Last night saw the annual HSJ Awards hit our twitterstreams. Billed as ‘the largest celebration of healthcare excellence in the UK, highlighting the most innovative and successful people and projects in the sector’, the photo above (via Derbyshire Community Health Services NHS Foundation Trust) clearly shows the scale of the ‘celebration’. Alastair McLellan, the HSJ Editor, is proud that this year’s award ceremony was ‘the largest celebration of healthcare excellence held in this country within living memory’. I bet he is, because this is big business for HSJ.
As print subscriptions fall publishers the world over have looked to diversify and expand on other ways of making money. The HSJ Awards are not new (they’re in their 33rd year this year), but they have grown in size, this is the biggest ever. The number of feeder awards and celebrations are growing exponentially too, every month there appears to be a ‘top 100 list’ of some sorts, appealing to misguided enthusiasm or ego or both, these lists get a foot in the door and build HSJ’s brand and visibility. I have no problem with any of this behaviour per se, if it appeals to people and lets them feel good about themselves so be it, but I do have a concern of how underhand it is. Look at the HSJ Awards website and it’s impossible to find clarity around the process, look for the cost of attending and you’re given an events number to call (to broker the best deal no doubt), murk, lots of it.
Last year my personal interest was piqued. A trust who were, by their own admission, responsible for the preventable death of a young man in their care, were seen celebrating and collecting awards days after his death. I appreciate that deaths happen in healthcare, I appreciate that not all care across a Trust is bad because care in one area is (in theory, not sure in this case), I struggle to empathise with a senior management team who are at glitzy parties and producing reams of Board Papers about their excellence (we won an award you know) while slowly destroying a grieving family. So I decided to dig a little further.
In July and August this year I submitted 170 Freedom of Information requests to NHS Trusts and health organisations who had made the HSJ awards shortlists, asking three simple questions:
Please can you supply the following information:
1. How many HSJ (Health Services Journal) Award events your Trust/organisation has attended in the financial year 2013-14
2. How many Trust/organisational representatives attended each of the above events in the financial year 2013-14
3. Total expenditure on purchasing group tables and individual places at each event, including bookings for forthcoming award events in financial year 2014-15.
I am not requesting information in relation to additional travel, subsistence or accommodation costs. I look forward to hearing from you,
What has been consistently argued as a morale boosting, bit of fun for an overstretched workforce, is actually big business for HSJ’s publishers. This FOI request relates only to HSJ awards ceremonies, of which there were three last year – HSJ Efficiency Awards; HSJ Patient Safety and Care Integration Awards; and HSJ Awards 2013. The same publisher also hosts the Nursing Times Awards, which sits alongside a plethora of other awards ceremonies throughout the year. It is safe to assume that this data is only a drop in the awards business ocean.
Headline figures
As an initial analysis I looked at three key metrics, the number of HSJ awards ceremonies attended in 2013-14, the number of people attending, and the total expenditure. I present this data below to enable discussion and debate about the scale and cost of such celebrations.
Exactly half of the Trusts contacted attended one awards ceremony organised by HSJ in the year 2013-14, this contrasts sharply with the 6% who attended all three ceremonies and the 17% who didn’t attend any.
The argument is frequently made that Trusts feel that they deserve, or need, to attend because they have been shortlisted. This does not really stack up to much scrutiny when you realise that the awards are mostly self nominated, as clearly indicated in this article on HSJ on the closing date this summer:
The organisation shortlisted for the most awards last year was East Midlands Ambulance Service NHS Trust. They were nominated for 6 awards and stated in their reply:
We place great emphasis on maintaining high levels of staff morale within EMAS and in our experience, staff get a great deal of satisfaction from knowing that their efforts have been recognised by being nominated for an award. If they are subsequently shortlisted, attend the ceremony or indeed win an award, these feeling are further enhanced. Furthermore, the awards process helps EMAS to promote the great work staff do and contributes towards the public’s perceptions of the service.
