Quarterly Workforce report – Q4 (January – March 2015) Trust Board

Enclosure E1

Kingston Hospital NHS Foundation Trust – Trust Board – June 2015 1

Quarterly Workforce report – Q4 (January – March 2015)

Trust Board Meeting Item: 7.3.1

3 June 2015 Enclosure: E1

Purpose of the Report:

This report provides an update in respect of activities progressing the Trust’s workforce strategy priorities in 2014-15 and performance against agreed workforce targets for the period January– March 2015 (Q4).

FOR: Information Assurance Discussion and input Decision/approval

Sponsor (Executive Lead):

Terry Roberts – Director of Workforce

Author:

Terry Roberts, Carolyn Floyd, Paul Hargreaves

Author Contact Details:

Ext 3148

[email protected]

Risk Implications – Link to Assurance Framework or Corporate Risk Register:

Staff satisfaction is linked to improved organisational performance and patient outcomes

Link to Relevant Corporate Objective:

Strategic Objective 2 - To have a committed, skilled and highly engaged workforce who feel valued, supported and developed and who work together to care for our patients

Document Previously Considered By:

Recommendation& Action required by the Trust Board :

The Trust Board is invited to a) note the contents of the report b) to confirm support for the actions taken in response to the issues raised.

mailto:[email protected]

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Quarterly Workforce Report – Q4 (January 2015 – March 2015) Introduction

1. This report provides an update in respect of activities progressing the Trust’s workforce strategy priorities in 2014-15 and performance against agreed workforce targets for the period January 2015 to March 2015.

2. The report is structured to provide:

1) A summary of the plan to deliver a new People Strategy 2) An overview of performance against the workforce objectives 3) Staff Friends and Family Survey results and Managers feedback 4) Key workforce issues and risks.

Part 1 – People Strategy Plan

1. People strategy outline. The Workforce committee has determined that the current workforce strategy needed to be refreshed and updated. Therefore, it was agreed that we would develop a People Strategy that not only engaged senior management but also engaged and included the ideas of frontline staff. The strategy will also draw upon existing Trust strategies and vision and values statements. The strategy will focus on the following 10 key areas

1. Setting the Context a. National NHS agenda b. SWL/local health economy, Wider labour market c. Political, Economic, Social and Technological (PEST) analysis, d. SWOT analysis – in relation to workforce issues e. Trust workforce profile

2. Trust vision a. Trust strategy, vision and values (summary – Work, Develop, Inspire) b. Link to other strategies (estates, IT, business development, OD strategy etc) c. Happy Staff and Staff engagement

3. Role of people management throughout the employee lifecycle a. The evidence base that people management matters (Dalton,West et al) b. How Workforce helps to support service and organisational development

through improved: c. Compliance (legislative etc), employee relations, resourcing, planning and

information, reward and recognition, engagement, staff development, organisational culture and structure

4. Improving HR policy and practice a. Developing Innovative and streamlined recruitment practice b. HR management arrangements and governance c. Approach supporting for business teams d. Use of HR KPIs

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e. Development of HR, clinical and management staff in people management skills

f. Legislative compliance and risk management g. Workforce information and flows h. Policy development

5. Improving workforce productivity and efficiency a. Workforce planning b. Workforce deployment and skill mix c. Temporary staffing usage d. Flexible workforce e. Workforce Information Systems/ Rostering

6. Organisational culture and staff engagement a. Happy Staff b. Trust Values c. Retention strategy d. Partnership working (staff) e. Duty of partnership (organisations) f. Devolution to line managers g. Business partnering h. Staff empowerment i. Change management approach j. Performance management arrangements k. Staff recognition and reward

7. Improving staff wellbeing a. Staff support b. Occupational health c. Promoting health and wellbeing (‘Boorman’ recommendations and action plan) d. Childcare and nursery

8. Training and development a. Mandatory training b. CPD and appraisal c. Development of education and training (including quality assurance and

delivery) d. Collaboration with other organisations

9. Leadership a. Leadership development b. Talent management

10. Equality and diversity a. HR practice supporting equality and diversity b. Monitoring of equality and diversity c. Achieving the stretch targets

The strategy will be developed and informed by feedback from our partnership forum, management groups and frontline feedback with the intention of ratification by the Board in September.

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Part 2 – An overview of performance against the workforce objectives The Trust’s overall performance is set out in Chart 1.

