A Respect & Resolution Framework for NHS, Health & Social Care organisations
The Resolution Framework™, also known as The Respect & Resolution Framework™ has been developed as a person centred, solutions-focused and fully legally compliant alternative to traditional NHS, health and social care HR policies and procedures.
Organisations as widely recognised as London Ambulance Service and The Royal College of Paediatrics and Child Health have worked with us in support of a better employee experience for their healthcare professionals.
Develop a person-centred, fair and just healthcare culture
The handling of workplace conflict has been a longstanding problem within the healthcare sector. Reports such as Robert Francis’ Freedom to Speak Up Review have shed a light on the extent of such issues, and the negative impacts upon workplace culture and patient safety. The COVID-19 pandemic further exacerbated the problem, stretching and testing the resilience and capabilities of an already strained workforce.
Our extensive background in working within the sector has shown us the damaging impacts of its antiquated, reductive, and corrosive HR policy frameworks. These are traditionally used to deal anything from minor fallouts between colleagues to serious misconduct allegations. Thankfully more and more healthcare trusts are recognising that there is an alternative. One which protects relationships, and maintains trust, respect and communication.
In a highly complex and pressurised healthcare sector, it would be unrealistic to expect that conflict would never arise. Of course, conflict isn’t all bad. Respectful, healthy debate between colleagues is the key to finding new and innovative ways of tackling some of the biggest challenges facing the sector, right now.
The problem is that people don’t understand to disagree well. Very often, a simple conversation between the individuals involved is all that is required to resolve less serious disputes. The Resolution Framework™ has been designed to support exactly that. By diverting the majority of healthcare complaints, concerns and conflicts away from traditional HR procedures, it serves to:
- Protect relationships and maintain trust, respect and communication.
- Protect people’s self-esteem and their dignity.
- Create psychologically safe places to resolve complaints, concerns and conflicts free from fear of retribution or retaliation.
- Reduce the stress, anxiety and trauma associated with traditional disciplinary and grievance procedures.
- Encourage adult to adult dialogue and remove the stigma of mediation and restorative principles.
“We must admit that we have hurt people. Staff are being harmed and we are doing this to them through our continual application of formal procedures. It’s time to put the policies away and adopt a common sense point of view. Very few staff come to work in order to make a mistake. We must listen to what our colleagues have to say, allowing them to fully explain their circumstances, rather than being forced to try and prove their innocence. When things go wrong, the question shouldn’t be who to blame, but who has been hurt by what has gone wrong?” – Nicky Ingham, Executive Director at the Healthcare People Management Association (HPMA)
How it works in practice
The image below provides a summary of the Resolution Framework™ which replaces traditional healthcare discipline, performance and grievance procedures. Additional guidance is provided below the image. TCM provides consultancy support and training to assist organisations to integrate a Resolution Framework. Full details of the modules and the support packages available from TCM can be viewed by clicking here
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The Resolution Framework™ is a fully integrated and legally compliant system for addressing discipline, performance, and grievances within the healthcare setting.
This unique E-Book has been created to shine a light on the urgent need for the NHS to reframe its current approaches for managing complaints, concerns, conduct and conflict at work.
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Administration, accountability and governance
As a tried and tested HR and ER policy framework, organisations which integrate The Resolution Framework™ work with TCM to develop a series of checks and balances which ensure that it meets and exceeds all statutory and best practice guidance. This section explains the role and purpose of the resolution unit, the request for resolution process, the role of the resolution champions and how the Resolution Index (RI)™ works.
The Resolution Centre (also known as the Resolution Unit) are the custodians of the Resolution Framework™. The Resolution Centre sits within HR but includes representatives from trade unions, employee reps and managers. In that respect, this is a cross functional team and it offers a modern and highly effective model of partnership working.
The Request for Resolution (RfR) is the new name for the form which is used to lodge a complaint or a concern. The RfR draws heavily on positive psychology and appreciative inquiry. It is written in such as way as to engender a positive, solution focused mindset in the parties.
The RfR is submitted to the Resolution Unit who will then undertake a triage (assessment) of the case using the agreed Resolution Index.
The triage (assessment) process ensures that each case is assessed on it merits and the appropriate route to resolution is applied in each case. Out with three step processes and in with a tailored and robust solution designed around the needs of the parties and the organisation.
The resolution champion role is a key role within the Resolution Framework. They are an independent group of people who support the parties throughout the resolution process. They work with the parties before, during and for an agreed period following the resolution process.
The resolution champions ensure that the resolution process is:
In a highly pressurised NHS and healthcare environment, it is inevitable that conflict will arise from time to time between colleagues, clinical leaders and their teams, and sometimes between staff and patients. Leaders may disagree about the way a particular unit should be run, and which patients should be prioritised. Front line nursing staff may feel they are being bullied or harassed by a colleague or manager. Patients may complain that they are not being communicated with effectively.
