NLG(14)098. DATE 25 March Trust Board of Directors Part A. Dr Neil Pease, Director of OD & Workforce. Monthly Staffing Report

Transcription

1 DATE 25 March 2014 REPORT FOR Trust Board of Directors Part A REPORT FROM Dr Neil Pease, Director of OD & Workforce CONTACT OFFICER Dr Neil Pease, Director of OD & Workforce SUBJECT Monthly Staffing Report BACKGROUND DOCUMENT (IF ANY) None REPORT PREVIOUSLY CONSIDERED BY & DATE(S) N/A EXECUTIVE COMMENT (INCLUDING KEY ISSUES OF NOTE OR, WHERE RELEVANT, CONCERN AND / OR NED CHALLENGE THAT THE BOARD NEED TO BE MADE AWARE OF) N/A HAVE THE STAFF SIDE BEEN CONSULTED ON THE PROPOSALS? N/A HAVE THE RELEVANT SERVICE USERS/CARERS BEEN CONSULTED ON THE PROPOSALS? N/A ARE THERE ANY FINANCIAL CONSEQUENCES ARISING FROM THE RECOMMENDATIONS? No IF YES, HAVE THESE BEEN AGREED WITH THE RELEVANT BUDGET HOLDER AND DIRECTOR OF FINANCE, AND HAVE ANY FUNDING ISSUES BEEN RESOLVED? N/A ARE THERE ANY LEGAL IMPLICATIONS ARISING FROM THIS PAPER THAT THE BOARD NEED TO BE MADE AWARE OF? No WHERE RELEVANT, HAS PROPER CONSIDERATION BEEN GIVEN TO THE NHS CONSTITUTION IN ANY DECISIONS OR ACTIONS PROPOSED? WHERE RELEVANT, HAS PROPER CONSIDERATION BEEN GIVEN TO SUSTAINABILITY IMPLICATIONS (QUALITY & FINANCIAL) & CLIMATE CHANGE? THE PROPOSAL OR ARRANGEMENTS OUTLINED IN THIS PAPER SUPPORT THE ACHIEVEMENT OF THE TRUST OBJECTIVE(S) AND COMPLIANCE WITH THE REGULATORY STANDARDS LISTED Yes N/A Maintaining adequate safe staffing levels ACTION REQUIRED BY THE BOARD Note the content of the report

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3 DIRECTORATE OF ORGANISATIONAL DEVELOPMENT & WORKFORCE MONTHLY STAFFING REPORT Dr Neil Pease Director of Organisational Development and Workforce March 2014 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. Page 3 of 20 pages

4 Introduction This report provides an update on the staffing position within the Trust, identifying key trends. The report includes details on recruitment initiatives and key recruitment challenges. Key issues for the Board to note this month include: Despite advertising for radiologists the Trust has not been able to recruit. Currently working with NL Group to source suitable consultant locums with potential to be recruited on a temporary basis initially leading to permanent employment. Overseas recruitment continues to be pursued for medical positions currently focusing on Greece and Amsterdam. Several applications through the Medical Training Initiative (MTI) Scheme continue to progress. NHSJobs 2 was launched during the reporting period which impacted on the ability to place adverts as the system was down for a two week period. All recruitment team members have received internal training and the new systems enables the teams to invite for interview, request references all automatically through the software which will improve the turnaround time for a candidate. Private accommodation for the second cohort of overseas nurses in SGH has now been secured with all nurses now being based close to the Hospital. A further recruitment drive is now underway to recruit to a number of vacancies within the Medicine group at both sites which will include a tour to Madrid in the first week in April coupled with a national/local recruitment campaign. All job descriptions and adverts are now produced utilising the visions and values of the Trust and the appropriate branding. Working on bespoke adverts to be placed nationally for A & E Staff Grades DPOW (4 Vacant ) and Band 5 nurses specifically for Medicine at DPOW and SGH to run alongside the international recruitment exercise. Medical Staffing Position The monthly medical staffing report for the mid-march 2014 position (Appendix 1) shows that there has been no overall change to the number of medical posts in the establishment; these remain at a total of 603 posts. The number of posts currently vacant on a substantive basis is 64, giving a vacancy rate of 10.6% which is an increase in 3 posts being vacant from February Following recent meeting with NL Managed Services for February they report 113 requests for locums being filled with 9 not being filled for the month of February equalling 92.6% fill rate for all requested shifts. Work is currently being undertaken to analysis those shifts they were unable to fill and a comparison exercise as to the current rates of pay against previous years rates of pay is being produced for analysis. Net savings as a result of using NL Managed Services verses direct supply of locums stands at 79,400 for the month of February The following chart shows the number of posts and vacancies in the medical establishment from August 2013, since the formation of the Recruitment HUB. Page 4 of 20 pages

