Workforce Performance ReportJanuary 2015

Jayne HalfordDeputy Director of HR

Caring, safe and excellent1

Headline HR KPIsTurnover – Target 12% - Actual 12.79 % Turnover is down this month from last month and at its lowest level since June 2014. Next month will show if this is a continuingdownward trend.Sickness – Target 3.5% - Actual 4.66%Although the trend October – Jan is a mirror image for 13/14 the current sickness of 4.66% is the highest rate for the last 4 financial years. Hot spots are Urgent Care 8.16%, Community Nursing 7.22%, Countywide Services 6.91%  and Older Adults MH 6.89%.FirstCare – a triage solution for managing sickness absence is still under consideration.Bank and Agency- Limit 5% Actual 6.5 %At 6.5% bank and agency is 0.1% lower than in December 2014 and below the 7.4% high of October 2014. Oxon Clinical Pathway is particularly high at 18.5% whilst community hospitals have decreased usage by 50% over last month and FinancePerformance contracts have also decreased usage but Strategy and Development have increased usage again to its highest level. Sessional usage at 2.4% is slightly down on previous months. Vacancies: Limit 9% - Actual 5.2%Vacancy levels have decreased again by 0.1%to the lowest level since June 2014; as can be seen on the Resourcing slides there is continued intensive recruitment activity with work continuing on the brand and varied recruitment campaigns. Whilst vacancy rates have improved the worsening turnover and sickness have contributed to the increased bank and agency spend together with increased complexity of patients. Headcount has been stable for the last 3 months at just under 6,200 and has been under 6,200 since March 2014.

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Headline HR KPIs - Sickness

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Sickness Reasons

Given the season it is no surprise that coughs, colds and flu have increased as one of the main causes of absence (up from 11.41% in November). Coughs, colds etc are at 38.54% of short-term sickness absence with gastro-issues at 12% and chest infections at 8.32%. Public Health England in their weekly reporting show influenza at a peak in December, stabilising through January and into early February.

This means that stress as a reason has decreased from a high of 23.79% in November but see below for long term absences.

Long Term Sickness

This graph shows reasons for long-term absence. Whilst seasonal conditions are in evidence Anxiety/Depression continues to be overwhelmingly the main reason for absence.

The Office for National Statistics Report on Sickness in the Labour Market 2014 states that more sickness absence days were lost to back, neck and muscle pain than any other cause followed by coughs and colds (the most common reason for sickness absence) and stress, anxiety and depression and that of the larger public sector organisations sickness absence rates are highest for those working in the health sector.

Directorate Performance – Headlines

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C&YP Directorate :

Sickness 3.33% V 3.5% Target Sickness absence has seen an increase from last month of 0.43%. Long term absence is currently 1.39% - an Increase from last month of 0.15%. This equates to WTE days 1107 lost (last month 929). Top reasons for sickness absence in CYP are : •Cold, Cough, Flu 18.42% (last month 10.46%)•Anxiety and Stress 16.39% (last month 26.91%)•Gastrointestinal problems 11.14% (last month 13.61%) The overall trend since April 14 has continued to be significantly below trust target. Sickness absence is being managed in line with support from Occupational Health; we have seen a number of successful returns to work plans in December/January.

Turnover 11.7% V 12.0% Target •We have seen a slight decrease in turnover from last month of 0.29%, turnover remains lowest % across all Directorates except Corporate. Highest turnover is within Dental Services at 21.38% (last month 21.56%) followed by Swindon, Wilts and Banes at 13.5% (last month 13.16%) and Complex Care at 12.4% (last month 12.47%). •To note sickness has steadily and consistently reduced within the Dental service from 12% in April to the 4.23% and the management of sickness issues are represented in the turnover figures.

