DATE OF MEETING 29 November 2016 REPORT FOR Trust Board of Directors Public REPORT FROM Jayne Adamson, Director of People and Organisational Effectiveness CONTACT OFFICER Paul Bunyan, Interim Head of Employment and Recruitment Services SUBJECT Monthly Staffing Report BACKGROUND DOCUMENT (IF ANY) None REPORT PREVIOUSLY CONSIDERED BY & DATE(S) Resources Committee 23 November 2016 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? Yes WHERE RELEVANT, HAS PROPER CONSIDERATION BEEN GIVEN TO SUSTAINABILITY IMPLICATIONS (QUALITY & FINANCIAL) & CLIMATE CHANGE? N/A 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 ACTION REQUIRED BY THE BOARD The Board is asked to note the contents of the Staffing Report
Director of People and Organisational Effectiveness MONTHLY STAFFING REPORT Jayne Adamson, Director of People and Organisational Effectiveness November 2016 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. _ 1 of 40 pages
Executive Summary October Monthly Staffing Report Vacancy Summary The Trust wide vacancy position has increased by 0.01% in October and is now 6.96% which is still within target. Nursing vacancies are now at 5.24% - 132 WTE which is a decrease in month as a result of our newly qualified nurse cohorts starting to receive there Pin numbers full effect of this will be in November. Band 2 unregistered nursing vacancies have decreased in month and is now 1.15 WTE over established and is now close to a balanced position. Medical and Dental vacancies have continued to increase month on month since February 2016. This is the case for all grades of Medical Professionals other than SAS which has improved slightly in month. other non-training grades are representative of the largest increase in vacancy in month, current vacancy rates are 21.20 WTE against an establishment of 49.90 WTE. This is as a result of the August rotation because of Trust grade doctors leaving to either re-engage with training programmes or to take up other Trust grade positions at other Trusts work is ongoing to fill these gaps. Scientific & Therapeutic vacancy position has increased by 0.17% in month. Recruitment Activities Nursing and Medical recruitment continues to be the primary Trust focus. The Recruitment Team and Scientific & Therapeutic group will commence a sustainability style programme in December to introduce recruitment initiatives into areas that are identified as hard to fill Nursing Recruitment Upon confirmation of all starts in the system DPOW will have a nurse vacancy rate less than 10 WTE. Targeted recruitment continues to support SGH Medicine in several hotspot areas. A total of 68 nurses have confirmed start dates at the Trust. The next nursing recruitment open day is to be held during November with support from an ongoing advertising campaign. The newly qualified nurse campaigns for 2017 have now launched with a view to appointing in November 2017. Current Focus: Theatres Recruitment Ward 24 SGH A&E Medical Recruitment Recruitment for medical staff continues using a variety of methods. Traditional recruitment methods used in conjunction with agencies, plus utilisation of the medical training initiative (MTI scheme), have resulted in appointments across various grades and specialties. There are currently 49 appointed candidates in the pipeline awaiting start dates. Candidates start dates will phase from January 17 throughout the following financial year. The August rotation fill rate of 77.37% resulted in a large number of junior training grade vacancies, some Trust Grades have been appointed with further recruitment activity continuing to recruit to these vacancies. We are currently working with a larger number of agencies to source fixed term and permanent medical staff than previously, as the numbers of suitable candidates being submitted by agencies in the last 6 months had diminished. The Talent Acquisition Team are in place from the 10 th November. The teams _ 2 of 40 pages
