Workplace support advisers were introduced in a hospital trust in 2000 to resolve issues arising between employees and their colleagues and supervisors. Since then, their use has been expanded. Walter Brennan shares the findings of an evaluation of their training and impact on the workplace.
In 2000, the first cohort of workplace support advisers (WPSAs) were trained at Borders General Hospital, Melrose. The course was launched in response to the number of stress-related referrals being seen by occupational health staff.
The major sources of employee stress (including anxiety and depression) were bullying and harassment issues, inter-staff conflicts, grievances and disputes.
The course was driven and led by the OH lead, who co-presented the course. Ultimately, the content was to cover:
- equality and diversity;
- bullying and harassment;
- stress;
- the Public Interest Disclosure Act 1998;
- the Equality Act 2010 (which replaced the previous separate Acts covering disability, race and gender); and
- grievance procedure.
The second cohort took place within an NHS trust in England.
The first part of the training course focused on establishing a clear understanding of the function of WPSAs and also establishing their motivation and commitment to the role. Delegates were then given a number of case studies, and working in pairs they had to identify the issues involved in scenarios, including:
- A disabled employee who uses a wheelchair being told she could not attend a training course, as she could be a fire hazard.
- A junior employee who was concerned at being told to leave a patient to try to stand up from a chair without any support.
- A theatre practitioner told that they had to restrain patients who may be confused and agitated as they recover from general anaesthetic. The staff are concerned that they have never been trained to restrain and feel uncomfortable about this.
- A female registrar complaining that a senior male colleague kept making inappropriate sexual comments towards her. She feels really uncomfortable, but does not know what she should do about it.
The delegates on the WPSA training course are asked to consider each of these issues from a personal, procedural, statutory and ethical perspective.
Ensuing discussion was passionate, challenging and provocative, as delegates considered each scenario within their own set of values.
Trying to define the role of a WPSA was fraught with difficulty in terms of what they can and cannot do; should and should not do, and what they are and what they are not.
The following list broadly covers what a WPSA is:
- adviser;
- listener;
- sign poster;
- reality checker;
- supporter;
- listener; and
- guide.
What they are not:
- union representative;
- HR professional;
- manager;
- bodyguard;
- mediator;
- disciplinarian; or
- management stooge.
However, neither list is exhaustive. So what does a WPSA do?
They are employees who are representative of discipline, grade, gender and race and who can provide support and guidance around work-related issues (such as bullying/harassment, care concerns or serious breaches in health and safety) and have an understanding of the relevant policies.
WPSAs are independent and available to both victim and alleged perpetrator, though not to both parties involved in the same dispute.
Their work is confidential, although confidentiality cannot be guaranteed where there are issues of safeguarding, an illicit nature or a risk of serious harm to an individual(s) is disclosed.
In training, each WPSA was provided with a folder containing slides, supportive articles and copies of relevant policies. Gaining familiarity with such an array of detailed documents can be a daunting task so short summaries were provided with more detailed copies for reference.
The service was promoted with posters, intranet and team briefings throughout the organisation, using photographs of the WPSAs. An audit tool was designed to assess the effectiveness of the service and identify trends in the types of issues being reported, whether gender, ethnic group, discipline or age group.
One problem was that the role was not clearly identified to colleagues working within the service. There was no record or audit of contacts, no advice provided or evaluation of the effectiveness of the service.
Only four of the original team had any kind of contact during this period, and of these four, just two were actually involved in providing guidance and information. However, it was only anecdotal and so data gathering was poor.
In 2010, the then Secretary of State for Health, Andrew Lansley, speaking of the Mid Staffordshire hospital scandal, described the organisation’s culture to the House of Commons in these terms: “A culture of fear in which staff did not feel able to report concerns; a culture of secrecy in which the trust board shut itself off from what was happening in its hospital and ignored its patients; and a culture of bullying, which prevented people from doing their jobs properly.”
In 2013, employees were invited to apply to become the second cohort of WPSAs.
This time it was agreed that an internal advertisement would be circulated throughout the trust and prospective advisers would be invited to contact the service and express an interest in the work.
There were about 10 applications and, after a brief interview, a total of eight delegates attended the course. Immediately, one of the delegates admitted that he did not know whether or not he could cope with the commitment required and promptly left the course. There were six female and one male delegate. This time it was important to include two new developments relevant to the NHS in general and these were:
- How events at Mid Staffordshire hospital could easily happen elsewhere and the need to learn from the major recommendations of the Francis report on Mid Staffordshire NHS Foundation Trust.
- It was crucial to consider how the hospital trust’s vision and values would apply.
The WPSA service was relaunched a week later with an announcement on the internal intranet. A newsletter and posters were also submitted throughout the trust, containing photographs of the advisers and contact numbers.
There have been about 43 contacts with the WPSAs during this two-year period. In terms of distribution of contacts, two in particular who were senior and more passionate about their role, tended to be busier with 13 and nine contacts respectively.
The remaining advisers had, on average, two contacts per year – one particular adviser found that two out of three of her contacts were with senior managers and a board member.
The issues raised were:
- whistleblowing – finance – 2;
- bullying and harassment – 13;
- potential neglect and/or safeguarding issues – 6; and
- health and safety issues – moving and handling, lone working, “unsafe” staffing levels, stress – 2.
Guidance provided by WPSAs included the following:
- Having to defuse an angry person and persuade them not to confront a colleague or telephone the press.
- Suggesting an employee should come back to work 24 hours after they had calmed down and had a chance to consider how they viewed the situation.
- Advising an employee to speak to the person concerned to see if the matter could be resolved without going any further.
- Guidance on following the bullying and harassment procedure and going through it with the complainant to establish that there was not a bullying incident.
- Guidance on the Public Interest Disclosure Act 2008, and Equality Act 2010.
- Advice to attend training courses on managing stress.
- Advice to speak to occupational health.
- The WPSA spoke to a person’s supervisor or manager.
An audit tool was designed to record more accurately the number of interactions that took place, the area involved (for example, clinical, medical, administration), the nature of the complaint and, finally, the suggested action and any follow-up.
Conclusions of the evaluation of WPSAs
Being a WPSA has proved to be rewarding and satisfying for some. For others, apart from learning “a few things”, there was no change.
Two WPSAs were responsible for almost 40% of reported activity within the trust. Many of the WPSAs were very motivated. One member of the team’s own daughter had been bullied within another organisation that had failed to support her.
She did not want to turn a blind eye to the issue. The other WPSA worked in a busy area and seemed to be the magnet that attracted approaches, hence an understanding of her high volume of interactions.
Another WPSA felt the responsibility was too onerous and that she was being used to fight the complainant’s battles.
She suggested that the complainant try to speak to their supervisor about the matter, but the WPSA was accused of being unhelpful. However, she did get feedback a week later from the complainant that he had done as suggested and the problem had been resolved.
Being a WPSA requires commitment, motivation to learn and a willingness to support and guide colleagues who may just need an objective point of view or more detailed information on pursuing a serious complaint. It is not easy and is often thankless, with no financial remuneration.
However, it is an increasingly relevant and supportive facility in the modern workplace. Having OH involvement as coordinator for the WPSAs works well, as they are viewed as, at worst, neutral and, at best, on the side of staff.
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The WPSA model needs greater exposure if it is to be adopted more widely. It also needs to be representative of the whole spine of the organisation, including senior managers, directors and more male representation in general.
Walter Brennan is a training consultant, mediator and expert witness.
