Workforce Performance ReportApril 2013

Jayne HalfordDeputy Director of HR

Caring, safe and excellent1

SPECIALIST MENTAL HEALTH SERVICES - PERFORMANCE AGAINST TARGET – ALL INDICATORS

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SPECIALIST MENTAL HEALTH SERVICES - PERFORMANCE AGAINST TARGET - ALL INDICATORS

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Analysis/Actions being taken by the HR Team in Month

Turnover

• The 3 month trend in turnover remains constant at a little over 10.5%. • The Bucks Adults of Working age wards remain high at 14% but a change in management in Mandalay ward at the end of March means that we will

monitor to see if this decreases.• Bucks Older Adults turnover trend remains very low at 4.5% and this may create difficulties when closing an OA ward and Day hospitals are part of the

Service remodelling.

Sickness

• The trend for overall sickness has reduced monthly since February but the long term sickness levels remain fairly constant at around 2.4% despite a number of 4 medical discharge cases.

• Oxford Older Adult wards has historically high levels of long term sickness which is being addressed by the management and HR team. This has resulted in 2 medical discharges and a resignation in April.

• There are now 2 cases where staff have been absent for over 365 days and these are in process for medical discharge panels.• Monthly meetings are held between ward managers and the HR team to discuss sickness cases and all staff who have met the trigger points are actively

managed.• High sickness in the community is dominated by a small number of teams and the main reason for sickness is anxiety/stress/depression/other psychiatric

illnesses. Management is those teams has been strengthened or supported by the Service Managers, the use of triggers reinforced and referrals to Occupational Health increased.

 

Bank and Agency

• Both bank and agency and sessional costs have increased month on month due to the ward shortages. • NHSP were unable to fill 43% of shifts in Feb, 34% in March and 33% in April.  As Mental Health has not historically been included on the NHS/ agency

agreement either the shifts remain unfilled or the use of sessional staff increases which can result in increased sickness. The Adult wards are booking short contract agency staff for the first time because NHSP cannot be relied upon to fill shifts. We will work with Procurement to ensure we are offered preferential rates by using agencies on the framework.

 

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Vacancies: • With a budgeted establishment of 1,144 the Mental Health Division has a headcount of 1,240 (includes staff seconded

from Oxford and Bucks County Councils) and vacancies of 131• Of the 131 vacancies 64 have been recruited to and are in the pipeline moving towards a start date. In addition 17

candidates have been interviewed and made job offers• In the last 3 months 55 staff have started in MH and 49 have left.• In particular In patient wards have been particularly short of staff and HR has facilitated a pilot of central recruitment.• The response from the last round of central recruitment resulted in over 400 applications • The feedback from the managers was that the shortlisting was appropriate but there is still an issue with candidates

who withdraw from the interview at the last moment or do not attend. Some of this may be due to the time between shortlisting and the interview and this area is being focused on for further measurement and improvement.

• The quality of candidates who did attend was high and managers were able to make job offers against all their current vacancies.

• The HR team attended workshops in Oxford and Bucks for Mental Health trainees who will qualify in Sept 13. We facilitated sessions on recruitment and selection and made contacts with potential candidates. We have also supported the Modern Matrons in arranging sessional contracts for trainees on ward placements who have shown potential and by getting an agreed Patient and Personal Safety Training (PPST) place.

• The Crisis team have had difficulty in recruiting suitable staff to the Band 6 CPN role and HR are supporting them by improving the advert and getting costing for advertising outside of NHS jobs if required

• The timeliness of CRB checks are much improved as is the process for taking and receiving appropriate references. Delays now are generally because the candidate only gives in their notice when all checks have been completed.  