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Directorate Performance

C&YP continued:

Bank & Agency 5.1% V 5.0% limit •Overall, Agency accounts for 4.9%: the highest users of agency are within CYP Specialist Services (includes 2 Oxford inpatient units) with Bank & Agency at 10.8% (last month 9.6%). Cotswold House Oxford will see a spike in staff/agency due to the admittance of a number of high dependency patients week commencing 2 Feb 15 which will require extra staff levels. Since December the Ward has been supporting a number of patients on level 3 and 5, all requiring extra staff. The appointment of new sessional contracts will help ease the level of agency and bank spend.•Medical agency remains high due to sickness absence/requirement of reasonable adjustments.

Change Management:•HR has input to and are supporting a number of re- tender/TUPE processes, namely Buckinghamshire CAMHS, Dental Services in Leicester & Nottingham, Smoking Cessation Service to a private provider, Paediatric Liaison to the OUH and Wiltshire Community Services.

Vacancies 3.9% v limit 9%

•The majority of vacancies are in the inpatient wards and community teams. Five nurses have been offered posts as a result of a recent open day for Boundary Brook House. An open day is taking place for nursing staff for the Highfield Unit and we are hopeful of filling a number of vacancies.•The most problematic area is recruiting nurses to the Community Team. Respite nurses are difficult to find. •Recruitment to student health visitor posts and student health nurses is taking place at the beginning of March. 

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Directorate Performance

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Directorate Performance Older Peoples Directorate

Turnover: 13.66% v 12% Target•Staff turnover in the Directorate continues to be high. In this period, there were 32 leavers across the Directorate including three dismissals, three retirements, two end of bank contracts and 24 resignations. 40% of those who resigned cited Work/Life Balance as the reason for their resignation. •Community Nursing continues to have the highest turnover in the Directorate at 16.65%. This continues to be monitored by the service and exit interviews offered.•Further analysis of the reasons for staff leaving the Directorate will be looked into. •Turnover in Older People’s Mental Health was also high in January – 14.49% (due to 2 resignations and 2 retirements). Sickness: 6.64% v 3.5% Target•There was an increase in sickness absence from 5.47% last month to 6.64%. Increases in short, medium and long term absence were all recorded. However more short term absence was recorded than had existed in the previous two months.•Sickness Absence in Urgent Care has increased to 8.16% (from 4.77% last month). This reflects long term absence which is specifically within the Witney EMU, this is being managed in line with the formal policy.•Countywide services continues to have high sickness levels particularly within the Reablement service at 14.2%. Management of sickness absence continues to be a priority in this area.•The main reasons for absence in the directorate continue to be:

– Anxiety and Stress – 21.46 % (last month 25.19%)– Muscoskeletal (MSK) problems 19.21% (last month 14.99%)– A specific pilot project looking at fast tracking physiotherapy for staff experience MSK problems is in the

process of being planned and should be in place by the beginning of March.

 

Directorate Performance Older Peoples Directorate Contd.

Bank and Agency - 6% v 5% limit•There was a slight decrease in Bank and Agency Spend from 7.07% to 6%.

•Bank and Agency is still high specifically in Urgent Care and Community Hospitals. One of the key reasons for high levels in Community Hospitals is the level of patient acuity continues to be high. However this is reviewed as patients are discharged.

•Recruitment in Community Hospitals and Community Nursing has resulted in increased staffing levels which is having a positive impact on bank and agency usage.   Organisational Change:•A new structure for 8a and 8b operational roles has been implemented within Older People’s Directorate in January. In addition integrated Locality Teams have been implemented in January resulting in Community Nursing, Therapy Services and Reablement working closely together. This has coincided with weekend working been introduced for Therapy services.

 Vacancies – 9.6% v 9% limit•Community Hospitals - Vacancies for registered nurses are spread across all the hospitals. There is a constant struggle for recruitment to keep up with turnover rates. Some of the hospitals are difficult to recruit to because of their remote geographic location. All 15 vacant posts for HCA’s have been offered and candidates are going through recruitment checks.

