Monthly Archives: November 2013

So just how do we keep Britain’s workforce safe?

Reading Time: 2 Minutes

Provisional figures from the Health and Safety Executive (HSE) released in October 2013 showed a significant drop in the number of employees killed or seriously injured at work in the past year. An 11% drop in major injuries was reported compared with 2011/12 and the number of people killed at work fell to 148 in 2012/13 from 171 in the previous year. All of which shows an improving trend but does it tell us the full story?

The study found that 19,707 major injuries – such as amputations, fractures and burns –were reported in 2012/13 compared with 22,094 in 2011/12. This is the lowest amount of work-related injuries since records began in 1995. According to the HSE Chair Judith Hackitt, these improved figures can be attributed to the commitment from Britain’s workplaces on improving safety for their employees.

 

In spite of this good news, major and minor incidences and accidents are still happening too frequently. With an estimated three million working days lost due to injuries at work  and slips and trips making up more than half of all reported major injuries, how do we correct ‘unsafe’ behaviour?

We all know that health and safety in the workplace is paramount, especially in industries where the potential dangers are high, such as the utilities or transport sector, but it is still a challenge for companies to get it right. A cross-industry report from industry analyst firm IDC entitled, “Counting the Cost of Employee Misunderstanding,” revealed that one in four employees do not understand certain aspects of their job role and major knowledge gaps remain unaddressed in many organisations. This is in spite of investment in training.

 

In many instances human behaviour is a contributory factor to the injuries. Employees misunderstanding their roles or making critical mistakes at work can not only result in injuries, absenteeism but in some cases millions of pounds worth of damages in terms of litigation and in the worst case scenario, loss of life.

In industries where health and safety is a big concern, providing employees with situational judgement assessments that correlate understanding and confidence can help to prevent injury and even death, caused by human error and importantly, evidence fitness to practice and compliance.

 

We work with many leading rail companies both in the UK and internationally to ensure their staff are competent and safe when performing their roles. All rail companies today are required to have formal competence management systems in place to maintain and assess the competence of operators carrying out safety critical work. For Network Rail, we deliver a formal competency management system to assess the competence of 10,500 operational, national delivery and graduate staff to ensure safe working practices and so as to enable regulatory compliance.

Britain’s workplaces could be far safer places if more companies revalidated their training and assessment programmes to improve the competence and confidence of their employees.   With regular situational judgement assessments that map employee competence, confidence, engagement and behaviour companies find out what their staff truly know, how they work and the decisions they are likely to make on the job. This knowledge is key to preventing errors and misunderstanding that could lead to incidences and injuries. There is a need to develop a long-term Safety Culture Strategy, recognising that most accidents are caused by unsafe acts, and that influencing staff behaviour and attitudes is the way to reduce accidents further.

 

 

Ensuring the safety and sanity of seasonal workers this Christmas

Reading Time: 3 Minutes

Online retailer Amazon employs more than 20,000 people across its eight warehouses during its peak Christmas season. However, according to a BBC Panorama investigation, broadcast on 25 November, the working conditions in Amazon’s warehouses could be putting workers at risk of “mental and physical illness.”

The BBC investigation showed workers undertaking long shifts without a break, it also highlighted some of the pressures they faced, such as having to complete orders within set timescales, as well as the physically demanding nature of the work which involved them walking up to 11 miles every night.

 

The investigation comes at a time when the company has announced it has employed 15,000 extra staff to cope with Christmas orders. Amazon is not alone in turning to seasonal workers – M&S has employed 12,000 additional workers to meet the Christmas demand and other retailers will be following suit. Whilst, Amazon said in a statement that worker safety was its “number one priority, hiring vast numbers of temporary staff en masse can create risks for any business, particularly in the area of health and safety.

To ensure health and safety standards are met, very specific training and knowledge is needed so that the right practices and procedures are followed. Obviously companies like Amazon face huge commercial pressures to ensure a great customer experience at Christmas and the success of their business depends on getting new recruits up to speed very quickly. However, there is a big risk that standards may become compromised as this investigation has highlighted.

Getting it wrong can place employees at risk – either the risk of injuries or in this case stress and mental and physical illness – all of which could lead to absenteeism and in the worst case scenario compensation claims, fines and reputational damage.

 

The Health and Safety Executive’s latest report into Workplace Injuries stated that 646,000 workers had an accident at work in 2012/13. Slips and trips were the most common cause, accounting for three in every ten injury reports. Handling was the most frequent cause of an injury that lasted more than a week. Around three million working days were lost due to handling injuries and slips and trips so ensuring that the warehouse environment is a safe place to work, where good working practices and processes are in place is essential.

