Workforce Performance Report February 2015

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

2. Headline HR KPIs Turnover – Target 12% - Actual 12.95% This represents a slight increase over last month which means turnover has been largely static since the autumn; clearly January turnover was not the beginning of a downward trend. Our stability rate at 84.24% is below the national figure reported by HSISC for May 2014 of 92.13%. Sickness – Target 3.5% - Actual 4.36% The NHS has just published its latest sickness absence figures to October 2014 and is reporting 4.42% across the NHS up 0.24% from October 2013. The Trust has been above that average in only November 2014 and January 2015 (outside the period reported). Lowest sickness absence is 3.68% in South London and at its highest 5.19% in the north-west. Generally sickness absence is above 2013/14 rates. Long term sickness absence is at a consistent rate – the increase in sickness absence reflects the increased prevalence of cold/flu this season. Bank and Agency- Limit 5% Actual 5.99% Use of the Agency framework has increased with robust management of the agencies and greater communication. Bank and agency is at its lowest since August 2014 with significant drops in Children’s and Families and Corporate although a slight overall increase in Operations and still significant usage in Strategy and Development (Oxford Pharmacy Store). Sessional use increased but is within the range seen over the last 2 years (2.4% to 3.4%). Vacancies: Limit 9% - Actual 5.08% Overall headcount is down for the first time in 4 months. Vacancies are down again continuing a downward trend from Autumn – and showing the results of intense recruitment activity as reported in January which continued into February. .

3. Headline HR KPIs - Sickness

4. Directorate Performance – Headlines

5. Directorate Performance Adults Directorate : Turnover 13.28% V target 12% • Very slight improvement in the overall turnover figure but Bucks Clinical Pathway and Oxford Clinical Pathway had a monthly increase in T/O. Overall there were 32 leavers and 19 starters which increases the activity in recruitment and proactively managing the candidate pipeline.  The 12 month rolling stability index in Bucks Clinical Pathway remains positively high at 89% of staff in position for a minimum of 12 months. . Inpatient recruitment remains a priority and open days have been organised in Oxford and Bucks. Chiltern and Oxford City AMHTs have regular turnover as the new way of working settles down. Ensuring they get enough quality Band 6 candidates to interviewremains a priority and we are working with the Team Managers to target appropriate journals, universities and other Trusts on our borders. Sickness 4.01% V Target 3.5% • Improvement from January 15 with 164 less days lost to sickness and an improvement is long term sickness cases. All services improved except for Bucks Clinical Pathway which increased by 0.3% in LTS.  There are some LTS cases related to ER casework which are drawing to a conclusion with  hearings scheduled. Other LTS cases are being managed with support from Occupational Health and managers are contacted monthly to ensure that sickness is being appropriately managed.

6. Directorate Performance Adults continued: Bank & Agency 10.3% V limit 5% • The agency % of spend increased from 5.7%  to 8.2% in February mainly due to a 9% increase in usage by the Forensic services. There are particular recruitment issues on Thames House which are being addressed with Recruitment Open days and additional HCA’s being recruited while there is difficulty recruiting Nurses. In the meantime agency staff are filling gaps and the safer staffing levels are reporting more wards as green.  New services are being commissioned in the areas of 24 hours assessment including Mental Health nurses in the South Central Ambulance Services, A&E and Bucks Street Triage and agency and bank are being used while recruitment is undertaken. Vacancies 7.5% V limit 9% • Proactive recruitment is taking place with a small Operational team supported by the Snr HRBP managing recruitment on a daily basis. Generic rolling adverts are being used and shortlisting and interviews being managed in a timely manner.  Recruitment Open days are being scheduled where appropriate and the candidate is proactively managed to start as quickly as possible. • The Deputy Ward Manager posts have not proved attractive to candidates and a programme is being discussed to develop our own Band 5 staff to prepare them for promotion.

7. Directorate Performance Older Peoples Directorate Turnover: 13.5% v 12% Target • Staff turnover in the Directorate continues to be above target in all services apart from Countywide therapies and Urgent Care. In this period, there were 33 (14.2 WTE) leavers across the Directorate including 1 dismissal, 3 retirements, 5 end of bank contracts and 24 resignations. 3 of those who resigned cited Work/Life Balance as the reason for their resignation (1 from Community Nursing and 2 from OA Mental Health). • Community Nursing continues to have the highest turnover in the Directorate at 17%. This continues to be monitored by the service and exit interviews offered. The issues being cited are known (age profile, size of DN patch / travel times, activity levels and support). An action plan will be developed by the ILTs. • Review of staffing levels and selection process to be undertaken in Abingdon Community Hospitals; staff citing stress / working hours as concerns. Sickness: 6.1% v 3.5% Target • There was a slight decrease in sickness absence from 6.64% last month to 6.1%. 3.4% of the sickness is due to long term absence. • All long term sickness cases are being managed appropriately in accordance with Trust policy (33 cases in formal stage). Short term absence was higher than previously. The HR team will review Bradford Factor scores and liaise with line managers. The amount of management time required for sickness absence management is considerable. • Countywide services continues to have high sickness levels particularly within the Reablement service at 12.1%. Management of sickness absence continues to be a priority in this area. • The main reasons for absence in the directorate continue to be: • Anxiety and Stress – 15.5% (a reduction from last month’s 21.46%) • Musculoskeletal (MSK) problems 13.6% (a reduction from last month’s 19.219%)