In most situations, the simplest and most effective way to resolve a complaint, a concern or a conflict in the healthcare setting is to sit down and have a prompt, informal conversation with the other person. Under the Resolution Framework™, it is the role and responsibility of well-trained managers to spot the warning signs and to engage their team members in a confident and productive conversation. In this way, an outcome can be found that is acceptable to all parties. Some coaching or mentoring may also be requested to support with the outcome of the meeting.
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Conflict can be complex and confusing. However, most issues follow a similar journey. In simple terms, conflict tends to get worse, the longer that it is left unaddressed. The more that can be done to manage conflict at its earliest possible stages, the less of a negative impact it will have. This is commonly referred to as ‘Nipping conflict in the bud’.
The sooner that an Early Resolution Meeting can take place, the greater its chances of success, and the lower the risk of the issue requiring more formal intervention.
Many conflicts have the capacity to spread wider than the individuals involved. This can have a damaging impact on team performance, providing a distraction from important tasks. This should be avoided wherever possible. It is the manager’s role to ensure that all that is discussed within the Early Resolution Meeting does not go further than the meeting.
Explaining to the parties that the resolution process is a confidential one can also be an effective means of creating the all-important psychological safety which can encourage participation. This is essential to help the parties to say what they really need to say during the session.
These 5 useful tips can help ensure that the manager or supervisor responsible for chairing the early resolution meeting does all that they can to facilitate effective resolution:
- Create a psychologically safe space by developing appropriate boundaries and ground rules.
- Understand the importance of empathy, self-awareness and active listening, and display these qualities during the session.
- Role model the behaviours that you expect from the parties, for example, responding to criticism in a non-defensive manner.
- Produce an agreement or Resolution Action Plan, with clearly defined objectives.
- Outline the consequences of not achieving an objective, in a way which avoids sounding threatening or confrontational.
The Early Resolution meeting provides the opportunity for the parties to say what they really need to say, and feel heard by both the manager and other party. For many, this might not come completely naturally. In such cases, the advice and support of a Resolution Champion can be called upon.
The benefits of early resolution can spread further than the meetings themselves. We aim to build a culture where all parties engage with one another constructively, enabling most issues to be resolved locally, reducing the need for more time-consuming processes.
The facilitated conversation is a confidential discussion between all parties facilitated by an independent third party. It is shorter than a full mediation and is typically used to resolve less serious cases or at an earlier stage of a conflict or a complaint. The facilitator provides all parties with a safe environment to discuss concerns in a supportive way. It will be led by one of the members of the Resolution Hub or a trained manager. Click each box to find out more.
The facilitator will meet with each party individually before the main face to face session. This allows the opportunity for each party to establish their framing of the issues, build some rapport with the facilitator and become clear on what they hope to achieve from the process. Parties also have the chance to ask any questions they may have about the process.
During the face to face meeting, the facilitator will create the opportunity for dialogue between the parties. They will ensure that each party has the opportunity to speak and feel heard. They will then guide the process towards a mutually acceptable outcome.
After the meeting, notes from the meeting are destroyed at the end of the session. The only document that will be retained is the final agreement, and both parties will keep a copy. The facilitator may check in with the parties at a later date to check progress with the agreements and offer a little extra support if needed.
Mediation is a more in-depth restorative process, that must be carried out by a specially trained staff member. It can also be provided by external professional mediators from The TCM Group. Mediation can typically be completed within one full day, but may take longer if more than two people are involved. All parties must agree to take part as mediation is a voluntary and confidential process.
In our experience, over 90% of mediations result in favourable agreements being reached for all parties involved. Not only this, but as the process can be completed in just one day, it offers huge savings in comparison to traditional investigative processes. Most parties will find the process less stressful, and its prompt delivery can greatly reduce the costs posed to your organisation.
The TCM Group are the foremost provider of workplace mediation services and mediation training. TCM were awarded Mediation Provider of the Year at the 2018 National Mediation Awards, and HR consultancy of the year at the 2020 Personnel Today Awards
Speaking to someone we are in conflict with is very often the last thing that we would like to do. It is the Mediator’s role to make this much more comfortable. They are specially trained with an in-depth knowledge of the psychology of conflict. They are also practiced in the conversational skills needed to make parties feel safe, at ease and guided through an effective dialogue. All mediators working for, or trained by The TCM Group, use the highly acclaimed Fair Mediation Model.
The mediator will guide the conversation to ensure that discussions do not get too heated, whilst ensuring that important issues are openly aired. As the process is confidential, parties can feel safe in the knowledge that what they say will not have any unexpected impact on their future work.