5 Medical vacancies Sept Oct Nov Dec Jan Feb Mar Post Substantively Filled A recruitment campaign aimed at engaging with consultants and medical staff based in the EU, South Africa, Australia, New Zealand and the Indian sub-continent commenced in January 2014 through the BMJ careers website. Originally 3 expressions of interest were received unfortunately this did not lead to securing any candidates and no further interest has been received. Work is being undertaken to scope the potential overseas recruitment of medical staff in both Greece and Amsterdam as possible countries of interest. As part of the research undertaken Greece is showing a significant development of health manpower with a high number of medical professions striking to protest at the government s austerity measures. A newly founded group called the Greek Medical Association consists of professionals who have decided to leave Greece and look for new career opportunities within the UK. Further work being taken to explore working in partnership with this group to undertake recruitment events within Greece. General Staffing Position Number of WTE Adverts Placed Sept Oct Nov Dec Jan Feb Medical Staffing DPOW Non Medical SGH/Goole/Communities Sept Oct Nov Dec Jan Feb Medical Staffing Non Medical Page 5 of 20 pages

6 In the 6-month period September 2013 to February, a total of wte posts have been advertised. This excludes the overseas recruitment and the UK cohort nursing recruitment exercises. There was a drop in activity due to the two weeks down time from the introduction of NHSJobs 2. External adverts are currently being designed to attract nurses into vacant positions within A & E at SGH and HDU at DPOW (pending the completion of the expansion). It is planned to advertise within the RCN bulletin alongside NHS Jobs/local recruitment campaign. New Starters within the Organisation In the 6-month period September 2013 to February wte, have commenced employment with Northern Lincolnshire and Goole Trust (excludes medical staff). We expect a rise in March/April due to a number of recruitment cohort days that have been held for Health Care Assistants and Bank staff. The recruitment team has communicated with existing staff within NLAG the requirement for additional bank members of staff and this has produced a number of applications which are being processed in a streamlined and efficient manner. 70 New Starters Sept Oct Nov Dec Jan Feb Zero Hours Bank All Directorates Admin, Estates, Scientific/Technical Nursing & Additional Clinical, Allied Health Page 6 of 20 pages

7 Bank/Agency Update Position This report provides a monthly update of bank shifts to allow the Workforce Review Group to monitor bank usage. The report provides data in terms of: The total number of shifts requested and total fill rate during the month Of the shifts that are filled, the number of shifts requested for both vacancy and sickness and other reasons Outcome Data Numbers of shifts requested The total number of shift requested for coverage by temporary staff in February was This represents a significant decrease compared to January of 1300 shifts. Of the total requested shifts 3748 were filled overall representing a percentage of 83% filled. The number of shifts filled by bank staff remains consistent this month from January to February at 2500 shifts approximately. The fill rate for agency however is significantly reduced from 1604 in January to 1199 in February. Diagram 1: Showing numbers of shifts requested, filled by Bank staff and filled by agency. Trust wide Requests for all Sites December January February Total Number of Requests Total Number filled by Bank Total number filled by Agency Reasons for requesting temporary staff Across the Trust the request reasons with the highest number of requests are vacancies and sickness. For February numbers of requests for Vacancy/Backfill remains consistently double the number requested for any other reason at Sickness and all other reasons show a slight decrease compared to January to 641 and 755 respectively. Page 7 of 20 pages

8 Diagram 2: Reasons for requests for Bank staff. Trust Wide Requests for all Sites December January February Vacancy/Backfill Sickness Other Nursing Figures Provided by Sheldon Mill/Finance by staff group Staff Groups Budgeted WTE Contracted WTE WTE Vacancy Factor Registered Unregistered ,2 6, , 4, % % Total Nursing % Medical & Dental % Scientific, Therapeutic, Technical % Admin & Clerical % Maintenance % Support Staff % "Other" % Totals % Page 8 of 20 pages