primary focus is to create and deliver specific targeted recruitment campaigns and engage with individuals on a 1:1 basis. The team will work primarily on Hard to Fill vacancies and will be able to engage candidates that would not normally respond to NHS Jobs advertising. Initially the focus of this team will be to target medical vacancies to support current activity. Work is ongoing with the divisions to create Group recruitment plans which are tailored and focused. Current Focus: Consultant Radiology DPOW Consultant Radiology SGH Consultant Urology DPOW Consultant Emergency Medicine DPOW/SGH Specialty Doctor Emergency Medicine Consultant Acute Care - DPOW Consultant Neurology DPOW/SGH Consultant Gastroenterology DPOW Consultant Microbiology Juniors in various Specialties DPOW & SGH _ 3 of 40 pages
Board Report Staffing Summary November 2016 Contents 1.0 Introduction 6 2.0 Board Action 6 3.0 Recommendations 6 4.0 At a Glance 7 5.0 Vacancies and Staff Movements 9 6.0 Recruitment Activities 23 7.0 Cover Arrangements 26 8.0 Supporting Activities 37 _ 4 of 40 pages
1.0 INTRODUCTION This, the latest monthly edition to the Trust s Monthly Staffing Report, outlines performance against the workforce and staffing priorities agreed for 2016/17 and reports on these indicators to the Resource Committee and ultimately the Trust Board. For the 2016/17 indicators wherever possible data is provided outlining the Trust position for the previous year to allow for comparison. 2.0 BOARD ACTION The Board is asked to: Review the performance against the range of targets/indicators included within the report. 3.0 RECOMMENDATIONS There are no new recommendations this month _ 5 of 40 pages
4.0 At a Glance STAFFING INDICATORS AT A GLANCE: Nov-16 2016/17 Indicators Indicator Time period / RAG Comparator Target VACANCIES AND STAFF MOVEMENTS Oct-16 Previous Trends (less than) VSM1 Trustwide Vacancy rate 0.01% 6.96% G 6.95% 7% VSM2 Medical Vacancy Rate 0.49% 21.67% R 21.18% 12% VSM3 Nursing Vacancy Registered -1.29% 8.18% R 9.47% 6% Unregistered 1.36% -1.15% G -2.51% 2% VSM4 Scientific and Therapeutic Vacancy Rate 0.17% 4.39% G 4.22% 5% STABILITY AND TURNOVER Change Oct-16 Previous Trends Target VSM5 Number of leavers within 2 years of Service (% of Workforce) 0.0% 0.26% G 0.23% All staff 0.07% 0.92% G 0.85% 9.4% VSM6 Turnover Exc Medical 0.09% 0.92% G 0.83% 9.4% Return rate -9.00% 17.00% R 26.0% 50.0% VSM7 Exit Interviews and Questionnaires Staff Engagement - - G - To be developed To be developed SICKNESS Change Sep-16 Previous Trends Target VSM8 Sickness Rate -0.26% 4.70% R 4.96% 4.1% VSM9 Days lost due to Sickness -671 7653 R 8324 not set Indicator RECRUITMENT ACTIVITIES (targets in Working days) Change Time period / RAG Oct-16 Comparator Previous Trends Target (Working Days - less than) Authorisation - Time taken for vacancy to be authorised by RA1 1.10 15.90 R 14.80 10 relevant vacancy chain from point of submission Conditional Offer to Unconditional Offer - Time taken from RA2 conditional offer sent to all employments check clear and -4.80 20.40 R 25.20 20 contract sent (unconditional offer). Full recruitment process - The length of time taken from the RA3 vacancy being authorised in Trac to an unconditional offer 0.7 57.6 G 56.9 58 being made. Indicator CA14 AHP agency spend as % of total spend 0.00 0.00% G 0.00% Not yet available 4% Change Time period / RAG Prev 12 mths COVER ARRANGEMENTS Oct-16 Previous Trends Target (WTE - less than) CA1 Internal Locum usage (WTE) -8.51 48.38 R 56.89 45.00 CA2 Registered Nursing Bank usage (WTE) 10.65 78.62 R 67.97 