8 April 2022 – non-executive directors – reversing the downturn in public perceptions of the NHS, with Sue Sjuve

This week’s session opened in conversation with Sue Sjuve, Chair Royal Surrey County Hospital, about reversing the downturn in public perceptions of the NHS. What’s driven the current downturn, how might boards support staff, what are the risks, and how can boards stem and reverse the trend?

Sue said: “What can we as chairs and NEDs do to alleviate the impact of this downturn in perception for those on the front line who deliver services? Not long ago, everyone was clapping to acknowledge our colleagues. Someone said to me then ‘this won’t last’ and they were right. Now we have the lowest level of satisfaction since 1997.

“The main areas are long wait times (65%), staff shortages (46%) and inadequate government funding (40%). GPs, who usually score highest, saw a fall in 30% since 2019. But we know this already. GPs are being called lazy for not offering appointments and yet in Guildford I’ve seen evidence that they are delivering 140% of pre-pandemic level of appointments, so there’s something wrong with perception there.

“On waiting time for hospital care there’s an assumption that we can clear backlogs but that doesn’t take into account infection prevention control measures, the pent-up demand and staff who are sick and isolating. Less than half of staff feel they can meet the demands on their time – that’s a 25-year low. And only 25% of staff feel there are enough staff in the system to do the work that’s required. And, shockingly, nearly 15% of our staff have experienced one act of violence or abuse from patients, their families or carers in the last year. And if you look at harassment and bullying it’s double that percentage.

“We can see that although dissatisfaction is with the way the NHS is run, it’s the staff on the front line who deliver the service who are experiencing the abuse and bullying.

“When I first became a chair a decade ago everyone was saying ‘we deliver in the NHS because of our frontline staff and they’re under huge pressure and that can’t be sustained’, but a decade later it sort of has been sustained and I have huge admiration for our staff but I’m beginning to feel that when I say to staff how fabulous they are and what a great job they’re doing it begins to sound a bit hollow because it’s just words. What can we do to help them deliver? Because that’s what they want to do.”

Overheard during the discussion:

“We must invest in people and networks. We have ten and they’re thriving and mature and adding value. We should be reaching out to the community more as well. Trying to make sure there are links with primary care, ensuring that issue around doctors are resolved.”

“We must be clear and honest about what we can actually do and change as an organisation. If staff raise issues – e.g. can’t get hot food at night – we need to do what we can to address their needs.”

“We should minimise the time staff need to spend producing papers for the board to reduce the burden on them.”

“This is such an important conversation. Three things are key, I think: true NED visibility, getting better at engaging with communities and staff and hearing what they tell us, and – most importantly – being seen to act on what they tell us. If we say we’ll do something, we have to do it. If we can’t solve a problem we need to tell them why we can’t solve it.”

“The things that people are experiencing about delays in treatment and so on are real. So the way we communicate is really important. We must have adult-to-adult conversations that are compassionate. We could alleviate some of the us-and-them and the pressures on frontline staff by having a more joined-up approach to support citizens, perhaps by working more closely with local authorities. How you tell someone that you can’t treat them immediately is really important.”

These meetings are by invitation and are open to all NHS non-executives directors, chairs and associate non-executive directors of NHS providers. Others may attend by special invitation.

If you have any comments, questions or suggestions about these webinars, please contact: events@good-governance.org.uk