• The HR team are supporting new and inexperienced managers by sitting on interview panels where appropriate

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SPECIALIST MENTAL HEALTH SERVICES - PERFORMANCE AGAINST TARGET - ALL INDICATORS

OXFORDSHIRE COMMUNITY SERVICES – PERFORMANCE AGAINST TARGET – ALL INDICATORS

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OXFORDSHIRE COMMUNITY SERVICES – PERFORMANCE AGAINST TARGET - ALL INDICATORS

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ANALYSIS: Turnover • The Division is slightly above Trust target at 12.6%: there is variation across the services with Turnover being highest in the Community Nursing teams at

14.7% and lowest in Urgent Care at 6.2%;• The Overall turnover for Community Nursing teams is 14.7%, however there are particular hotspots with the West locality being at 25.8% and the South

East locality 24.4%. The HR team will be reviewing staff survey results, which have now been circulated to the Division, with Heads of Service to inform local action plans;

• A meeting has been held between HR and managers from the Community Nursing teams to clarify and consolidate understanding of the BARM data and ensure that the managers are committed to using this data to drive improvement action plans;

Sickness• Sickness remains above Trust target in all areas of the Division apart from Oxon Community Management and is highest within Community Nursing

teams at 5.6%.• Training in short term sickness absence management for the Band 6/7s in the Community Nursing teams has been scheduled and training has already

been delivered to North East, South East (May) and Oxford City Localities. Training is booked for the North locality (in May) and we are in the process of arranging training for the South West locality.

• HR have met with the management team for the South East Community Nursing teams to discuss the management of individual cases and a plan of how to raise awareness of sickness absence and its impact amongst the employees in their teams.

• There are now 12 cases going through the formal Capability process relating to sickness absence and ill health – this includes 7 staff who are in their notice period.

• The main reason for sickness absence in Community remains MSK and HR are working closely with Occupational Health to review these cases.

Bank and Agency• Bank and Agency usage is below Trust target and usage continues to be predominantly within Community hospitals, who used 42 shifts during the week

ending 5th May 2013, representing 24% of the shifts used.• Townlands and Wallingford Community Hospitals have been the highest users during the week reported on, with Vacancy being recorded as the

predominant reason for use: this does not tally with recorded recruitment vacancies and HR is reminding managers of the need to accurately record reasons for Agency use so that reasons for usage can be more usefully monitored to inform any management actions required

• Agency levels have fallen in recent weeks as the need for escalation beds has reduced in Community hospitals;• .NHSP fill rates for shifts remains low and shifts are being cascaded to other Agencies. The problems have been discussed and reviewed with NHSP

who will place a dedicated advert for Community services.

Vacancies:•  The number of vacancies is currently 158 of which 75 are at offer and 33 are cleared to start.• HR/Recruitment are proactively reviewing occasions where there is a delay between candidates being cleared to start and the manager agreeing a start

date with the candidate. Where there are significant or repeated delays, this information will be discussed with Heads of Service to try and minimise delays. HR will continue to monitor the timescales associated with recruitment campaigns and will review all reasons for delays.

CHILDRENS & FAMILIES SERVICES – PERFORMANCE AGAINST TARGET - ALL INDICATORS

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CHILDRENS & FAMILIES SERVICES – PERFORMANCE AGAINST TARGET– ALL INDICATORS

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Analysis/Actions being taken by the HR Team in Month Turnover • The current turnover is 13.1% which is above the trust target of 12%. Although we have seen a reduction from last month (13.45) of 0.35%, has stabilised

over the previous 3 months and not significantly increased since August 2012.• T4 inpatients remains high at 18.48% with 2 leavers in April.• Highfield Oxford turnover has stabilised over the last 4 months. The new working environment, well trained staff should reflect a continued reduction in

turnover over the next quarter.• Highfield Swindon has again stabilised over the previous 2 months.• Community Cahms are above trust target at just below 14%. HR actions will break down and provide an analysis by services. Reporting next month • Psychological Therapies are above target (Healthy Minds & Talking Space), however this has reduced and stable since November 12• Leavers in April totalled 15. Five of which were in Psychological Therapies. A recent organisational change has resulted in a reduction of 8D posts. Two

staff will leave under MARs. HR has had direct input into the consultation, interview and appointment process and will continue to support the embedding of the new structure.

