WORKFORCE STRATEGY H

Transcription

1 H

2 INTRODUCTION The workforce strategy outlines the Trust s approach to developing the organisation to ensure that it is equipped and enabled to meet the challenges it faces and support the delivery of the Trust vision and strategic objectives. Our aim is to have a healthy organisational culture, a sustainable and capable workforce, working in an integrated manner with partners and where the leadership and management of our people is effective and conducted in a manner that improves staff experience and lets us demonstrate that we have put our values into action. We want to be an employer of choice and attract, recruit and retain a compassionate, engaged, skilled and experienced workforce who deliver excellent patient care and who work together to continuously improve the quality of the services and care we provide. The strategy sets out the workforce priorities and framework for delivery to achieve this.

3 CONTEXT AND DRIVERS

4 CONTEXT AND DRIVERS Northamptonshire Healthcare NHS Foundation Trust is operating in an ever changing and increasingly challenging environment. The growth in empowerment of service users and their ability to choose services creates increasing expectations which as an organisation the Trust aims to meet and exceed. Against these wider societal changes, the healthcare system has faced some serious challenges identified by the significant issues highlighted by the failings of Mid Staffordshire Hospital and the Winterbourne view care home. A number of key themes have also arisen from national and local strategies that are relevant to people who use our services and our workforce. Of particular note is the Five Year Forward View, Five Year Forward View for Mental Health, Lord Carter s review of Productivity in the NHS and locally the county s Sustainability and Transformation Plan and the county s Health and WellBeing Strategy. Add to this the financial constraints exerted on public expenditure as a result of the general economic downturn, which has been felt throughout the local health economy, then clearly we face an unprecedented challenge to meet all the demands being placed on the Trust. In addition, to the external context in which we are operating, the Trust faces a range of internal drivers for change, as such as the staff survey results and other key performance metrics such as the WRES, turnover, vacancy levels etc. A summary of the key external and internal drivers that shaped and informed this strategy are shown in Appendix 1.

5 TRUST VISION, VALUES AND STRATEGIC OBJECTIVES

6 TRUST VISION, VALUES AND STRATEGIC OBJECTIVES The Trust has defined its vision, values and strategic objectives: The Trust Vision is to be a leading provider of outstanding, compassionate care. We will be guided by our values which will drive our actions and behaviours. These are: People first Respect and compassion Improving lives Dedication Equality Our leaders, through living the values and role modelling the appropriate behaviours will be critical to developing an engaged, innovative and empowered workforce which in turn will enable the Trust to achieve its vision. The Trust has defined its leadership behaviours as: Working Together Taking Responsibility Being Authentic Embracing Change Our leaders will be expected to role model the behaviours in delivery of the Trust strategic objectives which are: Develop in partnership Innovation Grow our staff capability Build a sustainable organisation Quality and safety at the foundation of all we do The Workforce Strategy underpins the Trust s mission, vision and strategic objectives. It sets out an enabling framework to support the delivery of the objectives while ensuring the trust values are embedded in all that we do. It also provides a clear mechanism for engaging and developing Leaders and staff to enable the cultural changes necessary to deliver the Trust s vision.

7 ORGANISATIONAL DEVELOPMENT METHODOLOGY

8 ORGANISATIONAL DEVELOPMENT METHODOLOGY The Trust, as part of its strategic review, has identified that it will need to undergo a significant organisational change in order to deliver our challenging agenda. We believe that by adopting an organisational development approach we will enable the Trust to develop its internal capacity to efficiently and effectively provide its services and to reflexively continue to respond to future changes and thereby sustain itself long term. We have adopted an organisational development (OD) approach to responding to the challenges facing the organisation in terms of delivering its strategic objectives. In developing this strategy we considered the following definitions of organisational development: Organisation development (OD) is a planned and systematic approach to enabling sustained organisation performance through the involvement of its people (CIPD April 2014). A system-wide process of data collection, diagnosis, action planning, intervention, and evaluation aimed at (1) enhancing congruence among organisational structure, process, strategy, people and culture; (2) developing new and creative organisational solutions; and (3) developing the organisation s self-renewing capacity. (Michael Beer, 2009) In practice OD is a series of planned interventions to bring about significant improvements in organisational effectiveness and capability. To determine what the appropriate planned interventions should be for the Trust, our methodology was based on a typical OD map [NTL Institute, 2006], which utilises a phased approach from issue identification through diagnosis (data collection, analysis, feedback stages) through to action planning, action taking and evaluation. Clearly this journey is not necessarily one directional and it is expected that there will be some looping back as further insight is gained along the journey to allow agreed actions to be adapted and refined etc.. During the diagnosis and action planning phase we utilised the Mckinsey 7s model. The McKinsey 7s model is a tool that analyses organisational design by looking at 7 key internal elements: strategy, structure, systems, shared values, style, staff and skills, in order to identify if they are effectively aligned and allow the organisation to achieve its objectives.

