NLG(18)423. DATE OF MEETING 27 November Trust Board of Directors Public REPORT FOR

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1 NLG(18)423 DATE OF MEETING 27 November 2018 REPORT FOR Trust Board of Directors Public REPORT FROM Jayne Adamson, Director of People and Organisational Effectiveness CONTACT OFFICER Jayne Adamson, Director of People and Organisational Effectiveness SUBJECT Monthly Staffing Report BACKGROUND DOCUMENT (IF ANY) N/A PURPOSE OF THE REPORT: Provide workforce information for November 2018 EXECUTIVE SUMMARY (PLEASE INCLUDE: A SUMMARY OF THE REPORT, KEY POINTS & / OR ANY RISKS WHICH NEED TO BE BROUGHT TO THE ATTENTION OF THE TRUST BOARD AND ANY MITIGATING ACTIONS, WHERE APPROPRIATE Attached is the Monthly Staffing Report that gives an update for November 2018 on turnover, vacancies, sickness and workforce developments. This should be read in conjunction with the Integrated Performance report TRUST BOARD ACTION REQUIRED For Information

2 Directorate of People and Organisational Effectiveness MONTHLY STAFFING REPORT Jayne Adamson, Director of People and Organisational Effectiveness Nov-18 Northern Lincolnshire and Goole NHS Foundation Trust actively seeks to promote equality of opportunity and good race relations. The Trust seeks to ensure that no employee, service user, or member of the public is unlawfully discriminated against for any reason, including their religion, beliefs, race, colour, gender, marital status, disability, sexual orientation, age, social and economic status or national origin. These principles will be expected to be upheld by all who act on behalf of the Trust, with respect to all aspects of this document.

3 EXECUTIVE SUMMARY Turnover & Retention: The 12 month Trust wide turnover rate (permanent staff only) has improved once again, standing at 9.76% against the annual target of <9.4%. The decrease in the annual turnover rate over the last couple of months is encouraging. This time last year the annual turnover rate stood at 11.19%. The turnover rate for the month of October stood at 0.58% within the monthly target of 0.78%. This time last year the turnover rate stood at 0.76%, therefore the position has improved. This month, Staff Groups AHPs and Nursing and Midwifery were outside of target. 24% of the leavers from these Staff Groups left the organisation to work for another Trust. Turnover was higher in these staff groups due to relocation (43% of total leavers). The Medical & Dental Staff Group turnover rate has decreased in month to 0.24%. This is an in month decrease of 0.14%. When compared to this time last year the turnover figure stood at 0%. Nursing and Midwifery Staff Group turnover rate increased to 1.06%, outside the target of 0.78%. This is an in month increase of 0.25%. When compared to last month, the position has worsened. In October 2017 the Nursing and Midwifery Staff Group turnover rate recorded was 0.93%. The AHP turnover rate increased significantly in October 2018 to 1.04%. This is an in month increase of 0.41%. The turnover rate when benchmarked against similar sized acute Trusts on IView shows that we are in a comparable position but with high turnover in Nursing and Midwifery, AHPs and Medical and Dental. The exit questionnaire return rate for September 2018 stood at 21% against the target of 50% therefore below the Trust target. The return rate is unchanged when compared to the same time last year where the return rate stood at 22%. The directorates which have not met target once in the past 11 months are Medicine Group and Women's and Children's. Vacancy Summary: The Trust wide vacancy position has reduced slightly in month resulting in a vacancy position of 7.35% against the target of <7% therefore the Trust is heading in the right direction. The in month decrease was 0.61%. The vacancy position is better than the same time last year where it stood higher at 8.95%. The Registered Nursing vacancy position remains outside of target resulting in a slightly decreased vacancy factor of 11.15%, against the target of 6% which is an in month decrease of 0.78%. The vacancy position dropped in October 2017 but has been steadily increasing each month so the decrease is a positive step. When compared to this time last year the Registered Nursing vacancy position is much higher. The vacancy position stood at 8.71% in October It is predicted that the vacancy rate for Registered Nursing will decrease in the next 2 months due to the Newly Qualified Nurse (NQN) intake. The Unregistered Nursing vacancy rate has reduced significantly compared to previous months due to the intake of NQNs who are temporarily classed as band 2s until they receive their pins. The Unregistered Nursing vacancy rate stands at 2.92% whereas it stood at 7.95% in September It is predicted the vacancy rate will rise again once the pins have been allocated. The highest vacancy rates are within Communities and Therapies. The Medical & Dental vacancy position has decreased significantly in month to 14.29% within the target of <15% which is an in month decrease of 1.82%. This decreasing position is positive as the vacancy position has been gradually improving over the past 7 months due to targeted recruitment activity and the August rotation fill. This is the first time the Trust medical target has been achieved since January This time last year the vacancy rate stood much higher at 22.37% therefore the Trust is in a much improved position. The vacancy position is equivalent to whole time equivalent vacancies unfilled. Ongoing plans to address Medical and Dental vacancies are in place and can be found in the recruitment update section of this report. The Maintenance vacancy position is slightly improved when compared to last month standing at 17.74% (equivalent to 9.2 whole time equivalent vacancies unfilled) against target of <7%.The Maintenance vacancy position has remained high for a number of months. This Staff Group have struggled to recruit due to private sector salaries being generally higher for similar roles. The Admin and Clerical vacancy rate has decreased slightly in month with a vacancy rate of 5.24%, within the target of <7%.

