Workforce Performance Report May 2015

1. Workforce Performance ReportMay 2015 Jayne HalfordDeputy Director of HR Caring, safe and excellent

2. Headline HR KPIs Figures now reflect internal reorganisations – such as the structuring of Older Peoples community services into Integrated Locality teams and the movement of Estates to Corporate in budget terms. Turnover – Target 12% - Actual 13.64% Turnover has risen again and is above target in all Directorates. The work of the Recruitment Action Group is now focussing on retention whilst continuing with recruitment – the Trust has demonstrated the ability to recruit but turnover continues to rise. Sickness – Target 3.5% - Actual 3.82% Sickness has fallen significantly; the lowest since April 2014 and October 2013. The assignment of Estates and Facilities to Corporate has increased the Corporate sickness absence figure to above target. Bank and Agency- Limit 5% Actual 5.29% Bank and agency increased but remains lower than the previous 11 months – increased vacancies offset partially by reduced sickness absence.. Vacancies: Limit 9% - Actual 8.39% The vacancies are somewhat skewed this month by additional monies from the CCG and the incorporation of CIPS into budgets. Some smaller departments with few vacancies also skew the picture – see the recruitment section to complete the picture as regards recruiting to vacancies. .

3. Headline HR KPIs - Sickness

4. Headline HR KPIs - Leavers These figures are from leaving forms as opposed to exit questionnaires. Regrettably the incompleteness of termination forms means that a significant number of reasons for voluntary resignation are unknown. A third of leavers are leaving for reasons that we cannot control – relocation, end of fixed-term contract, retirement age; of those that we could influence – work life balance and lack of promotion opportunities are the most significant. As mentioned previously the Recruitment Action Group is turning its focus to retention and is not only looking at potential financial incentives but career paths and development. In terms of staff group we see a similar profile as in sickness – highest turnover in unqualified and qualified nursing and admin/estates. AHP however features highly for turnover but not for sickness.

5. Directorate Performance – Headlines

6. Directorate Performance Older Peoples Directorate Turnover: 14.3% v 12% Target • Turnover has increased since last month’s report and remains above target in all services with the exception of Central & North East ILT and Management. • There were 16 leavers from the 3 ILTs, 6 x leavers from Community Hospitals, 6 x leavers from Urgent Care services. • Various plans are being worked on to hopefully improve attraction, recruitment and retention (the Service Director and HR have recently discussed areas of focus for recruitment and the need for operational managers to work on retention of staff.) Discussions have also taken place with management teams about improving the shortlisting timescales and need to advertise vacancies as soon as leavers have given notice. • Discussions are taking place at Trust level about increasing notice periods. Sickness: 4.3% v 3.5% Target • A reduction since last month but remains above target. • The absence rate is mainly driven by long term absence. The highest levels of long term absence occur in Urgent Care (6.9%), Central / North East ILT (6.8%) and Mental Health Inpatient services (6%). • All long term sickness cases are being managed appropriately in accordance with Trust policy (29 cases in formal stage). The HR team have reviewed Bradford Factor scores and are assisting managers with cases of short term frequent absence as well as those on long term absence. The amount of management time is considerable. • The main reasons for absence in the directorate continue to be: • Back & Other Musculoskeletal (MSK) problems – 21.8% of absence attributed to this • Anxiety and Stress – 17.5% of sickness absence attributed to this reason

7. Directorate Performance Older Peoples Directorate Contd. Bank and Agency – 5.1%% v 5% limit • Recruitment in Community Hospitals and Community Nursing has resulted in increased staffing levels which is having a positive impact on bank and agency usage. • The Agency Co-Ordinator is working with line managers to move lines of work to framework agencies. Governance implications of using non-framework agencies are being raised through CQC Taskforce Group Vacancies –6.5% v 9% limit • Although the Directorate vacancy rate is within the 9% limit, Central & North East ILT (9.9% vacancy rate), Mental Health inpatient services (13.6% vacancy rate) and Urgent Care services (20.2% vacancy rate) are concerning. The Recruitment Team will contact managers in these services to ensure efficient processing of vacancies.

8. Directorate Performance C&YP Directorate Turnover 13.07% V 12.0% Trust Target • We have seen a decrease in turnover from last month of0.13 %, however turnover remains lowest % across all the Trusts Directorates except Corporate. Highest turnover is within Dental Services at 22.10% (last month 21.3%),followed by Swindon, Wilts and Banes at 17.01% (last month 17.4%) and Specialist Servicesat 12.89% (last month 13.7%). • Sickness 2.62 % V 3.5% Trust limit • The overall trend has continued to be below trust target. Sickness absence has seen a decrease from last month of 0.39 % and remains the lowest % across the Trust. Long term absence is currently 1.35% - a decrease from last month of 0.15 %. This equates to WTE 824 days lost (last month 821). Figures impacted due to a reduction of 10 in head count across the Directorate. • All cases are being monitored by HR with assistance from Occupational Health as required and we continue to see a number of successful returns to work. • This month has seen a decrease in long term sickness in all areas, with the exception of Specialist Services and SWB. Anxiety/stress/depression/other psychiatric illness remains high but below the trust target. Bank & Agency April 4.8% V 5.0% Trust limit • Agency accounts for 4.5%. The only Bank use has been in Specialist Services. • CYP Specialist Services (includes 2 Oxford inpatient units) - Bank & Agency 10% (last month 8.7%). Agency is 9.2% and Bank 0.8%. HR is working with the Highfield via regular meetings with the manager and input regarding the agency framework and availability of lower cost agency staff. Due to difficulties in recruiting the required grade of staff currently 3 agency contracts of 6 month are in place on one of the inpatient wards to provide consistent support while further recruitment is in hand.