9 The following diagram illustrates the interconnectivity of the 7 elements of the Mckinsey 7s model. In the McKinsey model, the seven elements of an organisation are divided into the soft and hard areas. Strategy, structure and systems are hard elements that are much easier to identify and manage when compared to soft elements. On the other hand, soft areas, although harder to manage, are the foundation of the organisation and are more likely to create the sustained competitive advantage. The following brief summaries provide an outline of what each element consists of: Strategy: the plan devised to maintain and build competitive advantage over the competition so basically the Trust s vision, values and strategic goals as detailed in the Trust Strategic plan document ( ), Quality Strategy, Operational Plan etc. Structure: the way the organisation is structured and who reports to whom.

10 Systems: are the processes and procedures of the organization, which reveal business daily activities and how decisions are made. Skills: are the abilities that the organisation s employees perform very well. They also include capabilities and competences. Staff: is concerned with what type and how many employees an organisation will need and how they will be recruited, trained, motivated and rewarded. Style: represents the way the organisation is managed by top-level managers, how they interact, what actions do they take and their symbolic value. In other words, it is the management and leadership style of the leaders/managers. Shared Values: are at the core of McKinsey 7s model. They are the norms and standards that guide employee behavior and company actions, typically referred to as the culture of the organisation or more simplistically it is about how we do things around here. When these factors are considered individually, there is a risk of conflicting operational plans, uncoordinated resources, slower processes and a lost opportunity for sharing knowledge; all minimising the return on investment from development initiatives. In highly effective organisations, these factors are considered holistically to drive performance, maximise efficiency and cost effectiveness and bring about sustained improvements in the organisation. Therefore the 7 factors must be internally consistent to enable effective behaviour. This model has acted as an intellectual framework for our overall approach. This approach ensures that we consider the Trust as a complex ecosystem with critical co-dependencies. Any resulting areas of action/improvement identified are considered and approached from this perspective to ensure they are supporting of the whole system rather than created and implemented in isolation. In the formulation of this Workforce Strategy there is a particular concentration on the components that related to style, shared values, skills and staff but clearly there is also an inter-relation with the S for structure and systems.

11 WORKFORCE STRATEGY FRAMEWORK FOR DELIVERY

12 WORKFORCE STRATEGY FRAMEWORK FOR DELIVERY The strategy is organised around eight priority work streams for action (as detailed below): OUR AIMS: To build a healthy organisational culture To grow a sustainable and capable workforce To enable integrated working with partners To ensure the leadership and management of our people is effective and conducted in a manner that improves staff experience and promotes innovative high quality care. Partnership Working Recruitment & Retention Health & Well being Leadership and Talent Management Learning & Development Inclusivity Staff Engagement and Workforce Communications Optimising Workforce Efficiency To create collaborate, constructive relationships, between the staff side and Trust, which enable shared understanding of all perspectives that support a model of working effectively together to deliver positive change within the organisation. To attract, recruit and retain high calibre, appropriately skilled, qualified and experienced staff who share our values, demonstrate our agreed behaviours and who will deliver safe, compassionate, excellent care. To support the health and wellbeing of our staff to enable them to fulfil their roles and responsibilities. To ensure that strategic, transformational and distributed leadership is visible across the Trust, with leaders role modelling the trust values and behaviours; with a constant drive to create more leaders through staff actively embracing their leadership roles; also to ensure that appropriate plans are in place to support talent management and succession planning. To improve patient safety, experience and outcomes through the provision of excellent and innovative learning and education. To realise a culture where there is a real sense of inclusivity, ensuring we have a diverse workforce that is able to bring all its different perspectives creating an innovation organisation that is aligned to the wide range and specific needs of our patients and service users. To help make NHFT a great place to work by informing, listening to and motivating our staff and ensuring they feel their contribution is recognised and valued. To ensure we have a flexible workforce that consists of the right people with the right skills, attitudes and behaviours in the right numbers to deliver safe, effective and high quality care today but that can adapt and innovate to develop new ways of working to support new models of care needed in the future. These priorities are supportive of the Trust s culture and also are consistent with the evidence based research conducted by Professor Michael West which indicates links between good Human Resources practice and quality improvements.

