September 25, 2020 | 12 minutes read

Report from the NHS People Plan tweet chats : 4th and 5th August 2020

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NHS Horizons

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NHS Horizons

This paper describes the outputs and outcomes from the NHS People Plan tweet chats that took place on Tuesday 4 August, 5pm to 6pm, and Wednesday 5 August, 11am to 12pm. More than 1,300* people took part in the tweet chats, generating around 3,000 tweets.

A tweet chat is a scheduled, organised conversation on Twitter focused around a specific topic. Anyone can join in a tweet chat, using the designated tweet chat hashtag(s), in this case #OurNHSPeople and #WeAreTheNHS.

This report is written in the spirit of the tweet chats. So, for instance, we have included hyperlinks to the Twitter accounts of all the people we mention in the report. Click on the hyperlink (the blue text) to go to the Twitter account of the person named or to the tweet they sent.

The tweet chats were led by Prerana Issar (NHS Chief People Officer). The panel for the chat on 4 August included Professor Mark Radford, (Chief Nurse, Health Education England); Navina Evans (Chief Executive of the East London Foundation Trust and Chair of the Best Place to Work workstream); and Julian Hartley (Chief Executive, Leeds Teaching Hospital NHS Trust). For the chat on 5 August the panel included Dr Nikita Kanani, (Director of Primary Care, NHS England and NHS Improvement); Rob Webster (Chief Executive, South Yorkshire Partnership NHS Foundation Trust); Professor Simon Gregory (Deputy Medical Director, Primary & Integrated Care, Health Education England). It was facilitated by the NHS Horizons team (@HorizonsNHS) who also prepared this report. The tweet chats each lasted for one hour, although the conversations continued actively on Twitter beyond that.

*Some people took part in both tweet chats so the number of unique individuals that participated will be slightly lower

These were the questions asked during the tweet chats:

What happened during the tweet chats?

The graphics below show the number of people who joined the chat. Participants used both hashtags, meaning the numbers cannot be simply added together. However, these analytics show us that across the two tweet chats more than 1,300 people participated, sending approximately 3,000 tweets which generated more than 20 million impressions.

#OurNHSPeople - tweet chat on Tuesday 4 August

#WeAreTheNHS - tweet chat on Tuesday 4 August

#OurNHSPeople - tweet chat on Wednesday 5 August

Themes:

We analysed the themes for the tweet chat using the themes from the NHS People Plan 2020/1:

Overview:

Common themes arising in both tweet chats were a sense of positivity about the new People Plan: a sense of hope, shared purpose, belonging, and a commitment to inclusivity and diversity.

Participants celebrated the many beneficial changes that had occurred during the Covid-19 pandemic response, and their desire to keep those changes in our working practices for the future, for the wellbeing of staff and benefit of our patients.

More detail about these points can be seen in the text below.

The process of the tweet chats:

Both chats featured diverse #OurNHSPeople from a range of professions, roles, and organisations.

Both chats began by asking participants to introduce themselves. Below is a summary of the responses to each of the questions. To view all the tweets sent during the chats, please view this document.

Question 2 (A2): What excites you most about the NHS People Plan?

This question sparked a really energetic and passionate exchange of tweets. Many responses relate to the themes of looking after our people, and belonging in the NHS. People seemed really inspired and hopeful about the future describing the optimism, commitment and determinism that the plan creates to “reset the way we work”. They reflected that for the first time there is a plan that embraces compassion, warmth, flexibility and respect. This sentiment is illustrated in the tweets below.

Respondents also commented on their hopes for growing for the future.

Relating to the theme of supporting our NHS people for the longer term, there was a clear emphasis on the value and importance of creating a workplace where ALL #OurNHSPeople have a sense of belonging and a shared purpose. Responses reflected a consensus on a shared desire to see our people and our capabilities as our most important asset - and to build for the future.

Participants appreciated the focus on staff wellbeing and that our NHS people are individuals, striving to model inclusivity and diversity.

There was a recognition that “To care for staff and colleagues is to care for patients.”

In summary, there is so much enthusiasm for the new People Plan: excitement is coming from a real hunger to put staff wellbeing at the heart of all that we do.

There was an overwhelming appreciation and relief that compassion, inclusivity, kindness is at the heart of the plan - that it is focused on looking after our people.

Question 3 (A3): Do you have a sense of what staff in the organisation you work in feel about the Plan?

