DRAFT NOTTINGHAM UNIVERSITY HOSPITALS NHS TRUST PEOPLE COMMITTEE MINUTES OF THE MEETING HELD ON 21 JUNE 2018 IN THE BOARDROOM, GROUND FLOOR, TRUST HEADQUARTERS, CITY HOSPITAL CAMPUS Present: E. Grant Non-Executive Director (Chair) D. Cartwright Non-Executive Director N. Hill Director of Human Resources K. Girling Medical Director S. Newport* Associate Non-Executive Director C. Reed Associate Non-Executive Director In Attendance: B. Asher Deputy Director of HR R. Carlin* Organisational Development Manager A. Chivinge* Pain Management and Ambulatory Care Matron B. Davies* Consultant Paediatric Surgeon R. Eddie* Deputy Chief Operating Officer O. Enwezor* Deputy Team Leader Theatres ENT A. Ghuwel* Orthopaedic F2 S. Gill* Consultant in Adult Critical Care C. Greaves* Chief Scientist L. Jonsson* Clinical Governance Facilitator H. Mancini* Assistant Director of Learning and Organisational Development G. Matsell* Head of Equality and Diversity A.M. Riley Deputy Chief Nurse Strategy L. Skaife-Knight Director of Communications L. Thomas Corporate Services Officer (Minute Taker) T. Wright Deputy Trust Secretary * present as indicated Cumulative Record of People Committee Members Attendance (2018/19) Name Possible Actual E. Grant 2 2 D. Cartwright 2 2 K. Girling 2 1 N. Hill 2 1 S. Newport 2 2 C Reed 2 2 M. Sunderland 2 1 2018/088 Introductions / Welcome 9.30 The Chair welcomed all present and in attendance at the meeting. Page 1 of 11
2018/089 Apologies for Absence Apologies for absence were received from: M. Rogan (Director of Corporate Governance) M. Sunderland (Director of Nursing, Midwifery, Operations and Service Improvement) 2018/090 Declarations of Interest on Agenda Items There were no declarations of interest on the present agenda. 2018/091 Minutes of the Meeting held on 24 May 2018 The minutes of the meeting held on 24 May 2018 were agreed as a true record subject to the following additions to the action log: Item 2018/072 Staff Story An update in respect of the business case for security and training on B3 to be added as an action Item 2018/073 Staff Survey Report and Action Plan Feedback encouraged from staff through team meetings and team building exercises to be added as an action 2018/075 Developing People and Improving Care Progress Report report to be linked with the Committee s Annual Programme of Work and priorities to be added as an action. 2018/077 Safe Staffing Quarterly Report winter staffing plans update to be added as an action Mrs Grant asked for an update following last month s patient story and in particular in respect of restraint handling training for staff on Ward B3. Mrs Hill explained that she had met colleagues from the Medicine Division and Estates and Facilities department to discuss this issue further. It was confirmed to Mrs Hill that level two training had been offered to staff on Ward B3, however, this had not been widely accessed. There was also a question over the use of the word restraint. Ms Riley added that violence and aggression remained under-reported within the Trust. Part of the level two training involved learning how to escalate issues as they arise. There was also the option for staff to call the Police. It had been identified that staff were not always following due process. Mrs Hill confirmed that a business case was currently under development for a dedicated Security Officer. Mrs Reed conveyed her concern over this matter and felt that the cost of providing support for the Ward far outweighed the costs of not acting. Dr Girling responded that the issue was more around vacancies within the team rather than a cost issue. Mrs Grant concluded that the business case must be completed in a timely manner, and the use of the word restraint monitored to ensure it was used correctly. It was a communications issue which required clarity. [Mr Matsell joined the meeting at this point] 2018/092 Matters Arising from the Minutes There were no matters arising. Page 2 of 11
2018/093 Terms of Reference The Committee received and noted the terms of reference. 2018/094 Committee Annual Programme of Work It was confirmed that both formats as requested by the Committee of the Annual Programme of Work had been included in the papers and were in use. It was noted that these should be formatted against the Trust s Strategy. In response to a question from Mrs Grant concerning the Medical Revalidation Paper, Dr Girling confirmed that this paper would be discussed at both July People and Trust Board meetings. 