13 WORKSTREAM SUMMARIES

14 WORKSTREAM SUMMARIES - PARTNERSHIP WORKING To create collaborate, constructive relationships which enable shared understanding of all perspectives that support a model of working effectively together to deliver positive change within the organisation. Where are we now Where do we want to be How are we going to get there Significantly improved relationship with staff side, working together in a positive and constructive way TSPF meets regularly and has good attendance Partnership relationship exemplified by learning agreements, close collaboration around recruit and retention and health and wellbeing of the workforce Challenges still exist as the Trust has undergone significant change and Staff side raised concerns about commitment from senior leadership to work in partnership. Both sides have been able to work through processes and build on this and develop and move forward with a focus to further improve future partnership working. Constructive and collaborative partnership working leading to beneficial outcomes for the organisation and therefore the workforce. Continue with Trust partnership forum with regular attendance of trade union leaders and senior leaders Continue to grow partnership working in all areas by building on the success of recruitment and retention group, apprentices working group and health and wellbeing collaborative working approaches Develop lessons learnt processes which allow both sides to review change processes and particular employee relations cases Introduce periodic workshops involving the Trust Exec. Team, senior leaders and staff side to develop and build a culture of positive partnership working Full involvement and engagement with staff side in Health and Wellbeing initiative and support of the Health and Wellbeing Charter Close working with Staff side to engage them fully and effectively in any change that relates to the STP work Work with trade unions and agree how they can support the further development of an open and transparent culture including the implementation of freedom to speak up initiatives and close working with the F2SU guardian. Closer and earlier engagement with Staff side when identifying potential organisational change programmes.

15 WORKSTREAM SUMMARIES - RECRUITMENT AND RETENTION To attract, recruit and retain high calibre, appropriately skilled, qualified and experienced staff who share our values, demonstrate our agreed behaviours and who will deliver safe, compassionate, excellent care. Where are we now Where do we want to be How are we going to get there Highly competitive and challenging labour market National shortages of key occupational groups including doctors, nurses, AHPs and management and support staff Low employment rates compound the issue of national skills shortages End of 16/17 FY Trust running at over 13% vacancy rate Removal of national nurse bursary scheme likely to impact on workforce supply chain National shortages of existing roles and changing service delivery/care pathways has created the need to look at new and emerging roles e.g. physician associates, associate nurse role etc. as an alternative workforce supply Recruitment plan is in place focused on closer links with Universities, proactive attraction campaigns e.g. Recruitment fairs, creative advertising and focused senior support for recruitment Review of processes to enable streamlining/faster on-boarding of recruits. NHSI focus on reducing agency spend and adherence to price caps. An Employer of Choice Clearly differentiated - brand and employment proposition Top 20% advocacy rating for recommendation of a place to work in national staff survey Best in class recruitment processes and practices fast, efficient, effective and customer focused Upper Quartile turnover rates cf. bench mark NHS group. Create an annual recruitment plan that identifies monthly recruitment targets and supporting campaigns Review and improve vacancy/turnover reporting and monitoring mechanisms. Achieve bench mark peer average for turnover/retention rates. Task & Finish group improving effectiveness and efficiency of recruitment processes (incl: delivery of internal audit recommendations) On-going focus on pro-active and creative attraction approaches Increased use of social media to enhance engagement with potential candidates Marketing Northamptonshire through leadership role for The best of both worlds campaign across the LWAB Define the employee value proposition and embed it throughout workforce processes Continue to work in partnership with staff side colleagues and education leaders via the R&R group to gain expert contribution to inform approaches Targeted OD and engagement interventions to build loyalty and improve retention Gain insight from key metrics e.g. staff survey, leaver exit data to identify and respond to drivers of dissatisfaction Feasibility study of financial incentives to support R&R e.g. refer a friend, bank loyalty schemes, attraction packages, local bursaries etc.

