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Listen
Chapter 2
Openness
We found performance in this area to be good, having important strengths with some areas for improvement.
TPS had a clear ethos of open communication and information sharing with all stakeholders. This was well evidenced during our review of preliminary information and other reports provided by TPS. It was further reinforced by results from our staff and stakeholder questionnaires and in some of our meetings with staff, purchasers, board members and service users. The majority of external stakeholders we met with described communication links with TPS as both open and strong. Board members were very satisfied with their levels of communication with the organisation, both during and in-between meetings. TPS was deemed by external auditors to have clear and open financial procedures. TPS had a good range of policies around financial controls which were publicly available.
Staff had mixed views on communication internal to the organisation. Some staff told us corporate processes were open and transparent, whereas others were less positive - citing examples of new policies they knew little about, or in recalling changes to their services without prior communication or understanding of the reasons for the changes.
There is effective communication
For a board to operate effectively it relies on information being communicated to and from all levels of the organisation. TPS had a clear communication strategy, which strongly reflected a commitment to openness with staff, stakeholders, board members and service users. It effectively laid out how this would be achieved through regular newsletters, emails, briefings, staff meetings, strategy days, conferences, team meetings and regular supervision between staff and managers. This review found that some of these communication mechanisms worked very well, whilst others had been less effective.
Board members require comprehensive, high-quality and timely information to make effective decisions for an organisation. They should be provided with detailed papers and reports in advance of board meetings, and have access to staff at board meetings and through other avenues, as appropriate and/or required. We were told by all TPS board members how papers and agendas were received well in advance of board meetings, and how they were both consistently informative and well organised. As part of this review, we attended a board meeting and received papers in advance of the meeting. We agreed that papers were easy to navigate, well presented, and informative.
We were told by board members that if they queried something in either a paper or the agenda, it could be raised and sometimes resolved in advance of board meetings. This was done through the chief executive/board support post holder, who acted as the main contact for board members within the organisation. All board members told us how communication with the organisation had significantly improved with the introduction of this post, 10 a year prior to this review. We found the communication between the board and the organisation to be open, effective and purposeful. We think that having some dedicated time from this specific post to support the board had made a significant difference and was important to its efficient and effective operation.
The chief executive and the chair of the board met in-between board meetings and agreed agenda items for forthcoming meetings. Both the current chief executive and the chair of the board agreed these meetings were used effectively and efficiently. The chief executive, other members of the senior management team and the board support post holder regularly attended board meetings. Board members were satisfied with verbal reports given by staff at board meetings and with the ability to question, challenge and openly debate issues with them. We noted that in three of the five board meeting minutes we reviewed, the board met without staff for part of the meeting. Furthermore, staff were not present for half of the most recent board review day. Board members told us that they thought the level of staff involvement in board discussions was generally appropriate and that is was important for boards to uphold the authority to have some discussions privately.
Board members relied not only on meetings and papers to gain an understanding of the organisation and to keep up to date with ongoing developments. They also attended training, strategy days, staff and external conferences and paid regular visits to the organisation's services throughout Scotland. We think that this level of board involvement in activities outside board meetings was important and found that it was well regarded by stakeholders. Some board members were more active than others, but all members had honoured the minimum commitment made to TPS.
Good practice example |
Board service visits Each board member was expected to make visits to at least two services per year. Board members told us how this enhanced their understanding of the organisation, the people it served, the staff it employed and the services it provided. Some staff told us how these visits were appreciated and had increased their confidence in, and awareness of the board and its role for the organisation. Service users who had met board members told us how they had enjoyed the experience of meeting board members. Board member visits were regularly reported at board meetings by way of written reports. |
There is openness in corporate processes
Senior management and board members told us how they drew upon different sources to ensure stakeholder involvement in the planning, delivering and evaluation of strategies and services. TPS had several channels through which communication within the organisation was intended to flow between service users, staff and board members.
TPS had a comprehensive policy and procedure document titled Stakeholder Involvement (incorporating project/service planning) Policy and Procedure. The document stated an organisational commitment to the "fullest possible involvement of stakeholders in the operation and planning of services". This policy made a clear link between the business planning at an organisational and governance level and the involvement of stakeholders. It required all services to produce an annual project/service plan and stated that "it was essential that feedback from all stakeholders should be included in the plan". The policy acknowledged that different services might approach consultation with stakeholders differently given the diverse nature of services provided by TPS.
Findings of our staff questionnaire supported the ethos of the stakeholder policy, where most (82%) of the respondents agreed that their team planned its services in consultation with service users and the majority (69%) agreed services were planned in consultation with other stakeholders. Service users we met told how they felt involved in decisions about their care from TPS. One service user told us how he had gained more confidence to speak out for himself by the encouragement and support provided by TPS. Furthermore, one purchaser told us "as an organisation, TPS are willing to work hand in glove with us, TPS have proved very flexible".
TPS had recently piloted a service user council. The purpose of the pilot was to ensure the views of service users were systematically gathered and fed into corporate planning processes. The pilot was led by a board member and staff member. We heard mixed views as to its effectiveness. This ranged from service users who described it as very helpful to others who had not heard of it, or benefited from it. The pilot was reviewed by the board member and staff member who had led on the project. We were told that their review reflected similar findings to ours and that the board had agreed additional resources to invest staff time in improving consultation with services users.
