Creating a Sustainable and Flexible Workforce

The Facilities Division is responsible for providing a high quality cleaning, hostess, portering, and catering service currently employing 190 staff within Ysbyty Ystrad Fawr (YYF). The facilities team at YYF have all contributed and participated in this programme. The Facilities Division mission statement declares:

“Proudly working to provide our Services with a professional and caring approach”

This work has been co-created between ABUHB and Caerphilly County Borough Council (CCBC) passport scheme (Jobs Growth Wales is funded by European Social Fund). The development work to modernise the workforce was initially undertaken across the whole range of facilities services at YYF with Workforce and Organisational Development staff offering support in employment and training.

Strategy for Change:

As part of our strategic planning for Clinical Futures we have had to consider fitness for purpose of the existing working models. We introduced our vision for the service to the supervisors, described as “To create a flexible and sustainable workforce in an environment of increasing demands and pressures”.

We engaged with the supervisors and together developed a strategy to implement our vision, including a new job description and working models.

Following an approach from CCBC the opportunity to develop this role in partnership with the local authority through the Passport scheme enabled us to provide employment experience and skills development to local unemployed young people while also allowing us to trial the new role and working models.

A structured programme of induction, training and work experience was prepared and implemented. The candidates have been successfully integrated into the teams, providing cover for absences and vacancies while gaining experience in the workplace.

A review of current rosters has commenced together with approval to appoint 12 new positions that will enable the new role to be introduced on a permanent basis.

Outline of Problem:

Facilities employ 1400 staff of whom 78% are A4C Band 1 and 2 with 48% aged over 50. This age profile presents a significant challenge in terms of the risk associated with the large number of staff retiring and leaving a skill deficit. There is little in the way of succession planning or talent management. The current cleaning, patient food & beverage service model is not attracting young people in to healthcare facilities management due to the lack of career pathways.

• Unplanned recruitment, tending to be opportunistic;
• Low turnover at supervisory bands, lack of opportunities;
• No structured training;
• Inconsistent and inappropriate induction programmes

These factors do not enable new staff to understand how all the services in facilities operate. We want our staff to take ownership “no matter what role they are undertaking if they see a patient’s water jug is empty it should be common practise to fill it up” and to instil a culture that acknowledges that facilities staff play an important role in the overall patient experience.

• Narrow job descriptions g. domestic assistant, ward hostess or porter;
• Limited skill sets;
• Lack of transferable skills;
• Use of external staff to fill gaps;

The current roles reflect the historic work models employed at the hospitals preceding YYF and have created significant difficulties in planning or prioritising how gaps could be filled. Current staff lack transferable skills and tend to operate in silos.

Assessment of problem and analysis of its causes:

In many instances staff are employed for only few hours a day across complex working patterns.

This also created difficulties in recruiting individuals who wanted the opportunity to have a career in facilities management. Through working with staff and managers we determined that the service requires individuals that are:

• Multi-skilled;
• Flexibly allocated;
• Committed to customer service

To meet this requirement we have developed the role of “Integrated Facilities Operative” (multi- skilled staff with transferable skills who are able to undertake a variety of facilities roles dependent upon service need). The challenge for the organisation was how to introduce this new role and concept and trial its operation.

Existing NHS recruitment processes are geared to professional staff groups and were not felt appropriate to many facilities roles. Alternative recruitment routes were sought. The NHS Scotland Competency Framework is being adopted and tailored to our local requirements to support improvements in skills and provide a framework within which staff can attain a range of competencies.

While in the long term existing staff will be encouraged to move into such roles, our partnership with CCBC has enabled us to introduce on a trial basis this new role while offering work experience and employment opportunities.

Effects of Changes:

A number of benefits have been seen:

• High retention. Of 9 starters, 1 has been appointed to a substantive post, 2 have gained external employment and 5 will join the staff bank in March on completion of the trial. Also 22 permanent staff members have increased their hours to full time.
• Reduced variable pay.
• Increased productivity due to flexible role and shift pattern.
• Efficiency gains with flexible workforce enabling supervisors to allocate and prioritise workload more effectively.
• Supports cultural change and integrated working.
• Encouraged staff to explore different ways of working.
• Established partnership with local authority.
• Staff feel empowered and valued.

The outcomes have reassured us that the model is effective and supports the organisation’s longer term aims of:

• A motivated workforce who go the extra mile.
• Team working.
• Sustainable employment opportunities with career pathways.
• Individuals using own initiative to undertake tasks like spillage clean up, litter pick up around site, walk around making sure all public areas are clean & tidy.
• Values and beliefs of the Health Board adopted.
• Individuals proud of their contribution to patient care.
• Empowering the workforce by listening to their concerns.

Lessons Learnt:

• Overcoming some staff prejudices and resistance to change requires a high level of commitment from those introducing the change.
• The candidates require a great deal of practical support, through mentoring and basic skills.
• Don’t underestimate the commitment and capability of these young people, give them a chance!
• Allowing reasonable time-scales to complete the project

Message for Others:

• It takes one person to make a difference.
• Individuals who may have no qualifications and/or lack of work/life experiences really can improve the patient experience for example.