16 Explore options for further overseas recruitment Further expansion of the Bank to support flexible deployment of staff, particular focus on HCAs Delivery of recruitment related aspects of the WRES action plan Plan to increase in education commissions through partnership working with the STP partners.

17 WORKSTREAM SUMMARIES HEALTH AND WELLBEING Aim To support the health and wellbeing of our staff to enable them to fulfil their roles and responsibilities. Where are we now Where do we want to be How are we going to get there Health & Wellbeing strategy in place Sign up to Workplace Wellbeing Charter Good Occupational Health and Counselling service which receives positive feedback from staff Programmes offering early intervention services on a self-referral basis to support musculoskeletal problems and mental health issues Signed up to Mindful Employer the charter for Employers Positive About Mental Health. Smoke Free from 1 st October 2017 A healthy, motivated, dedicated workforce able to deliver quality services. Individuals within the workforce will feel empowered to manage the balance between their work and personal lives and be able to support colleagues at times of difficulty. Year on year reduction of sickness absence rates Year on year reduction in staff absence due to work related stress Year on year improvement in staff reporting high stress levels in the staff survey. See Health & Well Being Strategy for full details. Key areas of focus are based on 4 themes: o Improving the physical wellbeing our staff o Improving the mental wellbeing of our staff o Improving wellbeing through people management practices o Supporting economic and social wellbeing. We will continue to: o Utilise the Wellbeing Steering Group. o Raise awareness and enhance the wellbeing brand and communications o Have an annual plan of wellbeing events and key public health campaigns o Develop and maintain wellbeing events/classes on the Trust s intranet site o Promote in-house psychological support for staff i.e. mindfulness, CBT. Promote all national healthy living campaigns relating to healthy eating, drinking etc Organise activities which promote healthy lifestyles and encourage staff to get Involved i.e. yoga, Zumba, running club, choir Develop training courses for staff about health improvement and train them to promote healthy options to others such as learning how to help patients and colleague to quit smoking. Achieve bench mark peer averages for sickness absence rates and well-being KPIs within the staff survey.

18 WORKSTREAM SUMMARIES LEADERSHIP AND TALENT MANAGEMENT To ensure that strategic, transformational and distributed leadership is visible across the Trust, with leaders role modelling the trust values and behavours; also to ensure that appropriate plans are in place to support talent management and succession planning. Where are we now Where do we want to be How are we going to get there Re-launched our approach to leadership highlighting that we would be guided by the concept of distributed leadership throughout the trust Focused on creating more leaders through the trust who hold to a common set of values demonstrated by behaviours which ensure that we provide the highest quality of care to our patients Created a positive set of agreed leadership behaviours which are now enshrined in our leadership behaviours framework Leadership Matters development programme created to support development and embedding of leadership behaviours On-going programme of leadership conferences and engagement to support continued improvement of the quality of leadership within the organisation. NHFT leadership culture continues to fully realise our values and leadership behaviours and delivers demonstrable outcomes which improve our organisational effectiveness, staff experience and quality of care for patients Positive leadership behaviours lead to lower turnover rates and higher staff advocacy of NHFT as a place to work Leaders and aspiring leaders have skills confidence to be effective in their roles and understand their impact on others and lead by example Talent management processes embedded, thereby ensuring that key leaders have been able to develop their abilities and are fully engaged in the work and leadership of the organisation In top 20% of bench mark Trusts for key staff survey questions related to leadership e.g. response to support from immediate manager, overall engagement levels, equality KPIs etc. Develop and embed the recently created senior leaderships team and process to support this, including implementation of appropriate KPIs Ensure that all formal identified leaders within the trust complete the leadership matters programme Deliver four leadership conferences each year to engage and stimulate future innovation and cultural change and improvement Further embed our leadership behaviours within our people management processes with a primary focus on appraisal and recruitment Develop Talent management processes that support development, retention and succession planning for key roles Coaching for Senior Leaders to be implemented Continue with SOFT week approach. Achieve bench mark peer averages for Leadership questions within staff survey