For any large company, ensuring that they have a competent and trained workforce before taking on more seasonal staff can be a major challenge. How can they effectively train high volumes of temporary workers and ensure that their health and safety knowledge is put into practice on the job and that risks are reduced?

For over 20 years we have worked with leading retailers providing assessments and consultancy services to highlight ‘People Risks’. In our experience 30% of employees in any organisation will unwittingly have a low level of understanding and are placing themselves and their organisations at risk.  This is likely to be even higher for those who are only employed on a temporary basis, as often after the initial induction they won’t receive any further assessment to see how well they perform in their role in an unfamiliar environment.

 

Companies need to implement assessment and training procedures for all workers whether seasonal or not, and avoid taking the ‘sheep dip’ approach – a one-size fits all approach to training which assumes everyone has the same knowledge. It can be ineffective and costly.

When Companies devise assessments that aim to uncover specific gaps in employee knowledge and confidence then they will know precisely what training is needed to improve performance and reduce health and safety risks. They need to uncover hidden gaps in each individual’s understanding of any given subject or process that may cause them to work or act inappropriately or incorrectly and then address them with targeted interventions to improve performance and reduce risks.

With the influx of seasonal workers, assessments can help companies like Amazon not only fully understand the knowledge and competence of the staff they are recruiting but also ensure that once in situ – they are working competently and safely, even if they are only with the company for a short period of time.

 

 

Nobody makes mistakes intentionally, but don’t cover them up says Jeremy Hunt

 Reading Time: 2 Minutes 

This week the government accepted 281 out of the 290 recommendations made by Robert Francis QC in his report on the Mid Staffordshire Hospitals scandal.

 

Many of the report’s recommendations focused on the need for greater transparency about safety measures and more openness about the mistakes made by healthcare professionals. As Health Secretary Jeremy Hunt rightly said, “nobody mistakes intentionally but if they are covered up, lessons aren’t learnt”.

 

Under the report’s guidance all health professionals will have to be candid with patients about all avoidable harm and, if they obstruct colleagues from being candid with patients, they will be breaching their professional codes. “Near misses” of serious harm will also be subject to a professional duty of candour and it is hoped that all these measures will foster an NHS culture in which reporting and learning from mistakes is the norm.

 

Training was high on the agenda too, with many of the recommendation focused on improving the competence of health care professionals.

 

A new national programme of patient safety will be introduced across England to spread best practice and build safety skills across the country. 5,000 patient safety fellows will be trained and appointed in the next five years. There will also be a new ‘fit and proper person’ test, to act as a barring scheme for senior managers and a new care certificate will be introduced for healthcare assistants and social care support workers to ensure they have the right fundamental training and skills. A new fast track leadership programme will also be launched to recruit clinicians and external talent to the top jobs in the NHS in England.

 

These are ambitious changes both in terms of reforming the NHS culture and the training and development for staff and the measures will clearly take time to implement and embed. It won’t happen overnight.

 

From working in the NHS and the field of employee assessment and development for over 20 years, we know there will be challenges along the way before patient safety is improved and serious incidences reduced. Mistakes will still happen in spite of the new processes and training programmes. In any industry typically a third of any workforce misunderstands key aspects of their role and these knowledge gaps can place their organisations at risk. The NHS is no exception.

 

As a first step the NHS needs to understand where its critical skills gaps lie before rolling out the new training and also it must assess not just people’s knowledge but how their knowledge is used on the job and how confident they are performing their job which impacts their decision making.

 

But a bigger question is surely how the NHS can truly transform its culture and restore the public’s trust? This isn’t as easy to solve – what do you think is needed? How will the NHS ensure that lessons are learnt from its mistakes and ensure greater openness and transparency across the board?

 

 

A different approach to the training and assessment of midwives could save the NHS £500 million a year

Reading Time: 2 Minutes 30 Seconds

 

A new review by the National Audit Office (NAO) has highlighted that a fifth of maternity services funding is spent on insurance against malpractice. The report found that the NHS in England spent £482m on clinical negligence cover in the last year – the equivalent of £700 per birth. The most common reasons for maternity claims are mistakes during labour or caesarean sections and errors resulting in cerebral palsy.

 

Clinical negligence maternity claims have risen by 80% in the last five years. Figures from the NHS Litigation Authority released last year showed the health service in England paid out more than £3bn in compensation claims linked to maternity care between 2000 and 2010.

