Appendix 1 provides a summary of sickness absence reasons across Sherwood Forest Hospitals NHS Trust.

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Council of Governors Meeting Subject: Sickness Absence, summary of main reasons 2015/16 Date: 1 st June 2016 Author: Robert Simcox Deputy Director of Human Resources Lead Director: Julie Bacon Director of Human Resources Executive Summary Following discussions at the February Council of Governors Meeting assurance was requested in relation to the trusts approach to management of sickness absence and in particular a summary of main reasons of absence. Appendix 1 provides a summary of sickness absence reasons across Sherwood Forest Hospitals NHS Trust. Recommendation It is proposed that the Council of Governors takes assurance from the paper and planned approach to supporting the reduction of sickness absence across the trust. Relevant Strategic Objectives (please mark in bold) Achieve the best patient experience Improve patient safety and provide high quality care Attract, develop and motivate effective teams Yes: Robust approaches the management of sickness absence can contribute towards achieving the best patient experience are required to support the governance of this. Yes: Robust approaches the management of sickness absence can contribute towards improving patient safety and provide high quality care are required to support the governance of this. Yes: Robust approaches the management of sickness absence can contribute towards attracting, develop and motivate effective teams are required to support the governance of this. Links to the BAF and Corporate Risk Register Details of additional risks associated with this paper 1

(may include CQC Essential Standards, NHSLA, NHS Constitution) Links to NHS Constitution Quality of care and environment It is the commitment, professionalism and dedication of staff working for the benefit of the people that the NHS serves, which really make the difference. High-quality care requires highquality workplaces, with commissioners and providers aiming to be employers of choice. Financial Implications/Impact Legal Implications/Impact Partnership working & Public Engagement Implications/Impact Committees/groups where this item has been presented before Monitoring and Review Is a QIA required/been completed? If yes provide brief details None identified 2

Appendix 1 Sickness Absence, summary of main reasons 2015/16 Background The Trust recognises that employees are our most valuable asset in delivering a high quality, safe and cost effective service to the people it serves. This will be achieved by offering attractive and fair conditions of employment, flexible working opportunities, a healthy environment and above all encouraging all employees to play an active role in the Trust s future. The Trust aims to raise awareness to help employees maintain good levels of health and wellbeing, enabling everyone to contribute fully through regular attendance. The Trust encourages and promotes a culture which ensures that employees are aware that their regular attendance at work and contribution to their team is valued; and recognises the need to minimise the impact of non-attendance on both the individual, their colleagues and on operational services. The Trust is committed to supporting employees, as far as is reasonably practicable where they have an underlying medical condition impacting on their ability to perform their role and where they are committed to their recovery and rehabilitation. Supportive management of staff who are ill should, as far as possible, enable: Staff to return to work sooner; or Staff to continue in productive employment for longer; or The Trust to take a timely decision whether their employment can be sustained. Sickness Absence Review 2015-16 The Trust adopts a proactive / supportive approach to the management of staff who fall ill at work using the Trust Policy on Sickness Absence at Work. In context to local and national bench marking the information in Table 1 provides a summary of current performance of the Trust. This has established that the trusts approach and performance of sickness absence management benchmarks well in comparison to a number of local and national NHS Organisations. In the majority of cases the Trust percentage figures below the average current in-month sickness absence and rolling average figure. This supports that a proactive approach to the management of sickness absence is in place across the Trust, however the March 2016 figures are 0.75% away from the trusts target and provides a target to be worked towards across 2016/17. Further to this detailed work has been identified below in relation to trends and overall analysis of sickness absence information, to support this the current HR Business Partnering teams are aware of the information and are addressing through the introduction of local action plans and remedies. 3

Table 1 Sickness Absence Information (Including local and national benchmarking) Trust Target Mar-16 (%) Rolling Average (%) Sherwood Forest Hospitals NHS FT 3.5 4.14 4.16 Derby Teaching Hospitals NHS FT 3.8 4.14 4.03 Nottingham University Hospitals NHS 3.5 4.01 4.03 Trust Chesterfield Royal Hospital NHS FT 4.0 4.76 4.89 Derbyshire Community Health Services NHS FT 3.0 4.92 4.57 NB: Year to Date is average of past 12 months. National NHS absence rate is 4.45% (4.62% East Midlands). The information held within Chart 1 establishes Sickness Absence over a reference period April 2015 March 2016 and provides evidence of a reducing pattern of sickness since a peak within November 2015. Local intelligence would imply that this associated increase was consistent with a seasonal winter weathers but also the uncertainty of the organisational following the outcome of the Trusts CQC report and the unknown information proposed within the Long Term Partnership process. However since November absence levels have reduced which the anticipation to being at a similar level to the April 2015 figure. Chart 1: Sickness Absence (April 2015 March 2016) Chart 2 provides information covering the same period but is captured at a divisional level. The information suggests that significant improvement has been made in some areas for instance Newark and sustained improvement within Planned Care 4

