Workforce Performance Report September 2014

1. Workforce Performance ReportSeptember 2014 Jayne HalfordDeputy Director of HR Caring, safe and excellent

2. Headline HR KPIs Turnover – Target 12% - Actual 13.05% Turnover has stabilised a little but is still significantly above the previous year and a little above 2012. In line with turnover stability has also decreased to 83.93% - in the 2 previous years it has been around 85%. (See analysis of reasons for leaving on slide 4). Sickness – Target 3.5% - Actual 3.95% The sickness rate has fallen from its high last month and is Slightly below last year’s level. Significant HR resource is dedicated to the management of sickness absence – on individual cases, training managers on sickness absence management and policy/guideline development. Bank and Agency- Limit 5% Actual 6.32% Bank and agency usage as a percentage of spend has Increased again contrary to the pattern in 2013 but in line with increases in sickness and turnover. Agencies on the framework have improved performance significantly but are more expensive than previous agencies contributing to the increase. Sessional usage is at a constant level. Vacancies: Limit 9% - Actual 7.65% Vacancies have increased again in line with increased turnover; the trend mirrors 2013 and so a decrease is anticipated later in the year. The vacancy rate however is lower than the same time in 2012. .

3. Headline HR KPIs - Sickness

4. Turnover Voluntary resignation is the biggest reason for turnover – at 62% over the past 12 months but up to 72% in September (50% only in August but a signifcant 21% retirees). However the 83 leavers and 72% (plus dismissals) represent only those leavers classed as avoidable i.e – unplanned. The Wellbeing Programme has expanded considerably (see slide 14) and retention means are being considered in a number of areas.

5. Directorate Performance – Headlines The following headlines focus on those teams areas which are out of kilter in terms of the KPIs and taking into account size of department i.e. where numbers are small one leaver can distort figures so these areas are excluded: Turnover In CYF although Specialised is over target at 13.3 % this represents 8  leavers of which 3 were at Highfield where options for retention are being trialled.  Of the remaining five, two were retirements and the others were spread, which suggests there is no particular area of concern. In Dental turnover is 14.3% and predominately a result of partnership working with managers and employees regarding long term sickness absence which has resulted in a further 3 resignations from staff last month. * see sickness comments. Mgt are at 12.9% but it is a small workforce – there was 1 leaver in September due to voluntary resignation – relocation. In Older Adults analysis of turnover in District Nursing has not identified any new themes but turnover is being monitored. Exit data will be used to explore whether there is any link with the high levels of sickness absence. In Adults the training programme for PWP and High Intensity trainees starts in September each year. Once qualified it is hoped that they will continue within the Service but the reality is that most of them were prepared to live in or travel to High Wycombe for the training but once qualified apply to Trusts closer to home. Their training is such that they are welcomed by other Trusts and they are prepared to offer salaries higher than those permitted under the rules of Agenda for Change. The hjgh turnover is as a result of the annual training cycle. HR and management will review the recruitment process of PWP and High Intensity trainees for 2015 and get legal advice on a trainee contract that requires trainees to repay part of their fees if they leave within 12/18 months of qualification. In the Oxford Clinical Pathway there were more leavers than starters in September but see the vacancies section for actions. In Corporate Research and Development has been experiencing high turnover with a high number of vacancies. All vacancies now filled with candidates due to start in November or going through pre-employment checks. In other areas turnover appears high but is skewed because teams are small. In HR there has been turnover in Occupational Health despite retention measures which were put in place.

6. Directorate Performance – Headlines Sickness Absence In CYF most of dental sickness is  due to long term absence which HR are managing and is shown through on the turnover.   There are also  2 members of staff who were on long term sickness who have since returned in early October.  The resignation and returned staff combined should show an improvement in sickness absence next month. HR are supporting managers with a high number of short term absences (10) . In CYF mgt a small workforce with 1 long term sick being managed under formal processes skews figures. In Older Adults at local level sickness absence is over target in all areas; the HR team have been training operational managers in managing sickness; in Community Nursing this is in addition to the training sessions that HR run in conjunction with Occupational Health and there has been an increase in management of individual ill-health cases . Bank and agency In CYF Specialised agency is being maintained whilst budgets and staffing levels are clarified following the changes of areas i.e. for Oxon CAMHS the integration of PCAMHS. In CYF management bank and agency at  5.28% is to cover 1 long term sickness absence.  In Adults in September there were 24 new starters in Psychological Services and that will reduce dramatically the  need for agency staff. The invoices for agency payments will continue in October but the agency staff have already left. There is high agency spend in Chiltern AMHT Treatment and Assessment team due to vacancies but staff are in the pipeline following a local recruitment day in September where 13 staff were invited back for a second interview and 19 inpatient staff are going through employment checks. A review of AMHT staffing levels and job roles will take place. There is high usage of bank and agency on Phoenix, Allen and VT to ensure safer staffing levels are met but see vacancies for actions.

