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Tue 14th March, 2017

Okay, today it’s the turn of the Mental Health Trusts to come under the spotlight. How have staff at your Trust rated leadership and culture via the 2016 National Staff Survey results? Read on.

In a similar vein to the Acute sector, NHS England and Picker set different thresholds for measuring results for Mental Health and Learning Disability Trusts, from those that also include Community Services. So the next two blog posts will have similar messages but focus on these two different groups.

This post focuses on the Mental Health, Learning Disability and Community Trusts cohort, providing both the LiA Scatter Map and the corresponding League Table.

We have reviewed and analysed the 32 Key Findings from the 2016 NSS results – produced by Picker Europe for the NHS – for all 29 MHLD&COMM Trusts for 2017.

Each Trusts' results are reflected at a grid reference on a 32 by 32 ‘Scatter Map’ that shows how staff have rated the Trust’s leadership and culture over the past year. It's simple to understand:

  • The higher up you are, the better your Trust is performing against your peers in the eyes of your staff
  • The further to the right you are, the more positive your trend, year-on-year.

So, the best quadrant to find your Trust in is 'top right': an above average performance and a positive trend. Second best is 'top left': a positive relative performance according to staff, but they are less positive than the same time last year. The second worst quadrant is 'bottom right': below median performance with some encouraging positivity from staff to soften the blow. The worst quadrant is 'bottom left', with staff views on leadership and culture resoundingly negative.













This year’s results have been updated and improved in several key ways:

  • All 32 Key Findings have been included in the analysis, giving a complete picture of how staff feel
  • Each Trust is colour-coded according to its status as either a Foundation Trust (blue) or a non-FT (yellow). Where more than one Trust occupies the same grid reference (green), their status is reflected in their name annotation
  • A League Table of how each Trust has fared from last year to this year is included (below), highlighting the movement up or down the league table for each Trust, relative to their scatter map grid position.

So what can we glean from the MHLD&COMM LiA Scatter Map:

This Trust cohort DOES reflect the trend from the Acute sector, with a pronounced shift towards a more negative staff response and a diminution of performance across the cohort. There are more Trusts in the left half and more Trusts in the bottom half than 2015 – so the question to be asked, following on from the challenge in the Acute sector is: ‘Are the pressures on local Trust leaders and front-line staff too damaging for the system to continue in this vein?’ If we believe what staff are telling us – and why wouldn’t we – the answer is yes. Change of tack required, soon!

  • There are only 5 non-FT Trusts in the cohort and they are represented in each quadrant, so a fair FT/non-FT split and relative spread (Go Solent! A great result! With Barnet, Enfield and Haringay also breaking into the top half as a non-FT)
  • The ‘scatter’ on the map is more uniform than the equivalent for MH&LD, with fewer outliers but more struggling on trend and performance, which raises the question of why? Is it the addition of the community aspect that makes work more difficult or impacts staff more? If so, what more do leaders have to do in this sector to connect with staff and overcome the challenges inherent in the wider spread of staff and services? And, importantly, how will this level of challenge look for staff and leaders as the emphasis and operations shift to the STP footprints? This is HUGE, and not being addressed in any meaningful way
  • Southern Health has done well to start the recovery from its calamitous leadership year, and has been replaced in the 'bottom left' by 6 new Trusts in 2017, including 5 FTs. Congratulations to Sheena Cuminsky and her team at Cheshire and Wirral Partnership FT for heading the League Table this year, and special mention to Sue Harriman and her team at Solent for their achievements in breaking into the FTs (is it a coincidence that all but one of the top performing Trusts on our Scatter Maps and League Tables based on the NSS results across all sectors is being led by women, and in many cases women with a medical/clinical background?), and to Ron Shields and staff at Dorset University Healthcare FT for a huge positive shift in the League Table from 2016.

The most pleasing thing we’ve heard from many quarters since the publication of the Acute Trust Scatter Map and League Table last year is how valuable it has been in helping Trusts ‘see where they are nationally’. Great, that’s the intent, and, on the basis that ‘nothing gets done that doesn’t get measured’, if the map and table elicit a response from Trust Boards and actions happen as a result, we’ve accomplished our goals. No more minutiae discussions by Trust Boards about how their NSS results are ‘up 1% on this target’ or ‘below median but trending better than last year’, or ‘we’re top 20% on 3 key findings, one better than last year’. Nope, now it's crystal clear what your staff results tell you. Are they good? Bad? Or downright ugly? Check out the LiA Scatter Map and League Table to find the answer.

League Table

We have produced the League Table below for all MENTAL HEALTH, LEARNING DISABILITY & COMMUNITY Trusts based on their LiA Scatter Map position. The National Staff Survey results on which the Scatter Map and League Tables are based are a summary of how staff feel about the leadership and culture of their Trust. Their response to 32 of the Picker Key Findings establishes the Trusts position on the scatter map for 2016. This position is then compared with each Trust’s position for 2015.

The League Table shows:
• In blue and yellow, a Trust status as an Foundation Trust (blue) or non-FT Trust (yellow)
• The league position for each Trust’s NSS results from best to worst
• The movement of each Trust up or down from last year’s position.

On this basis, the top 3 positive movers are: Dorset University Healthcare FT (+17), Cheshire and Wirral Partnership FT (+12), and South West Yorkshire Partnership FT (+12). The top 3 Trusts going the wrong way, in a big way, are: 5 Boroughs Partnership (-11), Bradford District Care FT (-17), and Worcestershire Health & Care Trust (-20).


The tables are designed to help CEOs and their leadership teams understand their NSS results, how they place the Trust within their peer group, and, hopefully, decide on a course of action that will build on success or address what staff say is not working for them at their own Trust.

Download the PDF version of the LiA Scatter Map.

For further information on your Trust’s position and its implications, or to discuss your Trust’s response to the analysis, please contact Gordon Forbes, Director at Optimise Limited and owner/architect of Listening into Action (LiA) at 07734 812311 or by email

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