4 Sickness Rates: The Trust s Sickness Percentage in September 2018 decreased to 4.21% (target <4.1%). This is an in month decrease of 0.02%. When compared to last year the sickness figure is slightly lower. Last year's figures for September 2017 stood at 4.26%. Nursing and Midwifery sickness figures for September 2018 stood at 4.92% which is an increase of 0.28%. The highest sickness by Staff Group was Estates and Facilities at 6.31%. The highest sickness reasons in month were Anxiety/stress/depression/other psychiatric illnesses (2,106 calendar days lost) and Other musculoskeletal problems (1,057 calendar days lost). Absence days lost for Anxiety/stress/depression/other psychiatric illnesses and Other musculoskeletal problems has decreased in-month by 58 days for Anxiety/stress/depression/other psychiatric illnesses and 101 days Other musculoskeletal problems'. Workforce Update: Monthly Workforce Feature: An analysis has been completed looking at Nursing and Midwifery retirement forecasts. This has shown that over the next 5 years there is potential for 339 Nursing and Midwifery staff to retire which is around 20% of the total Nursing and Midwifery workforce. Although, not all these members of staff will choose to leave or retire, some of these employees may choose to remain within the Trust in some capacity via the range of opportunities available such as wind down, step down and by retire and return.

5 Monthly Staffing Report November 2018 Contents 1.0 Introduction 2.0 Board Action and Recommendations 3.0 At a Glance 4.0 Monthly Dashboard by Directorate 5.0 Monthly Workforce Update 5.1 Monthly Theme Analysis

6 1.0 INTRODUCTION The at a glance section of this report has been refreshed to allow the KPI figures to be relevant and aligned to the Trust s current priorities. These will continue to evolve in line with Trust priorities and agreed KPIs as part of the Integrated Board Report and Improving Together Project. 2.0 BOARD ACTION The Board is asked to: Review the performance against the range of targets/indicators included within the report. Consider the information contained within this report. 2.1 RECOMMENDATIONS For noting and any appropriate action. Recommendations for the monthly feature are welcomed. Please send any suggestions to Marie Hill, marie.hill12@nhs.net

7 3.0 AT A GLANCE Indicator VACANCIES AND STAFF MOVEMENTS STAFFING INDICATORS: Oct /19 Indicators Comparator In Month Change Oct-18 Month Year Trend Target Trustwide Vacancy rate Medical Vacancy Rate Nursing Vacancies Registered Unregistered -0.61% 7.35% 7.96% 8.95% <7.00% -1.82% 14.29% 16.11% 22.37% <15.00% -0.78% 11.15% 11.93% 8.71% <6.00% 0.02% 2.92% 2.90% 5.82% <2.00% All Staff Turnover -0.06% 0.58% 0.64% 0.76% 0.78% Nursing and Midwifery Staff Turnover 0.25% 1.06% 0.81% 0.93% 0.78% Medical and Dental Staff Turnover -0.14% 0.24% 0.38% 0.00% 0.78% AHP Staff Turnover 0.41% 1.04% 0.63% 2.23% 0.78% Indicator OTHER WORKFORCE Change Sep-18 Sickness Rate -0.02% 4.21% 4.23% 4.26% <4.10% Exit Interview Return Rate % 21.00% 46.00% 22.00% 50.00% #### Comparator Month Year Trend Target Indicator Training and Development Change Oct-18 Comparator Month Year Trend Target Mandatory Training Compliance -3.00% 78.00% 81.00% 84.00% 85.00% PADR Compliance % 66.00% 76.00% 73.00% 95.00% *Please note that sparklines follow a 12 month rolling period and not the financial year to date. Once there are enough points of entry the financial year to date trend will be displayed.