9. Directorate Performance C&YP continued: Bank and Agency ctd • Swindon, Wilts and Banes (includes 2 inpatient units) - Bank & Agency 4.8% all of which is agency spend (last month 2.9%); Hr input is continuing to try to improve the availability and cost of agency provision. • Feedback on the agency framework continues to be provided to the Head of HR Operations. • The Directorate reports weekly on Safer Staffing for the In-patients Units and there are continued concerns regarding capacity of agencies in the Agency Framework to provide the staff required and of the right quality. Vacancies % v 9% limit • Cotswold House, Oxford continues to experience difficulties in appointing Staff Nurses, they currently have 4 vacant posts.  The advert text and additional information are currently being reviewed, we are also working with the service to create a focus group which will include nurses and HCAs from the service to look at what are the parts of their jobs that they enjoy the most and what they enjoy about working for the service so that we can start to look at improving the information provided when advertising.  This focus group will also start the process of looking at retention within the service. • Of 189 vacancies 101 are at offer accepted stage and of these 42 have been cleared to start and 12 have a start date. Casework: Change Management and General • HR are currently managing 7 formal cases), which consist of 2 disciplinary matters, 3 capabilities (2 of which related to Health),1 Probationary and 1 Bullying & Harassment. Investigatory reports are in the process of being finalised. A panel date has been set for 1 of the DP cases within June. There are no ET claims. HR continues to work closely with managers, support is also being provided regarding informal matters some of which are of a complex nature. All formal cases have an appointed investigation manager with investigations underway. There is one suspension in the Directorate, which is kept under review. • HR is supporting the Directorate with the implementation of the new CAMHS service in Bucks.

10. Directorate Performance Adult Services Directorate Turnover 13.9% vs 12% target • Turnover remains static and above target in Oxon Clinical, Forensic services and Psychological Therapies. A retention programme is being developed in the Directorate to address the turnover in inpatient and Forensic services and this will become easier to maintain when the wards become fully staffed. The Healthy Minds and IAPT services have a regular turnover due to the PWP training places that they advertise. Sickness 4.05% vs 3.5% limit • Sickness is reducing and almost 200 FTE days less were lost to sickness in April.  The Heads of Service and Service Managers are ensuring that sickness is being robustly managed and that trigger points are being adhered to. Long term sickness is being managed with support from Occupational Health and a number of long term sickness cases have recently been brought to a conclusion. Agency & Bank 6.5% vs 5% limit • The B&A figure has increased since April but has decreased significantly from March when staff were taking their remaining annual leave.  The use of agency staff is 4.4% of spend and relates to vacancies in the Adult Community teams or long lines of work for Thames House until they are fully recruited to. We have been successful in attracting student nurses to the Directorate who qualify in September 15 and their roles are currently being covered by bank and agency staff.

11. Directorate Performance Adult Services Directorate ctd Vacancies  5.2% v 9% limit  The number of vacancies in the Adult Services Directorate is reducing from a high of 8.1% in March. Oxon Clinical and Forensic Services both have a 12% vacancy rate mainly concentrated in the wards. Central recruitment is taking place for difficult to recruit to wards and this has resulted in Thames House making formal offers to 6 HCA’s in June and interviewing another 14 on the 15th & 16th June. There is an Open Day taking place on Saturday 20th June in Oxford to encourage qualified and unqualified staff to join the Trust. The services will be delivering presentations on the day and frontline staff will be talking to the attendees about their roles and why Oxford Health is a great Trust to work for.  We will also be holding interviews on the day for qualified posts where possible, interviews will be held during the 2 weeks after this event to ensure that all suitable candidates are seen. Following the Open Day all of the Forensic wards recruitment will be centrally managed. Through the use of open days and quick turnaround of interviews for applicants who apply to the rolling advert for the Oxford acute wards we have been able to appoint also to 15 out of the 30 vacant Staff Nurse posts.  We will also be running a sessional recruitment drive for the Oxford acute wards from w/c 22nd June, candidates appointed will be signed up to work with all of the wards so that there is a larger pool of workers for the wards to approach to cover vacant shifts. General • ER Casework - At the end of May the HR team were managing 20 ER cases including 12 Disciplinary and a Whistleblowing. The Whistleblowing case has been concluded and a number of panels have been held or scheduled to conclude the investigations.  • Service Reorganisations - The Complex Needs services in Oxford & Bucks are being consulted with regarding a new model. Consultation ends in June and it is not anticipated that there will be any redundancies.  

