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The Walton Centre: investing in staff

In June the Liverpool-based trust was awarded a second gold award from the industry standards body Investors in People.
Hayley Citrine

Bigger is always better or is it?

At the Walton Centre NHS Foundation Trust, small is proving the perfect size.

In June, the Liverpool-based trust was awarded a second gold award from industry standards body Investors in People.

Recognition

The award made even more noteworthy by the higher requirements than when the Walton first won, three years ago recognises the specialist neurological hospital as a great employer.

With just 1,300 staff, including around 600 nurses, the hospital treats more than 100,000 a year for conditions such as head and spinal trauma injuries, tumours of the central nervous system, neurovascular diseases, epilepsy, multiple sclerosis, motor neurone disease, and more.

According to chief nurse Hayley Citrine,

...

Bigger is always better – or is it?

At the Walton Centre NHS Foundation Trust, small is proving the perfect size.

In June, the Liverpool-based trust was awarded a second gold award from industry standards body Investors in People.

Recognition

The award – made even more noteworthy by the higher requirements than when the Walton first won, three years ago – recognises the specialist neurological hospital as a great employer.

With just 1,300 staff, including around 600 nurses, the hospital treats more than 100,000 a year for conditions such as head and spinal trauma injuries, tumours of the central nervous system, neurovascular diseases, epilepsy, multiple sclerosis, motor neurone disease, and more.


The Walton Way values are at the heart of everything the Liverpool-based
Walton Centre NHS Foundation Trust does, says chief nurse Hayley Citrine

According to chief nurse Hayley Citrine, the Walton Way values, which she says are at the heart of everything the trust does, are not just buzzwords used in management meetings.

The Walton Way values include:

  • Caring
  • Dignity
  • Openness
  • Respect
  • Pride

Clinical challenges

Openness is of particular importance for Ms Citrine and part of the reason she believes the trust won the award.

‘Nursing is becoming a tougher job and we can't reduce the challenges, but we can support people in their jobs and improve the environment they work in,’ she says.

Every year, the organisation runs up to six Schwartz rounds, involving clinicians, the safeguarding matron and neuro-surgeon consultants, to analyse emotional and clinical challenges.

Influence strategy

There are also four cross-departmental meetings a year to discuss how to improve patient care, with all nurses and staff asked to give feedback.

According to Ms Citrine: ‘Staff say what keeps them awake at night and what they are proud of. This helps all front-line staff influence strategy going forward.’

The trust also has monthly 'good-catch' meetings, where staff are praised for spotting potential risks to patient safety.

‘We have worked hard on being open-minded and having a no-blame culture,’ says Ms Citrine.

‘We have worked hard on being open-minded and having
a no-blame culture’

One-on-one support

Nurses joining the Walton undergo a four-week supernumerary period, during which they shadow another member of staff and get one-on-one support.

Those at the beginning of their careers go through a six-month preceptorship to ensure they are up to speed.

One of those to benefit has been Hannah Cowley, who joined the trust in April, after a placement during her degree.

‘As a new starter, I was in the first cohort to do the new preceptorship programme, which I found good.’

Discuss experiences

Newly qualified nurses are grouped together and given the opportunity to listen to specialist senior nurses, as well as discuss their own experiences.

‘You could talk about things you weren't sure about and talk in a bit more depth in a small group, rather than be thrown in at the deep end on your own.’

Ms Cowley thinks it is also a good opportunity to ‘put faces to names’ and make things less ‘intimidating’ when joining.

‘You’re absolutely brand new and you don't know anybody. But the way it works makes the senior staff seem more approachable, rather than just being known as “the matron”.’

‘It’s much easier to raise things in a casual rather than formal way’

‘Better for patients’

She says meeting senior staff in a small group makes it easier to raise concerns, ultimately making it ‘better for the patients’.

The small size of the trust also means staff of different disciplines know and work well with each other.

‘Because we see everybody on a daily basis, it’s much easier to raise things in a casual rather than formal way,’ Ms Cowley says.

Ms Citrine thinks newly qualified nurses and patients benefit from the highly skilled, specialist nursing workforce, many members of which hold postgraduate qualifications.

The trust has tried to ensure opportunities for continuing professional development (CPD) have remained in place, despite budget pressures.

‘Clear career progression’

This was a big draw for Ms Cowley, who highlights importance of the trust's clear career progression path, adding: ‘There is a benefit of shared knowledge, and the specialist nurses are all approachable if you've got concerns for a patient or want advice.’

Two years ago, the trust introduced practice education facilitators to manage the small groups of nurses on preceptorship, provide named support for nurses new to the trust, and manage CPD.

One of these is Rachel Bocking. She says: ‘There is one of us on each ward at the Walton, whereas usually there are one or two facilitators for a whole trust. We can work closely with the new starters and introduce them into the team.

‘It’s good for the retention of nurses… We are a single point of contact’

‘It's good for the retention of nurses. They have got one person who they know they can go to for advice, rather than speaking to somebody they perhaps don't know well. We can build a rapport, we know who they are, we are a single point of contact.'

‘Bounce ideas’

The practice educators meet every few weeks to ‘bounce ideas’ off each other and to suggest improvements.

Much of Ms Bocking's role is ensuring that staff can attend talks and improve their skills to help them up the career ladder.

She says that, despite qualifiying only two and half years before arriving at the Walton, she was encouraged by senior nurses to push for the next big role.

Ms Bocking recently participated in one of the Schwartz rounds focused on the role of band 6 nurses.

Learning curve

‘Being new to the position, I was asked: “What could we do differently?”. We were told not to hold anything back and it was all a learning curve. We were encouraged not just to say what was good, but what was bad.’

Protecting the well-being of staff is a priority for the Walton, with its plethora of staff teams and clubs offering a range of sports and activities, including netball, walking, pilates, art, comedy and mindfulness.

Ms Bocking says: ‘The management are pro-active. On our ward, we are quite busy and we have some challenging patients.

‘So the matron organised for somebody to come in and give all the staff hand massages one Friday, because the stress levels were high. It was only five or ten minutes, but it was nice.’

 

 

 

 

 

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