2018/095 Staff Story BAME Experience of NUH Career Progression and Workforce Race Equality Standard (WRES) Report 10.11 The Chair welcomed Ms Jonsson, Ms Chivinge and Ms Enwezor to the meeting. Ms Jonsson provided a presentation to the Committee on her personal experiences of career progression within the Trust, which included an overview of the blocks and barriers to progression for BAME (black, Asian and minority ethnic) staff. She explained that she had recently presented to Staff Experience Group. Ms Jonsson reported that BAME staff were keen to work with the Trust to assist with the retention of BAME staff and provide equitable opportunities for BAME career progression. Ms Chivinge provided the Committee with the background and explanation about the BAME Council. Ms Chivinge explained that the group had grown quickly and had become overwhelmed by the number of staff seeking support and wanting information on how to support others. The Council ran an international day to further raise awareness which was well attended and received. Ms Chivinge added that the Council s mission statement was; Unite, Empower and Inspire. The Council had also been approached by Trust PPI leads for support in the recruitment to PPI activities. The Chair also welcomed Mr Matsell to the meeting and invited him to present the WRES paper alongside the staff story. Mr Matsell explained that the Trust was required to complete this report annually and that this was born from a legacy of under representation of BAME staff within the NHS. It was also the direct result of the Snowy White Peaks report. The metrics within the WRES gave a range of indicators, which clearly showed a negative impact on BAME staff and demonstrated under representation from BAME employees at senior levels. There was collective working on this through the WRES. Mr Matsell added that the WRES did not include white minority groups. Mr Matsell explained some of the initiatives that were being undertaken to address the issues identified, which included reverse mentoring in nursing, for which NUH was one of the first Trusts to undertake. Mr Matsell added that there was more to be done though and he felt that this was a journey of training and dialogue. Mrs Reed noted the passionate presentations provided commented that it was useful to hear the personal experiences described. She explained, however, that it Page 3 of 11
would be useful to have some further information within the WRES report. For instance, although the report included details of the increase of BAME Nurses at band 8a and above, it did not provide a comparison figure to compare these figures to the total headcount. Mr Matsell would review this and circulate further information to the Committee. Mr Cartwright felt that this was something that required immediate action. He added that diversity training was offered within the Trust through mandatory training which all staff were required to complete. This would be a good opportunity to raise awareness of this issue. Mr Matsell added that there was the potential for people to have some type of unconscious bias and it was important, therefore for there to be diversification on interview panels. The Trust was actively training staff to fulfil these roles. Mr Cartwright added that studies had been carried out that demonstrated that the most successful businesses were those with good levels of diversity. Ms Chivinge added that the BAME Council had received numerous requests for advice from Managers seeking help for unconscious bias and managing this. The Council was very supportive of all people who contacted them. Mrs Reed added that the biggest regret was the loss of potential/opportunity in respect of recruitment, especially given the significant vacancies within the Trust. She expressed interest in observing how the Trust could increase mentoring and shadowing opportunities in order to help BAME staff meet their potential. Mrs Hill added that career development generally at NUH was lower than we would want. The Trust would need to develop plans to increase this. Mrs Reed stressed the importance of BAME staff receiving honest feedback following an unsuccessful interview process. Dr Girling gave thanks to the presenters for a powerful and important presentation, and for the positive work of the BAME Council. Dr Girling suggested that unconscious bias was more common than perhaps people thought and it was important to raise awareness to all staff about this issue and the impact of their actions. This required training and awareness, especially amongst recruiting officers. Dr Girling further commented that there were a number of areas within the Trust that could link into this work, for example, Guardians of Safe Working and Magnet. This was an issue that need to be discussed in more detail by the management team. Mrs Grant thanked the presenters and invited them to attend a further Committee meeting to provide an update. [Mr Matsell, Ms Jonsson, Ms Chivinge and Ms Enwezor left the meeting at this point] 2018/096 Guardians of Safe Working Report 11.03 [Dr Newport joined the meeting at this point]. The Chair welcomed Dr Gill, Dr Davies and Dr Ghuwel to the meeting. Dr Ghuwel presented his experiences of working as an F2 Junior Doctor on Wards C4, C5 and C6, which included some difficulties with fulfilling the medical staffing Page 4 of 11