Even with this rationale clearly offered, EMAS only attended two ceremonies and even then only sent three members of staff in total. Proving it is possible to attend with modest expenditure and still boost staff morale. The next analysis considers the number of people attending HSJ awards ceremonies each year:
Of those shortlisted for an award, 18% didn’t send anyone to the ceremony and 22% sent between 1 and 5 people. This would allow you to attend every award ceremony and receive the recognition so often quoted as the reason for attending. A further 24% of respondents sent between 6 and 10 people. Data is missing or not held for 16% of those contacted and the remaining 20% of Trusts (33 of them) send more than 10 people, the most extravagant being:
Derby Hospitals with 47 attendees
Nottingham University Hospitals Trust with 30 attendees
Oxford Health NHS Trust with 30 attendees, and
Northumbria Healthcare with 27 attendees.
Party animals in training (with more than 21 staff attending) were:
| South Devon Healthcare 25 people |
| Sandwell and West Birmingham CCG 24 people |
| Christie 23 people |
| Liverpool Women’s 22 people |
| University College London Hospitals 22 people |
| Wrightington, Wigan and Leigh 22 people |
| Barts Health 21 people |
| Walsall CCG 21 people |
So, if you believe that staff morale is a strong enough rationale and you are not concerned about limiting numbers, how much are people spending for these celebrations of excellence? In total over £304k was spent last year, just on HSJ Awards.
This total, way over a quarter of a million, does not include missing data from 18 Trusts, data that is not held from 5 Trusts and this total is solely expenditure on tables or seats.
It does not account for the cost of travel, accommodation, any additional expenses or staff time for attending.
Interestingly 42 of those who were shortlisted (25%) claimed not to have any expenditure on the awards, despite only 30 respondents saying they didn’t send anyone, therefore it can only be assumed that 12 Trusts attended having received free seats via HSJ or corporate partnerships. 20% of Trusts contacted spent £2,000 or less attending across the year, slightly more 22% spent between £2,000 and £3,000. 20% of Trusts spent more than £3,000 a year attending HSJ Awards, with 23 Trusts spending more than £4,000. This breaks down as:
9 spending between £4,001 and £5,000
8 spending between £5,001 and £6,000
1 spending between £6,001 and £7,000
2 spending between £7,001 and £8,000
1 spent £8,102, 1 spent £10,740 and the top spender spent £17,925.
I fail to see how it is necessary, not to mention acceptable to spend these sums of money on what is essentially a social occasion paid for by tax payers funds. Another common response while I’ve been looking into the cost and attendance at awards has been the argument that expenses are covered by charitable funds. The vast majority of respondents did not claim this, but one or two did, and it’s a frequent reasoning offered on twitter. The problem is the minute that justification is offered it makes me feel even worse. I’ve spent a lot of time in NHS hospitals over the past five years, hours watching very cute pensioners pushing tea trolleys around to raise funds for the Friends of X, giving their time and efforts to raise money to buy equipment. Then out of another budget heading the CEO, Board Members and management teams are off on a jolly to London, I fail to see how it can be justified. I wonder how many local fundraisers would be content to know that they are working hard while others are draining the pot for a knees up?
Only one respondent mentioned a patient representative attending the awards ceremonies, and only one tweet referenced one last night. The vast majority of those in attendance appeared to be CEOs and NHS managers. I’ve no problem with celebrating success and sharing acknowledgement, but if that’s the case why aren’t their more porters and cleaners in attendance? No NHS service is successful solely off the back of their management team and sadly the NHS Leadership Academy even had to remind people of how to be gracious when receiving their awards! We also know from the recent CQC State of Care Report that quality and standards are not consistent across Trusts or within Trusts. It is perfectly possible to provide exceptional care in one area and mediocre in another, yet countless Boards appear to be dazzled by the promotion of the award winning label.
I’d love to know what you think about the expenditure, attendance and promotion of an awards culture across the NHS and whether you feel the means justify the end. Is it not time that awards were nominated by those receiving services, celebrated without the need for such excess? After all these are times of austerity and cash strapped NHS no?