8. Directorate Performance Older Peoples Directorate Contd. Bank and Agency - 6% v 5% limit • Bank and Agency is still high in Community Hospitals. One of the key reasons is that the level of patient acuity continues to be high. However this is reviewed as patients are discharged. Urgent Care Service and HR are looking at a potential strategy to reduce reliance on agency for EPs. • Recruitment in Community Hospitals and Community Nursing has resulted in increased staffing levels which is having a positive impact on bank and agency usage. Vacancies – 9.3% v 9% limit • Community Hospitals – The vacancy rate is 12.2%. The Recruitment Advisors report an increase in applications for posts in Community Hospitals. • Community Nursing – The Recruitment Advisors report an increase in applications for posts in Community Nursing. One of the localities (south) will have recruited to establishment levels once pre-employment checks have been completed. • Other areas where we struggle to recruit are Band 2 posts in Reablement due to the nature and structure of the role and requirement to travel (service to consider some form of recruitment event), nursing staff for the Community Mental Health Teams in Bucks due to proximity to London and EP posts within Urgent Care.

9. Casework C&YP Directorate: Sickness 2.80% V 3.5% Target • Sickness absence has seen a further decrease since last report of 0.53%. Long term absence is currently 0.95%, a decrease of 0.44%.  Highest % is within Dental at 3.29% this is a significant improvement since April 14. This equates to WTE days 935 lost (last month 1107).   Top reasons for sickness absence in CYP are: • S13 Cold, Cough, Flu, Influenza 18.55% • S10 Anxiety/Stress/Depression 13.37% • S25 Gastrointestinal problems 11.46% • The overall trend since April 14 has continued to be significantly below trust target.  Sickness absence is being managed in line with support from Occupational Health; we have seen a number of successful returns to work plans in place in February. Short taster training sessions are delivered to managers on HR management topics. Turnover 12.24% V 12.0% Target • We have seen a slight increase in turnover from last month of 0.54%; turnover remains the lowest % across all Directorates except Corporate.  Highest turnover is within Dental Services at 20.90% (due to lack of promotion opportunities), a reduction from last month of 0.48%, followed by Swindon, Wilts and Banes at 14.53% and Specialist Services at 12.94%. • The total number of leavers in February were: 23 Employees (Equivalent to 16.21 WTE)

10. Directorate Performance C&YP continued: Vacancies 3.9% v limit 9%  Reasons for leaving: • Voluntary Resignation (Other/Not Known) - 5 • Voluntary Resignation (Work Life Balance) – 4 • Voluntary Resignation (Better Reward Package) – 2 • Voluntary Resignation (Relocation) – 2 • Retirement Age – 2 • End of Fixed-Term Contract – 2 • Bank Staff not fulfilled minimum work requirement – 2 • Voluntary Resignation (Health) – 1 • Voluntary Resignation (Incompatible Working Relationships) – 1 • Voluntary Resignation (Lack of Opportunities) - 1 • Voluntary Resignation (Adult Dependants) – 1 Bank & Agency 2.7% V 5.0% limit We have seen a significant decrease in bank & agency since last month of 2.4%. Overall, Agency accounts for 2.5%: the highest users of agency are within CYP Specialist Services (includes 2 Oxford inpatient units) with Bank & Agency at 5.7%, a reduction from last month of 5.1%.  Both Oxford inpatient wards now use the Trust’s framework agencies for the majority of their agency requirements; previously they have relied on the high cost framework agencies.

11. Casework C&YP continued: • Since December, the wards have continued to support a number of patients on level 3 and 5, all requiring extra staff.  The appointment of new sessional contracts will help ease the level of agency & bank spend. We also have the ability to recharge NHS England for high dependency patients currently on the wards. • Medical agency remains high due to sickness absence/requirement of reasonable adjustments. Casework is progressing and we should see an improvement in this area over the coming months. Change Management: • HR has input to and are supporting a number of re- tender/TUPE processes,  TUPE transfer consultations are going within  the Dental, Smoking Cessation  and Paediatric Liaison Services. New/existing business Tenders are also underway namely Buckinghamshire CAMHS, Dental Services in Leicester & Nottingham and Wiltshire Community Services. • Formal Casework: currently 10 cases consisting of 5 Capability Health/Performance, 2 Bullying & Harassment and 3 Disciplinary matters. Vacancies 3.9% v limit 9% Recent recruitment has been successful in securing 3 x Respite Nurses - a previously difficult discipline to which to recruit, plus 2 x B6 Clinical Nurse Specialists which have also been difficult to recruit to. A recent open day at the Highfield has resulted in 1 x B5 Nursing post being filled with 6 people still to be interviewed for the remaining 2 vacancies.