rota and the subsequent actions which had been undertaken, resulting in increased staffing levels. Ms Hill queried why a locum had not been employed sooner and whether this story could be used to advise other junior doctors of the actions required should they find themselves in a similar situation. Dr Gill explained that some rota co-ordinators were more proactive than others and some junior doctors were more inclined to report this than others, whilst some perhaps felt it was part of their training and more inclined to accept the circumstances. Dr Gill explained that situations such as this were not viewed as exceptions. Cases such as this helped to highlight the reality of gaps on rotas and to raise the wider concern of junior doctors vacancies. Ms Hill emphasised the need for reporting on Datix. Ms Riley highlighted the Nursing Staffing App which had scope to be broadened beyond Nursing. This included questions such as, do you feel safe. Dr Girling added that unfortunately this was not a unique experience. The importance was in awareness raising and communication and support with identifying and reporting. Dr Gill explained that there had been guidance released on Good Rostering which the Trust would review and learn from. This would also be raised during the job planning review. Mrs Reed commented that she did not agree with the conclusion in the report as she did not believe that the Committee had received adequate assurance in respect of this report and that further work was still required.. Dr Girling confirmed that the medical workforce plan would be submitted to the Committee next month but added that this issue was being addressed through medical workforce planning, training for rota co-ordinators and training within HR teams. Following discussion, the Committee agreed that they could not accept the assurances within the report. Mrs Grant concluded that given the concerns raised by the Committee, this issue would be referred to the Trust Board. [Dr Gill, Dr Davies and Dr Ghuwel left the meeting at this point] 2018/97 Winter Review 11.30 Ms Hill explained that this paper had been the result of a request made previously by the Committee. Ms Hill reported that the winter had been a difficult and emotional period for staff, which included numerous instances of missed training and development opportunities. There was also particular reference made to those staff who had to liaise with patients to cancel operations and the impact this had had on those staff. There was also significant impact on speciality General Managers regarding back logs and waiting lists, which was on-going. Ms Hill confirmed that this report had been shared with Divisional Leadership Page 5 of 11
Teams. Ms Hill felt that the report provided good preparation for winter, including the language used to support staff from a resilience perspective throughout the period. Mrs Reed asked if there was the option to over-resource on staffing over the winter period to help with managing leave and absence. Ms Riley explained that planning had begun earlier this year, including in-nurse plans to over-resource where possible. Divisions were also agreeing safe staffing levels for all periods of the year taking seasonal changes into account. Dr Girling added that with the current number of vacancies it would not be possible to over-resource. An alternative model was to review other staffing groups, which was being discussed at the Quality Assurance Committee (QUAC). Ms Riley noted that alternative options needed consideration to gain staff feedback,as the Swartz Rounds for example were poorly attended due to lack of time to attend. Mrs Reed asked if over-staffing could be an option using Bank and Agency staff. Dr Girling confirmed that it would remain impossible to over-staff due to a national shortage of nurses. Dr Girling explained that discussions were taking place within Management Board to better understand what constituted a Black Alert, as this was taking a number of staff away from day to day duties with a query over the necessity of this. The Committee received and noted the report. 2018/098 LEC/Academy Board Quarterly Report 10.48 Mrs Mancini explained that the report detailed an overview of Learning and Organisational Development activity against the Trust s key priorities. This included key deliverables and the actions required and progress made against the actions for quarter one. Key progress included: strategy roadshows, a values refresh, a strategy experience group to review a revamp of the appraisal scheme, extended access to the NUH Leadership Programme and Organisational Development support for the Urgent and Emergency Care Work-stream Mrs Reed noted the need within the Strategy for talent and career progression, and the most efficient way to roll out the multi-disciplinary approach to Magnet Plus. Ms Hill explained there was a plan in place for this. This could be seen in the People Promise Milestones. Mrs Skaife-Knight added that this was timely as the point had been raised at a staff roadshow. There was appetite to understand Magnet. Ms Mancini added that improvements in engagement had been seen at many levels. Also, there was much work planned over the summer as a drive to encourage Apprenticeships. Page 6 of 11
