The NHS is a melting pot of varieties of committed and talented people facing intense pressures, emotional strain and public scrutiny. There’s going to be conflict – misunderstandings, personality clashes, friction between different points of view – all the kinds of relationship and communication problems that choke the flow of working days and, ultimately, the services for patients.
When there’s a clear plan for managing workplace relationships the picture changes. Staff begin to have more trust and confidence in the principle that their issues and grievances are going to be handled in constructive, more informal ways. Conflict starts to look and feel a healthy part of organisational life – something that happens when people care; when conventions are being challenged and when good new ideas are being pushed through.
A Healthy Conflict Management Plan is an important way for any NHS employer to make the most of their people resources, of doing more with less. It’s also critical in terms of responding to the new world of work. In the #MeToo age employees are more comfortable and willing to speak out about any kind of inappropriate behaviour, or any perceived abuse of power and authority. Health Secretary Matt Hancock, for example, has been vocal in demanding a different attitude to whistleblowers in the NHS: bosses need to listen and respond; Non-Disclosure Agreements are not to be used to protect the reputation of senior staff.
The evidence suggests there remains a lot of work to do to turn around the NHS conflict culture:
- The costs of bullying and harassment cases are reported to be around £2.3 billion a year. Such costs are accrued by staff less able to do jobs, a drain on management time, and a series of problems and anxieties that seep into the workplace environment more generally.
- Stress, anxiety and depression account for almost half of all working days lost.
- The average cost of a bullying/harassment case for an NHS organisation is £40,000.
- There’s also an underlying lack of trust among staff.
- Only 14% of bullied staff felt able to report it to authority.
- 30% of whistleblowers say they feel ‘unsafe’ in terms of a future career.
When steps have been taken to introduce a culture of healthy conflict, there has been tangible ROI. CMP has been working with NHS employers across the UK, including the National Patient Safety Agency, Foundation Trusts and ambulance services. In one example, CMP worked with NHS Lothian to introduce a new in-house mediation service by upskilling managerial staff in handling difficult conversations and training key staff as internal mediators. The NHS Lothian board also used CMP’s experience to advise on the infrastructure and materials required to manage, monitor and evaluate the service, and as the source of external conflict resolution partners to bring in for particularly complex or sensitive cases.
In the two years following the end of the initial programme, at NHS Lothian, 94% of mediation cases resulted in an agreement between the parties; there have been falls in the number and length of sickness absences; and a reduction in the amount of time needed for managing conflict situations, both formal and informal, estimated at a saving of over 100 days. In terms of a tangible Return on Investment, the Board undertook the CMP Resolutions Conflict Profile Audit at the start of the project and then again after 18 months. Combining this data with data gathered through the Courage to Manage pilots and other data sets, the analysis indicated that the financial return on investment could be as much as £2.32 for every £1 spent, a potential return of 232% in the first year alone.
Let CMP support your NHS organisation, in improving the way you respond to conflict, through our Healthy Conflict Management Plan!