When asked if they had a feel for what staff in their organisation felt about the plan, most participants felt that initial reactions had been broadly positive. Many described feelings of excitement and optimistic anticipation; and were pleased to see that the plan recognised the hard work and dedication of NHS people throughout COVID-19 and beyond.

Others noted that they recognised and shared the ambition, but that the proof would be in the implementation and delivery. There was a keenness to see a summary of the actions set out in the plan set against clear timescales for delivery, both for clarity on the objectives and so that tired and time-poor staff could digest the plan more easily.

There was also acknowledgement that organisations are hugely varied and that for some of the workforce, these ambitions may already be a reality; whilst in others, they feel a long way off. There was a feeling that system governance and accountability will be key and that at a national level, more can be done to acknowledge and champion the issues and connectivity with social care.

One of the strongest themes that emerged from the conversation was around the opportunities the plan offers in terms of staff wellbeing and looking after our people. Again, there was an acknowledgement of intent vs implementation, but there was a strong sense that colleagues in all roles and at all levels wanted to support their colleagues and felt hopeful about the ambitions set out. Participants felt it was key that we built on the momentum around wellbeing that was driven by COVID-19.

Other participants shared how positive changes – such as flexible working and increased training opportunities – were already happening in their workplaces. This also led to a point around inconsistency, and how staff may have vastly different experiences depending on their organisation – or even line manager.

One participant made a very pertinent point around the fact that rest spaces/wobble rooms – highlighted so frequently during COVID-19 – were already being withdrawn.

Belonging in the NHS - the importance of creating an organisational culture that was diverse and inclusive was another strong theme throughout the discussion. Many participants shared their own personal commitments to promoting equality, diversity and inclusion and how they would continue to educate themselves to be a strong champion or supportive ally.

There was also a feeling of excitement around the ambitions – for example, a workforce that better represents the community it serves – but again, some scepticism around if this would become a reality. Points were also raised about the ‘postcode lottery’ of cultural experience, and the language that we use to define and talk about staff from a minority ethnic background.

The exclusion of the Trans community was also mentioned by a number of participants, with disappointment expressed at the singular reference to LGBTQ+.

Participants were keen to hear more about some of the initiatives that will support new ways of working and delivering care , including the NHS cadets.

Given the strong focus on digital transformation and rapid implementation of new technology, many participants were keen to hear more about how the NHS will tackle digital exclusion and ensure that staff will be digitally literate; and feel skilled and supported to use these new tools and services.

Many participants were keen to hear more about the ambitions in the growing for the future chapter of the plan, including international recruitment. Some expressed disappointment that certain roles or remits within the workforce seemed to have a much more significant focus than others, whilst there was also a feeling that the plan could have done more to include social care and wider system considerations.

Question 4 (A4): Which of the beneficial changes from #Covid-19 do you want to amplify?

This question drove some passionate discussion among participants, who felt many positive changes had been seen in services during the pandemic. Naturally, many responses relate to responding to new challenges and opportunities.

There was a clear view that the new ways of working and benefits seen through COVID-19 must remain.

Colleagues were impressed with the speed at which change took place, with many of the barriers to improvement and development removed. Some of this was attributed to distributed leadership, collaborative working across the system and the ability to quickly access and deploy technology. Staff referenced being able to use their personal judgement and feeling empowered.

Participants reflected that during the pandemic so many lessons have been learned, and ideas shared. There was a call to build on the lessons learned during the pandemic, and maintain the phenomenal strides forward in practice that we have made across boundaries, technology and care, such as articulated by Nate:

So many of our staff were inspired and energised by the way that several barriers vanished during the pandemic. Participants reported that they were able to step up and make the changes required quickly regardless of their band and job title. As Tracy tweeted, our NHS people reflected all our NHS people had a shared purpose to beat Covid.

Belonging in the NHS was reflected in responses. Kat shared her huge sense of pride, and energy gained from working together:

A really strong narrative has emerged about seeing the best of humanity during the pandemic, with everyone working together, and the public supporting our NHS people as these tweets illustrate.

During the pandemic new ways of working and delivering care were developed. Colleagues appreciated changes to working practices such as flexible working and collaboration - and are keen to keep them.

As a result of social distancing measures digital networking has become a valued way of staying connected, a support mechanism and a real breakthrough in the way that we can get the work done - as well as benefit patients.

Our staff put forward a clear and compelling message that now more than ever, flexible working and personalised career portfolios have been recognised as key to career development. A good work life balance will ensure a committed and passionate workforce is retained in our NHS.