Ms Hill noted that Talent Management had been rolled out across the Divisions. Mrs Grant asked that a report come back to the Committee detailing the actions and outcomes of the risks including attendance at mandatory training especially within Corporate Departments, the Apprenticeship Levy and the inadequacy of training venues. [Mrs Mancini left the meeting] 2018/99 Healthcare Scientist Update 12.02 Ms Greaves provided a presentation to the Committee detailing the role of a Healthcare Scientist at NUH, the national picture, what was going well, the excellent feedback received and the challenges that the service faced. Mrs Reed asked if Healthcare Scientists were working in any way with the ICS. Mrs Hill explained that there was workforce modelling which included looking at roles in an agnostic way to determine what skills were needed to develop care in the future. Mr Cartwright made reference to an award received for Equality and Diversity to which Ms Greaves explained that this was the result of diverse and wide recruitment resulting in a strong and vibrant team. The Committee thanked Ms Greaves for a strong, informative and positive presentation and she left the meeting. 2018/100 Six Monthly Detailed Workforce Information Report Mrs Hill explained that this was a six monthly report which had since added the characteristics of age and length of service. Mrs Reed asked for information regarding resilience planning for employees aged 56 plus and for more qualitative data on staff leavers and starters. Mrs Hill explained that this information was gathered and would be presented to the Committee at the next meeting. Ms Hill confirmed there was a campaign to ensure all staff requiring role related fire training was attending in a timely manner. 2018/101 Agency Spend 12.28 Mrs Hill provided a brief overview to the report explaining that agency spend was above cap. This was due to Consultant vacancies, with a lack of substantive staff to fill these vacancies. 2018/102 HR Board KPI s Mrs Hill explained that the report was also submitted to this month s Trust Board. Page 7 of 11
Mrs Hill reported that turnover was around target at 11.03% against a target of 11%. Healthcare Assistant turnover had reduced significantly. 2018/103 Items Referred to Other Board Committees The Committee asked that in future the Supporting Colleagues Report be submitted to this Committee. The Committee confirmed that the Audit Committee had asked that the People Strategy be included in the Internal Audit Plan for the year. 2018/104 Items to Draw to the Attention of the Board The items to draw to the attention of the Board were as follows: Guardians of Safe Working Report additional assurance required The Alcohol trends experienced in the City to be reported to the Health and Well-Being Board. Recruitment action plan following the BAME Career Progression presentation 2018/105 Items to Draw to the Attention of Other Committees None 2018/106 Agenda Items Identified For Future Meetings None 2018/107 Informal Review of People Committee Progress so far 2018/108 Evaluation To be given thought and added to the July agenda What went well? The Staff Story was insightful Even Better If? Kept to time (ten minutes over) What New Risks (if any) Have We Identified? Mandatory Training and medical rotas How Will Things be Different as a Result of Today s Meeting? Review of career progression opportunities Congruence with NUH s Values? Yes Page 8 of 11
2018/109 Date of Next Meeting 19 July 2018 at 10.00 am, Boardroom, City Hospital Campus Page 9 of 11
People Committee - Action Log 21 June 2018 Item/Reference Action Lead Deadline Comments/Update 2018/091 To present the outcome of the business case for a dedicated security presence on B3. A. Chatten L. Hourd TBC Minutes of the Meeting held on 24 May 2018 2018/094 Committee Annual Programme of Work 2018/095 Staff Story Committee s Annual Programme of Work to be formatted against the Trust Strategy. Additional figures on numbers of BAME staff against total headcount to be circulate to the Committee. B. Asher 19 July 2018 G. Matsell 19 July 2018 2018/095 Staff Story Further discussion concerning the BAME career progression would be undertaken within the NUH management team. N. Hill, K. Girling 21 August 2018 2018/095 Staff Story Mrs Grant invited the presenters to attend a further Committee meeting to provide an update. G. Matsell B. Asher TBC 2018/097 Guardians of Safe Working Report 2018/098 Winter Review Dr Girling agreed to present a medical workforce plan to the Committee in July A Management Board response to be provided on the definition of Black Alert K. Girling 19 July 2018 R. Eddie 21 August 2018 2018/099 Mrs Grant asked that a report come back to the Committee detailing the actions and H. Mancini 26 September 2018 Page 10 of 11
LEC/Academy Board Quarterly Report 2018/101 Six Monthly Detailed Workforce Information Report 2018/104 Items Referred to other Board Committees 2018/108 Informal Review of People Committee Progress so far outcomes of the risks in the report. Mrs Reed asked for information regarding resilience planning for employees aged 56 plus, and for more qualitative data on staff leavers and starters. Mrs Hill explained that this information was gathered and would be presented to the Committee at the next meeting. The Committee asked that in future the Supporting Colleagues Report be submitted to this Committee. To be considered and discussed at the next meeting N. Hill 19 July 2018 K. Girling TBC N. Hill 19 July Page 11 of 11