Workforce Performance Report March 2015

1. Workforce Performance ReportMarch 2015 Jayne HalfordDeputy Director of HR Caring, safe and excellent

2. Headline HR KPIs Turnover – Target 12% - Actual 13.06% Turnover is back to the highs of summer after a promising decrease – leavers outnumbered starters by 135 to 78 (headcount) in March. As recent analysis has shown that we are able to recruit staff, the focus of the recruitment group is turning to retention measures. Sickness – Target 3.5% - Actual 4.32% Sickness has been falling slightly now for 3 months running and is more in line with the 2014 figure but still slightly above 2013 and 2012. Due to the CIPS position it is unlikely that consideration of the FirstCare system for managing absence will continue. Bank and Agency- Limit 5% Actual 8.1% Bank and agency has shown a significant increase this month; as sickness is down and vacancies have not risen significantly, we expect that the increase in bank and agency is due to end of year catch up with invoices and to the utilisation of annual leave allowance in March (see overleaf). April figures will show whether this was a one off figure. There were similar spikes in 2014 and 2012. Vacancies: Limit 9% - Actual 5.76% Vacancies have been within tolerance for the year and the vacancy rate for the latter part of the year has been well below the limit; analysis has shown that we can recruit but the turnover rate is higher than tolerance and above last year’s figures for the majority of the financial year. The Flexible Recruitment project is underway which will optimise staff allocations to rotas which will lead to reduced agency usage, improved holiday scheduling and improved sickness management. .

3. Headline HR KPIs - Sickness

4. Headline HR KPIs - Sickness One day absences account for over 50% of all short term absence. 21.7% of one day absences occur on Monday. Human Resources teams send out Bradford factor reports each month to managers which show levels of unrelated sickness so that managers can make early interventions to manage sickness appropriately. Human Resources also provide regular training sessions, and ad-hoc sessions for managers on management attendance. The new e-rostering will enable enhanced reporting on for example sickness absence patterns.

5. Directorate Performance – Headlines

6. Directorate Performance Adults Directorate : Turnover 13.7% v 12% target • Turnover remains over target in the Oxon clinical pathway where there are a high number of leavers and staff are being employed externally. Forensic services are also over target and the Heads of Service are working on initiatives to attract and retain staff working in challenging environments such as Thames House and Ashurst PICU. Psychological Therapies has a turnover of 16.3% due the requirement of training places. Sickness 4.56% v 3.5% target • Sickness is over target in the Bucks and Oxon clinical pathways and Forensic services. Bucks Services in particular have had a challenging month with 6.32% sickness of which over 50% is long term sickness. All sickness cases are raised and monitored with line managers with support from Occupational Health. Bank & Agency 10.86% v 5% limit • The use of bank and agency remains high in inpatient areas while successful candidates complete their pre-employment checks, work contractual notice periods and agree start dates. Requests for shifts to be filled by NHSP are never 100% satisfied and where necessary for safer staffing, requests are made to agencies on the framework. • There is a requirement for agency cover in the AMHT Assessment Functions to cover vacancies. The assessment function is a small team of nine staff in each AMHT undertaking all of the assessments both urgent and planned. Where possible managers flex staff between the Treatment and Assessment functions but an agency short term contract is sometimes more appropriate.

7. Directorate Performance Adults continued: • The use of agency staff in Psychological Therapies has reduced from a high of 25% in mid 2014 to 0.9% in March Vacancies 8.08% v 9% limit • 50% of vacancies in the Oxford Adult Acute Wards have been filled following recent open days and centralised recruitment. All HCA vacancies have been filled in Oxford Adult inpatient wards and the Resourcing Team is targeting Thames House and Ashurst for additional support to recruit experienced staff nurses. HR has received very positive feedback from nurses due to qualify this year for our timely recruitment activity. • Care Coordinator Posts for Oxford AMHTs are proving difficult to fill, in particular for new services funded by resilience monies. Casework Casework is slightly reducing in all areas of Mental Health but is unpredictable . 21 formal cases being currently managed are:- Whistleblowing 2 Disciplinaries 9 Conduct Safeguarding 2 Conduct other 2 Grievances 1 Capability 2 Health Capability 3

8. Directorate Performance C&YP Directorate: Sickness 2.73% v 3.5% target • Sickness remains below trust target, with significate improvements in Dental. This is now below target for the first time since Feb 2014.  We have seen further decreases in Specialist Services and Cotswold House Oxford. Highfield is slightly above target as a result of an increase in medium to long term absence, however 3 staff have since returned to work so we should see a reduction next month.  We have seen a fall in short term absence generally. Turnover 12.6% v 12% target • Turnover is slightly above target but has remained stable since July 2014.  We have seen decreases in Complex Care Services. Cotswold House Oxford has remained stable and below target for 2 consecutive months. We have seen an increase in Swindon, Wilts and BaNES (which includes 2 inpatient wards). Turnover in Highfield Oxford is continuously high and the main reason for leaving cited is promotion. There is limited career progression for Band 5 nurses. Dental Services is also historically high, again the main reason being lack of promotion opportunity for Senior Dentists. Marlborough House Swindon has seen a slight increase but has remained stable since Sept 2014. We are aware of neighbouring Trusts offering ‘golden handshakes’ incentives for new starters, we may therefore see a further increase in turnover. This issue forms part of the overall Trust recruitment plan.