55.00 CA3 Unregistered Nursing Bank usage (WTE) 1.54 65.61 R 64.07 60.00 CA4 Allied Health Professional Bank usage (WTE) -0.10 0.49 G 0.59 1.00 CA5 Medical Agency usage (WTE) 20.74 122.07 R 101.33 70.00 CA6 Registered Nursing Agency usage (WTE) -6.41 42.14 G 48.55 65.00 CA7 Unregistered Nursing Agency usage (WTE) 0.00 0.00 G 0.00 0.00 CA8 Allied Health Professional Agency usage (WTE) 1.74 25.12 R 23.38 11.00 Change Oct-16 Previous Trends Target CA9 Registered Nursing agency spend as % of total spend -0.01 4.47% G 5.90% 6% CA10 Registered Nursing bank spend as % of total spend -0.01 5.43% G 6.91% 8% CA11 Medical locum spend as % of total spend -0.02 7.69% G 10.11% 8% CA12 Medical agency spend as % of total spend 0.05 25.89% R 21.10% 15% CA13 AHP bank spend as % of total spend 0.00 0.00% G 0.00% Not yet available 4% Page 6 of 40 pages
Indicator Change Time period / RAG Prev 12 mths SUPPORTING ACTIVITIES Change Oct-16 Previous Trends SA1 HR - Number of open cases -35.00 234 G 269 Target Reduction of 0.42% per month (5% over the year) SA2 HR - Number of cases closed in month -6.00 51 G 57 45 SA3 HR - Age of oldest case under investigation (Weeks) -23.00 56 R 79 <26 weeks This Section 5.0 VACANCIES AND STAFF MOVEMENTS Vacancies Turnover Exit Interviews Sickness Page 7 of 40 pages
5.0 VACANCIES AND STAFF MOVEMENTS 5.0 VACANCIES AND STAFF MOVEMENTS 5.1 Vacancies VSM1 The number of vacancies across the Trust by staff group and Directorate Target: Less than 6% Trust total The below table shows a Trustwide overview of the vacancy position by Directorate and staff group Directorate Budgeted WTE Contracted WTE Vacancies WTE Vacancy Factor Previous Month Operations 4370.74 4051.30 319.44 7.06% 7.31% Path Links 389.93 356.25 33.68 9.71% 8.64% Facilities 533.89 502.77 31.12 6.60% 5.83% Corporate 515.90 496.18 19.72 4.47% 3.82% Totals 5810.46 5406.50 403.96 6.96% 6.95% Budgeted WTE Contracted WTE Vacancies WTE Vacancy Factor Previous Month Staff Group Nursing (Registered and Unregistered) 2328.33 2196.11 132.22 5.24% 5.68% Medical & Dental 623.14 591.19 131.95 21.67% 21.18% Scientific, Therapeutic, Technical 1070.83 1025.66 45.17 4.39% 4.22% Admin & Clerical 1268.65 1207.88 60.77 5.09% 4.79% Maintenance 49.00 49.80 0.80 0.41% (1.63%) Support Staff 467.82 433.17 34.65 7.66% 7.41% "Other" 2.69 2.69 0 0% 0.00% Totals 5810.46 5406.50 403.96 6.96% 6.95% Page 8 of 40 pages
Comments: The Trustwide vacancy position has increased by 0.01% in October. Medical and Dental continues to be the staff group with the highest vacancy rate, followed by Registered Nursing Actions: Please see Recruitment Activities (RA) for actions being taken to address vacancies Section 6 VSM2 Medical Vacancies Vacancies by Grade. Target <10% Source: Finance, Monthly Vacancy Report Budgeted Contracted Vacancies Vacancy Previous WTE WTE WTE Factor month Consultant 226.47 192.86 33.61 15.75% 14.84% SAS 127.47 96.77 30.70 23.30% 24.08% Other-Training 219.80 173.36 46.44 22.66% 21.13% Other-Non-Training 49.40 28.20 21.20 39.45% 42.91% Total Medical & Dental 623.14 491.19 131.95 21.67% 21.18% Comments: Vacancy rates across Medical and Dental remain outside of target, and have increased during October by 0.49% Actions: Please see Recruitment Activities (RA) for actions being taken to address vacancies Section 6 Page 9 of 40 pages
VSM3 Nursing Vacancies Vacancies by Service Area. Registered Nursing Vacancies. Target <6% Source: Finance, Monthly Vacancy Report Budgeted Contracted Vacancies Vacancy Previous WTE WTE WTE Factor month Medicine 545.89 473.47 72.42 9.62% 13.27% Clinical Support Services 61.87 58.24 3.63 6.29% 5.87% S&CC 426.23 367.88 58.35 12.15% 13.69% C&TS 179.65 168.56 11.09 7.07% 6.17% W&CS 311.42 313.18 (1.71) 0.65% (0.55%) Corporate 66.99 60.04 6.95 11.52% 10.37% Registered Nursing Total 1592.05 1441.32 150.73 8.18% 9.47% Comments: The overall vacancy rate for Registered Nursing has decreased during October by 1.29% Actions: Please see Recruitment Activities (RA) for actions being taken to address vacancies section 6 Page 10 of 40 pages
