including update against the staff survey action plan ...The E-Roster Project Manager and Bank/...

Author: Sue Smith, Deputy Director of Human resources Approved: Lynn Vaughan, Director of Human Resources

Date: 15 May 2012 Version: Draft

Agenda item: 12. Page 1 of 22

Report to: Management Board Agenda item: 12 Date of Meeting: 23 May 2012

Title of Report: Progress against the Workforce Strategy, including update against the staff survey action plan

Status: For Information Board Sponsor: Lynn Vaughan, Director of H uman Resources Author: Sue Smith , Deputy Director of H uman Resources Appendices : 1: Workforce Strategy - Workforce Priorities 2012/13

2: Staff Survey Action Plan 2012/13

1. Purpose of Report (Including link to objectives) To highlight and describe progress against the main workforce related priorities for the Trust, as outlined within the Workforce Strategy, for this business year.

2. Summary of Key Issues for Discussion

• Nurse Recruitment activity to meet turnover and permanent establishment of former medical escalation wards

• Compliance with core skills attendance • Improved appraisal compliance rates but need to maintain progress • Medical re-validation task and finish group established • Terms and conditions negotiations commenced and expectation of challenging

climate • Staff Survey Action Plan

3. Recommendations (Note, Approve, Discuss etc. ) The Trust Board is asked to note the report and be satisfied that the priorities and actions being taken are both appropriate and necessary to support the Trust in delivering its service objectives.

4. Care Quality Commission Regulations (which apply) Outcomes 12,13 and 14

5. Legal / Regulatory Implications / NHS Constitution (NHSLA / ALE etc. ) NHSLA standards 1, 2, 3,5,

6. Risk (Threats or opportunities link to risk on register etc. ) Ensure a workforce is in place to deliver a safe service that is fit for purpose. 401, 429, 430, 435, 446, 457, 458

7. NHS Constitution 3a. Staff – your rights and NHS pledges to you, 3b. Staff – your responsibilities, and NHS values.




8. Resources Implications (Financial / staffing) Additional temporary staffing to support recruitment activity.

9. Equality and Diversity This strategy supports equitable opportunities for staff across the trust.

10. Communication Shaping the Future Workforce Conference.

11. References to previous reports April Trust Board – Update

12. Freedom of Information Public.




Appendix 1 Workforce Strategy – Workforce Priorities 2012/13 1. Introduction

The purpose of this report is to highlight progress against the main workforce related priorities for the Trust that have been identified and agreed within the Workforce Strategy, for 2012/13.

This report also provides an opportunity to identify any emerging issues or risks in relation to the key workforce themes, which have the potential to impact on our ability to deliver operational services.

2. Background 2.1 Staff are the Trust’s most valuable resources, both in terms of the contribution

that they make to the delivery and quality of patient care but also in terms of financial investment. As such, the effective management of staff should be the highest priority for all managers and supervisors.

2.2 Through the Workforce Strategy, the Trust Board explicitly directs that all staff

should be managed in line with the pledges to staff laid down in the NHS Constitution, Trust values and the RESPECT behaviours. Trust Board members are expected to role model these behaviours and values and personally uphold the pledges1.

3. Key Issues 3.1 Planning effectively for future work 3.1.1 Shape of the Workforce

The graph below shows the Trust’s Agenda for Change banding profile compared to the Medium Acute Trust benchmark group within the South West.

As demonstrated in the graph over page, the Trust has less Band 3, Band 4 and Band 7 staff and significantly less Band 6 staff than the benchmark group; however we have more Band 1, Band 5 and Non-Agenda for Change staff than our comparator group.

1 Workforce Strategy 11/12-13/14




Source: NHS iView (Benchmark - Medium Acute Trust, South West), ESR (Royal United Hospital Bath)

3.1.2 Operational Gap

The operational gap describes the gap between funded establishment and actual staff in work i.e. all forms of absence and actual vacancies. The Strategic Workforce Committee has set a stretch target of 7% inclusive of the 3.4% sickness absence target. The current operational gap is 10.6% and indicative of work pressure felt by staff.