19 WORKSTREAM SUMMARIES LEARNING AND DEVELOPMENT To improve patient safety, experience and outcomes through the provision of excellent and innovative learning and education. Where are we now Where do we want to be How are we going to get there Mechanisms to deliver mandatory training To ensure that we have a confident and Undertaken a review of role specific training, define and roles specific training are in place and the training is monitored to ensure that the competent workforce able to deliver a responsive, equitable, safe and compassionate audiences and then implement robust monitoring of compliance delivery of these is of high quality service that meets all required standards Improve reporting metrics/kpis and the governance Non- traditional modes of delivery replaced To become a centre of best practice for which provides assurance about the level of training and by engaging approaches that create the right learning and development the verbosity of the reporting process learning environment to ensure effective and Training is well planned and delivered in the Review all training to ensure that it is based on the efficient learning right environment and has the right resources principles of brain based learning and engagement of A brain based or whole brain theory learning Training is underpinned by a new approach to staff approach has been adopted which focuses recording and monitoring training through the Develop an annual plan of training opportunities on the learning environment and enabling delivery of self-service ESR and OLM system Embed OLM and self-service ESR staff to learn effectively rather than simply which empowers staff to manage and record Continue to embed the enhanced appraisal process and focusing on content and delivery methodology A new appraisal process that embeds the their own learning and appraisal and also enable s managers to more easily monitor oversee this process monitor compliance levels. trust values and behaviours has been created Top 20% of bench mark group for % of staff and is being rolled out across the Trust with having appraisals in staff survey. supporting training for staff and managers.

20 WORKSTREAM SUMMARIES INCLUSIVITY To realise a culture where there is a real sense of inclusivity, ensuring we have a diverse workforce that is able to bring all its different perspectives creating an innovative organisation that is aligned to the wide range and specific needs of our patients and service users. Where are we now Where do we want to be How are we going to get there Visible senior leadership commitment and support of diversity and inclusion Active networks in operation with designated leads for BME, Disabilities and LGBT Active engagement of network leads with chief exec and other senior leaders within the Trust Equality, Inclusion and Diversity plans in place. WRES action plan in place EDS2 response in place Work undertaken with reverse commissioning has seen significant contribution from BME community and equally the Trust has agreed actions to address issues raised through our work with the network leads. Workforce reflective of the population we serve at all levels of the organisation No disparity between the Staff survey results for different demographic groups. Further develop our diversity group and networks Deliver against WRES action plan Make diversity a key theme in our leadership conferences to give appropriate profile Develop specific leadership interventions that will support our staff with protected characteristics (LGBTQ etc) Will provide development for staff to enable them to effectively develop their careers and succeed within internal environments Continue to review develop and enhance our recruitment process to ensure that they encourage staff from under-represented groups to apply and be successful and we will continue to review our develop our management development and processes to not disproportionally affect specific groups Work closely with Freedom to Speak up and diversity network to ensure that any issues or concerns experiences by staff are raised at earliest opportunity and addressed effectively within the organisation Implement reverse mentoring Host BME focus groups and develop action plans as appropriate.