9 Directorate Budgeted WTE Contracted WTE WTE Vacancy Factor Operations % Diagnostics & Therapeutics % Facilities % Corporate % Totals % DPOW A&E review - Registered 8.71wte (To be agreed by trust board) SGH A&E review - Registered 15.87wte (To be agreed by trust board) UK Cohort - 2 wte (Mar/Apr) Spanish Nurse recruitment - 35wte (April) Central UK recruitment - 20wte (Apr/May) DPOW A&E review - Unregistered 5.43wte (To be agreed by trust board) SGH A&E review - Unregistered 6.11wte (To be agreed by trust board) GP F2 Doctors included in Dec report have been removed from February report and will not be included for future reports (21wte budget) Registered Nursing Budgeted WTE Contracted WTE WTE Vacancy Factor As at 28th February % Increased Establishments A&E DPOW 8.71 Increased Establishments A&E SGH Mar-14 UK Cohort 2 Apr 14 - Spain Recruitment 35 Apr 14 - Central UK Recruitment 20 Forecast registered nursing % Unregistered Nursing Budgeted WTE Contracted WTE WTE Vacancy Factor As at 28th February % Increased Establishments A&E DPOW 5.43 Increased Establishments A&E SGH 6.11 Forecast unregistered nursing % Total Nursing (As per above) % Page 9 of 20 pages

10 Bank and Agency Spend (nursing) Figures Provided by Sheldon Mill Nursing ET Report Nursing Pay Costs - Headlines Monthly figures for nursing staffing are now being produced, looking at WTE and actual expenditure. Nursing pay costs have continued to increase year on year since March 2011 Bank costs increased significantly in 2012 before plateauing at a high level. They are increasing again. Agency costs have remained relatively low until the current year when agency usage and costs increased significantly. No net vacancies for unregistered staff, whilst for registered staff the vacancy rate is falling. NURSING STAFF REPORT EXECUTIVE TEAM SUMMARY M11 28 Feb WTE TREND Worked WTE Mar-11 Mar-12 Mar-13 Jun-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Total Unregistered Total Registered 1,394 1,385 1,379 1,368 1,373 1,377 1,390 1,424 1,416 1,431 Total Nursing 1,979 1,998 1,998 1,978 2,023 2,049 2,073 2,106 2,113 2,146 Bank Ureg Bank Reg Bank total Agency HCA Agency Reg Agency total Total Bank & Agency Total Nursing 2,073 2,055 2,117 2,080 2,184 2,177 2,223 2,251 2,313 2,328 Central Nursing Functions Diagnostics TOTAL (Ops nursing) 2,008 1,987 2,053 2,016 2,120 2,114 2,157 2,183 2,246 2,254 Page 10 of 20 pages

11 Worked WTE - Operations Medicine DPOW Medicine S&GH Operations Central Surgery & CC Therapy & Comm Womens & Childrens ,008 1,987 2,053 2,016 2,120 2,114 2,157 2,183 2,246 2,254 Budgeted WTE Mar-11 Mar-12 Mar-13 Jun-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Total Unregistered Total Registered 1,470 1,409 1,448 1,473 1,485 1,496 1,506 1,506 1,536 1,536 Total Nursing 2,102 2,039 2,108 2,141 2,159 2,172 2,204 2,203 2,244 2,244 Bank Agency Total Bank & Agency Total Nursing 2,102 2,039 2,108 2,141 2,159 2,172 2,204 2,203 2,244 2,244 Central Nursing Functions Diagnostics TOTAL (Ops nursing) 2,032 1,969 2,044 2,080 2,098 2,110 2,141 2,140 2,180 2,180 Redundancy reductions - WTE Nurses HCAs CNS Nurse mngt Total DPoW SGH Goole Total Increase in budget: Feb n/a, Jan Medicine Estab ward review; Medicine DPOW Reg UnReg (8.16), Medicine SGH Reg UnReg W&C Reg (3.03) UnReg (1.2), TCS Macmillan Reg 1.0, Dec n/a, Nov Macmillan HT 20 SGH, A&E 8, Childrens HV 2, Oct SGH Surgical Wards 8 Single Access 3 Sep Louth Midwifery 9, B1 3, Operations Centre 5. Page 11 of 20 pages