Source: Vacancies - Agresso (data subject to Auditor sign off), Absence - ESR

3.1%

18.9%

10.8%

6.0%

21.1%

15.3%

8.2%

2.2%

1.0%

0.4%

0.2%

0.0%

12.6%

7.1%

18.1%

9.6%

5.0%

23.4%

10.8%

7.6%

2.2%

1.1%

0.5%

0.3%

0.1%

14.2%

30.0% 20.0% 10.0% 10.0% 20.0% 30.0%

Band 1

Band 3

Band 5

Band 7

Band 8b

Band 8d

Non Agenda for Change

Agenda for Change Banding Profile Compared to Benchmark

Average

Medium Acute Trust (South West) Benchmark Average Royal United Hospital Bath

10.3%

11.9%

10.1% 9.6% 9.2%

10.7%11.6%

12.3%11.2%

10.7%11.4%

10.6%

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

0

100

200

300

400

500

600

WT

E

Operating Gap within the 2011/12 Financial Year

Vacancies (WTE) Sickness Absence (WTE) Other Absence (WTE) Operating Gap (%)




3.1.3 Temporary Staffing

The chart below shows the Agency, Locum and Bank utilisation within the Trust from April 2011 to March 2012, which shows both the agency and locum spend, and bank spend peaking in March 2012. Discussions have commenced to determine whether outsourcing would be an efficient and economic route to temporary staff management.

Source: Agresso (data subject to Auditor sign off)

3.1.4 E Rostering The implementation of E rostering is a QIPP enabling project.

A benefits realisation event was held on 23 March 2012 and provided the opportunity for participants to better understand the potential that our RosterPro Central (RPC) roster package might provide, particularly when interfaced with ESR for pay and workforce information purposes.

A further demonstration of RPC will take place on 12th June in the PGMC Lecture Theatre between 11am and 1pm. The demonstration will focus on RPC’s tools and enhanced functionality designed to achieve efficiencies and cost-savings by: • streamlining roster-planning • replacing manual time-sheets • improving accuracy of pay for time worked • better anticipating and responding to staffing changes and workloads to

maintain continuity of service delivery • demonstrating compliance with relevant legislation and trust policies

£0

£100,000

£200,000

£300,000

£400,000

£500,000

£600,000

Bank, Agency and Locum Cost within the 2011/12 Financial Year

Bank Spend Agency Spend Locum Spend




Rollout of RPC to the wards continues. Positive feedback has been received from ward managers, confirming that the upgraded software is more intuitive and easier to learn and use. The E-Roster Project Manager and Bank/ Roster System Manager are also about to embark on testing of the next RPC upgrade (to version 11.5) prior to deployment.

3.1.5 Job Planning

Revised job planning guidance has been issued following consultation with LMNC regarding use of SPA time.

3.1.6 Mutually Agreed Resignation Scheme (MARS)

Although scheduled to run for a second time from 1st April to 31st May 2012, NHS South have just advised us that due to changes to Treasury rules effective at 31st March 2012, all existing schemes must be withdrawn pending the introduction of revised national scheme.

3.1.7 Workforce Plan

A 5 year workforce plan is currently under development to take account of a number of factors such as:

• Service changes and developments • Changes in commissioning • The requirement to make year on year efficiency savings (cost

improvement requirements) 3.1.8 Shaping the Future Workforce Conference

This conference will build on the work of the various workforce planning groups who have contributed to the workforce plan, to share learning and knowledge and ensure it is designed to attract, develop and retain a high quality workforce whilst also enabling the Trust to continue to perform within its budget over the next five years. The conference is scheduled for September 2012 and will examine issues such as that highlighted in the benchmarking 3.3.1.

3.2 Recruiting the Best Staff 3.2.1 Proud to be a Nurse Recruitment Campaign

A refresh of the original campaign has been scheduled and it is anticipated that it will go live later in May, comprising regular inserts into external journals, a micro site for interested applicants to find out more about the Trust and a




recruitment day in July which will also showcase the various nursing roles within the Trust.

Recruiting to ‘full establishment’ will support achievement of a range of key KPIs as reported later in this paper.

3.2.2 Recruitment Processes

Recruitment processes have been reviewed and handbooks for both recruiting managers and applicants have now been launched. The policy framework, comprising Recruitment and Selection, Pre and Post Employment Checks and also Professional Registration, has also been revised to ensure NHSLA level 2 compliance. Updated Recruitment and Selection training to reflect these changes, is due to commence in June 2012. It is intended that the recruitment process will be subject to a ‘lean process’ during this business year.

3.2.3 Shadowing for Medical Graduates

Following recommendations made in the Collins Report, the Medical Programme Board has agreed that all medical graduates about to start their foundation programme should undertake a paid period of four days’ shadowing with their first FY1 employer immediately prior to the start of their employment. Ideally, the medical graduate should shadow an F1 doctor on the same rota that they will be joining from 31 July 2012. This recommendation will now be incorporated into the recruitment plans for the new August take of F1 doctors and shadowing is due to commence on Tuesday 26 July, with funding provided within the MADEL contract.

3.2.4 The Youth Contract

A Government scheme was launched in April to help 16 to 24 year olds prepare for and secure employment, as part of the Government's drive to tackle youth unemployment. The Youth Contract includes wage incentives for employers to employ young people. The Operational HR team will be issuing guidance in June regarding the practical application of this scheme, for managers within the Trust.

