny Lewis - Learning from COVID Wayfinder changes

Below starts to describe some of the work that is taking place across the Trust which we have categorised into the main feedback themes we received. Your departmental feedback and ideas were also shared with your area senior leaders to progress with you locally.

Theme: Health and Well-Being

About this theme: Change is often hard. It’s particularly tough when it arrives like the pandemic; uninvited, threatening and enveloping most aspects of our lives. In this theme we collected your ideas around what we could do to support our health & well-being more as we learn to live with Covid-19.  Your ideas and comments will be used to shape wellbeing activity over the next year.

Your Feedback:

Risk Assessments

You shared your concerns that risk assessments were not consistent. Over recent months we have focused on developing a risk assessment process that is fair and transparent. We have reviewed and revised our guidance to ensure it takes into account the latest evidence and that expectations are clear.

Our assessments now cover both people and places; you’ll have seen the signs on doors to tell you the number of people who can safely be in each room.  Don’t forget risks can change, please do speak to your line manager if you feel you need to re-visit your assessment or have a concern about your work area.

Getting the Basics Right

We heard from many of you around the difficulties of finding a safe and comfortable space to pause to drink, eat or relax on your breaks. We’ve created a dedicated group to support this important work and they have been exploring many of your ideas. We’ve started by investing in refurbishing existing staff areas with support from Leeds Cares via the Captain Tom funding, with the first refurbishment appearing on the Lorraine Show! And we are now planning to support those areas with nowhere to rest. We’re also advocating clever ways to use staff spaces differently so that everyone can get a break in a socially distanced way, such as taking brunch and afternoon tea rather than a lunch break. You will see further information about this over the next few months.

Mental Health

We are aware that the pandemic has put many of us under new and sustained pressures at work, at a time when we’re not as easily able to access our usual social support and activities that re-charge our batteries. We’re delighted at the positive response to the services that are available to support you, including the employee assistance programme and the fantastic work of the Psychology team who have extended dedicated staff support such as their telephone advice line and the insightful ‘Pause Button’ email. These services will continue to be available to all staff due to additional charitable funding committed to this important work. The Health and Wellbeing Team have created posters to help you easily find and access the support available to you.

Your feedback has also helped illustrate that there are opportunities to coordinate and develop our Trust approach to training and resources for mental health. We’re also going to further develop our gym offer online and outdoors. We’re working on this and look forward to sharing more information shortly.

Theme:  How Care is Delivered

About this theme: This theme captured all your feedback that related to how we deliver patient care. Understandably for some of you there were times when it was difficult to provide the level of care you wanted for your patients and their families and yet you found innovative ways to make the best of the situation. It was also fantastic to see that for some of you the challenges presented by Covid-19 created a unique opportunity to be brave and try new approaches which have delivered positive impact and will continue to benefit our patients for years to come.

Your Feedback:

Improving access to diagnostics

We know getting some diagnostic tests for your patients could be difficult at times. It was a great idea to utilise the Yorkshire Nightingale Hospital to increase our diagnostic scanning capacity and alongside some incredible commitment and collaboration particularly from colleague in Radiology we have made huge progress getting these vital tests completed for patients. You may also have seen we’ve invested in 4 new MRI scanners for the Trust. Two of these replace older equipment and the additional 2 will be a great boost to our scanning capacity looking forward.

Discharge to Assess

Once again your ideas, commitment and collaboration across the Leeds healthcare system has ensured we have made some excellent progress in terms of safe, effective and timely discharge for our patients. The discharge to assess (D2A) model is working well to fast-track medically fit patients to the right care setting ensuring our beds are available to those most in need.

Virtual and Telephone Consultations

We’ve seen countless examples where you have adapted your clinical practice to ensure the best possible care can be delivered without the need for patient to visit our hospitals. We know this requires a real team effort behind the scenes to ensure that things run effectively. Based on patient and your feedback we know that for some this will be an approach they will definitely continue. For others it may create additional challenges and potentially worsen health inequalities. Looking ahead we’re excited to see how you’ll develop a ‘best of both’ approach for outpatient services to meet the individual needs of all our patients.

Repurposing to support different roles and teams

Many staff have taken a valuable role in supporting different departments during the pandemic. However we understand from your feedback that there were improvements that could be made to the way in which this new process was structured, and in the support you receive as you embark into less familiar environments. A ‘good practise’ checklist has now been created to ensure that both the originating line manager and the receiving line manager understand the roles they play in fully supporting the staff member that was being repurposed. A meaningful Jobs Board was also developed to support staff that are Clinically Extremely Vulnerable, or over 30 weeks pregnant; giving staff the opportunity to work in a variety of support roles across the organisation using their skills whilst working from home.  And, where staff have had their normal job role stood down due to service pressures elsewhere, access to the meaningful jobs board has enabled them to work in alternative CSUs supporting crucial front line work, utilising their current skills and knowledge, and also providing an opportunity to develop new ones. 

Theme:  Prevention and Control of Covid-19

About this theme: In this theme we collated your feedback that related to how we keep ourselves and our patients safe from Covid-19 as we continue to deliver the best possible patient care.

Your Feedback:

Safely separating care for patients without Covid-19 and those confirmed as positive cases.

We appreciate the early challenges with the rapid changes in guidance with regard to separating patient flows as well as PPE particularly earlier in the pandemic response. Hopefully you’ll have seen and felt the benefits of the huge amount of work that has been done in the Trust as well as on a regional and national level to establish clear and consistent guidance and terminology. Most recently this has seen us adopt the Public Health England RED/ AMBER/ GREEN designation for clinical areas and PPE requirements.