I’ll leave you with my favourite tweet from last night, from the HSJ Editor, a freudian slip methinks, or a perfect summary of where things are at:
ps I’ll be making a donation to What Do They Know the platform I used to make the FOIs and collect data. I highly recommend it. You can also use that link to view all the FOI requests and data collected, to see what your local Trust spent.
I feel rather torn about this. You make valid and worthwhile points about commercialisation, self-regard, subliminal marketing/income generation, and they are articulately and persuasively made. On the other hand, I support public recognition of good practice, whatever the field, and the opportunity – particularly for more junior staff – to experience a big celebratory event where part of the recognition is that employers foot the bill.
However, I struggle to see good reasons for huge contingents (well into double figures) to attend from an individual organisation and I completely agree that to accept awards when one’s organisation is under investigation for serious problems is crass and demonstrates the kind of insensitivity that should be anathema to award judging panels.
In my view, attendance needs careful thought, maybe a ceiling on costs, and better transparency in nominating and judging to avoid criticism about the ‘usual suspects’. It’s a tightrope to walk, but if sensibly managed should be acceptable. The sums spent are tiny drops in the ocean of organisations’ budgets, but still need careful rationale for spending. I think big, national awards have good intentions and help morale in most cases, but the proliferation of awards locally and nationally throughout health care particularly is troubling. It trivialises the recognition when so many are recognised, and for such a plethora of activity, and this in itself diminishes the value of the awards over time. As the currency diminishes, the criticism becomes more valid, and a downward spiral into cynicism becomes almost inevitable.
Perhaps the bigger award organisers could consider how to reverse this potential trend and keep their awards a little more rare and a lot more meaningful in so doing.
Interesting reading, thanks George.
Not sure how awards ceremonies where you nominate yourself and then send a large number of senior management to party your self nominated ‘success’ is an acceptable way to spend tax payers money. Personally I would think that if awards do enhance employee moral, (sending a handful of senior execs on a jolly will not enhance moral for the masses, just cause resentment,) surely a greater sense of achievement would be felt by nominations being independent and attended by a maximum of 3 people representative of the workforce (top to bottom) in the areas reflected by the nomination. The best way of enhancing moral is senior execs getting out of their offices and on to the shop floor and give their workers the support and recognition they deserve in person and show they understand the pressures their staff are under and that they care. That would achieve more than a night out for the chosen few would ever do.
Bless S Devon Healthcare, they really do themselves no favours at all. Awarding their staff by giving them a free kit-Kat a year or so ago was a joke.
Thank you for discussing this George. I have had similar concerns about the BMJ awards, even though I have attended twice, but also recognise the need to celebrate staff. I am not convinced that this level of expense is justified to do that.
Thanks for an excellent article. I am guilty like many other Trust. I am the Medical Director of Wrightington, Wigan and Leigh FT and last year we got 22 Awards. I totally agree that in an ideal world we should not spend on these ceremonies and spend money on patients. However, these awards have really boosted our staff confidence and morale and they feel their work is being recognised nationally and staff feedback has improved by 33% and this reflects on outcome for patients. All 22 quality measurements have improved.
I take note of your excellent comments and we will make sure that we do select and attend few of such awards and I also feel those who award must make sure that these awards are not held frequently and awards have real meaning. Thanks for an excellent article.
Our 10th birthday party is free to attend and is being run at cost with lovely people sponsoring the following elements –
the ghandi hall (delta 7)
the cake (caroline pakel)
the food (Pure)
we are looking for a sponsor for the non alcoholic ‘your health’ cocktail bar and the music which is being offered by Lewis Fieldhouse who is hopeful we can cover a weeks grocery shopping – in my view if people who are working in healthcare are suffering from low morale we should put the kettle on and listen to them – and respond to what they say with sensible self organised humane solutions – Where does real change happen I wonder? I hope you can come. From one shed to another – thanks for all you do to hold up a mirror to the madness …..Andy
Interesting read.
My husband works for local government where similar issues apply. Numbers of staff attending are deliberately limited (and apart from the cost of the ticket) they and/or their senior managers pay expenses from their own pocket. I too am not at all sure those practices are reading across to the NHS.