Canberra Health Services defends survey results that are not 'statistically valid'

Health Minister Rachel Stephen-Smith this week pointed to the survey of nearly 3000 staff to say it showed a "significant improvement" in culture at the organisation.

However, officials were told survey results were not definitive unless more than 40 per cent of the organisation responded, documents have revealed. Only 35 per cent of staff responded.

Canberra Health Services have now backtracked from those statements, saying the firm which conducted the survey has since applied a "response validation test".

"A greater response rate would not have had a significant impact on the overall results," a spokesman said.

"For this reason we can have confidence in the pulse survey results."

The response rate was lowest among frontline workers, with only 23 per cent of workers from the nursing and midwifery division and 24 per cent of staff in the division of surgery completing the survey.

The bulk of the responses came from staff in strategy, policy and planning and staff in the people and culture division with an 83 per cent and 81 per cent response rate, respectively.

This was highlighted by opposition health spokeswoman Leanne Castley who pointed to the fact that divisions with an interest in a positive result had high response rates.

The company that analysed the results said in areas where the response rate was below 40 per cent data was "indicative not definitive and should be used with caution".

In an internal memo sent to staff before the survey closed, the communications team from Canberra Health Services told staff the result needed to be above 40 per cent to be "statistically valid".

Both Canberra Health Services and Ms Stephen-Smith have been referring to the survey to point to an improvement in culture within the territory's public health system.

Canberra Health Services chief executive Dave Peffer said this week it was the best result in nearly two decades.

"It had been a pretty tough year for us if you consider everything that went on underlined by the pandemic but [the culture survey] came back and it said we've got the best culture at this point in time that we've had in 18 years," he told ABC radio.

Canberra Health Services deputy chief executive Janet Zagari revealed the survey results to The Canberra Times last month when she was acting chief executive. She said she was "heartened" by the results.

Ms Stephen-Smith also referenced the survey on ABC Radio this week, saying the survey showed a "significant improvement in culture year-on-year".

She also said in the same interview she felt it was important that positive stories about Canberra Health Services were amplified.

"It's really important that we talk about that, that we have a positive message about working in Canberra Health Services because, of course, when we hear these negative messages that's going to make it more difficult to recruit," she said.

"We really need to get out the positive stories about how fantastic some of our teams are in working together and supporting one another."

Following questions from The Canberra Times on Wednesday morning, Canberra Health Services sent through a lengthy defence of the results late in the afternoon.

A spokesman said the organisation's "engagement score" was above the national benchmark for public hospitals and health services.

"We are encouraged with the results from this latest workplace culture 'pulse' survey, with CHS recording the highest 'engagement' score since the organisation started measuring this through workplace culture surveys in 2005," a spokesman said.

"This is a particularly positive result given the impact of the COVID-19 pandemic on the health service, as well as the fact CHS implemented the single biggest organisation-wide change in its history - the digital health record - in 2022."

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In response to a question about the low response rate for nursing and midwifery and the division of surgery, the spokesman said: "The culture survey results are not intended to provide a 'conclusion'. Culture improvement is a journey, not a destination and we will use these results to continue to strive for improvement".

"The value of the survey results are that they provide us with data on work areas that are doing well, as well as helping identify those that need extra help. This includes both the engagement scores of work areas as well as participation rates."

The survey's response rate was also the lowest since 2005 and was much lower than the 2021 survey where 50 per cent of staff completed the survey.

Canberra Health Services blamed the lower response rate on the fact the survey was sent later in the year and it followed the implementation of the new digital health record.

The Health Minister was criticised by Ms Castley over the comments about the results showing an improvement.

"The minister wants to pretend that the culture is improving, but the fact is more staff are becoming disengaged than ever before," she said.

"If the minister wants new staff to stay, she must make real improvements to CHS' culture, as stakeholders have suggested.

"The Health Minister should stop focusing on rebranding and spin, and seriously address the significant cultural issues afflicting Canberra's public health system."

Cultural problems have plagued Canberra Hospital for years. A damning review into the ACT's public health system almost four years ago found troubling levels of mistrust and bullying.

Following the release of the review, the ACT government formed an oversight group to focus on the cultural reform. Each year an independent review of its implementation is undertaken, however, the review from 2022 has not yet been released.

The Australian Nursing and Midwifery Federation was part of the group but pulled out in December 2021 after expressing frustration at the slow rate of change.

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