Chart 1 – Trust Overview of Workforce KPIs

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10

20

30

40

50

60

Leavers by Month against Target

2014 Target 2014/15 Target 2015/16

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4

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14

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18

20

Admin &Estates

AlliedHealth

Professions

ClinicalSupport

NursingAssistants

OtherDoctors

OtherQualified

ST&Ts

QualifiedMidwives

QualifiedNursing

Leavers by Staff Group in Quarter 4

Jan-15 Feb-15 Mar-15

Chart 1: - analyses the leavers for the year against the target. This shows peaks in August (46), September (46) and March (48). For the year as a whole the highest number of leavers was from within the Qualified Nursing group (158) this was followed by Admin & Estates (138).At no time in the year did the number of leavers reach the target of 26 leavers per month.

Chart 2: - analyses the leavers in the quarter by staff group. There is a significant rise in leavers from within the Admin & Estates and Qualified Nursing staff group in March.This contribute to these staff groups being the highest for the whole quarter. There were 42 leavers from Admin & Estates coming from Operations/Finance/HR Ophthalmology, Anaesthetics and Theatres. There were 34 leavers from the Qualified Nursing staff group- 9 from A&E and AAU, 7 from Paediatrics and NNU and 4 from Elderly Care. There was a reduction in Nursing Assistants in March.

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Objective 2.1: To ensure all our staff are up to date with core (mandatory) training, have clear objectives, regular appraisal and a personal development plan reflecting our values

Position at Q4 Actions in Place (a) 80% of staff to have had an

appraisal and agreed objectives and a PDP by the end of June 2014 and 90% by September

The Staff survey reported 95% compliance with appraisal completion.

This will be reported in the next Q1 report as the new appraisal cycle has started.

New appraisal paperwork has been developed to make the process smoother and improve employee experience and subsequent PDP

(b) All staff are formally evaluated against the Trust values as part of the annual appraisal process – 80% by June 2014, 90% by September 2014

See above This will reported in the next Q1 report as the values are incorporated in the new APD system.

(c) All managers have feedback on their people management skills from their staff and have the results built into their PDP

In preparation for the new ADP cycle, staff were sent the link in March 2015 to provide feedback in relation to their managers.

As part of their appraisal process, we have developed a system where managers will receive individual feedback summaries for 2015/16 plus 2014/15 for comparison.

Introduction of Staff Feedback on the 2015/16 Appraisal process to obtain staff views on how they felt about their appraisal.

(d) 90% of staff up to date with their mandatory training – to be achieved by March 2015

In Quarter 1 this will change to

80%

80% of staff were fully up to date with their mandatory training as of 31st March 2015. Target data for 2015/16 has been discussed and a target of 80% compliance was agreed.

Feedback from service lines has been that this lack of performance is linked to high turnover and vacancy rates. Plans are in place to address these issues.

The poorest service line is Respiratory which has the lowest compliancy rate at 55%. Action plans are in place to address which includes a set date for all staff to attend mandatory training and compliance rate is expected to improve within the next quarter.

Commercial Director, Histopathology, Imaging, Medical Director, Operations IM&T, Pharmacy, Trauma & Orthopaedics have successfully used their actions plans to achieve compliancy

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Objective 2.2: To eliminate the need for agency staff Position at Q4 Actions in Place

(a) All service lines and other areas of high turnover to have a strategy/plan to address this

Turnover for the Trust remains high at 18%. The highest number of leavers in the quarter was from within the Admin & Estates staff group (42 leavers). Leavers in this staff group came from Operations/Finance/HR Ophthalmology, Anaesthetics and Theatres

The Turnover for this group is 20.79%. There were 34 leavers from the Qualified Nursing staff group and a turnover rate at quarter end of 21.93%. Although there were only 13 leavers from the Nursing Assistants staff group turnover is proportionally the highest in this staff group at quarter end (28.26%).

The Turnover target for 2015/16 has been increased to 16%. This is more in line with the average for London Trusts. This means that our currently number of leavers per month needs to reduce to an average of 32 per month.

Continuous work in place to address turnover and vacancy rates (e.g. overseas recruitment, retention questionnaire, exit interviews) as well as a number of corporate actions (please see below)

In relation to the admin staff group the People First Programme has been developed which addresses a number of issues that admin staff have highlighted.

A number of the corporate departments are restructuring to enable better career paths and are actively recruiting to vacant posts.

(b) 50% reduction of nursing agency usage by April 2015

Agency usage this quarter has increased to an average on 10.77% of the total pay bill. Highest usage areas were Unqualified Nursing (28.51%) and Qualified Nursing (22.39%).