 

Public Accounts Committee chairwoman Margaret Hodge said the figures were “absolutely scandalous” and that the current system is not working as it should. Ms Hodge recommended that the NHS needs to review its monitoring and reporting processes to ensure all relevant bodies can work together to deliver maternity services that are ‘value for money and fit for purpose’.

 

I would go one step further and ask why the underlying root causes of the problems in maternity in NHS Trusts in England are not being addressed? Why are there so many critical mistakes being made by midwives in spite of training? Could some of the problems be solved if the right level of resources were in place as staff shortages were mentioned in the report and if midwives were given targeted training interventions that would improve their competence and confidence performing their roles?

 

From our experience working with NHS Trusts we have seen that some are investing in training before firstly identifying critical skills gaps or confidence issues amongst their mid wives teams. This means that training is often blanketed and one size fits all and fails to address individual skills gaps or confidence issues. Traditional assessment processes are equally failing to uncover what an individual actually understands about their role or versus how their knowledge is actually applied on the wards and particularly in high pressured or emergency situations.

 

If NHS Trusts could expose their People Risks and critical skills gaps they could address them using targeted training and coaching interventions that would improve the competence and confidence of midwives. This would also reduce the risk of errors and negligence claims whilst most importantly, improving patient safety.

 

In both clinical and non-clinical environments over the past 20 years and through delivering thousands of assessments, we know that around 30% of any workforce will unwittingly have a low enough level of understanding, to place an organisation (or their colleagues and patients) at significant risk.

 

For the past three years we have worked with a leading NHS trust as they introduced a new approach to help eliminate the risks of serious case incidents and deaths in Obstetrics. We have shown how significant improvements can be obtained by measuring and correlating employees’ confidence with competence and then adapting existing interventions such as ‘Skills & Drills’ training to focus on the area of greatest need/risk, particularly where it relates to the behaviour of staff.

 

Employees often know what to do, but lack the confidence to do so in an emergency situation.  If you can find this out before they are confronted with this ‘on the job’ then you can coach and mentor them to achieve a more confident and ‘risk free’ performance. Our programme requires Trusts to obtain a health check of employees before any training is given.

 

Our programme has not only improved the performance of clinical teams when handling emergency situations, it has benefitted patient care and, since it was initiated, there has been a reduction in avoidable incidents.

 

The same approach could be introduced across all NHS departments to improve the competence and confidence of multidisciplinary teams. Only with regular situational judgement assessments that map employee competence, confidence, engagement and behaviour will managers in the NHS find out what their staff truly know, how they work and the decisions they are likely to make on the wards.

 

A different approach could see a major reduction of negligence claims and a significant improvement in patient safety. What’s more – the big budgets now being put aside for such claims could be put to much better use across the NHS, for example, addressing the shortage in midwives and consultants on labour wards. The NAO report suggested a further 2,300 midwives are required in England alone, a factor which has no doubt also contributed to a rise in claims.

 

 

Shape of Training Report claims training of Doctors and Healthcare Professionals must evolve

A new way of training doctors is needed for a changing healthcare landscape, according to the final report from the ‘Shape of Training’ Review published at the end of October. The report follows a review into postgraduate training in the NHS and was sponsored by the General Medical Council, Health Education England, NHS Wales and Scotland amongst others.

The report highlights that training for doctors and healthcare professionals has to evolve to keep pace with the changing UK healthcare environment with medical, technological and scientific advances and changes in the demands on the healthcare system including higher patient expectations, a growing and ageing population and increasingly complex medical conditions.

 

The Shape of Training report recommends:

– Following broad specialty training, doctors will go on to train in more specialised areas where there are local patient and workforce needs.

– Medicine has to be a sustainable career with opportunities to change roles and specialties throughout doctors’ careers.

– Full Registration should move to the point of graduation from medical school, provided there are measures in place to demonstrate graduates meet the GMC’s standards at the end of medical school.

– Implementation of these recommendations must be carefully planned on a UK wide basis to ensure minimum disruption to service.

 

It is clear that doctors and healthcare professionals today need to have highly specialist knowledge to meet the challenges of an ageing population and handle patients with more complex medical conditions than in previous years.

Training and competency management therefore must be given a higher priority in the NHS to ensure doctors are competent and confident in their knowledge and that patients receive the right advice and care at all times and critically, that they are safe.

In August, healthcare expert Professor Don Berwick delivered his verdict on the NHS. He recommended that the NHS, regulators and the government must build a robust nationwide system for patient safety rooted in a culture of transparency, openness and continual learning with patients firmly at its heart.

