Workforce Performance ReportOctober 2014

Jayne HalfordDeputy Director of HR

Caring, safe and excellent1

Headline HR KPIsTurnover – Target 12% - Actual 12.97% Turnover is below 13% for the first time since June and the number of starters exceeded leavers for the second month running. We have seen this drop in October for 3 years now and it is generally attributed to job searching more likely to be in Spring/early summer months.

Sickness – Target 3.5% - Actual 4.2%Sickness levels have risen again and this is not a trend that we have seen in previous years. Public Health England reports outbreaks of norovirus beginning but that flu levels are low.

Bank and Agency- Limit 5% Actual 7.45%Bank and agency increased significantly linked to sickness rates, complexity of patients, Although vacancies have dropped the impact of this on bank and agency would not be seen until next month. Sessional usage at 2.5% is not out of line with previous months.

Vacancies: Limit 9% - Actual 6.5%

Vacancy levels have dropped to their lowest level since May and now below 2013 levels as a result of intensive recruitment particularly for the wards. The HV student programme is now delivering the autumn cohort of conversion from students.

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Headline HR KPIs - Sickness

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Sickness Reasons

Stress/anxiety/depression as the main reason for absence has dropped since last month whilst musculoskeletal problems have increased – the two sometimes present for the same issue.

Pregnancy related issues and heart conditions have dropped out of the top 10 reasons to be replaced by ENT and coughs, colds etc. In addition chest and respiratory problems have increased and these developments are to be expected at this time of the year.

Discussion is taking place with Occupational Health about further programmes to address stress issues. 43 staff attended the pilot stress management courses held in the spring.

Short Term Sickness

After a short lived drop October saw an increase in short term sickness, 1.05% compared to 0.67% in September. This is visible across all Directorates.

The top 2 reasons for short term sickness are Gastrointestinal 22.3% and Cold/Cough/Flu 20.5%.

HR are exploring costs and benefits of using a scheme such as First Care which is the first point of call for sickness absence reporting.

Sickness

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Actions concerning these areas include: informal and formal capability (health) processes; regular reporting to managers where there are high levels of short term absence; ill-health dismissal and formal and informal absence management training.

Turnover

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Last month we reported on reasons for leaving as reported on leaver forms; the chart attached provides further detail from completed exit questionnaires. It should be noted that from 1 April 2014 only 13.7% of leavers have completed an exit questionnaire as the majority of leavers cannot be persuaded to complete the short questionnaire. This data should therefore be treated as indicative only. As previously reported promotion is the recurring reason for perhaps avoidable leaving and relocation as an unavoidable reason.Discussion has taken place about the promotion issue; along with work on the PDR format and the link to increments Learning and Development are working on a structure for succession planning .

Leavers were as follows:

Directorate Performance – Headlines

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Directorate Performance – Headlines

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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 CYP Dental – there have been 14 leavers in the service so far this year, of which a total of 5 have left in the last two months via proactive management of situations. 

In Adults turnover in Psychological Therapies will fall – whilst the 25 new trainees taken on in September are recruited agency staff are used; the next round of recruitment will start in April 2015 and HR will work with the service to improve the process and give places to local staff who will be more likely to stay with the service.

In Older Adults turnover is high amongst unqualified nurses because of lack of career progression – the job description will be reviewed an the career development issue will be discussed with Learning and Development.

 Bank and AgencyIn CYP at Marlborough House Swindon recruiting to full establishment is taking place and 9 HCA’s are under offer, 1 Housekeeper is also at offer stage and 3 Staff Nurse posts have been advertised with a closing date of 11 Nov.  Marlborough House is experiencing problems getting agency staff from the preferred supplier and is using pro-health at an expensive rate – the issue is being progressed.In the Community Team – the balance relates to the Community Team needing to support a YP on an Adult Ward until a YP bed could be found. In Cotswold House the new Matron has discovered shifts are not always covered appropriately and to safe staffing levels.  This is being addressed short term through sessional cover when possible, alternatively via bank or agency, explaining the rise in costs.  Longer term recruitment is in hand to fill vacancies. At Highfield, Oxford full establishment has not been recruited to; a significant number of new staff are expected to start September/October; following a settling in period agency use is expected to decrease.  There is currently one demanding patient on unit requiring additional staffing; 2 members of staff are long term sick; there is one return to work supporting  a return to work following long term sick. One locum is to cover a member of staff who is on  compassionate leave and annual leave. 

Directorate Performance – Headlines

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In Adults Doctor agency spend is the main reason for high bank and agency. This is a combination of sickness and vacancies; 3 Specialist doctors, one consultant for early intervention, 5 PAs for AMHT are all in the process of being recruited and one redeployment will replace a locum.