When analysing reason for agency usage for staff that are rostered the top 3 reasons were: Staff Vacancy (average 12.62wte per week), Escalation Beds (average 9.81wte per week) and Establishment Shortfall (average 8.43wte per week). The WTE used on Special Nurses has increased this quarter to an average of 5.80wte per week.

A new Specialist nursing rate for Bank staff has been agreed, offering competitive rates. It is anticipated that bank will be more attractive for staff so agency is projected to reduce as a result.

The Safer Staffing Group is developing taking place to incentivise joining and working on the bank.

Moving forward, Service lines will not be measured against Bank usage, with a view to encourage this over agency usage.

(c) Reduce the vacancy rate to 5% by April 2015

The vacancy rate at the end of Q4 stood at 8.10%. The delay in recruits from the Philippines has meant that the fill rate has slowed down this quarter and the overall percentage has remained fairly static.

The highest vacancies are in the following staff groups: Qualified Nursing (99.08wte) and Admin & Estates (76.98wte).

Overseas nursing - By October 2015 the Overseas nurses recruited will have commenced and the expectation is that nursing vacancies will be reduced to 39.

15 nurses starting on 26th May, 37 nurses in pipeline due to arrive in September 2015. Interviews are taking place in Portugal, Greece, Ireland, Italy and Spain with a view to recruit more qualified nursing staff.

CPL – planned 5 trips to Portugal, Greece, Ireland, Italy and Spain between May and July, to get up to 90 Nurses – Portugal (May’15)

Medical staffing – Initiatives include international recruitment, using head hunters and offering R&R

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premium.

Objective 2.5: To ensure that the Trust recruitment function is fit for purpose Position at Q4 Actions in Place

(a) SLA created, agreed and business case for recruitment team developed

SLA had been agreed after consultation and has been issued.

Resources and training in the Recruitment Team to continue to be monitored to ensure they are sufficient to meet the Trust’s needs.

(b) SOPs are developed for all recruitment processes

Completed.

All the SOPs have been implemented. We have strengthened SOP’s with regard to pre-employment checks.

(c) An end to end recruitment system is purchased and fully utilised

The TRAC system has been implemented. When comparing data with the year before there has been a reduction of 58 days in the length of time to recruit.

Actions to resolve data cleansing and reporting issues on TRAC have been put in place. Post implementation review to ensure full capability is used on the system and it is as user friendly as possible.

(d) Reduction in lead times to recruit

SLA consultation has taken place and agreed at EMC

The reductions in lead times are implemented in Q3 and 4. The Recruitment team has been aligned to each Division. The Recruitment Team has got SOPs for each stage of Recruitment to enable them to work efficiently.

(e) Agreed KPIs are achieved

Out of 6 SLA KPI’s 1 is green, 2 are amber and 3 are red, the main red KPI is length of time to complete pre-employment checks

The KPIs in the SLA were implemented in Q3 and 4. KPI Reporting is now in place to check progress.

We are improving the recruitment process though streamlining, quicker OH clearances and reviewing induction.

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Part 3 – Staff Friends and Family Survey results and Managers feedback

1. The three Quarters of the Staff Friends & Family Test (SFFT) for 2014 / 2015 were undertaken on behalf of the Trust by Quality Health. The response rate for Q4 was 11% (289 respondents), Q2 was 12.8% (127 respondents). Q1 survey was conducted on-line and 204 responses were received. In response to Question 1 ‘How likely are you to recommend this organisation to friends and family if they needed care or treatment’, 79% responded that they were “extremely likely” or “likely” (67% in Q2 and 78% Q1) and 11% said “neither likely nor unlikely (21% in Q2 and 13% in Q1). In response to Question 2, ‘How likely are you to recommend this organisation to friends and family as a place to work’, 61% said that that they were “extremely likely” or “likely” (53% in Q2 and 59% in Q1) and 16% said “neither likely nor unlikely” (23% in Q2 and 24% in Q1).

2. The 2015/16 Managers Staff Feedback process was launched on 6th March 2015 with a total of 410 managers identified to receive feedback from their staff. Staff we will also be collating feedback from staff on how they found the process.

3. Work continues to take place as part of the retention strategy to identify on a monthly basis key reasons why staff have left or may leave the Trust through the exit questionnaire and the 100 day survey which targets staff who have been in post for 100 days.