and Surgery. The notable challenges are across Corporate, Emergency Care and Medicine, and Diagnostic and Rehab that have remained static. Chart 2: Sickness Absence per Division (April 2015 March 2016) In addition to the information identified in Charts 1 and 2 further analysis has been obtained in the relation Chart 3 Top 5 Reasons for FTE Days Lost (April 2015 March 2016), this data is also split by occupational group within table 2. This has identified that 34% of all absence within 2015 /16 was related to Anxiety / Stress / depression / other followed by other musculoskeletal at 23% and gastrointestinal problems at 17%. Chart 3: Top 5 Reasons for FTE Days Lost (April 2015 March 2016) 11% 15% 34% Anxiety/Stress/depression/other Other musculoskeletal Gastrointestinal problems Other known causes Back Problems 17% 23% 5

The Trust is currently reviewing the employee offer that Occupational Health can provide to support Anxiety / Stress / depression within the workplace and establishing what more can be done to tackle the top reason for absence within the workplace, including further staff counselling provision and the option of offering an additional e- counselling model. In addition to this the Divisional HR Business Partners play an active role in promoting the Trusts current offering to the management of Stress, through Resilience Training, Managing Stress at Work Talks and early intervention through Occupational Health referrals and Stress Risk Assessments. The Occupational Health Service offer fast track physiotherapy appointment in the anticipation of supporting back and other musculoskeletal problems and has been directed to particular staff group areas. In relation to Staff Grouping Registered Nurses are identified in 4 of the 5 absence reasons, and to support ward leaders a recent programme of development has been introduced to support leaders in regards to having difficult conversation allow the topic of sickness absence to be discussed at an earlier stage supporting a duty of call mind-set. Table 2: Top 5 Reasons for FTE Days Lost (April 2015 March 2016) by Staff Group Absence Reason Staff Group % Total FTE Days Lost 1 Anxiety/Stress/depression/other Registered Nurse 48.2% Anxiety/Stress/depression/other Admin & Clerical 24.5% Anxiety/Stress/depression/other Unregistered Nurse 20.1% 2 Other musculoskeletal Registered Nurse 35.3% Other musculoskeletal Unregistered Nurse 32.5% Other musculoskeletal Technical & Other 18.4% 3 Gastrointestinal problems Registered Nurse 38.0% Gastrointestinal problems Admin & Clerical 31.9% Gastrointestinal problems Unregistered Nurse 22.0% 4 Other known causes Registered Nurse 37.2% Other known causes Admin & Clerical 28.9% Other known causes Technical & Other 14.5% 5 Back Problems Unregistered Nurse 27.9% Back Problems Technical & Other 16.3% Back Problems Medical & Dental 8.3% Additional Information In addition an approach to offering further support to the reasons for sickness absence and establishing lessons learned from areas that are positivity managing 6

sickness absence the Trusts Health and Wellbeing committee are establishing a 2016/17 strategy that aims to focus on Improving Health and Wellbeing within the Workplace. The strategy will be aligned to the current NHS England CQUIN NHS Staff health and wellbeing and be the driver for focused work around standards 1a and 1c CQUIN 1a Introduction of health and wellbeing initiatives Introducing a range of physical activity schemes for staff Improving access to physiotherapy services for staff Introducing a range of mental health initiatives for staff CQUIN 1c Improving the uptake of flu vaccinations for front line staff within Providers The introduction of a variety of Fast Track Occupational Health option from 1 st June 2016 will also aim to support and address the current levels of Sickness Absence and promote earlier possible return to work dates. Next Steps In anticipation of reducing the trust sickness absence figure further planned work is in place over the next few months associated with the following actions, along with contribution to the proactive management of absence reasons: Finalise Health and Wellbeing Strategy 2016/17 that is aligned with the in year CQUINN Implementation the Health and Wellbeing Strategy 2016/17 action plan Additional promotion of the Trust Sickness Absence Policy Conditioned approach via the Confirm and Challenge of Divisional Sickness Absence at Monthly Performance Meetings Embed and promote further the Fast Track Occupational Health options available to trust employees Reviewing the employee offer that Occupational Health can provide to support Anxiety / Stress / depression within the workplace. Robert Simcox Deputy Director of HR May 2016 7