Mediation is completely different to a formal investigation. Rather than being guided by policies and the person conducting the procedure, the process is owned by the parties themselves. No one is instructed as to what they have to do. The mediator simply helps the parties to talk through what isn’t working in their current relationship, and how they’d like to see things improve.
It is up to the parties themselves to create their own ideas and actionable solutions to solve the issues they are facing. The mediator’s role is to guide them along this journey.
A traditional investigation is very much focused on re-visiting past events, to determine exactly what happened. This doesn’t help resolve the underlying issues, or move things forwards. In fact, the opposite very often happens. By focussing heavily on previous conflict, the parties involved can drift even further apart.
While mediation does explore past events, it does so with the purpose of resolving them. Just as much time is spent on thinking about the future, and how the situation can change, and improve moving forwards.
Team Facilitation or Team Building
Team facilitation builds upon the principles of mediation, but applied to situations where a dispute or breakdown has occurred amongst a wider team. It is a very useful process to help move a team from toxic to transformational. Team disputes can be very complex. For this reason, the process should be led by a highly skilled and expert facilitator.
The initial aim of the team facilitation is to gain an insight and understanding of the underlying problems and issues affecting the team. These may include behavioural, cultural, systemic, structural, environmental or political factors. Information will be gathered from a variety of means, including:
- Interviewing a sample of key stakeholders
- Performing a root cause analysis
- Review of the key policies, reports and documents relating to the chronology of the case.
This part of the process consists of a session with all the key team members, to allow for a consensus to be formed on the unsatisfactory nature of the situation, develop specific requirements and an action plan. The expert facilitator will undertake a deep dive into the team and help identify a series of shared solutions to the challenges identified by the team members.
Problem areas may include poor communication, hidden agendas, unclear roles or goals and ambiguous reporting lines.
The Resolution Framework™ is designed to divert the majority of issues away from formal processes and procedures. However, in serious or complex cases, or cases where previous attempts at early resolution have been unsuccessful, a formal resolution meeting may be required. This section explains how formal resolution works.
A formal approach should be considered as an option in the following situations:
- If informal resolution methods have been unsuccessful.
- Where 2 reminders have been issued and a third reminder may be required.
- For the most complex and serious issues ie situations which achieve a high score high on the resolution index (RI)
In HR policy terms, the formal resolution meeting is equivalent to a formal hearing or a determination.
The Resolution Unit will appoint a chair for the formal resolution meeting. They should be from outside of the team where the issue has presented, and be at an appropriate management level.
For more sensitive/complex issues, an investigation may be needed prior to the formal resolution meeting. The investigation will be conducted by a trained, unbiased member of staff. (internal or external). The purpose of this process is to discover all the facts, which are analysed objectively and presented in a fair and reasonable manner.
Following the investigation an dthe submission of the report, all relevant parties will be invited, in writing, to attend the investigation and/ or formal resolution meeting.
During the formal resolution meeting, the chair will meet with each party, for the opportunity to talk about their concerns and how they could be resolved. A note-taker may also attend the meeting, and notes of the meeting will be shared without unreasonable delay. The chair may also arrange for all parties to meet at a pre arranged meeting. This is a chance to explore all issues and to consider next steps
Following the meeting, the chair will review the facts, decide the outcome and their recommendations for resolution. The outcome of the formal resolution meeting will be confirmed to the parties in writing without unreasonable delay.
Right to be accompanied: All parties have the right to bring a trade union representative or colleague to the formal resolution meeting.
The aim of the formal resolution meeting is, wherever possible to seek a restorative approach for addressing the issues. In this case the chair may refer the situation for further mediation or a restorative justice process. However in more serious cases the chair has the following options available to them:
- Issue a third reminder. This is the final reminder and this reminder can only be issued through a formal resolution meeting.
- Support the manager and the employee to agree action plan to help improve the performance and/or to improve the relationship.
- Suggest training or coaching be made available to one or more of the parties.
- In cases of gross misconduct, the chair may dismiss the employee – with or without notice.
Parties have the right to appeal against the outcome of a formal resolution meeting within 7 calendar days of receiving the outcome and must specify in writing, the full grounds of their appeal, such as:
- Procedural errors where there is evidence the process was incorrectly followed; or
- New evidence is available that may change the outcome of the formal meeting; or
- Fairness and reasonableness of the outcome.
Appeal meetings are formal meetings and will be led by an independent appeals manager. There will be a review of the fairness of the original decision or there may be a full re-hearing at the discretion of the Appeal Hearing Manager. Possible outcomes include:
- Confirming the original decision stands; or
- Revoking the original decision; or
- Substituting a different outcome.
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