In Older Adults whilst community nursing turnover and sickness are high bank and agency are not significantly above limit because of use of additional hours and re-allocation of work. However until earlier this year bank and agency usage in CN was very low. Vacancies are driven by Abingdon where there will be a number of new starters shortly. The drive for greater productivity in Older Adults has surfaced a number of capability and sickness absence cases which is reflected in the casework database.

In Corporate vacancies are high in Strategy and Development (Oxford Pharmacy Store) and bank and agency is correspondinglyhigh – practice is being discussed with the manager.

Sickness Absence In Older Adults sickness continues to be above the Trust target across the Directorate with 36 individuals being supported under The Trust’s absence management process. The Directorate will work with Occupational Health and HR to develop ways to deliver faster support to staff members through physiotherapy and Talking Space services.

In Corporate sickness absence management training has been arranged for Estates and Facilities managers. Sickness absence management training has also been delivered to the Pharmacy Department as there are a number of sickness absence cases and referrals to Occ Health are awaited. High sickness in Strategy and Development (OPS) is skewed because of small numbers and represents one formal capability (health) case only

In Adults the high levels of casework and recruitment are taking priority over sickness absence management.

 

Directorate Performance – HeadlinesIn CYP specifically Dental most of the sickness is long term that has been managed and is waiting to reach end dates.  There were 9 staff on long term sickness absence in October. There is currently one long term sickness absence remaining in November which is pending Occ Health input for proposed ill health retirement. Of the other eight, 4 have returned, 2 have resigned and there have been 2 ill health dismissals.

VacanciesIn Older Adults specifically Urgent Care – recruitment is in progress for circa 24 vacancies in the service. The budget indicates that there 34 vacancies in total across Urgent Care. The variance is mainly around Hospital At Home which has approx. 6 vacancies which are not being filled at present. The H@H service is over-performing on its contract and the Service Head will consider whether these vacancies need to be filled or can be counted as cost savings. In Community Hospitals – recruitment is in progress for circa 44 vacancies in the service. The Recruitment Action Plan will address some of the recruitment difficulties experienced in the service. In Older Adult Mental Health – recruitment is in progress for circa 36 vacancies.

In Corporate specifically in Estates and Facilities some vacancies are being held or recruited to temporarily pending organisational change. In procurement agency staff have terminated but recruitment to permanent posts has not been successful.

In Adults 3 local recruitment events were held over the summer and there are plans for HCA recruitment in Oxford on the 29th November. Staff Nurse local recruitment is scheduled for 15th Jan.  HR are leading a recruitment project with 2 members of operational management to improve recruitment into the Inpatient areas and those services that present operational risk. The first meeting is scheduled for the 12th November and approval for changing the advertising is being sought. Recruiting at weekends is being carried out to improve attendance and the Directorate is holding a number of monthly recruitment events to improve effectiveness and efficiency. Recruitment processes will be analysed to see where blockages are occurring and to prepare a strategy for hard to fill roles and areas of poor retention.

In CYP Medical vacancies are being recruited to and the interviews are on 18th Nov, 4 candidates have confirmed which is encouraging.

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Recruitment DataThe number of new vacancies for the month of October remains high but steady as it has not increased since September.  The number of live vacancies remain high as the candidates that were appointed during the busy period of the summer are continuing through the pre-employment check process/notice period before they are able to start. 

The number of applications has increased slightly which is seasonal as the autumn sees those staff that are due to qualify in January applying for roles as well as candidates wishing to obtain new roles before the pressure of Christmas is with us.

Value Based Interviewing ProjectThree post grad students from the Said Business School have been enlisted to helping to produce a draft behavioural framework.  They are presenting this to HR early November. The Senior HR Business Partner (Recruitment) is attending a train the trainer session at NHS Employers in Leeds in early November.   A package of support materials will be made available to us to enable us to roll out training to other in-house trainers. Recruitment Plan The recruitment action planning group is meeting for the first time early November to refine the action plan and to agree on quick wins and an implementation plan.

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Casework Data

There are currently 5 Whistleblowing cases with 1 new case opened in October. Only this ward features in the amber list for staffing ; however 4 of the 5 are showing in the highest sickness rates for the Directorate vacancies and all but 1 have high rates of vacancies with correspondingly high usage of bank/agency and sessional.

11 members of staff are currently suspended whilst investigations take place which equates to 0.17% of staff.

The majority of the capability- ill health cases are in Older Adults where sickness absence is highest. The majority of disciplinary cases are in the Adults Directorate where the focus is currently on performance rather than absence.

Casework Data

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By comparison with 2013 casework in all the main areas is showing considerable improvement.

Policies for Capability, Grievance and Disciplinary are being further reviewed to streamline processes which will contribute to casework times improving further along with consideration of the optimum way of engaging and freeing up investigators.