9. Directorate Performance C&YP continued: Bank & Agency 7.29% v 5% target • Remains significantly below target, we have seen a decrease in usage in Specialist Services and Complex Care. We are aware of the hotspot areas, those being : Highfield Oxford where agency remains high, although we will be reimbursed by NHS England for some costs. Marlborough  House Swindon are still experiencing difficulties with the Agency Framework being able to supply suitably trained staff, resorting to expensive agency usage (as our Medics). Agency Framework leads are in the process of looking at the national framework. Casework: • We continue to support managers with a number of informal employment matters, and have 9 formal cases comprising of 4 Capability Health, 1 Capability Performance, 2 Allegations of Bullying & Harassment and 2 Disciplinary cases. All have associated HR and/or Occupational Health input. Vacancies 5.5% v 9% limit • Registered nurses for Cotswold House Oxford are proving difficult to recruit to. The resourcing manager is to attend the next Modern Matrons’ meeting to discuss a further recruitment strategy to address the problem. Change Management and General • The HR team is delivering bespoke performance management training to Therapies in May. The Probation Policy is working well; currently we have 3 staff that may be subject to review. • The HR team is supporting a number of TUPE and Tendering projects, which include: Wiltshire Community Services - £50 Mil contract, Buckinghamshire CAMHS - £29+ Mil contract and Oral Health Promotion – Dental Services in Leicester and Nottinghamshire - £340K contract • Staff Survey results have been received and HR are working with an allocated lead in CYP Management to form a learning/action plan to cascade to senior managers and teams.

10. Directorate Performance Older Peoples Directorate Turnover: 13.6% v 12% target • There were 6 leavers from Community Nursing and concerns about workload / work life balance and support, although PDR and supervision continue to be cited as reasons for leaving. The service management has conducted exit interviews locally and the report is awaited. Work continues to look at employment options that would enable the service to train qualified nurses internally. • Following a request from the Community Nursing teams, the Recruitment Action Group will look at a proposal to extend contractual notice periods. Whilst this in itself will not reduce turnover, it would allow managers to recruit behind leavers in a more timely manner. It would also create parity with the OUH. • COO and Clinical Director met some DNs recently and ideas were shared that the service could use to assist with recruitment. ILT Service Heads to take forward with Recruitment Team • Review of staffing levels and selection process to be undertaken in Abingdon Community Hospitals; staff citing stress / working hours as concerns, although it is noted that there was only 1 leaver from Abingdon during February. Sickness: 5.19% v 3.5% target • All long term sickness cases are being managed appropriately in accordance with Trust policy (33 cases in formal stage). Short term absence was higher than previously. The HR team will review Bradford Factor scores and liaise with line managers. The amount of management time devoted to absence management is considerable. • The main reasons for absence in the directorate continue to be: • Anxiety and Stress – 13.65% (a 1.85% reduction from last month’s 15.5%) • Musculoskeletal (MSK) problems 14.94% (a 1.34% increasefrom last month’s 13.6%) • The pilot project offering fast tracking physiotherapy is now live and its effectiveness will be evaluated later in the year. The service is open only to Older People’s Directorate staff during the pilot. It will treat conditions that are work related and those which are not work related with the aim of early intervention to prevent injury leading to sickness absence. Clinics are available Mon – Fri across Oxfordshire (Occupational Health are exploring options for Buckinghamshire).

11. Directorate Performance Older Peoples Directorate Contd. Bank and Agency – 9.17% v 5% limit • 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. Urgent Care Service and HR are looking at a potential strategy to reduce reliance on agency for EPs. • Recruitment in Community Hospitals and Community Nursing has resulted in increased staffing levels which is having a positive impact on bank and agency usage. • The Agency Co-Ordinator is working with line managers to move lines of work to framework agencies. Governance implications of using non-framework agencies are being raised through the CQC Taskforce Group. Vacancies – 9% v 9% limit • Community Hospitals – The vacancy rate is 11.9%. The Recruitment Advisors report that vacancies at Abingdon are at an 18 month low following an increase in applications. Witney and Wallingford Community Hospitals are still experiencing difficulties. • Community Nursing – the Recruitment Advisors report an increase in applications for posts in Community Nursing. One of the localities (south) will have recruited to establishment levels once pre-employment checks have been completed. • A manager in OPMH services delayed shortlisting for a post. This resulted in all candidates for the post being lost and therefore delays in filling vacancies. A reminder about the importance of adhering to process will be included in the HR Update. • 50% of vacancies in the Oxford Adult Acute Wards have been filled following recent open days. Recruitment for the remaining vacancies is ongoing. • Care Coordinator Posts for Oxford AMHTs are proving difficult to fill. Recruitment continues.