 

The focus on continual learning is of course paramount, but it is not enough on its own.  A new approach to competency management is needed that will help the NHS firstly identify skills gaps that exist amongst doctors and healthcare professionals.

Existing training interventions should be analysed first to ensure they are delivering the right outcomes and then the training needs of every individual must be identified so they are given a targeted development programme that addresses their skills gaps and improves their knowledge and confidence.  Regular assessments for doctors are needed too – assessments that not only to ensure that doctors truly understand their knowledge, but that they are applying it in the right way when dealing with patients.

In our 20 years’ experience of delivering assessments across all sectors, including the NHS, we have found that typically a third of employees misunderstand key aspects of their roles. In organisations like the NHS, these ‘misunderstandings’ are hugely risky and can cost lives.

 

We also know that by introducing regular situational judgement assessments that map employee competence, confidence, engagement and behaviour vital information can be uncovered. Such assessments will measure what doctors really know versus what they think they know, their confidence and the decisions they are likely to make. The specific training interventions needed to improve performance can also be identified which will not only help doctors improve their competence but also reduce risks of errors being made.

The NHS was 65 years old on 5 July 2013 and in that time the health system has undergone profound change and so has the UK’s population. Factors such as an ageing population, the costs of new drugs and treatments and lifestyle factors, such as obesity are having a huge impact, and training and assessment must evolve too.

 

 

Are you being served?

In September 2013 Which? revealed the best and worst brands for customer satisfaction. Cosmetics firm Lush topped the satisfaction survey, scoring 88% overall and five stars for its helpful and knowledgeable staff, leaving shoppers feeling like valued customers. They were followed by Lakeland (85%), First Direct (84%), John Lewis (82%) and RAC (82%).

The lowest scoring brand was Ryanair with 54% and only two stars across all categories, followed by Npower (59%), Talk Talk (59%), 99p Stores (62%) and TKMaxx (62%).

The results are perhaps not surprising as we all have a perception of these well-known brands even if we don’t buy from them; however, with customer service fast becoming the major differentiator between companies these results are not good news for the companies at the bottom.

 

Getting customer service wrong can spell disaster for a business. However, we must recognise that it is becoming more challenging to keep customers loyal. Not only has competition got tougher, we are operating in an omni-channel world where customers expect excellence at every interaction –  in shops, on the phone, via email or social media.

A 2010 report from call centre software provider, Genyses, claims UK business lost £15.3 billion as a result of poor customer service, with each customer lost or abandoned costing £248. The report, “The Cost of Poor Customer Service: The Economic Impact of the Customer Experience”, estimates that financial services firms lose £2.18 billion; utilities £1.98 billion and telecoms £1.91 billion every year due to poor customer service.

It’s not just the lost profits that are problematic; poor customer service can damage brand reputation, cause customers to defect in their droves and in regulated industries, increase the risks of financial penalties.

 

The Which? Survey is interesting as it shows that even in the banking sector which is often associated with poor service; some banks, like First Direct can achieve excellence in customer service.

For banking this is more important than ever with the recently introduced ‘ 7-day switch’ – as it makes switching banks easier than ever. In the first four weeks since this service was introduced, 89,000 customers switched bank accounts, an increase of 11% on the same period last year. First Direct reported a doubling of phone enquiries in the first week of the switch service. Brand loyalty it appears is a thing of the past unless you can deliver consistently excellent customer service.

John Lewis is a great example of a company that delivers excellence in customer service but it works hard at it. A few years ago we were invited to work with John Lewis to develop a new approach to the assessment and training of their delivery drivers.  The company deemed this to be a big priority owing to the dramatic expansion of its online business.

 

Together we launched the ‘You are more than just a driver’ programme which was designed to make drivers ‘brand ambassadors’ The programme used situational judgement assessments to measure not only how competent the drivers were in their roles but how they acted and behaved with customers. The assessments highlighted skills and knowledge gaps or any ‘risky’ behaviour which was then addressed using targeted training, coaching and mentoring. The programme has since been rolled out to other parts of the business. So this just shows that good customer service doesn’t just happen on its own – targeted interventions can make all the difference.

To deliver excellent customer service, companies need to understand how their employees behave on the job and this not only means ensuring they are competent and knowledgeable but that they use their knowledge in the right way – every time – at every interaction. By changing the way employees are assessed and tailoring training accordingly, businesses can start to ensure that they are delivering top notch customer service.