def Agenda Item: 9c TRUST BOARD - February 2012 Workforce Report PURPOSE: PREVIOUSLY CONSIDERED BY: To brief the Board on the strategic analysis of key current Workforce / OD issues facing the organisation Finance & Performance Committee IMPLICATIONS: Objective(s) to which issue relates: Risk Issues: To improve continuously the quality of all aspects of our services by identifying trends and issues. Workforce changes with continuous service re-configuration. Financial: The financial impact of workforce changes including centralisation / consolidation of services and skills mix changes. HR: Healthcare/ National Policy: Workforce changes linked to workforce planning, service reconfiguration and Our Changing Hospitals Programme. Liberating the NHS: Delivering the Healthcare Workforce Legal Issues: Care Quality Commission Compliance Equality Issues: Equality Act 2010 RECOMMENDATIONS: The Board is asked to consider this paper and acknowledge the direction of workforce development and organisational development across the Trust. DIRECTOR: Director of Workforce and Organisational Development PRESENTED BY: Director of Workforce and Organisational Development AUTHOR: Deputy Director of Workforce and Organisational Development / Workforce Analyst DATE: February 2012
Workforce Report 1. Executive Summary This report is designed to provide an assessment of the workforce in terms of the management of identified risks and ongoing performance. The key workforce issue for the Trust is the ongoing programme of service consolidation. Divisions will need to ensure a balance is maintained between overall reduction of staffing numbers and costs and the ability to maintain safe staffing levels. To facilitate this, a workforce control plan is currently being refined to inform and provide a structure to meet a continuum of workforce reductions for the next 3 years inclusive of the Phase 4 consolidation. The draft People and Workforce Development Strategy is presented as a separate report to this committee. The workforce indicators set out in Appendix 1 give the latest workforce data to end January 2012. Appendix 1 Workforce Data Appendix 2 Capsticks Information Appendix 3 Turnover Trends 2. Workforce Flexible Workforce The way in which the total workforce is to be managed during the transitional phase from now until consolidation is completed in mid 2014 is under review. There is a requirement ethically and financially to reduce the number of redundancies that the Trust will have to implement in 2014. The current reliance on appointing to site specific permanent positions will hamper this. Currently the Trust runs with a 90%+ permanent workforce. The review will challenge this and explore innovative and more flexible models including the potential significant growth of the bank and the reintroduction of NHS Professionals as an internal agency. The aim is to negate the need to engage any temporary staff via external agencies over time as the percentage of this element of our workforce is secured via more cost effective means. 3. Key Performance Indicators and Recruitment Trust turnover has remained between 9.8% and 10.31% during the last 12 months. Turnover was running at 10.01% in January 2012, a small drop from 10.3% in December 2011. A detailed appendix showing 12 months of figures by site and Trust overall position is attached at Appendix 3. A range of 8-12% is considered to be a healthy figure. Over the period August November 2011, the WTE at Lister increased by approximately 330: the commensurate reduction of staff at QE11 was approximately 210 WTE. The shift in staff was associated with the consolidation of clinical services most especially Maternity, Paediatrics and more recently A&E. Turnover at Lister has reduced over the year from an average of 9.5% to 8% whereas at QE11, the figure has increased from 11% to 13% albeit with a drop from a high of 14.37% to 13.6% in the last month. The position at MVCC has increased from 11% to 12.5% over the last year. See graph below for trend information.