The stakeholder policy stated how each service was expected to engage in a stakeholder process. Prior to this policy, services were expected to host 'stakeholder days', to which service users, staff, purchasers and board members were all invited. The purpose of these days was to receive feedback on the service and to feed it into future planning. We heard mixed comments as to the effectiveness of these days. Board members were more enthusiastic about stakeholder days, describing them as opportunities to meet service users and staff. Although described as a good idea in principle, both staff and external stakeholders told us that stakeholder days were not always well attended and in some cases, had not happened for some time.
TPS had recently reviewed the use of stakeholder days which found similar conclusions to this review. The most recent stakeholder policy (mentioned above) acknowledged this and emphasised the importance of all services having a stakeholder process versus set activities which may only work for some groups and not others. For example, we were told how some service users would not come to stakeholder days, as they did not feel comfortable in public meetings. In the case of one service where stakeholder days had been less successful, we heard how the co-ordinator met with service users individually to gather feedback on the service.
Each service was required to complete an annual Improving Measurement Performance And Quality Tool ( IMPAQT) form, which was the quality management tool used by TPS. We were told that information collected from these played a key role in organisational planning and in informing the board of the overall performance of the organisation. However, we found that it was being used inconsistently throughout the organisation. In some services, administrative staff had responsibility for completing it and in others, service co-ordinators. It was not clear who had responsibility for its completion.
Staff told us that although the IMPAQT was a useful process, it was lengthy to complete and it would normally fall to one staff person to complete rather than consultation with the whole team. This left questions as to the comprehensiveness and accuracy of the IMPAQTs. Given their importance in organisational and strategic planning, this was concerning. Findings from the 'my view' survey undertaken internally by TPS in 2006 also suggested a lack of engagement from staff in evaluation and planning, where only half of the respondents either agreed or strongly agreed with the statement "I am encouraged to contribute to the development and review of TPS policy".
Information gathered from each service through mechanisms such as those mentioned above (i.e. stakeholder processes and IMPAQT) inform the business planning template. Each operational manager completed one of these for their service area, from which themes were identified and used to inform business planning for the next year. These were reviewed by the board and senior management at annual strategy days. Our review identified some areas throughout these processes that could be strengthened. The majority echoed issues that the organisation was already aware of and had been taking active steps to address.
There was a staff council called ER4U. Each regional area had a representative on the ER4U group. This group met regularly with the chief executive and other relevant staff from the head office. The meetings were used for staff to bring issues to management and for senior management to communicate with staff. This group was for information sharing and consultation. It was not for formal negotiation between staff and management. This was done through the trade union, as per the trade union agreement. Formal minutes were taken of ER4U meetings and action points were produced, with named persons responsible for follow up. All staff we met were familiar with ER4U, but some felt it was not as effective as it could be at communicating front-line issues to management and the board.
All staff had access to an internal intranet site, 11 but not all staff had personal email addresses at work. 12 All internal staff could access monthly e-bulletins. Most staff told us that they read the e-bulletins and found them informative, and some staff commented to us how recent biographies on board members had given them better insight into the board, who they were and what their roles were. Staff were also provided with access to minutes of senior management and board meetings. TPS produced a summary document of meetings for staff, but these were also described to us as difficult to understand, and most staff we spoke to paid minimal attention to them. We noted that TPS had reviewed the usefulness of the board summary documents and its findings were more positive. However, the majority of staff we spoke to found the summaries difficult to understand.
Team meetings are a key vehicle for keeping staff informed and involving staff in developments within any organisation. We heard mixed reviews as to how effective team meetings were throughout TPS. Some staff told us that team meetings did not happen regularly and were often cancelled. Others told us that although they took place, they did not find them informative. Yet, in some areas staff were enthusiastic about team meetings and found them an important vehicle for hearing about and contributing to developments in the organisation. Findings of this review reinforce results from the TPS 'my view' staff survey completed in 2006, which also found that staff did not think information was shared openly throughout the organisation. 13 This issue was picked up by management and had been identified as requiring attention.
We found that staff in one region where TPS provided services were more informed and engaged in the organisation than in the other areas. This particular area had what was described as a regional structure - whereby there was central administrative and financial support to the services located there. Services in this area used this local support as a means of communicating with the head office. We were told by both frontline and management staff that this had worked very well. In other regional areas, we were told that communication with head office was less effective. However, we noted that in the area where communication was described more positively there was a co-terminus health board and local authority. Furthermore, TPS services were managed locally by one operations manager. We were told by senior managers and the board that they were working towards locality structures elsewhere, but that structures must also take account of local variables.
In addition to the internal site, TPS also has a public website. 14 It contained clear information about the organisation, where services were located and what they offered. It also had information about the board of directors and what their responsibilities were in governing the organisation. TPS had a number of regular publications to assist with both external and internal communication. Comprehensive annual reports were produced and distributed to internal and external stakeholders and were also available on the TPS website. Financial reporting was at an appropriate level in these reports. Quarterly newsletters were also produced and sent out to stakeholders. We were told by stakeholders that both the annual reports and the newsletters were well received, informative and generally well read.
TPS was involved in public events, which had raised its public profile. The chief executive and other senior staff sat on national and local groups. However, the influence of these initiatives on the public perception and understanding was not examined in this review. Some board members told us they thought the organisation could do more to enhance the public's understanding of who they were and what they did, but that this shortfall was often seen as more to do with lack of capacity than a willingness to do so.
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