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20 October 2023
Case studies
Bringing staff with you when delivering major change in health and care
Insights from the health and care community helped produce a shared definition of how to engage staff positively in major change.
Insights from the health and care community helped produce a shared definition of how to engage staff positively in major change.
Q is a community of thousands of people collaborating to improve the safety and quality of health and care across the UK and Ireland. It brings together people from across sectors, varying in role and experience, who inspire each other to deliver improvements to health and care – supporting individual and collective change that extends far beyond the community.
"Our sector is facing massive challenges and conflicting priorities. Q is one response to that - a collaborative community where people can share learning effectively, collaborate and make progress.”
Matt Hill - Head of Insight, Evaluation and Research, Q
The Insight Team at Q focuses the knowledge and skills from the Q community on particular challenges and hypotheses. In this project, the team wanted to use insight from the community to explore a question: when making major changes across health and care, how can we engage staff as well as possible to make them an effective part of the change?
During the pandemic, difficult changes in healthcare were achieved at pace and scale due to urgent pressures and unavoidable new ways of working. This meant that improvement took place in new formats. It often featured better collaboration across traditional boundaries because of a common understanding about the need to change things swiftly.
However, as the pandemic rolled on, existing challenges for the system took on a new severity. Pandemic-induced pressures combined with existing workforce shortages and waiting lists, alongside rapidly growing unmet needs. The NHS staff survey (an annual workforce survey to improve staff experiences across the NHS) has also shown measures of staff wellbeing heading in the wrong direction since 2020.
The Q team wanted to understand what this particular set of challenges and pressures means and requires for organisations and leaders engaging staff. How might they bring staff with them as part of major change, and create more successful change by doing so? Is it possible to do that in the context of an environment where people are feeling increasingly burned out from this set of unrelenting pressures and workload challenges?
There were four premises behind the team’s project:
The Q and Thiscovery teams are linked through their connections with the Health Foundation, and the Q team’s interest in the platform was already piqued. The big attraction for them was the inherently participatory nature of Thiscovery. They could see that Thiscovery would give a diverse group of participants access to their study. All of which chimes with the Q community’s values.
The team were also interested in the quality of the user experience on Thiscovery and the bigger approach to tasks. Their project wouldn’t just be a one-off survey, but a collaborative approach with a group working together to find solutions. Again, this is exactly what Q is about.
“Traditional surveys are often very functional. Thiscovery lifts things up a level - the experience of the person answering the questions really matters. We saw the impact of that in our response rates.”
Henry Cann - Evaluation, Data and Impact Manager, Q
The Q team were keen to get the views of the Q community, and also drew on their wider networks and across social media. Working closely with the Thiscovery team they were able to design and deliver a project which exceeded their expectations for participant involvement.
The project involved four tasks across two stages. The first stage asked people what it means to engage staff well in major change: what were their experiences of engagement in change projects; and their thoughts on defining what good looks like. This first task included presenting visual stimuli to participants as background materials, including newspaper clippings, quotes from experts and statistics from reports.
Participants were initially asked to list up to five elements most import to staff engagement in major change
Later tasks involved rating statements to reach a consensus on how the measurement of staff engagement should be approached
"Throughout all four tasks we really got a level of detail, richness and thoughtful engagement from participants that was above and beyond our expectations.”
Matt Hill - Head of Insight, Evaluation and Research, Q
The second task then showed participants a summary of initial findings, and asked them to comment on and rank suggestions for what good looks like. This process allowed the Q team to develop detailed definitions of key terms at an early stage in the project.
At a later stage the same individuals were asked about how to measure good engagement - their thoughts on how to know if it’s working and how to improve. The final task then presented back suggested measurement tools and criteria and asked users to comment and rank the options.
Holding the project on Thiscovery helped the Q team to establish results with more breadth and depth, and with higher levels of participant engagement, than they had experienced using other approaches.
More than 300 people contributed throughout the process, allowing the Q team to deliver:
“Thiscovery is set up perfectly to engage a wide range of busy people. It gave us a way to reach people who could help us understand and develop solutions in response to the challenges facing health and care.”
Henry Cann - Evaluation, Data and Impact Manager, Q
Q is a community of thousands of people across the UK and Ireland, collaborating to improve the safety and quality of health and care. Q is delivered by the Health Foundation and supported and co-funded by partners across the UK and Ireland. Membership of Q is free. Find out how to join.
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