Unregistered Nursing Vacancies (HCA) by Service Area. Target <2% Source: Finance, Monthly Vacancy Report Budgeted Contracted Vacancies Vacancy Previous WTE WTE WTE Factor month Medicine 306.10 325.47-19.37 6.35% -6.33% Clinical Support Services 80.76 73.29 7.47 7.75% 9.25% S&CC 160.98 168.22-7.24 0.02% -4.50% C&TS 63.80 64.60-0.80 4.80% -1.25% W&CS 123.84 122.41 1.43 1.15% 1.15% Unregistered Nursing Total 736.28 754.79-18.51-1.15% -2.51% Comments: On-going work is taking place to review the band 3 over established position which is currently balancing the band 2 vacancy positions. Actions: Please see Recruitment Activities (RA) for actions being taken to address vacancies Section 6 Page 11 of 40 pages
VSM4 Scientific, Therapeutic and Technical Vacancies Vacancies by Service Area. Target <6% NB. Numbers in this area are low and therefore small adjustments can create large variations in the percentage vacancy rate Budgeted Contracted Vacancies Vacancy Previous month WTE WTE WTE Factor Medicine 28.36 25.01 3.35 11.81% 11.81% S&CC 52.26 74.50 (22.24) (46.38%) (42.56%) C&TS 336.66 316.55 20.11 5.62% 5.97% Clinical Support Services 299.82 280.09 19.73 6.52% 6.58% Pathlinks 338.93 315.51 23.42 8.43% 6.91% Corporate 1.80 1.00 0.80 44.44% 44.44% Facilities 13.00 13.00 0.00 0.00% 0.00% Scientific, Therapeutic, Technical Total 1070.83 1025.66 45.17 4.39% 4.22% Comments: The overall vacancy rate across this staff group has increased by 0.17% in October. The over establishment in Surgery and Critical care is due to an over establishment of ODPs Actions: Please see Recruitment Activities (RA) for actions being taken to address vacancies Section 6 Page 12 of 40 pages
5.2 Stability and Turnover VSM5 Number of Leavers with 2 Years of Service. * Excludes those on fixed term contracts Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Additional Clinical Services 4 5 6 6 4 5 5 5 5 2 1 8 17 4 9 6 Administrative and Clerical 1 3 2 2 0 0 1 4 2 1 4 6 4 4 8 7 Allied Health Professionals 1 4 4 2 0 1 1 2 1 0 3 6 0 0 0 2 Estates and Ancillary 0 4 0 1 1 0 2 0 3 0 1 6 1 1 2 0 Healthcare Scientists 0 1 0 0 0 0 1 0 0 2 1 3 0 1 2 0 Medical and Dental 0 2 1 0 1 1 0 1 1 0 1 0 5 0 2 0 Nursing and Midwifery Registered 8 7 3 3 5 10 4 4 3 2 3 12 3 4 5 1 Scientific, Therapeutic and Technical 0 1 1 0 0 0 0 0 0 0 1 2 2 0 0 0 Total 14 27 17 14 11 17 14 16 15 7 15 43 32 14 28 16 Total Workforce* 5788 5777 5783 5829 5874 5861 5865 5912 5960 5989 5992 5991 5985 5999 5998 5998 Percentage of Workforce 0.24% 0.47% 0.29% 0.24% 0.19% 0.29% 0.24% 0.27% 0.25% 0.12% 0.25% 0.71% 0.53% 0.23% 0.46% 0.26% Comments: October sees a decrease in the number of leavers within 2 years by 0.2% Actions: Please see actions under Turnover section (VSM6) Page 13 of 40 pages
VSM6 Turnover the proportion of employees who leave the Trust over the period, expressed as a percentage of total workforce numbers. Target <9.4% NB: Additional Clinical Services consists for Healthcare Assistants and Support Workers Actions: The main priorities remain as per the below: KF7 % of staff able to contribute towards improvements at work KF30 fairness and effectiveness of procedures for reporting errors, near misses and incidents KF31 staff confidence and security in reporting unsafe clinical practice Page 14 of 40 pages