7. Directorate Performance – Headlines Vacancies In CYF recruitment has been successful at Highfield but not all new recruits have yet started – vacancies will drop next month. Bank and Agency should also diminish as agency cover has been sustained as the high number of starters at Highfield are inducted. Complex care vacancies reflect the turnover although there were no new leavers in October. Again 1 vacancy in CYF management skews the figures. In Older Adults there are difficulties in recruiting in some Community Hospitals. An Open Day event was held and two candidates were appointed. Adverts are being refreshed and applicants interviewed as soon as applications are received . Re-ablement always have a high number of vacancies due to the nature of the posts but a Recruitment Event has recently been held backed up by advertisements – the results of this will be analysed to improve such events for the future.. In Adults at Thames House there are 5 staff nurse vacancies and 10 unqualified staff vacancies. 1 staff nurse offer has been accepted and 2 unqualified offers have been accepted. The remaining vacancies are either at shortlisting or have been advertised.  A meeting has been arranged to discuss local recruitment events. The Directorate held a workshop on 15/10 and staff being ‘burnt out’ was discussed, the lack of quality nursing staff being available to recruit and the particular challenges of working in a Women’s forensic unit. Further discussions are to be held about rotation, paying enhanced recruitment and retention premia for specialist staff and how the Trust recruitment plan might support recruitment.

8. Directorate Performance – Headlines Vacancies ctd In the Oxford Clinical Pathway the Directorate is recruiting up to establishment following reorganisation and high vacancies on inpatient wards. There is high recruitment activity also following the increase in establishment on inpatient wards New starters will come on stream from local recruitment days held in July where 12 band 3 & 5 staff were recruited and August where 3 Band 6 staff were recruited . Adverts have been placed in all Northampton and local press as a result of a reduction in Mental Health staff in Northants following reorganisation. In Vaughan Thomas vacancies are 3 staff nurses , 2 deputy ward managers and 5 HCA’s  of which 5 are going through employment checks , 2 are at shortlisting and 3 at interview . In Allen Ward vacancies are 3 staff nurses, 2 deputy ward managers and 5 HCA’s of which 6 are going through employment checks, 2 are at shortlisting and 2 at interview stage. In Phoenix vacancies are 5 staff nurses and 7 HCA’s of which 6 are going through employment checks, 4 are at shortlisting and 2 are to be advertised. Additional recruitment plans include local recruitment events where appropriate, links with Southampton University and attendance at RCN nursing job fair in London. In Corporate /Medical Director there are a high number of Locum Appointment for Service posts which are proving difficult to fill. In the Office of the Ceo there is a small number of vacancies within Comms and Legal but there are no particular issues in recruiting for either of these areas.

9. Recruitment Action Plan Recruitment Action Plan A draft action plan has been fleshed out to include candidate attraction and retention strategies. A Recruitment Action Group has been formed and is meeting mid November to finalise the plan and includes senior staff from key clinical areas as well as Communications, Estates and IT. Areas included in this are the development of recruitment materials including the Trust’s website, temporary staff accommodation and values based recruitment. International Recruitment The viability of International Recruitment is currently being investigated. Following discussions with our nursing colleagues at the OUH, this would be a longer term strategy as it takes on average 6 months to induct and train overseas staff including 3 months to obtain NMC registration. Average agency costs per nurse based on the NHS Framework start from £2,645 per nurse based on recruiting 1-50 nurses for EU candidates and £2,929 for international candidates. This does not include costs of flights, visas or relocation packages. Further investigation is taking place to establish if this is a viable or necessary option as the figures in the table above indicate that we eventually fill most of the vacancies we advertise. Values Based Recruitment Analysis phase – 161 staff interviews have been completed. Free gratis assistance has been offered from students at the Said Business School in the development of a behavioural framework. A draft framework should be available at the beginning of November. This will then influence the recruitment materials and work can begin on the recruitment process to incorporate values based recruitment. Members of the Recruitment team regularly attend national meetings with NHS Employers and other member Trusts so that learning can be shared. It is envisaged that a rolling training programme will start early in the New Year. Employer Brand The Recruitment Action Group will look at the Employer Brand in terms of how do we make ourselves the employer of choice through looking at candidate attraction and retention strategies.

10. Recruitment Data The number of advertised posts in September has declined from previous months due to the student posts being filled, a number of hard to recruit posts that would normally be re-advertised have been filled through our recent open days and improved engagement with the local universities.  The number of applications has declined due to the reduction of posts advertised as well as the continued success of the pre-application questions that we now utilise on NHS Jobs. Of the 709 live recruitments 338 (48%) are at offer accepted , 55 at interview, 81 at offer, 96 at shortlist, 119 at advertisement and only 4 were unfilled. In June recruitment times stood at 149 days from date of recruitment approval to appointment date and 94 days from interview date to appointment date. With the creation of a new recruitment database we will be able to better report on these trends in coming months. The Access database will also streamline the candidate pipeline process.