21 WORKSTREAM SUMMARIES OPTIMISING WORKFORCE EFFICIENCY To enure we have a flexible workforce that consist s of the right people with the right skills, attitudes and behaviours in the right numbers to deliver safe, effective and high quality care today but that can adapt and innovate to develop new ways of working to support new models of care needed in the future. Where are we now Where do we want to be How are we going to get there Workforce plan in place Workforce planning workstream established to support STP plans Allocate used for rostering Vacancy control processes in place. Appointment of a Head of Workforce Systems The ability to accurately forecast our current and future workforce requirements based on national and local supply and demand data To have sufficient staff for our current models of care whilst, at the same time being flexible enough to cope with changing internal and external pressures that will affect the organisation over the coming years Reduced agency costs significant reduction beyond ceiling levels Allocate utilisation full optimised. ESR holding accurate and upto-date information. Review all workforce planning information and develop appropriate workforce initiatives within the overall workforce planning approach Optimise the use of allocate through development of approaches and metrics to aid efficiency of workforce scheduling/allocation Review of consultant and junior Dr rotas and job pans to ensure they are aligned to activity and service delivery needs and demonstrate value for money Review employment contracts/terms and conditions to ensure we can attract, retain and flexibly deploy our workforce to meet evolving needs of the service Continue to work with education providers and Health Education England to commission realistic training numbers and commission new roles where needed Work with partners involved in STP programme to agree work force plan Proactively review skill-mix in light of emerging service delivery models and identify retraining to maximise the full range of existing and potential skills of existing workforce On-going detailed analysis of agency usage and development of reduction initiatives Develop a proposal for Workforce Systems Team to support allocate, payroll, ESR and staff bank. Achieve bench mark peer averages for average staff cost as outlined in Model Hospital.

22 WORKSTREAM SUMMARIES STAFF ENGAGEMENT AND COMMUNICATION To help make NHFT a great place to work by informing, listening to and motivating our staff and ensuring they feel their contribution is recognised and valued. Where are we now Where do we want to be How are we going to get there Developed our communications strategy to complement the Trust Strategy, DIGBQ. DIGBQ has five themes and so we have created five communications themes to match with supporting plans. Working with our colleagues, in line with our strategic requirements, to ensure our audiences have access to accurate, upto-date and timely information. To ensure our vision, innovations and future plans are communicated clearly to everyone. To showcase our Trust to appropriate audiences and channels. To ensure our staff and volunteers are aware of the priorities and requirements of those who purchase or regulate our services. Launch new intranet and incrementally increase staff usage of and involvement with the site. Ensure services are regularly engaged on their responsibility to support our strategic initiatives, the delivery of accurate information and management of our reputation Continue to deliver the Quality Awards quarterly and the annual event; raising its profile incrementally each quarter. Launch showcase campaigns ; showcase Quality Award winners, communications activity, selected innovators and our top five innovations. Create a home for our ideas, research and innovations by launching an innovation space on our intranet. Create initiatives and innovative communications which increase the reach of this space and grow interactions. Manage the delivery of our Staff Surveys each quarter and increase the benefits to be gained and opportunities for growth by sharing our results, providing engaging feedback and involvement opportunities for staff. Launch NHFT style guide to provide clarity and direction on our Trust styling. Create and manage channels which improve capability to learn from lessons, best practice and reduce avoidable harm. Evaluate the effectiveness of our communication methodologies on a regular basis and make adjustments as appropriate Achieve bench mark peer averages on employee engagement metrics within staff survey, including recommendation as a place to work.

23 CONCLUSION

24 CONCLUSION The challenges facing the Trust are significant and the rate and complexity of change will only become more rapid. To cope with these demands we recognise that it is inappropriate to believe that these challenges can be met by senior leaders heroically leading the troops. We also recognise that such a model leads to a culture of control, dependency and encourage passivity. We therefore need to develop our organisational model to one of distributed leadership that recognises that leadership is not the domain of the few, but is prevalent throughout the organisation in the untapped talent of all our employees. Our role is to create a culture in which the potential of all our staff is nourished, recognised and released in daily interactions and ways of doing things together. This means ensuring we have a diverse workforce operating within an inclusive culture so that we are best place to provide quality care to the population we serve. Engagement will be critical to harnessing this resource as it enables us to maximise the amount of discretionary effort applied by our staff in their work. We will focus on evaluating the implementation of the strategy to assess whether we are able to evidence improved engagement and leadership. This will be done through monitoring our staff engagement levels within the staff survey and by gaining feedback from staff who attend engagement events both through dialogue and survey mechanisms. It is critical that we adopt a holistic approach to responding to challenges in respect of appropriate alignment of interventions to ensure they are appropriate and reinforce one another. We believe that the combined effect of the interventions identified in the Workforce Strategy, through enabling real and lasting change and improving organisational effectiveness and capability will be pivotal to enable the Trust to deliver its strategic objectives.

