I have been a union representative in the NHS for seventeen years. For the last eight years, I have used that position to promote sincere partnership working and mediation (rather than adversarial methods) to resolve work based conflict issues.

I am currently employed to coordinate the in-house mediation service for a large acute and community healthcare trust in NW England.

In my experience of mediation in large NHS organisations over the last eight years, the following key points underpin a successful mediation service:

• It is essential to have a coordinator who can ensure a timely response to staff needing mediation, provide a central point of contact for mediators and staff and who can ensure proper support and professional development opportunities for mediators
• A combination of management, HR partners and union representatives trained as mediators works well, encouraging partnership
• Placing the mediation service with a widely trusted department (in the case of ELHT, Occupational Health & Wellbeing) increases wider employee acceptance
• Using the principles of true partnership between employers and unions to support referral of members in conflict to mediation. Mediation should be regarded as a first, not last, resort and HR policies should be amended to reflect this. In my own Trust, an effort is being made to introduce a mandatory mediation awareness session for parties lodging a bullying & harassment complaint or grievance. In this way, mediation is an informed choice, or not if they choose to refuse it. In fact, mediation is recommended as a resolution tool in the Agenda for Change Handbook (2016), Section 32 – Dignity at work, paragraph 32.21
• Securing the support of unions (via the TUC would be perfect) and training union reps to recognise when mediation would benefit their members more than adversarial processes. The 2007 Gibbons Report called on employee organisations such as unions, not only employers, to commit to implementing and promoting early dispute resolution
• Using partnership funding to develop this key link between unions and organisations; the funding is already available, it could be used to support and develop alternative forms of dispute resolution. Although most NHS Trusts fund full time release for Partnership Union Reps, the systems remain adversarial and costly. In my own organisation, the Partnership Team has four members of staff stood down full time, most Trusts have the same setup, the cost to the trust can be over £100,000 p.a. just for the staff stood down
• Reducing sickness absence and costs associated with implementation of formal processes (up to and including employment tribunal), as well as improving retention and engagement of existing staff are all benefits of mediation services, as detailed in several case studies
• Organisations might increasingly look for more formal, ‘harder’ evidence, perhaps in the form of cost-benefit analysis. Of the organisations that had undertaken such an analysis, it was concluded that mediation merited its adoption/use and also that formal investigations typically cost six times as much (Mediation: A Thematic Review of the ACAS/CIPD Evidence; Latreille 2013)
• From 2009, the following data describes savings in East Lancashire PCT:

Measuring the cost of conflict¹

Table taken from Consensio Partners Resolution Ltd Case Study – In-House Mediation Scheme: NHS East

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• In my current organisation, the in-house mediation service started life as an HR function with no dedicated coordinator. In two years, they received 49 referrals, only 20 cases went to mediation and, of those 20, 16 gained a resolution.
• From September 2016 to January 2017, once a mediation coordinator was appointed, 20 referrals were made, 19 chose to go to mediation and, of those 19, 18 gained a resolution

The facts and figures speak for themselves. The challenge laid down to employers and unions by Gibbons in 2007 was not met.In the public sector, Ministers have the capability to directly influence positive change.In the TUC, senior union officials have the power to move the mediation agenda forward, in the interests of their members who stand to suffer less and gain more. Since 2009 to present day, 75 mediations have taken place with only 7 not getting a resolution. This demonstrates a 93% rate of positive outcomes.The second highest reason for long term sickness absence in the NHS is stress/work related stress. A significant amount of this stress is brought on by relationship issues or allegations of bullying and harassment in the workplace.For very little capital investment and low running costs, the saving to the NHS is potentially immense, reducing sickness absence, enabling teams to be more productive by spending less time concentrating on conflict issues. The average time a member of staff takes off with work related stress is approximately four to six months on full pay, some stay off longer, mediation can address this issue in most cases.

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1 This calculation is based on the cost of using formal processes vs. mediation. Set up costs for training accredited mediators are not included nor are the training costs associated with formal processes.
2 CIPD (2004). Managing Conflict at Work, p.9 and CIPD (2007). Managing Conflict at Work, p.4.
3 CIPD (2004). Managing Conflict at Work, p.4.
4 Ibid., p.20.
5 Ibid., p.11.
6 CIPD (2007). Managing Conflict at Work, p.24.
7 CIPD (2008). Absence Management, p.6.
8 Ibid., p.16.
9 Ibid., p.21.
10 Ibid., p.23.

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