3.2.5 Changes to Tier 2 of the Points Based System

On 4 April 2012, the UK Border Agency made an announcement on changes to Tier 2 of the Points Based System. These changes are part of the Government's radical overhaul of immigration which has already seen changes to the student and settlement routes, further changes will be announced on the family migration route this summer. Recruitment processes for overseas applicants have been reviewed to incorporate these changes.




3.3 Developing our Workforce for Success 3.3.1 Appraisal

A review of documentation used by the private sector and the NHS has been undertaken and a simplified version of the existing documentation has been piloted and implemented. Feedback is positive.

A new method of reporting has also been developed which enables information about specific departments to be analysed and the appraisal reporting system has been reviewed following discussions with managers about accuracy of the data in appraisal reports.

The Trust appraisal rate is 71.2% in April.

Appraisal training for managers is now available on a regular basis.

Source: ESR

343 366321

353 354317

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pra

isa

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)

Appraisal Rate

To be appraised (Headcount) RAG: Green RAG: Red

Appraisal Rate (%) Projected Appraisal Rate (%)




3.3.2 Induction

The induction process has been reviewed and changes to the induction arrangements for new starters were introduced with effect from April 2012. Trust induction takes place in the first week of a new starter joining. The induction consists of three parts:

• Corporate Induction – the welcome to the organisation. The session is

now highly participative rather than a ‘chalk and talk’ approach. • Initial Mandatory Training – the mandatory training that is required for the

role the new starter will be undertaking. New starters continue to receive a timetable which fits their role however specific subjects are now grouped together, e.g. Patient Safety, Health & Safety, and Patient Records & Patients at Risk days.

• Local Induction – minor changes have been made to the training and information new starters are given on arrival in their ward or department.

Improvements to reporting and the local induction process will be a priority for 2012/13.

Source: ESR

60%

65%

70%

75%

80%

85%

90%

95%

100%

Induction Attendance

RAG: Green RAG: Red Trust




3.3.3 Mandatory Training

Training attendance at Core Skills has improved from 57% in Jan 2011 to 70% in Feb 2012, but despite significant improvement over the past 12 months; compliance is still well below the RUH target of 90%.

A review of mandatory training has been completed and new arrangements have been put in place. These include the following:

• The learning outcomes and target audience described in the Cheshire

& Merseyside Core Skills Framework has been adopted and implemented.

• The Mandatory Training Matrix has been revised.

• Two new Core Skills programmes have been introduced, every 2 years

for staff with patient contact and every 3 years for staff with limited patient contact. A three year rolling programme of Conflict Resolution Training for all frontline staff commenced in September 11; this incorporates customer service and equality and diversity training.

• With effect from 1st April 2012 subject specific training compliance

reporting will be introduced.

Priorities for 2012/13 include improved communication about training and development requirements and opportunities, introducing choice in the methods by which staff can maintain their mandatory training requirements e.g. self-assessment, e-learning and self-directed learning.

Source: ESR

40%

50%

60%

70%

80%

90%

100%

Core Skills Compliance Rate

RAG: Green RAG: Red Trust




3.3.4 Productive Leader

The Surgical Matrons and some Speciality Managers have completed the Productive Leader modules over the last 5 months.

In June we will be starting Productive Leader for the facilities team, who have asked to go through the programme together so that they can encourage each other to make improvements.

3.3.5 Every patient matters transformation programme

An Education Centre staff member has taken part in the training for LEAN champions and will continue to provide the link between Learning and Development and the programme. She will be available to support the HR team in any innovation or improvement they wish to undertake. Further training will be developed with the Transformation Project Lead to support staff during the Transformation programme.

3.3.6 People Management

The increasing emphasis on accountability and patient safety, places a real emphasis on high quality human resource practices. As part of the Trust’s People Management programme, local update training is now available to support line managers in dealing effectively with Conduct, Performance, Sickness & Flexible Working issues, as well as centralised Training on Management skills & techniques to support Appraisal, Performance Management & effective Recruitment. Additional one-to-one coaching is also provided for managers by the HR Directorate team on an on-going basis.

3.3.7 Medical Revalidation

The Medical Revalidation Appraisal Task and Finish Group met for the first time in April and have agreed terms of reference and a plan of work. The NHS Revalidation Support Team (RST) has also published new materials to support the implementation of medical revalidation. The resources include information management guidance, appraisal guidance, a framework for quality assurance of medical appraisers and a responsible officer dashboard.

3.4 Staff as Stakeholders for Success 3.4.1 Staff Survey

The 2011 survey has identified a number of areas for improvement across the Trust and a robust 25-point action plan, underpinned by a communication plan, is under development to address the areas highlighted (Appendix 2).