12. Directorate Performance Corporate Directorates : Turnover 10.2% v 12.0% Target Staff Turnover has reduced slightly since last month with all departments showing a downward trend from last month. Sickness  3.5% v 3.5% Target Sickness has increased since last month. The figures for the Medical Director department reflect some long term sickness for individuals on nil pay within CPSU pharmacy. There has been seasonal short term absence also in HR&OH, Strategy & Development & Finance. Bank & Agency 2.16% v 5.0% limit Bank & Agency overall has reduced this month from 4.7% last month, with a reduction across all departments. There has been a small but planned reduction in Strategy & Development & Finance, Performance & Contracts. Vacancies 12.63% v limit 9% • There are a few difficult to fill posts within Corporate Services. The post of procurement manager remains unfilled, despite various attempts to fill and the resignation of the Head of Procurement will add to difficulties in this area. This area of concern needs to be addressed urgently. • There is difficulty recruiting for the IT department’s band 7 and band 8a posts .

13. Casework • The casework data reflects a fairly static number of cases. Older Peoples continues to run higher than other areas and particularly due to high levels of sickness in Community hospital associated with MSK sickness. The recent addition of physiotherapy in that area should begin to address this and reduce the numbers in due course. • Whistleblowing cases continue to be closely monitored. • A review of duration of all casework has been undertaken in the last 4 weeks and some root causes of some delays have been identified. Whilst duration of cases has , in the main decreased from previous years some further work will be done on duration to propose whether changes could be made to reduce timescales. (Examples of this are : timescales for availability of investigations and numbers of availability of trained investigators). • Suspensions are kept under review but in the next month a targeted piece of work will be done to review costs and suspension durations.

14. Casework

15. CASEWORK

16. Casework Shows casework type by percentage by division based on open cases at 09.04.15.

17. CASEWORK Shows cases open at 09.04.15 by division by case type.

18. Directorate Performance The recruitment data demonstrates that there has been a continued reduction in new advert requests in March as expected towards the financial year end. The number of live vacancies has increased which is due to adverts not being filled and going out to repeat advert. The number of applications received has reduced in line with the reduction in new vacancies being advertised. We are attending a job fair in Bicester in April specifically targeting Reablement Assistants. Detailed review of the recruitment process has taken place with a precise flowchart mapping all steps being documented along with the key control metrics. This will be monitored to ensure maximum effectiveness of the process. Initiatives will be introduced to minimise the recruitment gap between leaving and joining. A number of retention options are now being considered by the Recruitment Action Group and work is continuing on a new recruitment database, improved web sites and the Apprenticeship scheme.

19. Staff Health and Wellbeing Oxon Bikes The action group was successful in receiving funding through Oxfordshire County Council to install 22 bikes (similar to Boris Bikes) which will be available to staff at our three main sites in Oxford (Chancellor Court, Warneford and Littlemore). The bike docking stations have now been installed and the bikes will be delivered within the next two weeks and available for staff to use from Monday 20April 2015. The official external launch date is Wednesday 17June 2015. May Pedometer Challenge • Team entries are now open for the next pedometer challenge taking place in May 2015, in line with national walking month. New Logo • The staff health and wellbeing action group have designed a new logo which encompasses a range of the main different aspects of health and wellbeing. FY16 Activity Plan • The Group is consulting with staff and reviewing the survey Results to set the priorities for FY16 activities.

20. KPIs for March 2015 – 99% (target 100%), 119 Referrals by manager received and average from date received to first offered was 10.75 days against a target of 10. This was due to a staff shortage. • Average of days between date attended and date report was dispatched was 2.38 days (target 2 days based on best practice), this includes employees who wished to see their reports prior to release (which potentially adds an additional 5 working days if sent by hard copy). • The activities above exclude the following: • GP and Specialist request letters • Transfer of care or Urgent/immediate responses required by Managers • In addition to the above appointments the following activities were undertaken:  • Partnership working with Older People’s directorate re Fast track Physiotherapy pilot has been rolled out to staff. At present 23 referrals have been passed to the scheme of which we have received interim reports on 13 individuals. It has been suggested that this project required further advertisement as uptake is slower than expected. This has now been actioned. Occupational Health

21. Occupational Health

22. Occupational Health Appointment and Triage Combined January 2013 to March 2015 Appointment and Triage Combined January 2013 to February 2015

23. Occupational Health Appointment comparisons 2013-2015