12 3. VACANCIES Budgeted WTE Unregistered Registered Total as at 28th February DPoW A&E to be confirmed by Trust Board SGH A&E to be confirmed by Trust Board Post review establishment Contracted WTE Unregistered Registered Total as at 28th February Mar-14 UK cohort Est by ODW recruitment team Spain Recruitment Apr-14 Phase Est by ODW recruitment team Apr-14 Central UK recruit ment Est by ODW recruitment team WTE Unregistered Registered Total as at 28th February forecast as at Feb net shift in vacancies Page 12 of 20 pages

13 NURSING STAFF REPORT - OVERVIEW NHS Foundation Trust Vacancy % rates Unregistered Registered Total as at 28th February % 5.80% 3.37% forecast as at Feb % 3.63% 2.40% net shift in vacancies 1.64% -2.17% -0.97% 4. EXPENDITURE TRENDS Nursing pay costs per month Mar-11 Mar-12 Mar-13 Jun-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Total Nursing 5,738 5,851 5,866 5,936 6,010 6,014 6,061 6,154 6,272 Bank % 5.4% 4.9% 4.4% 5.0% 4.5% 5.2% 3.7% 4.6% Agency % 0.67% 2.33% 2.29% 7.88% 4.34% 6.55% 9.55% 11.57% ,015 TOTAL 5,968 6,204 6,290 6,332 6,782 6,545 6,774 6,967 7,286 Nursing pay costs ytd Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Total Nursing YTD 5,986 11,866 17,802 23,792 29,696 35,706 41,720 47,780 53,935 60,206 Bank YTD ,043 1,272 1,570 1,840 2,156 2,381 2,670 Bank YTD % 4.64% 4.47% 4.44% 4.38% 4.28% 4.40% 4.41% 4.51% 4.41% 4.43% Agency YTD ,293 1,554 1,952 2,539 3,265 Agency YTD % 1.60% 1.83% 1.98% 2.13% 2.76% 3.62% 3.72% 4.09% 4.71% 5.42% ,142 1,549 2,092 2,863 3,394 4,108 4,920 5,935 TOTAL 6,360 12,613 18,944 25,341 31,788 38,569 45,114 51,888 58,855 66,141 Page 13 of 20 pages

14 Agency costs per month Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Med DPOW Reg Unreg Med S&GH Reg Unreg Ops Central Reg Unreg Surgery & CC Reg Unreg W&C Reg Unreg Total Reg Total Unreg TOTAL Bank costs per month Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Med DPOW Reg Unreg Med S&GH Reg Unreg Ops Central Reg Unreg Surgery & CC Reg Unreg TCS Reg Unreg Page 14 of 20 pages

15 W&C Reg Unreg Diagnostics Reg Unreg Corporate Reg Unreg Total Reg Total Unreg TOTAL Page 15 of 20 pages

16 MEDICAL STAFFING - Northern Lincolnshire and Goole NHS Foundation Trust - February APPENDIX ONE Scunthorpe Grimsby Goole Total Department Grade total Vacancy total Current Situation Anaesthetics Consultants SAS Doctors Trust Doctors SGH - attempting to recruit locally Training Grades SGH - 2 substantive vacancies. One locum appointed to cover. Unsuccessful recrutiment process. Adverts due to go out over the next couple of weeks DPOW - two vacancies advertised repeatedly - offered jobs twice but declined. Not to be re-advertised until after February DPOW - attempting to recruit Specialty Doctors as above to cover, re-advertised. DPOW Junior post will be covered by Medical Training Initiative recritment. Start date TBC. ENT Consultants SAS Doctors Trust Doctors Training Grades General Surgery Consultants SAS Doctors Trust Doctors Training Grades Urology Consultants SAS Doctors SGH - Advert closes 14/01/2014, didn t appoint from these interviews Mr Coombs revising JD Trust Doctors Training Grades Ophthalmology Consultants SGH - Post to be advertised SAS Doctors additional Ophthalmology posts created. Advertised and agency sourcing Training Grades Oral Surgery Consultants SAS Doctors Training Grades Page 16 of 20 pages

