Background Poor medical engagement in NHS organisations has many detrimental effects. Trusts with better medical engagement, do better on a range of measures. These include patient outcome and experience, as well as financial performance.

Avon and Wiltshire Mental Health Partnership Trust (AWP) is a large provider of mental health services in England. Last year our Chief Executive engaged the Trust with ‘Listening into Action’ (LiA). This is an ethos whereby staff take a bottom up approach to solving issues within the organization affecting staff, patients and carers. LiA uses an innovative ‘7 step’ approach to tackling issues identified through the Pulse Check survey and ‘CrowdFixing’ events.

When we conducted the initial survey, it clearly identified medics as the most dissatisfied and disengaged staff group.

There have been problems with recruitment and retention because of poor medical engagement.

Engagement as a concept has supplanted what was previously thought of as commitment, motivation and job satisfaction.

Objectives To improve the medical engagement in the Trust and reduce attrition rates and agency spend.

Methods Quantitative assessment via a ‘Pulse Check’ survey of all staff, repeated after a year. We followed this with qualitative research, via a semi-structured interview with 10% of the 120 strong consultant body. A thematic analysis was undertaken.

Results Thematic review showed doctors felt they lacked influence, that communication from senior management was poor and they lacked a feeling of belonging.

We have encouraged senior medics to lead on a host of strategic clinical initiatives, pathways and QI projects.

We have instigated a series of ‘quick wins’ from feedback gained thus far, to address doctors concerns and communicated these widely through a ‘you said, we did’ approach.

Our repeat Pulse Check survey has shown improvement in medical engagement across all domains.