25 . APPENDIX 1

26 APPENDIX 1 - EXTERNAL AND INTERNAL/LOCAL DRIVERS FOR CHANGE The following tables summarise the key drivers for change that informed the development of the workforce strategy. External Drivers for Change Driver The Five Year Forward View (October 2014) describes the future of the NHS and the importance of developing new care models to support the increasing demands on the service. The Five Year Forward View for Mental Health (February 2016) focuses on the future of Mental Health within the NHS. Lord Carter s review of Productivity in the NHS (February 2016) identified clear workforce implications. Impact on workforce We need to ensure: Our workforce is reflective of our local community and has the right numbers, skills, values and behaviours with the ability to work across organisational boundaries. We need: To ensure we have robust workforce planning processes and plans for mental health Promote MH as a profession of choice Identify workforce gaps and recruit efficiently Provide the right training and support provided for staff. We need to: Ensure we have robust performance management practice Make effective use of nursing staff Set clear staffing levels Ensure effective management of sickness and annual leave Ensure effective use of e-rostering systems.

27 APPENDIX 1 - EXTERNAL AND INTERNAL/LOCAL DRIVERS FOR CHANGE External Drivers for Change Driver The NHS Leadership Academy s Towards a New Model of Leadership for the NHS 2013 details the links between leadership and service outcomes. Lord Rose s review Better Leadership for tomorrow 2015 makes recommendations for improving leadership in the NHS and the updated NHS Leadership framework provides the skills and competencies NHS leaders should have. The Outcomes of the Francis Inquiry (February 2013) are still relevant to Trust Workforce strategies. There is a need to continue to develop a culture of care with safe staffing levels and the ability for staff to be able to raise concerns. New Agency Rules were issued by NHS Improvement in 2015 and updated in This includes working only with recommended suppliers; monitoring usage and spend; and adhering to the hourly cap on rates as well as extensive reporting on the tenure and cost of agency staff with escalating levels of approval required. Impact on workforce We need to: Improve the leadership skills of our leaders and ensure our leadership framework takes consideration of the NHS Leadership framework. We need to: Continue to develop the trust cultures aligned to trust vision and values. Work to support the further development of an open and transparent culture including the implementation of freedom to speak up initiatives and close working with the F2SU guardian We need to: Continue to monitor usage and spend on agency and develop initiatives to reduce reliance on this source of workforce supply.

28 APPENDIX 1 - EXTERNAL AND INTERNAL/LOCAL DRIVERS FOR CHANGE External Drivers for Change Driver Changes to the removal of the Nursing and AHP tariffs will take effect from September 2017 will have a potential impact on the future supply of nurses and AHPs. Bursaries will no longer be available for students to undertake nursing and AHP training potentially resulting in a change to the age demographic of students. The introduction of an Apprenticeship Levy in April 2017 to support apprenticeship training. Impact on workforce We need to: Develop further our employee brand and our employment proposition Develop creative attraction approaches Explore financial incentives to mitigate any emerging supply chain issues as a consequence of the removal of the bursaries. We need to: Explore how we maximise the utilisation of this levy through conversion of existing training to approaches that attract apprenticeship funding.

29 APPENDIX 1 - EXTERNAL AND INTERNAL/LOCAL DRIVERS FOR CHANGE Internal/Local Driver Driver County s Sustainability and Transformation Plan sits alongside the county s Health & Wellbeing Strategy and builds upon previous work to shape services in a joined up way. It describes how health and social care can be improved to bring real benefits to individuals and communities. The aim is to provide a more person centred model of care which focuses on individual s health and wellbeing first and then supports their needs, when required, with fast access and appropriate intervention. People can expect to receive timely, appropriate, holistic care with physical and mental health needs assessed and addressed in a consistent and co- produced manner. National Staff Survey Results Trust performed well overall but there were areas where we performed below bench mark Trusts. Equality & Inclusion The WRES action plan identifies a range of areas where the Trust needs to improve its performance, including underrepresentation of BME staff at higher AfC bands. Impact on workforce We need to: Work in partnership with other providers to implement the key enabling and supporting strategies, including the development of a new flexible workforce Support the implementation of the Northamptonshire Workforce and Organisational Development Strategy the resulting workforce objectives. Work together to: Develop a system-wide approach to attraction and retention including place based marketing; Rotational nursing posts project to develop the ability to move people around the system e.g. through closer alignment of TS&Cs, rotational posts; Develop the secondary care workforce; Develop the Culture, system leadership capacity, staff engagement and change management; and Develop a combined workforce wellbeing approach. We need to improve: Appraisal rates Support from immediate managers Reduce the percentage of staff /colleagues reporting harassment, bullying or abuse Staff satisfaction with resourcing and support. We need to: Deliver the WRES action plan