12. Directorate Performance Corporate Directorates : Turnover 11.12% V 12.0% Target Staff turnover was the same as last month with most departments below the trust target. Sickness  2.5% V 3.5% Target Sickness is at its lowest level since February 2014, bucking the seasonal trend. The sickness figures for the Medical Director department reflect some long term sickness for individuals on nil pay within CPSU pharmacy. Similarly the sickness figures in Strategy and Development department mostly reflects a long term sickness case in OPS on nil pay. Bank & Agency 4.7% V 5.0% limit Strategy and Development: Agency in this department has increased month on month and increased again for February from 26.8% to 30.1% . A plan has been agreed to employ agency staff where budgeted and where appropriate. This will be reviewed in March. Organisational change: The consultation for Estates and Facilities began on March 2nd. This first stage of the process with information meetings and one to one meetings has started with little disruption. A smaller organisational change in the Business Development and Performance team has identified one individual at risk for redundancy. Vacancies -22.8% v limit 9% • There are a few difficult to fill posts within Corporate services; the post of procurement manager remains unfilled; the delay is due to the department’s workload • We have now recruited the B7 & B6 Occupational Health nurse posts • There is difficulty recruiting for the IT department’s band 7 and band 8a posts

13. Directorate Performance The recruitment data demonstrates that there has been a slight reduction in new advert requests in February which has resulted in a lower number of applications received. A reduction in recruitment requests in February and March is expected due to the end of the financial year. In terms of the Recruitment Action Group: the next meeting is scheduled at the end of March.   An accommodation brochure has been produced and is on NHS Jobs for prospective candidates to see.  A draft accommodation policy is going to the Recruitment Action Group in March. It is of interest that the only nursing occupation on the shortage occupation list is Specialist Nurse (Neonatal Intensive Care). The NHS continues to lobby Government to add nursing to the national skills shortage list.

14. Recruitment Data Job Fair Update

15. Turnover Data

16. Turnover Data Turnover is shown by length of service and discipline (first slide) and then years 0-4 by year (without discipline). It is of concern that we lose significant numbers of staff after a short period of time in service and retention plans will be drawn up.

17. Payroll Salisbury Payroll continues to perform well; the graph below shows the level of overpayments with a continuing downward trend. The 2013 peaks are the result of additional data cleansing and resulting overpayments.

18. 2015 Pay Award Doctors and Dentists • The 2015/16 financial year is the second year of the two-year pay award that the Government announced in 2014.  • The pay award offered a 1 per cent non-consolidated award for doctors and dentists at the top of their pay scale for each of the two years. This means that for 2015/16, there will be a 1 per cent non-consolidated pay award for all doctors and dentists on the top of their pay scale.  • For those at the top of the pay scale as at 31 March 2014, and in receipt of the 1 per cent non-consolidated award for 2014/15, they will be given a 2 per cent (1 per cent + 1 per cent) non-consolidated award for 2015/16 (based on 2013/14 pay scale values). Those who incremented to the top of the pay scale during the 2014/15 pay award period, will only get 1 per cent non-consolidated for 2015/16 (based on 2013/14 pay scale values). Agenda for Change Staff • On 9 March the NHS trade unions announced that they had accepted the Government’s pay offer, bringing to an end the recent industrial action.  The pay settlement comprises a 1% uplift to pay scales to pay point 42 (mid 8C), a freeze on increments for staff above point 34 (2nd pay point on 8a) and an additional £200 consolidated payment for points 3 to 8. We are awaiting pay circulars with specific details and a roll-out timetable.

19. Staff Health and Wellbeing Staff health and wellbeing workshop • Members of the wellbeing group, wellbeing champions and members of staff have been invited to attend a morning workshop on Wednesday 18th March to: - review the work of the group in 2014/15 - drill down and discuss staff survey results - set the priorities for the upcoming year - update the staff wellbeing guide Oxford Health NHS FT has gone smoke free • Oxford Health NHS FT went smoke free from 2 March 2015 across all its sites. Smoking is not allowed in any of the Trust’s buildings or within any of its grounds; this applies to all staff, patients and members of the public visiting our sites. • Under the revised Policy, staff are no longer allowed to take “smoking breaks” and staff who wish to smoke whilst on duty will have to do so within their allocated breaks. • Smoking cessation advice and support is available for both patients and members of staff. • A copy of the revised Policy and related documents can be found on the Intranet. • Updates have been made to the documents used in the recruitment process to fully incorporate information re: OHFT going smoke free.

20. KPIs for February 2015: Of the 132 referrals 82% were offered appointments within 10 days. The average of days between date attended and date the report was dispatched was 1.17 days. • The activities above exclude the following: • GP and Specialist request letters • Transfer of care or Urgent/immediate responses required by Managers (in which there was an increase throughout the month of December) • In addition to the above appointments the following activities were undertaken: • SEQOHS: following a lot of hard work and an inspection by assessors on the 17th February we have gained SEQOHS accreditation. Occupational Health

21. Occupational Health

22. Occupational Health Appointment and Triage Combined January 2013 to February 2015