% Turnover by site (excluding Medical Staff) 16.00% 14.00% 12.00% 10.00% LISTER % 8.00% 6.00% 4.00% 2.00% QEII MOUNT VERNON TRUST 0.00% Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Month One of the emerging workforce schemes proposes to manage the balance between the percentage of staff employed on a permanent basis and those engaged via the internal bank and external agencies. The current position reported at the January shows a composition of 91.5%/4.8%/3.7% permanent/bank/agency. It is proposed that this is skewed to reduce the number of those directly employed on a permanent basis down to 85 or even 80%. The financial, contractual and service implications are currently being discussed within the Executive and Divisional senior teams. Progress in this and other workforce schemes will be included in next month s workforce report. As centralisation and change of services continues, the relationship between turnover and vacancy rate becomes more crucial and will be monitored down to speciality level. Vacancies have risen from 8.6% in December to 8.8% in January. The recruitment process is also under review to ensure that Divisions will be better supported in making the most appropriate appointment i.e. permanent vs temporary, that posts will no longer be site specific and that the time lag from resignation to appointment is reduced. All vacancies will continue to be considered via the Vacancy Panel but the parameters within which appointments will be made will changed. More detailed information in relation to this workforce planning will be made available for the March committee meeting. The discussions held at the January committee meeting and progressed at the January Workforce PMOs have resulted in a decision to adopt the SHA methodology of calculating sickness namely by calendar days rather than days worked. This is the first month for which figures will be displayed in this way and there is therefore a commensurate drop in the overall figures from 5.87% in December using the old methodology to 3.94% in January using the new. The most recent SHA data available gives a sickness rate of 3.7% for quarter 1&2. The number of staff on long term sick leave has dropped from 99 in December 2011 to 94 in January 2012 with the overall percentage figures dropping from 3.15% to 1
1.98% in the same time period. Short term sickness has reduced from 2.72% to 1.96%. Appraisal rates have fallen slightly this month from 68.32% in December to 67%. An exception report is enclosed with committee papers. The electronic staff survey conducted in December/January 2012 indicated that 83% of respondees (approx 600 staff) have had an appraisal in the last year. More detailed analysis of the data from the local survey will be available in March. 2010/11 national staff survey data indicates that we are in best 20% compared with other acute Trusts for the quality of our appraisals. 2011/12 staff survey results are due in March. The internal audit department has just embarked on a Trust wide review of appraisal processes which will include both qualitative and quantitative evaluation of the current process. The results of this audit are due at the end of March and will report in detail to the Audit Committee. The Statutory and Mandatory Training rate rose to 81% at the end of January 2012: please see grid and graph below. The ESR clean up continues. The inputting of training data is almost complete and the more complex work to realign competencies is being managed under the supervision of the HR workforce analyst. The revised induction and targeted core training programmes for the period April December 2012 are now being published on the Knowledge Centre and staff are being encouraged to book online. Work continues to meet capacity needs and refine the more specialist core training courses e.g. the Acute Core Training and a separate paper identifying professional training requirements by post is due to be presented to the March RAQC meeting. DIVISION POSITION AT END DEC 2011 EXPECTED POSITION AT END JAN 2012 EXPECTED POSITION AT END APRIL 2012 MONTH THAT 80% COMPLIANCE ACHIEVED Medicine 70% 73% 77% MAY 80% Surgery 70% 74% 84% MARCH 80% Cancer 73% 84% 95% FEB 82% Clinical Support 100% 100% 100% DEC 100% Corporate 68% 70% 80% APRIL 80% Women & Childrens TRUST SUMMARY POSITION 80% 85% 85% DEC 80% 76% 81% 87% 83.6% 2
4. Human Resource Advisory Service The Human Resource Advisory Service, supplied by Capsticks, commenced on 3 May 2011. In January 2012, a review meeting was held between the operational leads for the Capsticks HRAS, the DHRMs and the senior HR team. A number of enhancements were agreed at the meeting: - a revised schedule of reports including a weekly report to the Director of Workforce and OD - a review of registered level 1 & 2 sickness cases as it was felt that the loop was not closed sufficiently robustly on these cases and that a number currently reported as open may in fact be resolved - a report to be provided following the completion of the remaining dedicated Surgeries to review effectiveness of the training and early indicators of where subsequent training should be targeted - a meeting with key Surgicentre managers to ensure that the same processes are being followed in both organisations For the reporting period 1-31 January 2012 a total of 50 new enquiries were received. The service has received 779 enquiries since commencement of the contract. 40% of all cases received to date have been closed or completed. Of all cases still open, 84% relate to absence management. 