•Community nursing – historically this is a difficult to recruit to area. In particular we struggle to recruit in the City, South East and South West although there has been a small rise in applications in recent months.

•Other areas where we struggle to recruit are Band 2 posts in Reablement due to the nature and structure of the role; nursing staff for the Community Mental Health Teams in Bucks due to proximity to London; and nursing posts within Urgent Care. 

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Directorate Performance

Corporate Directorates :

Turnover 11.12% V 12.0% Target Staff turnover was down in most areas and below the trust target. An increase in turnover in the Strategy and Development department was the result of one leaver in OPS and 1 temp ended their contract in Research and Development. In the CEO office one individual left as a result of failing the probationary period.

Sickness  2.5% V 3.5% Target Sickness is at its lowest level since February 2014, bucking the seasonal trend. The sickness figures for the Medical Director department reflect some long term sickness for individuals on nil pay within CPSU pharmacy. Similarly the sickness figures in Strategy and Development department mostly reflects a long term sickness case on nil pay.

Bank & Agency r 4.7% V 5.0% limit Strategy and Development: Agency is this department has increased month on month. A plan has been agreed to employ agency staff where budgeted and where appropriate.

Organisational change: The organisational change paper for the Estates and Facilities department for the soft FM services went to SPNCC for the consultation to commence Monday 2nd March.

Vacancies -22.8% v limit 9%•There are a few difficult to fill posts within Corporate services: we are struggling to recruit to a procurement management post and to senior informatics posts. We are looking into advertising on specialist websites. •We are struggling to recruit to B7 & B6 Occupational health nurse posts despite offering a substantial recruitment and retention premium. This reflects a national shortage of these skills.•We continue to look at other ways of advertising for domestic assistants.

Directorate Performance

Adults Directorate Turnover 13.4 V target 12% •There has been a slight decrease mainly due to the 12 month trend from Psychological Therapies decreasing after a peak in Sept 14. The PWP recruitment cycle started again in February for Bucks and 8 new roles have been offered so the downward trend will reverse when they start in April . Inpatient wards continue to have the highest turnover and although recruitment is our highest priority at the moment, we are encouraging the Operational Management to develop a retention strategy. HR will support with a plan to increase the use of the exit data questionnaire.  

Sickness 4.44% V Target 3.5% •There has been a slight decrease from December 2014 mainly due to an improvement in the Service Delivery and Development team. Sickness remains high on inpatient wards with an increase in colds and flu which is predictable at this time of year. Long term sickness cases are being managed with support from Occupational Health.  

Bank & Agency 9.1 V limit 5% •The use of bank and agency has increased significantly since December 2014 mainly in the Clinical Pathways in Bucks and Oxford. Forensic services used very little Bank or Agency in January with some inpatient wards being up to establishment and Kennett not able to get agency support to fill short notice shifts.  There are a high number of Inpatient vacancies at Band 6, 5 & 3 and hard to fill Band 6 roles in the Community. Recruitment events are being held regularly and in January we specifically targeted student nurses qualifying in July 2015, inpatient staff nurses and HCA’s.   Bank & Agency use is appropriate for the known vacancies and increased sickness on the inpatient wards where,  due to safer staffing requirements shifts have to be filled through sessional, NHSP or as a last resort agency staff. Agencies are used for longer term cover in the Community to ensure that caseloads are manageable while recruitment is undertaken. Hard to fill roles are being addressed through targeted recruitment and discussions are taking place regarding rotation placements.  10

Directorate Performance

Adults Directorate

Vacancies 7.9% v limit 9%

•Vacancies within Oxford Inpatients remains high although a recent successful open day held at the Warneford has seen 5 nurses being offered posts and 11 HCA’s. Further interviews from contacts from the open day are taking place w/c 16 February. There is difficulty recruiting to the deputy ward manager roles. Job adverts are currently being revamped for these posts.

•Following a recent open day, Thames House have invited 7 nurses and 8 HCAs to attend interview.