3.4.2 Staff Engagement

A new staff engagement plan is being developed for 12/13. Divisional/directorate leadership of ‘engagement’ is a critical development to be addressed and a significant requirement will be to demonstrate that the Trust is listening and responding to the ‘voice’ of staff.

3.4.3 Industrial Action

In response to the NHS Pension Reforms, no official strike action is scheduled to take place at present. However, the BMA has decided to ballot members for action short of a strike and the results of the ballots undertaken by SoR, and CSP are awaited. Contingency plans are ready to be put in place once further clarification regarding potential action has been received.

3.5 Valuing a Diverse Workforce 3.5.1 Equality Objectives

The Trust has followed the Department of Health guidance for implementing the Equality Delivery System (EDS) and following consultation with both internal and external stakeholders, has set specific equality objectives to comply with the public sector duties of the Equality Act 2010.

3.5.2 Equality & Diversity Strategy

A new draft Equality and Diversity Strategy is being developed based on the EDS framework and will replace the Trust’s previous Single Equality Scheme.

3.5.3 Equality, Diversity and Human Rights Week (21 – 25 May 2012)

The main focus of this week will be to raise awareness of our new equality objectives, the importance of data capture for both patients and staff, and celebrate the work of our staff.

3.6 Maintaining a Healthy Workforce 3.6.1 Sickness

The graph below shows the Trust’s sickness absence as 3.7% benchmarked against medium acute trust within the South West. Until October 2011 the Trust had consistently lower sickness absence rates than its acute Trust peer group, and although our sickness absence rates increased slightly in September 2011, it has stabilised at 3.7%, which is amber against a target of 3.4%.




Source: NHS iView (Benchmark - Medium Acute Trust, South West), ESR (Royal United Hospital Bath)

The graph below shows the rolling 12 month average Trust sickness absence rate, compared to the planned reductions in absence rates (3.4%). Sickness absence rates have clearly risen, but there are multiple factors that contribute to this, one of the key reasons being work pressure felt by staff, ‘Back and Other musculoskeletal problems’ and ‘Anxiety/stress/depression/other psychiatric illnesses’ being the top two reasons for absence. The Manual Handling trainer and the Occupational Health Services team continue to support staff with musculo-skeletal health problems.

Source: ESR

2.5%

3.0%

3.5%

4.0%

4.5%

Sickness Absence (12 Month Rolling Rate)

RAG: Red RAG: Green Benchmark Royal United Hospital

2.5%

3.0%

3.5%

4.0%

4.5%

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3Sickness Absence (12 Month Rolling Average) Progress Against Plan

RAG: Red RAG: Green Royal United Hospital Royal United Hospital Target Reduction




3.6.2 Getting Fit in 2012

This new campaign supported by the Charities Committee was launched in the Oasis fitness centre on 1st May 2012, with a range of free classes offered to staff such as weight and inch loss, Zumba, Yoga, Tai Chi, Kung Fu, Squash, Tennis etc. The programme includes fund raising challenges in support of the Forever Friends activity and will culminate in a medal ceremony after the Olympics.

3.7 Valuing all, rewarding excellence 3.7.1 Staff Awards

Funding from the Charities Committee for the Awards Ceremony is uncertain at present due to the need to resolve tax issues and a revised bid will be made to the Charities Committee in May.

3.7.2 Clinical Excellence Awards

We are waiting for news on whether an official round of employer-based or national clinical excellence awards will take place this year. NHS Employers have advised employers to prepare for an employer-based awards round, but not to progress this until the status of these awards is clarified and any documentation published.

3.7.3 Terms and Conditions of Employment

A paper proposing possible cost reduction measures in relation to terms and conditions of employment was discussed at the May TCNC meeting. Discussions will continue in July, following a ‘time-out’ to resolve our approach to partnership working.

3.8 Enabling the HR Directorate to deliver the strategy 3.8.1 Key Workforce Indicators (KPIs)

The Strategic Workforce Committee has reviewed the KPIs for the forthcoming year in line with benchmarking information regarding from comparable medium sized acute Trusts in the South West. A detailed HR Performance Report is reviewed by the committee on a bi-monthly basis.

3.8.2 Operational HR Team structure

Following a benchmarking exercise in line with the recommendations of the Efficiency QIPP project, the Operational HR Team has been restructured and a Head of HR appointed to oversee the management of the four HR Managers and the HR Advisors now allocated to Medicine, Surgery, Facilities




and Corporate, in addition to the management of the Medical Staffing and Recruitment functions.

4. Recommendation

The Trust Board is asked to note the contents of this report and be satisfied that the priorities and actions being taken are both appropriate and necessary to support the Trust in delivering its service objectives.






















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