A clear message also came through around staff health and wellbeing - looking after our people. Many felt that the challenging circumstances they were working in had been recognised and both the local and national health and wellbeing support that had been put in place was well received. There was a strong wish for this focus on health and wellbeing to remain.

The essence of responses to this question is that working collaboratively across the system at pace to innovate has shone the light on what can be achieved in terms of things like remote working, flexible working, and virtual learning.

Flexible working, networking, learning, sharing, kindness, compassion, collaboration have made it uniquely possible for many staff to feel more connected to and with a greater understanding of the national priorities of the NHS than ever before. These relate to each of the overarching themes in the People Plan: in addition to the themes mentioned above in this section of the report, growing for the future, and supporting our NHS people for the long term. Dismantling hierarchies through colleagues being able to make changes at pace, mindset shifts, unifying purpose, camaraderie and digital working seem to be at the top of the leader board for amplification, together with a passionate call … as Gill Phazey asked, “Let's not go backwards!”

Question 5 (A5): What action are you going to take as a result of what you’ve seen and heard so far?

A number of our participants shared their commitment to creating a fair and inclusive NHS for all by learning how to be an effective ally.

Kat shared a reflecting action related to belonging in the NHS, acknowledging that change is through ‘self and work’, with which many participants related:

Lynsey highlighted her desire to be the best ally she can be to all of her colleagues and consciously trying to learn more. Within the theme of belonging, the commitment to actively learn more was shared by many.

Dr Navina Evans shared similar thoughts to Lynsey, sharing that she needed to be even more inclusive than she thought she was. Rosanna shared that she is focusing on allyship by spending more proportional work-time networking in the new digital spaces.

As well as commitment to learn, there was also a number of participants ready to influence, Sonali was determined to push for equivalent BAME representation:

Whilst Claire recently started her role as Disabilities Network Co-Chair and hoped to enable People Plan ideas through that.

In respect to New Ways of Working and Delivering Care, the situation with Covid-19 changed the way of working for the majority of staff, this highlighted a number of practices that staff want to keep beyond Covid-19. Karen shared that she would love to see an increase on how we can use virtual spaces more effectively.

Madhu explained that as part of Bring Back Staff, the process of pre-employment checks were expedited which could be very helpful for changes in post Covid recruitment.

Andrea expressed her enthusiasm for all of the innovations and initiatives that are enabling NHS people to do their very best work. We need to share them, spread them & help them stick. Similarly, Jeff Wren said that it would be great to identify where things have worked exceptionally well and been welcomed by staff and we could share it better.

Similarly, Gill explained that she wanted to keep sharing the good stuff and shine a light on things that make people cynical.

As well as technology and policy changes during the peak of Covid-19 there was huge emphasis on kindness, whether that was relative to work or home life. We were made to be more conscious of what our colleagues were individually going through. Farzana explained that she wants to incorporate that kindness to people in her everyday work and be mindful about doing that.

Related to the theme of looking after our people, Julian said that we need to continue the efforts to understand and respond to the needs of our staff and patients.

This was also highlighted by Prerana who said that we should all look out for each other by encouraging our colleagues to seek help as soon as it is needed.

Sam spoke about growing for the future, mentioning that we need to start by listening and working locally to impact long term change.

Supporting our NHS people for the long term is key: Rajiv explained that we all need to play our role, and model the behaviours we want to see.

This section relates to general conversation during the tweet chats, and do not relate to the five specific questions posed. They are grouped into topics as per the below.

Trans community

Members of the NHS trans community joined the tweet chats to voice their upset at having no specific mention within the plan.

There are more than 100 trans people throughout the NHS in a variety of roles . Tara Hewitt said she felt with the lack of any mention of trans colleagues in the plan she does not feel included.

The Trans Staff NHS Network noted that trans colleagues have used phrases such as "Disappointed but not surprised" "deeply hurt" "why we are reluctant to be out at work as we are an after thought" in response to seeing no meaningful inclusion of trans colleagues or inequalities they face.

Prerana pledged action:

The Trans Staff NHS Network has acknowledged Prerana has been in touch.

Digital Inequalities

Due to social distancing guidelines during the #Covid-19 pandemic, where possible #OurNHSPeople have been working at home. There are many benefits to colleagues from working at home, meaning many are choosing to continue this practice – this is consistent with working differently, as outlined in the People Plan. However, it should be noted that not everyone may be able to work at home, for a variety of reasons.

BAME

‘Black Asian Minority Ethnic’ (BAME) as is typically used has been described as an unhelpful umbrella term that assumes everyone is a homogenous group.

Read Tracie Jolliff’s statement here.