Exit questionnaire - to date we have received 76 out of 128 responses. From the top three reasons for leaving 37% included Career development, 26% stated job dissatisfaction, 26 % stated lack of development opportunities and 21% suggested promotion or a job with more pay.

100 day survey - to date we have received 74 out of 159 responses with 13% of respondents indicating that they intend to leave within the year. The survey highlighted that staff believed that training and development, staffing levels, improved induction and managers would help improve staff retention.

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Part 4

1. Corporate actions to engage staff and improve day to day working experience

A PMO approach will be taken in order to achieve our goal of happier staff (see appendix 1). This approach will have resource implications, however, it is vital to ensure the health and wellbeing of our most important resource – our staff.

2. The main risk to the workforce and HR programmes continues to be the capacity and capability to deliver the range of change programmes underway and responding to unexpected additional work.

Recommendation The Trust Board is invited to a) note the contents of the report b) to confirm support for the actions taken in response to the issues raised.

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Appendix 1- Corporate Actions

Making staff happy objectives

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Objective

Deliverables Lead Others (EMC)

1 Create a positive narrative Commission provider

Role model from the top (Board)

Shape the narrative

Clarify our values

Change the context

Develop positive leaders

KG

DB,TR, LW

2

Develop mechanisms for measuring staff happiness /staff survey feedback/temperature checks

Engage staff in developing mechanisms

Develop proposals to measure happiness

Commission company to implement proposals

Managers taking action to improve happiness

TR TR TR DDs

LW, DDs KG KG DCEO, TR

3 Strengthen quality of Appraisal and personal development plan process

Amend appraisal paper to facilitate coaching approach

Train managers to carry out appraisals in coaching manner

Measure if staff feel valued after appraisal

Support service lines where staff report that they do not feel valued

TR TR TR DD’s

DD’s TR

4 Improve Corporate Induction Develop new induction template

Commission film to engage all learning styles

Launch New induction

TR TR KG

GMc, FW LW TR, GMc, FW

5 Develop Local Induction template Share current service lines local induction

Propose core local induction features and service line add on service specific items

Service Line implement and improve local induction

Retention interviews show improvement in local induction

TR TR DD’s TR

FW,DD’s FW,DD’s DCEO, GMc

6 Understanding Discrimination and Bullying & Harassment

Develop mechanism for staff to raise concerns anonymously

Implement system

Develop recommendations from concerns raised.

Commission external specialist to address issues raised

TR TR FW TR

FW, GMc, BC, JW TR, GMc, BC, JW DD’s

7 Develop plan for 15/16 to improve equality targets

Relaunch the Equality and Diversity committee

Launch protected characteristics groups e.g. LGBT/BME/Disability

TR TR

JW, KG LW, DB, CB

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Monitor WRES targets and set stretch target

Improvement in WRES and equality stats

TR TR

DD’s

8 Develop Capability of Managers Develop competency for service managers

Launch development centre for potential service managers and service manager

Paired learning – service improvement workshops, change leadership and action learning session launch

Develop competencies for all managers

Assess managers against competencies

CB CB TR CB CB

TR, FW TR, FW FW, JW, DB TR, FW TR, FW

9 Education and Development

Develop multi professional education, training and development strategy

DB GMc, TR

10 Improve staff accommodation Review current accommodation in partnership with local community.

Propose solutions for accommodation issues

Implement solutions for accommodation issues

CB CB CB

DB, GMc DB, GMc DB, GMc

11 Improve staff rooms/break out space Review current staff rooms/break out space

Find out from staff what they require

Develop proposed solutions

KG KG KG

CB, LW CB, LW CB, LW

12 Pay Review Recruitment and retention premia (RRP)

Develop flexible increment process

Cost RRP

Implement RRP in relevant areas

TR TR JF DD’s

JF JF TR TR

13 Develop innovative and streamlined recruitment methods

Develop proposals to recruit innovatively

Implement proposals to recruit

Integrate recruitment KPI’s in PRMs

Ensure Recruitment processes are lean

TR DD’s DCEO TR

DD’s,DB TR, DB TR

14 Staff Survey Project manage increase in respondents of staff survey

TR LW, KG, DD’s

15 Service Line Action Develop Diagnostic tool about what each service line needs in relation to People metrics

TR DDs

16 Board Doing Things Differently Role model from the top (Board)

Shape the narrative

Clarify our values

Change the context

Board

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Appendix 2 Service Line Turnover – Red rated areas

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Documents

Quarterly Workforce report – Q4 (January – March 2015) Trust Board