17 Department Grade Scunthorpe Grimsby Goole Total total Vacancy total Current Situation Trauma & Orthopaedics Consultants SGH - New Consultant post SAS Doctors Trust Doctors Training Grades Emergency Medicine Consultants SAS Doctors Trust Doctors DPOW - Post appointed to waiting for start date SGH - 2 locums in place, unsuccessful recruitment in partnership with Hull, posts to be advertised locally. DPOW - 1 locum in place. Repeated attempts to recruit on a substantive basis been unsuccessful. SGH - advertised repeatedly, JD been revised by the deaprtment, locum cover provided on ad hoc basis. DPOW - One vacancy filled, doctor started 6 January Will continue to advertise and work with locum agencies to fill the other vacancies. Training Grades SGH - 1X ST4 Vacancy interviews 18/02/2014, waiting for the candidate to confirm. Despite several attempts to confirm the candidate has failed to accept the post. Given deadline of to accept or decline. Acute Medicine Consultants SGH - 2 new posts. have been advertised twice, no suitable candidates. SAS Doctors SGH - New post from October 2013, General Manager finalising JD and advert Trust Doctors SGH - New post from October 2013, General Manager finalising JD and advert. Training Grades Cardiology Consultants SAS Doctors Training Grades SGH - Vacant ST3 - various unsuccessful recruitments 0 0 Gastroenterology Consultants SAS Doctors Trust Doctors SGH - ed General Manager to check about the recruitment. DPOW -One Consultant currently on sabbatical SGH - Agency locum in place - despite numerous adverts cannot recruit to the post. Job description sent to Royal College 04/10/2013, advert sent back from college with comments for the department. Job description sent to General manager for comment on 11th October no response received team to chase. Training Grades DPOW - ST3 post vacant not being recruited to by the Deanery, Fixed Term Specialty Doctor to be advertised - awaiting job description. Diabetes / Endocrinology Consultants SGH - ed General Manager to check about the recruitment. SAS Doctors Training Grades Page 17 of 20 pages

18 Scunthorpe Grimsby Goole Total Department Grade total Vacancy total Current Situation Respiratory Consultants SAS Doctors SGH - Long-term vacancy (since Nov 2012), agency locum in place. Post advertised twice, no suitable applicants Training Grades SGH - ST3 been vacant and unfilled on long-term basis. Care for Older People / Stroke Consultants SGH posts have been advertised twice, no suitable applicants SAS Doctors SGH - General Manager drafting JD. DPOW - Post re-advertised again, no shortlistable candidates, awaiting instructions on re-advertising. Training Grades SGH - Vacant ST3 - various unsuccessful recruitments Palliative Care Consultants New post - Post advertised but no suitable applicants. SAS Doctors Trust Doctors Training Grades Dermatology Consultants SAS Doctors General Manager drafting JD Training Grades Haematology/On cology Consultants General Manager drafting JD SAS Doctors Appointment made to Specialty Doctor vacancy at DPOW Trust Doctors Training Grades Neurology Consultants SAS Doctors Trust Doctors Training Grades Interviewed and offered post but declined. Awaiting revisied Job Description before being readvertised. Rheumatology Consultants SAS Doctors Trust Doctors Training Grades Page 18 of 20 pages

19 Department Grade Scunthorpe Grimsby Goole Total total Vacancy total Current Situation Obstetrics & Gynaecology Consultants SGH - Waiting for JD SAS Doctors Training Grades SGH - Department have put vacancy on hold. DPOW - F/T SD advertised,unsuccessful - need to check about re-advertising Paediatrics Consultants SAS Doctors DPOW - unsuccessful recruitment, re-advertised as Specialty Doctor, interview date TBC. Training Grades SGH - Candidate withdrew, need to check with the department about re-advertising Radiology Consultants Working with NL Group to fill on a temp to perm basis CV's being submitted for approval to interview. SAS Doctors Training Grades New post (based cross-site, not just DPOW) interviews 1 November unsuccessful (candidate not suitable) awaiting instructions regarding re-advertising. Path Links Consultants SAS Doctors Training Grades Lincoln Cellular Pathologist - post re-advertised, closing date 30 December 2013, interviews 30 January 2014, offered to candidate who didn t accept, gone back to the department to see what the next steps are. Community Dental Consultants SAS Doctors Trust Doctors Training Grades Rehabilitation Medicine Consultants SAS Doctors Trust Doctors Training Grades Advertised twice, no candidates. Not re-advertising at this stage, considering using agencies to source a locum Page 19 of 20 pages

20 Department Grade Scunthorpe Grimsby Goole Total Minor Injuries Unit Consultants total Vacancy total Current Situation SAS Doctors One doctor appointed from SGH. Rotas being reviewed Trust Doctors Training Grades General Practice (F2's) Training Grades Psychiatry Training Grades TOTALS Page 20 of 20 pages