11. Casework Data Cases increased significantly in September; overall there have been 11 cases closed in month and 23 new cases opened. These comprise 13 new cases in Older Peoples of which 7 were new ill-health capability, stemming from focussed management of sickness absence overall. The 8 new cases in Adults cover the range of casework. This casework figure (including capability management) represents 1.5% of the workforce. Some additional solutions to health management are being considered, such as improved access to physiotherapy, which should assist in prevention of cases in the future. The timescale for closure of disciplinary cases is increasing. Some of this is related to delays in utilisation of trained investigators and their availability alongside their substantive role. Other options for improving this are being reviewed. As the clinical Directorates restructure it is likely that in the short term case work will continue to rise and this is being kept under close scrutiny and solutions being developed to deal with that.

12. Casework Data Case duration is mostly showing further improvement: Disciplinary – 91 days Conduct - 48.7 days Bullying and harassment - 83.3 days Grievance - 84.3 days Capability -: Ill-health 75.3 days Performance 139 days The duration of disciplinary cases has plateau-d; the duration of conduct, bullying and harassment and grievance cases continues to decrease. Capability is now reported as 2 different cases types and so the trend on this will emerge in subsequent months. When one category the average duration was 129 days which is why the duration on performance cases appears to have increased from 129 days to 129 days on average. The suite of key policies – capability, grievance and disciplinary are being reviewed to align processes and make them more effective and efficient.

13. Staff Health and Wellbeing September Pedometer Challenge • 436 members of staff took part • Over 51,000,000 steps were taken • Write-up of challenge to be circulated by the end of the month • Feedback from participants reflected that staff enjoyed the event and that many reported that it made them aware of how inactive they were and as a result have increased the amount they walk and some have bought their own pedometers. Ping • During August and September we had table-tennis tables from Ping! Oxfordshire for three weeks at two of our sites (Oxford Business Park and Littlemore Site), which staff and patients thoroughly enjoyed and felt it was a great way for teams to interact, take a break and have fun Macmillan’s Biggest Coffee Morning • Teams from across the trust hosted coffee mornings, cake sales, bake offs, raffles, quizzes and more to help us reach a total of £409.60.

14. Friends and Family Test – Quarter 2 The Staff Friends and Family test was introduced on 1st April 2014. The aims as announced by the Prime Minister are: • To encourage improvements in the service delivery – by ‘driving hospitals to raise their game’. • To increase transparency by enabling patients and the public to readily access and compare scores for different providers and services. The two questions posed by the SFFT were: • How likely are you to recommend this organisation to friends and family if they need care or treatment? • How likely are you to recommend this organisation to friends and family as a place to work? Key messages from the test are: Quality of Care +The trust was seen to be well led and forward thinking with high standards of care, whilst also reactive to feedback. - The quality of care was seen to be stretched due to under-staffing and many felt this could be potentially dangerous to both staff and patients. First hand / family / friend experience + Experiences were positive with descriptions of clean wards with friendly, supportive and knowledgeable staff. - Staff who had used the services felt that they were rushed through treatments and were seen as a number rather than an individual/ patient.

15. Friends and Family Test – Quarter 2 • Resources • + Staff were felt to be knowledgeable, well trained, and dedicated to providing excellent patient care, who go above and beyond • - Although staff were seen to be capable, they were also seen to be overstretched with high workloads and increased demands. • Service • + Staff felt that a wide range of services were offered and felt proud that many of these were unique to the trust. • - Staff felt that long waiting lists for treatments meant that many people do not get the service that is needed in a timely fashion. • Oxford Health as an employer • + Staff felt that the trust takes an interest in what staff have to say and provides them with an environment which enables them to deliver quality care to patients. • - Staff have not felt supported or communicated effectively by the trust through the ongoing remodelling of services. • Learning and Development • + Great opportunities for advancement and an environment that encourages staff to grow as professionals. • - Many staff felt that opportunities and training were Oxford focussed. • Wellbeing • + The trust understands that staff morale and wellbeing is a core component of ensuring effective, high quality care. Staff feel valued and supported valued in their roles. • - Staff felt that they worked hard but their work wasn’t recognised or rewarded.

16. Friends and Family Test – Quarter 2 Comparison between Quarter 1 and Quarter 2 Question One (Treatment) Question Two (Workplace) Next steps: • Below average response rate: 12% response rate (compared to national average of 16%) • Communicating results to staff • Focus on how best to direct staff in to giving a more positive/negative response, rather than a neutral response. • Action plans to be developed by Senior HR Business Partners • Next survey commences between 1st January to 31st March 2015