 Sickness • The trend for overall sickness has been consistently below trust target since March 2012. Currently 3.07% which is the lowest across all Divisions.• Long term absence accounts for 1.57%. A proactive and collaborative approach to managing sickness absence has significantly reduced absence in

Highfield Oxford’s long term sickness , which relates to one individual who has since returned to work, and one person has resigned. Highfield Swindon has reduced to short sickness only.

• Eating Disorders & Oxon Childrens and Families have the highest %(3.30%) followed by Eating disorders (2.4%). Begin tumours are a primary reason for absence. HR and OH are supporting staff and managers.

• Eating disorders Cotswold House, Marlborough all long term, but accounts for one individual and we are supporting through OH and expect a return to work in June.

• We have also seen a reduction of long term sickness within Psychological Therapies • Community Camhs – has seen a decrease but long term medic sickness has contributed to % figures. Sickness absence was as a result of open ended

recording in ESR, this has been amended.• Direct HR involvement and support to managers and staff have resulted in the 9 staff who are either approaching a ½ or nil pay situation 2 are being

supported through medical discharge, 4 have returned to work, the remainder are awaiting OH guidance.

CHILDRENS & FAMILIES SERVICES – PERFORMANCE AGAINST TARGET – ALL INDICATORS

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Bank & Agency • Overall the 3 month trend has been below trust target. Currently running at 2.57% which is below trust target. • All services below trust target with the exception of Tier 4 (inpatient) Camhs e.g. 10.2% agency and 3.2% bank ( 13.4%). However this has reduced from

last month by 0.8% and 1.0% respectively. Agency usage was up in Highfield Oxford due to all staffing requiring training on new unit and new starters.• Cotswold House Oxford are using agency to cover ancillary posts (.95 wte) this should decrease next month due to one resignation and the return of

med/long term sickness cases.• Oxon Children and Families, main use of agency/bank are Paediatric SaLT at 3.01%.• HR provide surgeries/hot desk across sites, attend Modern Matron meetings, local intelligence and feedback is NHSP are not reliable and staff cancel

shifts at short notice and are not able to provide staff across Swindon/Wilts and BaNES area. A review is currently underway. In the meanwhile HR actions have ensured safer recruitment principles are in place.

•  Vacancies

• The budgeted establishment is 1,169 with a headcount of 152. Vacancy activity is currently 154• Of the 154 vacancies 7 are at the interview stage, 95 offers have been accepted, 21 cleared and 12 have an agreed start date• HR have provided bespoke training to managers and recently attended the modern matrons meeting. Feedback has been positive, however further

suggestions around recruitment forms in particular duplication of information will be taken forward.• Reference checking within C&F continues to be a challenging aspect of the process, HR continue to work with managers to expedite start dates, a flow

chart of responsibilities and offers of further training to managers have been provided.• Recruitment within the CaSH service has been difficult due to lack of qualified candidates; HR will work with Service Head to indentify internal

training/grow our own staff strategies.  Other • In patient pilot Costwold House no major concerns reported. Meetings are monthly, managers sharing comments book from staff with working group 14

May 13. Local feedback to date is similar to the community pilot e.g. staff are tired on long shifts and working patterns are beginning to impact on staffs days off.

• Staff Survey Local action plans have been updated in light of 2012 survey results and will be shared with the HWB group and cascaded to managers to share with

staff. Main areas relate to previous years and will continue to focus on staff working excess hours/team working.