•AMHT’s – there are ongoing difficulties in recruiting B6 Care Coordinators and Night Assessment Workers particularly in Oxford City due to the nature of the work. We continue to think of new ways to attract staff. These roles are currently out to advert. 

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Directorate Performance

As described last month the following graphs are available to drill down into specific areas.

As we can see from the Kestrel figures vacancies have been relatively consistent as has sessional and bank usage although there is an increase corresponding with increased sickness in September and December. Therefore what has to be considered are other factors such as patient acuity, holidays, study leave etc

For Urgent Care vacancies are not high but increased bank/agency mirrors an increase in sickness from September.

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Directorate Performance

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WTE Differences By Subjective

AbsenceAgency/Bank/ Sessional Spend

Kingfisher AAFP07

Directorate Performance

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WTE Differences By Subjective

AbsenceAgency/Bank/ Sessional Spend

Urgent Care WVIE04

Recruitment DataJanuary has seen an increase in live adverts as vacancies that were not advertised during the Christmas period have now been published.  There has been an increase in applications received as is expected in January as people tend to think “new year, new job” .

Values Based RecruitmentThe Values Based Framework is still to be given final approval from the Exec Team before launching. Positive feedback was received from SPNCC. Work continues on updating recruitment materials. Recruitment Action PlanWork has progressed on identifying available staff accommodation and a revised accommodation policy regarding allocation has been drafted by Estates colleagues. Detailed work continues on identifying improvements to the current recruitment process. We have attended six different recruitment fairs/open days with some success in attracting candidates for hard to fill vacancies.

In addition further analysis of leaver data is underway to aid consideration of pre-emptive recruitment i.e. to have recruits lined up to backfill vacancies.

Event Date FeedbackMilton Keynes 23rd January 2015

10am-6pmWell attended event. Spoke with over 100 attendees, obtained details for 86 attendees. Mainly HCA/Support Worker and Administration interest. Small number of clinical attendance, mixture of Nursing and Therapy. Contact made with all applicants seen on the day. Follow up to be diarised.

Milton Keynes 24th January 201510am-6pm

Cherwell School

22nd January 20156pm-8pm

Well attended by pupils and parents. Spoke with over 20 pupils. Interest in medical career, GP and Psychiatry. Useful to have RS in attendance due to the questions asked. Learnt that pupils had used our services which stemmed their interest.

Warneford Hospital 24th January 201512pm-5pm

54 people attended, 16 were nurses and 38 were HCAs5 Staff Nurses offered roles, 1 unsuccessful, 11 to be interviewed over the next 2 weeks13 HCAs offered, 3 unsuccessful, 22 to be interviewed over the next 2 weeks

Warneford Hospital 28th January 20152pm-6pm

Saw 4 people in total. Nobody interviewed on the day.Shortlisted to interview WC 9th February. 16

Recruitment Data

Job Fairs – January and February

Westfields, London 6th February 201510am-7pm

 We saw over 100 jobseekers in all across the 2 days Mainly Administration candidates, very little clinical staff. Minimal interest in relocation/accommodation. Provided lots of advice to those looking to get into the NHS or school leavers with parents looking for advice about various options.

Westfields, London 7th February 201510am-7pm

As above

Highfield 12th February 20152.00pm-7.00pm

TBA in next months report

Whiteleaf 28th February 2015 TBA in next Months report

Oxford Town Hall (Admin and HCA’s)

4th March 201510am-3pm

TBA in March Report

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Recruitment Data

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Casework

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Casework

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Casework

Overall the casework duration has improved again in all but whistleblowing and performance (capability).

At 94 cases there are 3 fewer cases than last month.

Childrens and Families HR are currently managing 9 formal cases (a decrease of 2 since last month), which consist of 2 disciplinary matters, 5 capabilities (3 of which relate to Health) and 2 Bullying & Harassment. One performance capability is in abeyance. Neither of the 2 grievances that have been closed were upheld and decisions were not appealed. There are no current ET claims or suspensions.HR continues to work closely with managers, support is also being provided regarding informal matters some of which are of a complex nature.