12. Directorate Performance Corporate Directorates : The inclusion of Estates and Facilities in the Corporate finance structure impacts on overall figures. Turnover 12.97 % v 12.0% Target Turnover has increased with the inclusion of Estates where stability is also relatively low. Turnover is still high in the CEO Office and R and D however as mentioned before these are relatively small teams. Sickness  4.13 % v 3.5% Target Sickness absence has also increased with the inclusion of Estates and Facilities. One long term sickness absence case has been resolved and so figures should improve. Sickness is high in Strategy and Development – again this latter is a small team and so figures are skewed. Bank & Agency 4.6% v 5.0% limit Bank and agency are high in Finance & Performance contracts – specifically Informatics and Strategy and Development, this latter also has a high percentage of vacancies and the tendency has been to fill with agency this – the audit of business requirements of Strategy and Development is underway. Vacancies 21.2 % v limit 9% Vacancies are high in Estates and Facilities – vacancies have been on hold whilst restructuring has taken place and with the possibility of staff being displaced. As reported last month additional funding for R and D means there are new posts which are not yet filled Strategy and Development . General The restructuring of Estates and Facilities is near completion.

13. Recruitment The seasonal increase in live adverts continues as we have now placed the adverts for the trainee posts within our IAPT service; this increase in live adverts has led to an increase in the number of applications being received through NHS Jobs.  It is expected that the vacancy figures will remain high until September when the student places will have been filled and the impact from the current recruitment campaigns will be visible. 49% of adverts are for nursing posts and the next largest group is for administrative posts at 32.47%. This is in line with turnover in staff groups.

14. Recruitment Agency Framework Update Expansion of current agency frameworks • Work continues to develop the new Medical Locum framework, with agencies having been shortlisted and supplier clarification meetings to take place in June. Senior medical staff will be attending these meetings and will be providing clinical input on the questioning. The agencies that have been shortlisted are specialist medical-locum agencies who currently supply the Trust with doctors ‘off-framework’.  • HR and Procurement, along with clinical support from senior medical staff, held clarification meetings with potential Medical Locum agencies on 8th and 9th June. Following these meetings, and further clarification questions being submitted, the Trust will nominate an extended list of Medical suppliers from the NHS Commercial Alliance Framework, who are proven in supplying quality Medics to the Trust. This will successfully reduce the cost of agency supply, whilst expanding the trust’s supplier list. • The same process will be conducted for both Nursing and AHP staffing groups, in order to strengthen agency support across the directorate’s workforce. • Nursing will be the next staffing framework to be reviewed, with longlisting expected to be finalised by end of June. Operational stakeholders, who currently rely on agency nursing supply, will be invited to clarification events with agency providers in July, further information on this process will be provided when it is finalised. • Allied Health Professionals will then follow, with clarification events currently expected to take place in August.

15. Casework • Casework numbers have dropped slightly due to closure of cases. • Duration of cases is still below previous years but as this is based on cases closed then 2 months data is insufficient to say whether the downward trend will continue. • The split of cases between directorates is remaining roughly the same but with the appearance of some probationary cases in Childrens and Young People Directorate as the probationary process becomes embedded. • The proactive management of ill-health cases continues and forms the largest type of casework.

16. Casework

17. Casework

18. Casework

19. Staff Health and Wellbeing Britain’s Healthiest Company Oxford Health NHS FT took part in the Britain’s Healthiest Company 2015 assessment - one of the largest employee health and wellbeing surveys in the UK and supported by Mercer and VitalityHealth. The assessment helps us to assess the health of our staff and measure the impact of our wellbeing initiatives and strategies. Every member of staff was sent a link to a 15 –20 minute online Employee Health Assessment and upon completion they immediately received a personal and confidential report on their health risks. The data from this assessment will help us to tailor future wellbeing initiatives and give us a baseline indication of the general health and wellbeing of our staff. We are currently waiting on final figures of staff who completed the assessment, last count on 26th May was 858 (14% of staff) with five days remaining. Wellbeing Guide The staff health and wellbeing guide has been re-designed for 2015-2016 and is currently waiting for sign off from the wellbeing group. The guide provides an overview of the work of the health and wellbeing action group over the last year, our priorities going forward, staff survey results and how staff can get involved. This guide will be available to all staff via the intranet, to potential staff via job adverts on NHS jobs and recruitment fairs, to new staff at induction and hard copies will be placed on our sites.

20. KPIs for May 2015: Of the 125 referrals 100% were offered appointments within the 10 day target (average of 9.59 days). The average of days between date attended and date the report was dispatched was 1.26 days within the 2 day target. Of the 125 referrals received 25 were MSK related and 9 stress related. Of the 25 MSK related referrals 4 were referred on for physiotherapy, and of the 9 stress related referrals (8 perceived work stress and 1 perceived non work stress) 3 of the perceived work related stress were required to be referred on to the counselling service for additional support. The MSK pilot is due to end in July 2015. OH is currently struggling to finance Physiotherapy and Counselling services despite only referring for work related issues. We are in to Month 3 of the financial year and predictions indicate that by Month 4 we will have exhausted our £11,000 budget for Counselling and £10,000 budget for Physiotherapy. Occupational Health

21. Occupational Health