South Essex Partnership University NHS Foundation Trust (SEPT) is one of the largest and highest performing NHS providers in England of health and social care services for people with mental health problems and learning disabilities across south Essex and Bedfordshire.
With a budget of approximately £200 million, SEPT employs around 5000 people who serve a population of 1.5 million. It is the first mental health and learning disability trust in the country to achieve University Trust status and the only mental health trust to have been rated ‘excellent’ for quality of services and use of resources by the Care Quality Commission for three consecutive years.
In 2010, SEPT broke new ground with its acquisition of mental health services in Luton and Bedfordshire - the first ever of its kind in the NHS.
Unlike acute hospital services, mental health and learning disability services are mainly provided in community settings and SEPT operates from about 100 sites across south Essex, Luton and Bedfordshire working with a range of partner organisations to deliver care and support to people in their own homes and from a range of hospital and community based premises.
In common with many mental health trusts in England, SEPT owns or leases clinical buildings and offices which are no longer appropriate for the delivery of modern, community-based services. It was clear that introducing more flexible working for health care personnel would release surplus estate and make considerable savings that could be directed into improving patient care and also help the Trust meet government efficiency targets.
In addition, SEPT aims to be an employer of choice; in 2010 it was voted Top NHS Healthcare Employer and Top Mental Health Trust at the prestigious Healthcare 100 Awards. SEPT was one of the first Trusts to achieve the Improving Working Lives Standard (IWL), which evaluates NHS trusts’ HR practice and commitment to improving the working lives of their employees. And as Martin Norton, WorkSmart Project Manager for SEPT points out: “Flexible working is a vital part of Improving Working Lives and has a demonstrable impact on recruitment, retention and return to work.”
SEPT chose BT Workstyle Managed Services to help introduce and implement its WorkSmart programme of flexible working. BT Workstyle Managed Services provides a practical framework of applications, support and professional services, in a managed model where BT assumes full responsibility for delivery, connectivity, service levels and hardware maintenance and software upgrades.
BT has a strong track record of delivering flexible working, especially in the public sector. Its professional experience of implementing flexible working within BT and for customers, gives it unique insight into how to overcome objections and ensure that the whole organisation recognises and realises the benefits.
BT and SEPT worked together to ensure that the WorkSmart programme would reflect the complex, often long-term and multi-disciplinary care programmes that mental health patients require and the implications this has for working styles. It was important that the programme recognise and accommodate interdependencies with other providers and partners in the cycle of care, meaning that it was designed to be highly flexible and able to evolve with the changing requirements of the Trust. Says Martin Norton: “Mental health outcomes are often more difficult to measure than physical recovery. We tend to look at patient needs in a holistic way, often working across service boundaries, and this has an impact on the way our people work”.
The specific objective for WorkSmart was to optimise the Trust’s use of space in order to reduce property costs by around £1.5m - which could then be invested in patient services. Early studies showed that the Trust was similar to many other organisations in having office areas that were underutilised in some areas of their property estate, enabling them to dispose of some office accommodation early on in the project. BT worked with the Trust to develop the policies, processes and templates it required to successfully support flexible working, including developing the terminology and “branding” of the programme as well as the practical issues around implementation. With support from BT, SEPT first piloted the WorkSmart programme in Thurrock, Essex, on a community hospital site with two large administration buildings, housing finance, purchasing and HR departments.
At the heart of the programme is the WorkSmart portal, a central, online delivery point for flexible working services and support for SEPT employees. The portal lets employees find out about flexible working and order services and equipment; it then continues to provide ongoing support such as health & safety assessments, helping the Trust ensure it meets its duty of care for employees. BT also helped the Trust install a new Touchdown area for mobile health workers on the Thurrock site, advising on the design and operational aspects of the new workspace.
Says Samantha Powell WorkSmart Implementation Manager: “It is important to recognise that for a successful flexible working project, you must bring about a cultural change in your organisation to reach that ‘tipping point’ where it becomes business as usual. We found BT’s experience of delivering flexible working in other parts of the NHS very valuable, especially as we were introducing physical change alongside operational change, in a tight timeframe.”
The pilot proved popular, with 500 employees opting for some form of flexible working and the Trust was able to roll out WorkSmart further. As a consequence, it has been able to close one redundant site and relocate 100 people. “Generally, employee reaction to WorkSmart has been positive; we also made sure that our senior managers bought into the programme and led by example,” comments Samantha Powell.
With the acquisition in April 2010 of services in Luton and Bedfordshire, SEPT wanted to extend flexible working to these new employees. BT helped the Trust design and deliver a programme of communication and education to the Luton and Bedfordshire workforce, inviting them to sign up to one of five defined work styles.
These work styles encompass all patterns of work across the Trust:
Employees who would need to register for flexible working do so via the WorkSmart portal, which uses questions and answers to determine which work style is most suitable for the individual, who can then discuss and agree this with his or her manager.
Home and Mobile Plus employees benefit from enabling technology such as BT MobileXpress Internet Teleworker which connects home-based employees to the corporate network through a secure Internet connection. Those employees then have the same access to email, files and applications as in the office. The Trust is currently developing its electronic patient record system so that clinical personnel will have secure, remote access to patient records.
By the end of 2010, around 30% of SEPT administrative and community clinical employees will be working flexibly in some way (ward staff already work in this manner). The Trust expects that the majority of its 2000 support staff will opt for shared desk working in the WorkSmart programme, many based in new administration hubs on retained operational sites.
Reduced demand for desk space to date is such that SEPT expects to be able to reduce overall office provision by 20%. This will deliver not only financial savings but also reduce carbon emissions from buildings costs and commuting by employees, helping SEPT to meet its environmental targets. SEPT expects to realise further savings in estate costs as the WorkSmart programme extends across all Trust departments and services from 2011.
Importantly, Martin Norton says that flexible working has the capability to enhance patient care. “Clinical colleagues can optimise time with vulnerable clients and be more productive as they no longer have to return to the office to check emails or deal with paperwork.”
SEPT employees are required to complete reports within 24 hours of a patient visit. Now that clinicians have access to the corporate network from any Trust building or at home, it is much easier to comply with this requirement. Rapid completion of paperwork also reduces the potential for error. For SEPT chief pharmacist Hilary Scott, WorkSmart transforms service delivery. “My colleagues are really keen to adopt these new ways of working, because they see that it lets them spend more productive time with their patients. Being able to access the corporate network from home means we can complete reports more quickly. And people are less tired because they can organise their own working day and travel more efficiently."
BT continues to work with SEPT implementing WorkSmart across the whole of the organisation. The Trust has asked BT to look at adapting WorkSmart to new technology – for example, using smartphones in place of laptops for some staff. Martin Norton concludes that SEPT has total confidence in BT’s ability to deliver. “We enjoy a good relationship with BT; the team delivered on their commitments and demonstrated a key understanding of how to implement flexible and agile working and make it work for SEPT. We will continue to work with BT to deliver our WorkSmart programme across the whole of the organisation.”