PPE Supply

There was some rapid learning from our early efforts to ensure that there was sufficient PPE for all our colleagues and patients. As a result of some outstanding work from the Procurement team we now have a PPE tracker which can forecast stock levels and is able to alert the organisation if activity levels rise and the stock level falls, this allows us to move stock to areas very quickly based on usage. The additional storage nearby allows the mobilisation of PPE to main site very quickly. 

In support of extra measures to provide a Covid safe workplace for colleagues, and in response to your feedback, the Estates & Facilities team installed an additional 130 hand gel dispensers, in both clinical and non-clinical areas, as well as in high footfall areas such as main entrances.

Social Distancing

Understandably the critical issue of social distancing generated many ideas and comments. We hope you’ve seen the benefit of the huge amount of work has been done to create visibility around this for patients and staff over recent months, supported by the Social Distancing Group. Let’s remember that social distancing will be most effective if we are committed as a team to ensuring we all work in a safe way. We can all take responsibility for ourselves as well as supporting each other with respectful reminders where we notice lapses.

Theme:  Flexible Working

About this theme: We must grasp the learning that has come from COVID-19. Flexibility in our work is one transformation that you wish for us to continue long after the pandemic has passed; providing a positive learning and outcome from what has been the most difficult year. Whether this is where, when, or at what times you work, and in order to reach our goal of becoming the best place to work, where our people are valued, and their wellbeing is supported, we are committed to creating a culture where flexibility is welcomed. 

Your Feedback:

Remote Working

We had an overwhelming response to the positive impact remote working has had on your lives, but also on the environment, to parking capacity and to valuable office space. Research also tells us that remote working can have a positive effect on staff engagement and productivity. We wish to support remote working wherever it is an option within a role and team, and now have a Remote Working Steering Group, sponsored by several Directors, to support progress. We have created remote working guidance materials, and the Group are working in collaboration with IT to be able to provide the necessary IT resources to meet the new demand. 

IT Resources

Over the last 10 months, the IT Team has worked incredibly hard and provided some fantastic advancements in helping to provide the necessary resources required to work remotely. However, we understand that we still have some way to go in meeting demand, which increased exponentially overnight back in March. We have now provided in excess of 400 new laptops, increased accessibility to VPN (remote access to IT drives and systems) by a factor of 5, and provided secure access to Microsoft Teams and Attend Anywhere; all of which are priorities for continued development and investment. IT is also now looking at new options to increase the flexibility to work remotely, including the potential to use a personal device.

Flexibilities

You told us that having more flexibilities in the work that you do has been valuable to your personal lives, whilst still meaning the work gets done. This has particularly helped you as you experience continuing changes in child care arrangements for example, but also had a positive impact more generally on your wellbeing. We want to continue to help you work with you manager and team to create opportunities for flexibility that works for you, the team and the service, and so have made this a Trust priority. We have created a Flexible Working Task and Finish Group, who are now developing a refreshed and modern procedure, as well as looking at how we can improve flexibility within e-rostering, for carers, and from day 1 at recruitment stage. Watch out for its launch this year.

Theme:  Communication and Recognition

About this theme: This theme was created following your feedback regarding the new communication strategies since the start of the pandemic. You also gave some fantastic shout outs to other teams who you felt deserved dedicated recognition, which was fantastic to see.

Your Feedback:

Recognition

You have all been fantastic in making sure we shout out the great work and support we have experienced from other teams and colleagues over the last 10 months, which has been more important than ever as we face ever changing challenges. We saw many ‘shout outs’ mentioned within the Wayfinder, and we wanted to continue this well-deserved recognition, by launching a ‘Thank you’ month in December, mixed with Christmas celebrations. We saw goodie boxes being delivered all across the Trust, surprise virtual visits to departments and team meetings from our Executive and Non-Executive Directors, and thank you videos and cards. We also wanted to recognise the challenges faced and wonderful support provided by the children in your lives, through our ‘Letters to Children’ service, which we have just re-launched, given the closures of the schools once again, and was a fantastic idea provided through the Wayfinder campaign.

Communications

Your feedback helped us to understand that the new Communications have helped you to stay updated and informed about the constant changes the pandemic has brought. However, when asked to identify ideas or opportunities to improve communications, a number of themes became clear:

  • Improve the consistency of message from corporate levels to frontline teams
  • Improve accessibility to information
  • Increase opportunities for two-way communication
  • Improve the frequency of frontline communications between managers and staff

To achieve the above we have:

  • Continued to provide the Operational Updates email.
  • We have launched Ask the Experts live Q&A sessions to create an easy and more personal way to stay connected with HR, IT and Building the Leeds Way.
  • Introduced the weekly Q&A round-up, opened up to more staff, to ensure values based decisions.
  • Published a user-friendly covid-19 dashboard online for all staff to view, to help provide transparency to decisions made.
  • Established a website review panel to ensure key sections such as PPE are kept up to date and guidance archived as appropriate; recognising that there were inconsistencies in messages around PPE, which led to confusion, at the start of the pandemic response.

Theme:  Travel

About this theme: The pandemic has brought with it changes in the number of staff working remotely and the Government provision of free car parking on site; and in turn we had an opportunity to consider and experience a different model for our car parking provision at the Trust. Your feedback, in not only this campaign, but from the Staff Survey and Staff Friend and Family Test, demonstrated this should continue to be a priority for the Trust.  

Your Feedback:

Fair and sustainable car parking

You have fed back in the Wayfinder Campaign, Staff Survey and Staff Friends and Family Test, that we need a car parking system that feels fairer to all staff, is sustainable, and is flexible.  Following this feedback, over the last few months our Project Lead, Sylvia Craven, has been working with staff to conduct a car parking review and new model design. Over 450 staff responded with constructive ideas, who were then able to rank the most popular options put forward in order of preference. The final strategy is now being written, and will be based on these preferences and our Trust values. Watch out for an update in the next few months!