67% of all open cases are marked as internally managed. It is likely, as indicated above, that a number of these cases have in fact been resolved locally and/or do not require active management presently. It is anticipated that the review of cases over the next month will reduce the number considered as open and internally managed. The information provided at Appendix 2 from Capsticks is for January 2012. 5. Sickness Benchmarking Data Table 1: Workforce absence rate benchmarking E & N EoE Average Av. for large National Average **Public **Private Herts NHS (16 Trusts) peripheral Trusts (168 Trusts) Sector Sector Trust (24 Trusts) Total Staff (WTE) 4697 3092 5667 3888 2000 or more 2000 or more Sickness Absence Rate 3.6 3.7 4.2 4.0 4.9 3.9 *Sickness rates above based on calendar days rather than worked days. The above table reflects the latest NHS benchmarking figures for quarter 2, 2011/12. The ONS& Chartered Institute of Personnel and Development figures are from the beginning of 2011 and are seasonally adjusted 3
It is generally accepted that sickness absence is higher in the public sector than the private sector. The explanation for the public private sector absence gap is not straightforward. Factors include: Differences in demographics, with a higher proportion of women and older workers in the public sector. The public sector has a higher proportion of front-line staff who have to deal with the public in difficult and emotionally charged situations, which can contribute to higher levels of stress-related absence in the public sector. The public sector is more likely to provide leave for family circumstances. Public services employers are also more likely to provide access to occupational health services, counselling services and physiotherapy. Public sector organisations are typically larger than their private sector counterparts and large organisations tend to have higher levels of absence than smaller ones. 6. Staff Consultations There are no current staff consultations at present. 7. Organisational Development / Accelerate, Refocus, Consolidate (ARC Programme) and Staff Engagement The Trust continues to implement the organisational development strategy through the ARC programme. The 2011 programme was completed in November/December 2011 with increased attendance over the 2 nd session held in September. Bookings are currently being taken for all 4 sessions planned for 2012. The themes for the year were agreed at the steering group meeting which was held on 14 th February. The March sessions are aimed at exploring the impact of the staff experience on patients and the June sessions are likely to focus on customer care. Projects which form part of the overall ARC programme are all currently green/amber rated and are reviewed monthly at ARC steering group and quarterly through the RAQC cycle. Current projects include: Staff recognition Improving team based working Leadership and management development Equality Delivery System Electronic Staff Records (ESR) self service & e-learning implementation An additional project stream will be commencing in the coming months to support work around health and wellbeing recognising that this is another key driver for overall staff satisfaction and engagement. Staff Survey The annual national staff survey was conducted between September & December. Our response rate was 43% which is similar to previous years. Results will be available from mid-march & will be benchmarked against other Acute Trusts. 4
The Trust s internal survey, an electronic survey sent to all staff, was launched in December and in early January. We received 722 responses which is twice as many responses as the national survey which is sent only to a 15-20% sample of staff each year. Evidence showed that over 90% of respondees used email to access the survey rather than the Knowledge Centre or the Trust Bulletin. Full analysis of results will be completed and reported at the March committee meeting. The March ARC sessions will be used as a way to communicate the results of both surveys to our leadership population and to involve them in the process of action planning for improvements. 8. Matching House/Redeployment Report January 2012 The number of staff on the redeployment register reduced from 10 in December to 9 in January. The Trust continues to work closely with the Regional Redeployment Coordinator. On 13 January, an individual registered with the Hertfordshire pool was interviewed for a post within the Trust. The applicant was unsuccessful on this occasion. A County Workforce Redeployment Leads meeting is being held on 14 February to build on the actions agreed at the first event held in November 2011. Redeployment Process When a member of staff has been added to the redeployment register and suitable alternative employment has been identified, staff are entitled to an 8 week trial period in the new role. The length of the trial period is under review with the potential to reduce to 6 or 4 weeks. At the end of the trial period, if satisfactory, a change of circumstance form is completed and the post is made substantive. Measures will be put in place to closely monitor and track the progress of staff undergoing trial periods. The proposal will be linked with the workforce reduction plans. 9. Equality Delivery System (EDS) Leads have been assigned in order to gather and collect evidence against the four goals of the EDS: Better health outcomes for all Improved patient access and experience Empowered, engaged and well-supported staff Inclusive leadership at all levels The evidence is currently being collated for an end of February deadline. This will be presented to the RAGP (Red, Amber, Green and Purple) panels at the beginning of March who will be responsible for rating the Trust against the above goals. The panel will consist of staff and stakeholders. Draft priority objectives are currently being agreed. February 2012 5