8 5.1 MONTHLY WORKFORCE UPDATE AND THEME ANALYSIS Workforce Update: Recruitment Update: Nursing: The Registered Nursing vacancy position remains outside of target resulting in a slightly decreased vacancy factor of 11.15%, against the target of 6% which is an in month decrease of 0.78%. The vacancy position dropped in October 2017 but has been steadily increasing each month so the decrease is a positive step. When compared to this time last year the Registered Nursing vacancy position is much higher. The vacancy position stood at 8.71% in October It is projected that the vacancy rate for Registered Nursing will decrease in the next 2 months due to the Newly Qualified Nurse (NQN) intake. Overseas Candidates:- 1 candidate arrived in the UK and started at the Trust following successful IELTS qualification. An OSEC examination has been booked for December 2018 and will be supported by the CPD team with the necessary training for successful completion of the course and NMC registration. 2 candidates have successfully passed CBT part 1 of the NMC registration and still pending IELTS results. Regular contact is being made to offer support to the remaining candidates and help with rescheduling IELTS exams. Recruitment for this cohort is not likely to come to fruition for a further 6 months. After the successful recruitment of NQNs this year, a further 10 commence in November, 2 in January, 1 February and 1 March. The 2019 NQN campaign has been launched. The Trust will be attending career events in Nottingham and Hull over the next month to recruit. Interviews will commence in January 2019, with allocations made later on in the year. Nursing Associates have commenced and into their second week at the trust, plans have commenced for the next cohort. For HCA recruitment, 30 employees will be hitting Care Camp in the next few weeks and then onto the ward areas. A further 40 will be interviewed this month. Medical & Dental: The Medical & Dental vacancy position has decreased significantly in month to 14.29% against the target of <15% which is an in month decrease of 1.82%. This decreasing position is positive as the vacancy position has been gradually improving over the last 7 months due to targeted recruitment activity and the August rotation fill resulting in a significant reduction. This time last year the vacancy rate stood at 22.37% therefore the Trust is in a much improved position. Ongoing activity has created a substantial pipeline of doctors that the Trust is working hard on to convert into starters; this pipeline currently stands at 48 doctors awaiting a start date. Ongoing plans to address Medical and Dental vacancies are in place and can be found in the recruitment update section of this report. The grades which this includes are Consultant, SAS, Other-Training and Other-Non-Training. Local backfill arrangements to cover training vacancies are taking place through advertising, utilising the existing pipeline, and interim agency locums. The existing pipeline and potential starters, projects an overall fill of training posts (with both trainees and locally appointed non-training backfill) of circa 89% by three months after rotation. This is equivalent to 25 training vacancies. Due to doctors starting over the last few months the pipeline has reduced from over 100 to the current position. Work to further build up the existing pipeline and maintain this pipeline and deliver divisional recruitment plans is ongoing. Further sourcing of candidates from overseas for posts under the medical training initiative is underway alongside other methods including headhunting. Workforce Update: Advanced Clinical Practitioners Project: The current position for the trainee ACP posts is as follows: Trainee ACPs Accident & Emergency/ECC 4 Medical Assessment 2 Midwifery 2 Respiratory 3

9 Surgical Assessment Unit 1 Critical Care & High Dependency Cardiology 1 Community 1 Care of the Elderly Divisions are now working with Workforce Planning to identiy where recruitment for 2019/20's cohorts will focus on. Monthly Theme/ Analysis - Nursing and Midwifery Age Profile An analysis has been completed looking at Nursing and Midwifery retirement forecasts. This has shown that over the next 5 years there is potential for 339 Nursing and Midwifery staff to retire as can be seen in the graph and table below. This splits the number of potential retirees at different times over the next 5 years. 339 is around 20% of the total Nursing workforce. Although, not all these members of staff will choose to leave or retire, some of these employees may choose to remain within the Trust in some capacity via the range of opportunities available such as wind down, step down and by retire and return. These options support work life balance and offer flexible opportunities to staff whilst retaining skills and expertise. In contrast, as can be seen by the age profile chart below, those Nursing and Midwifery staff under the age of 30 equates to just 16% of the Nursing and Midwifery workforce. *Based on average retirement age 60. Pay Scale Retirements Due 3 Months 6 Months 9 Months 12 Months 5 Years Non Review Body Band 8 - Range A Over Seas Nurse Band Personal Salary Review Body Band Review Body Band Review Body Band Review Body Band 8 - Range A Review Body Band 8 - Range B Review Body Band 8 - Range C Review Body Band 8 - Range D Review Body Band ` Grand Total

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11 Headcount Sickness Rate Turnover Exit Questionnaire Return Rate Vacancy Rate Mandatory Training Rate PADR Rate 4.0 MONTHLY DASHBOARD BY DIRECTORATE Directorate Target N/A 4.10% 0.78% 50% <7% 85% 95% Chief Nurses Office % 0.00% 0% 3.62% 91% Estates and Facilities % 0.45% 0% 8.76% 94% Finance % 0.00% 100% 13.33% 90% Medical Directors Office % 0.00% N/A 6.82% 47% Operations Clinical Support Services Operations Therapy & Community % 0.58% 60% 5.18% 90% % 0.62% 0% 7.98% 85% Operations Medicine % 0.96% 0% 12.78% 73% Operations Surgery & Critical Care Operations Women & Childrens People & Organisational Effectiveness % 0.41% 40% 6.88% 73% % 0.81% 0% -0.39% 75% % 0.00% N/A 3.11% 91% Strategy and Planning % 0.00% 0% 6.77% 97% * Exit questionnaire return rates and sickness rates are reported 1 month behind to ensure accuracy of data. * On the exit questionnaire column, N/A will be shown were there have been no leavers in the directorate. Were there have been leavers and no exit questionnaires returned this will result in a 0% return rate. 85% 90% 63% 67% 76% 72% 58% 54% 67% 80% 90%