30 APPENDIX 1 - EXTERNAL AND INTERNAL/LOCAL DRIVERS FOR CHANGE Internal/ Local Driver Driver Recruitment and Retention challenges The Trust has higher than optimum turnover and has struggled to recruit to key roles. Impact on workforce We need to: Develop creative and innovative approaches to recruitment and retention. Develop a clear employment proposition and employee brand.

31 #wearenhft NHFT WORKFORCE STRATEGY ; OUR PLANS SAFE We will attract, recruit and retain high calibre, appropriately skilled, qualified and experienced staff who share our values, demonstrate our agreed behaviours and who will deliver safe, compassionate, excellent care. We will improve patient safety, experience and outcomes through the provision of excellent and innovative learning and education. EFFECTIVE We will ensure we have a flexible workforce that consists of the right people with the right skills, attitudes and behaviours in the right numbers to deliver safe, effective and high quality care. We will create flexible employment frameworks that can adapt and innovate to support new ways of working and new models of care. CARING We will ensure we have a diverse, inclusive workforce that is able to bring all its different perspectives thereby creating an innovative organisation that is aligned to the wide range and specific needs of our patients and service users. We will support the health and well-being of our staff to enable them to fulfil their roles and responsibilities, whilst achieving an appropriate work life balance. RESPONSIVE We will create collaborate, constructive relationships which enable shared understanding of all perspectives that support a model of working effectively together to deliver positive change within the organisation. We will help make NHFT a great place to work by informing, listening to and motivating our staff and ensuring they feel their contribution is recognised and valued. WELL-LED We will ensure that strategic, transformational and distributed leadership is visible across the Trust. Leaders will be role models of the trust values and behaviours. Talent management processes will be embedded to enable our staff to realise their full potential. OUR AIMS: To build a healthy organisational culture To grow a sustainable and capable workforce To enable integrated working with partners To ensure the leadership and management of our people is effective and conducted in a manner that improves staff experience.

32 NHFT WORKFORCE STRATEGY ; OUR ACTIONS SAFE Create an Employee Value Proposition and embed it throughout recruitment and wider workforce processes Improve effectiveness and efficiency of recruitment process and implement recruitment audit recommendations Implement enhanced appraisal and performance management systems Improve compliance reporting processes for mandatory and role specific training, appraisal and supervision. Achieve bench mark peer averages for turnover/retention rates RESPONSIVE Expand the collaborative working approaches with staff side, such as that adopted for recruitment and health & well being work streams. Continue to develop the effectiveness of the Trust Partnership Forum. Develop lessons learnt process to improve employee relations handling. Continue to develop the Staff Room and increase staff usage of and involvement with the site. Create and manage channels which improve which improve capability to learn lessons, best practice and reduce avoidable harm. EFFECTIVE Support the implementation of the STP, in particular the HR & OD work streams. Actively participate in Agency and Cost Control Group. Support the optimisation of workforce scheduling/rota design through effective use of systems. Review employment terms and conditions to ensure they remain flexible and appropriate. Review Management of Change processes. Achieve bench mark peer averages for key metrics including average staff cost. WELL-LED Roll out the Leadership Matters programme. Support managers to gain the skills and confidence to be effective in their roles through direction, coaching and advice. Embed leadership behaviours throughout HR & OD processes, with a particular emphasis on appraisal, recruitment and organisational change. Develop talent management approach that supports development, retention and succession planning for key roles. Achieve bench mark peer averages for Leadership questions within national staff survey CARING Implement the WRES action plan Support and develop our diversity networks Improve physical and mental well being of our staff, through implementation of a range of initiatives. Introduce the role of Cultural Ambassador Achieve bench mark peer averages for relevant key findings within national staff survey.