SPECIALISED SERVICES – PERFORMANCE AGAINST TARGET - ALL INDICATORS

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SPECIALISED SERVICES – PERFORMANCE AGAINST TARGET - ALL INDICATORS

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Analysis/Actions being taken by the HR Team in Month

Turnover

• The turnover rate is above target at 15.3%• This is mainly driven by the planned removal of Bullingdon Healthcare staff from the payroll following the transfer of the service to the private sector. This explains the very high turnover rate of 46.5% in Prison Healthcare services. Whilst technically correct a more accurate measure would be to have excluded the Bullingdon leavers as the turnover in Huntercombe is below target• The Forensic Mental Health Services are also slightly above target. The Division is aware of turnover / retention concerns in Thames House. The HR team has sent the Head of Low Secure Service a report and recommendations. These will be included in the Operational Plan to review the recruitment and selection processes in the unit• Turnover will continue to be monitored by the HR team and further action plans developed as necessary

Sickness

• The trend for overall sickness has reduced monthly since February. However at 4.8% absence levels remain above target• The Forensic Services remain above target at 5.2%. This is largely attributable to long term absences. 2 staff in Medium Secure wards Kennet and Watling result from assaults by patients – appropriate support for those staff members is being provided. A number of other long term cases are due to leave (1 on ill health retirement terms, 1 on MARS) and a number are due to return to work. Therefore we expect the downward trend to continue• There appears to be a number of long term absences attributed to stress & anxiety in one of the Low Secure wards. A report has been requested from Occupational Health and is awaited• The Forensic Services have undertaken a review of the impact of patient mix on sickness absence and therefore bank & agency. The focus has been on, Medium Secure Service (particularly Watling Ward) although the implications could apply in other areas. The conclusion was that managing the patient mix differently could result in a reduction of short term absence. This would need to be taken forward clinically in the services and monitored by HR• The Prison Healthcare Service remains above target at 4.4%. This still includes Bullingdon absences. Huntercombe absence levels are within target and we expect to see a reduction in absence levels over the coming months in Prison Healthcare• Specialised Community Services remains above target at 4.1%. This results from a peak of medium / long term absences in the Salaried Dental Service which do not appear to have any identifiable underlying cause• Sickness absence will continue to be monitored and reviewed with line managers

Bank & Agency

• Use of bank & agency is generally within target in the Division. The Forensic Services prefer the use of sessional staff, although as noted last month this can result in difficulties where the pool of sessional workers is small• April saw an increase in use of bank & agency workers in the Forensic Services. This has been attributed to staff taking their final annual leave (thus reducing the pool of sessional workers) and the fact that Easter fell at the very end of the leave year. All managers should be aware that staff should plan their leave through the year •There appears to be a small increase in use of agency Housekeepers in Low Secure Service. The Recruitment Team will advise the manager that temporary resource of this type can now be supplied through Recruitment Solutions

CORPORATE SERVICES - PERFORMANCE AGAINST TARGET – ALL INDICATORS

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CORPORATE SERVICES – PERFORMANCE AGAINST TARGET – ALL INDICATORS

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Analysis/Actions being taken by the HR Team in Month

Turnover

• The three month trend in Corporate services remains fairly steady at around 11% which is 1% below the Trust target.• Turnover in Facilities is on a slight upward trajectory and remains high at 29%. We are currently working with the management team to establish reasons

why and to put an action plan in place to address this.• Turnover in the Office of the Chief Executive has risen to 16% from a previous steady state of just under 10%. The small number of staff in this area will

skew the percentage. Sickness

• Overall sickness rate although slightly up for the past four months, remains well below target at 2.6%.• Sickness rates in Nursing & Clinical Standards have increased significantly over the past 3 months and are now at 4% above the Trust target of 3.5%. A

long term sick case is being performance managed with the assistance of Occupational Health and the individual has now returned to work. •  Bank & Agency • Overall Bank & Agency spend has come down significantly to just below target at 5.5%.• Pharmacy spend remains above target at 20% which is largely associated with cover at Bullingdon. This spend is expected to come down by September.• Bank & Agency spend in Facilities has been high at 16%. This has been in part due to the department holding vacancies open prior to organisational

change proposed for August/September.

Vacancies

• Vacancy rate within the Corporate Services functions remain low and constant.