Workforce Report appendices in data pack: 1 Workforce Data 2 - Capsticks Summary Report 3 Turnover Trend Data by site 6
Abc Performance Exception Report February 2012 Target / Core Standard: Cultural Indicators NB: In month performance for January 2012 (month 10) = Red Cultural Indicators Cultural indicator ratings need to be in the top 20% of Acute Trust staff survey results to achieve a green rating. The current red rating is triggered when ratings fall in the bottom 20% of Acute Trust staff survey results. The Issue The cultural indicators on the floodlight scorecard have been populated based on the results from the 2010 staff survey. The 2 areas that are red-rated based on the revised bottom 20% benchmark are as follows: Job related training Team working Comments and Actions The annual national staff survey was conducted between September and December 2011. A sample of 850 staff was selected, and our response rate was 43%, which is similar to previous years. Results will be available from mid-march and these will be benchmarked against other acute Trusts as part of a CQC report. The results will be used to refresh the Trust s cultural indicators. The Trust s internal survey was launched in December and closed mid-january, having achieved 722 responses, which is twice as many as the national staff survey. A Discussion Paper on benchmarking and targets for cultural indicators will be presented to the ARC Steering Group meeting on 14 th February, to facilitate discussion on future benchmarking arrangements. Future survey results will then be assessed against the new benchmarking arrangements. Specific updates on the red-rated indicators are provided below: Job related training Education & training is being provided to improve current compliance figures. Strategies for workforce development & education are being developed to ensure our future provision for training is aligned with organisational needs. This includes the realignment of statutory and mandatory requirements for all staff to meet external standards such as NHSLA and CQC. The ESR improvement project will give increased opportunity for staff to access e-learning packages to supplement other forms of training. This will increase the availability and flexibility of job-related training options from June 2012. Team Working As noted last month, 14 people have been trained to use the Aston OD team coaching tools, which are designed to support line managers to review & improve the overall effectiveness of their teams. More recently, all team coaches have now provided team coaching strategies for their Divisions. Co-ordination of this project is being provided by the project lead. LEAD DIRECTOR Director of Workforce and OD
abc Performance Exception Report February 2012 Target / Core Standard: Staff Appraisals NB: In month performance for January 2012 (month 10) = Red The number of staff being appraised during the previous 12 months should be equivalent to at least 90% of the workforce to achieve a green rating. The current red rating is triggered when appraisal rates fall below 70%. The Issue The December Trust appraisal rate was reported at 68%. The overall position has deteriorated slightly to 67% at the end of January. The Divisional rates are as follows: Division November December January appraisal rate appraisal rate appraisal rate Cancer Services 66% 73% 64% Clinical Support Services 75% 84% 82% Medicine 51% 65% 66% Non-Clinical Support Services 68% 74% 70% Surgery 45% 57% 56% Surgicentre 58% 46% 40% Women s and Children s Services 52% 64% 66% Comments & planned actions Cancer Services is reporting a 64.47% appraisal rate for January 2012. This is below the Divisional trajectory. A new measure for monitoring progress by managers has been introduced in January, with the effects expected to be realised from February 2012. Medicine has a planned trajectory is to achieve 90% compliance by end April 2012. Areas impacted by the recent A & E reconfiguration will not achieve the required 90% compliance until April at the earliest. In December, Medicine was under additional pressure with respect to opening additional capacity as well as the closure of wards as a consequence of Norovirus. A significant proportion of nursing staff were moved between wards to ensure safe staffing levels which compromised appraisal plans at ward level. Feedback from Non-clinical Support Services managers highlighted a delay in returning appraisal summary sheets to HR. All managers have been advised of the importance of returning sheets by the 5th of each month, so as to ensure all appraisal activity is captured in the next monthly report. Members of the Surgical Division senior management team are planning to meet and identify a strong course of action, so that Surgery makes progress towards the 100% target. The figure of 66% for Women s and Children s Services is under the planned trajectory figure of 73% for January. The failure to achieve the trajectory figure was mainly due to the consolidation of Paediatrics in January. Managers have made assurances that appraisals will now take place. An internal audit of appraisals is to take place at the end of February. Outcomes from this, together with the feedback from our staff surveys, will help to inform the actions needed to make further improvements. This work will be taken forward from March/April following receipt of audit results. LEAD DIRECTOR Director of Workforce and OD