CorporateHR are currently managing 16 cases of ( which 10 relate to health) There have been 2 new cases this month, a complaint and a grievance. These are being managed with HR support.

Older Peoples DirectorateHR are currently managing 55 formal cases which consist of 8 disciplinary matters, 35 capabilities (31 of which related to Health) and 1 Bullying & Harassment, 7 Grievances, 3 Grievance Appeals and there is 1 current ET claim. 8 formal cases have been closed in January.

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Casework

Casework Adults 

•Bucks 3 Disciplinaries.  2 have dates for hearings in February and March. One is adjourned for an OH appointment•Bucks 2 Conduct Safeguarding – hearing scheduled in February•Bucks 1 Conduct Other – On maternity leave• •Oxford 2 Whistleblowing – one complete waiting to be presented to Exec Team. One being investigated outside Directorate, report being written•Oxford 1 Grievance Hearing on 10 Feb. 15 Specialised •6 Disciplinaries – 3 have hearings scheduled•1 Appeal held on 9/2•1 Conduct Safeguarding•1 Whistleblowing completed waiting for action plan to be signed off by Exec Team 

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Oxford Health NHS FT is going smoke free•Oxford Health NHS FT will be smoke free from 2 March 2015 across all its sites. •From 2 March smoking will not be allowed in any of the trust’s buildings or within any of its grounds and this will apply to all staff, patients and members of the public visiting our sites. •Under the new policy, staff will no longer be allowed to take “smoking breaks” and staff who wish to smoke whilst on duty will have to do so within their allocated breaks. •Smoking cessation advice and support is available for both patients and members of staff.

Oxon Bikes (similar set-up to Boris Bikes)We entered 3 bids to Oxfordshire County Council for their Local Sustainable Transport Fund from the Department for Transport in December 2014. We were awarded funding for Littlemore (5 bikes ), Chancellor Court (5 bikes) and Warneford (12 bikes)We are hoping that these will be installed and ready for staff to use from April 2015.

Benefits•The introduction of OxonBikes will help encourage and support staff to make healthier choices when travelling between sites. •As well as improving staff physical and mental health, increased use of cycling will help reduce the significant congestion around our sites. •Cycling is an efficient, economic and environmentally sustainable travel choice, in line with the Trust’s Travel Plan and Environmental Policy.

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Staff Health and Wellbeing

Occupational Health

KPI’s for January 2015 –

68% of referrals were seen within 10 days and the average amount of days between attendance and dispatch of the report is 2.35 days.  In addition to the above appointments the following activities were undertaken: •Drop-in Flu clinics daily at Littlemore. Currently 63.2% of front line staff to date have been vaccinated.

•Partnership working with Older Peoples Directorate re Fast track Physiotherapy pilot is in progress with commencement due in February/March 2015.

Slide 3 demonstrates the increased workload taken on by the Occupational Health Department with immunisations and work health assessments (pre-employment) providing the highest numbers of work items.

Occupational Health

Occupational Health

2012 2013 2014 2015 13-14 % inc 14-15% incJanuary 512 1019 2058 50%February 561 857 65%March 491 1029 48%April 263 523 949 55%May 470 670 1002 67%June 453 690 1183 58%July 452 741 1353 55%August 353 582 1229 47%September 461 627 1592 39%October 834 698 1537 45%November 785 719 1544 47%December 467 574 2115 56%

2013 2014 2015 13-14%inc 14-15%inc

January 512 1019 2058 99% 102%

February 561 857 53%

March 491 1029 110%

April 523 949 81%

May 670 1002 50%

June 690 1183 71%

July 741 1353 83%

August 582 1229 111%

September 627 1592 154%

October 698 1537 120%

November 719 1544 115%

December 574 2115 268%

Occupational Health