5.3 Exit Interviews VSM7 Rate of Return the percentage of Exit questionnaires returned against the total number of leavers. Target not yet established Value How valued staff feel as a member of the Trust. Target not yet established There were 40 leavers reported in October. Of the total leavers, 5 forms were returned Leavers Number Exit questionnaire received % Exit interviews returned 52 9 17% Drilling into exit data reveals: In month change As a member of your ward or department's team how valued do you feel? Value and Satisfaction As a member of the Trust how valued do you feel? How much satisfaction do you get from working with your immediate colleagues? How much satisfaction do you get from working with your management team? How much personal satisfaction do you get from coming to work? -1.0-1.6-0.6-1.0-1.0 Oct-16 6.8 5.6 8.6 8.2 7.6 Sept-16 7.8 7.2 9.2 9.2 8.6 Aug-16 7.6 5.3 9.6 8.1 8.1 Jul-16 10 7.7 9 7.8 10 Jun-16 8.0 4.0 10.0 5.0 10.0 May-16 7.1 5.2 7.7 6.5 6.3 Apr-16 6.2 4.8 8.3 7 6.2 Mar-16 7.8 5.8 8.6 8.3 7.3 Feb-16 4.7 4.5 8 5.8 7.2 Jan-16 6.4 6.1 8.4 6.6 7.8 Dec 15 6.8 4.9 8.1 6.1 7.7 Nov-15 9.4 4 9.6 7.4 9 Page 15 of 40 pages
Return rate (%) Sense of Value In month change How well informed do you feel about what s happening within the Trust? Engagement and Workload How aware are you of the Trust s goals? How well do you feel you are able to cope with your current workload? How aware and engaged do you feel about the Trust s Vision & Values? How effective were your team meetings? -1.3-1.0 1.0 1.4 0 Oct-16 5.1 5.6 8.6 8.2 7.6 Sept-16 6.4 6.6 7.6 6.8 7.6 Aug-16 6.3 5.5 7.8 5.6 6.8 Jul-16 3.7 5.0 6.0 5.7 5.0 Jun-16 5.0 7.0 9.0 5.0 5.0 May- 16 6.1 5.9 7.6 6.3 5.5 Apr-16 6 6 7.8 5.8 5.3 Mar-16 5.8 5.5 8.3 5.1 5.1 Feb-16 5.3 5.2 6.3 4.8 5.5 Jan-16 4.4 6.6 6.9 5.2 4.1 Dec-15 6.4 6 7.2 5.6 5.5 Nov-15 6.2 5.8 9 6.4 8.6 Exit Interview Return Rates and Sense of Value 40.00% 35.00% 30.00% 25.00% 20.00% 15.00% 10.00% 5.00% 0.00% 12.00 10.00 8.00 6.00 4.00 2.00 0.00 Return Rate (Trustw ide) Sense of Value Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Aug- Sep- Oct- Jul-16 15 15 16 16 16 16 16 16 16 16 16 Return Rate (Trustwide)15.00%37.00%20.00%27.00%19.00%19.00%31.00%5.00%8.00%26.00% 13% 14.51% Sense of Value 4.00 4.90 6.10 4.50 6.80 6.20 6.30 10.00 10.00 8.10 8.6 7.60 Page 16 of 40 pages
5.4 Sickness VSM8 Sickness Rate. Target <4% NB Sickness data will always be reported 2 months behind. This is due to the timescales for accurate sickness data to be available The above graph shows where areas are in relation to the Trust s sickness target. Page 17 of 40 pages
Sickness % by Directorate Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Chief Executive & Chairman's 0.00% 0.64% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% Chief Nurses Office 4.63% 4.30% 4.33% 6.79% 5.56% 2.37% 2.71% 2.63% 3.28% 2.06% 4.06% 5.53% Deputy Chief Executives Office 1.39% 2.57% 2.74% 1.43% 3.54% 8.65% 7.57% 6.03% 3.40% 4.45% 3.54% 4.03% Estates and Facilities 5.86% 6.05% 5.41% 6.49% 7.61% 5.50% 5.85% 5.49% 4.98% 6.21% 5.98% 4.88% Finance 2.89% 1.63% 3.92% 5.46% 5.44% 4.72% 3.68% 2.49% 2.76% 3.27% 1.18% 0.91% Medical Directors Office 1.20% 1.19% 3.54% 0.36% 1.88% 2.38% 1.55% 2.15% 2.48% 1.12% 0.38% 0.90% Operations Clinical Support 4.87% 4.72% 6.21% 4.70% 4.83% 4.07% 3.65% 4.03% 3.99% 4.68% 5.33% 4.49% Operations Comm & Therapy 5.03% 4.20% 4.64% 4.76% 5.20% 5.54% 4.86% 4.29% 4.85% 5.57% 5.83% 5.29% Operations Medicine 5.13% 4.85% 5.31% 5.40% 4.94% 4.75% 4.27% 4.48% 4.96% 5.33% 5.22% 5.70% Operations Surgery & Critical Care 4.42% 3.95% 4.40% 4.61% 4.98% 4.34% 4.26% 4.28% 4.67% 5.05% 5.06% 4.84% Operations Women & Childrens 3.73% 4.09% 3.78% 4.77% 3.73% 4.39% 4.74% 4.81% 5.16% 5.54% 4.26% 4.48% People & Organisational Effectiveness 2.18% 2.01% 2.89% 2.22% 4.14% 4.23% 4.90% 1.27% 3.97% 2.03% 0.24% 0.65% Path Links 2.84% 2.48% 3.09% 2.94% 3.43% 4.83% 3.64% 3.50% 3.67% 3.71% 3.18% 3.35% Governance 0.32% 1.28% 2.26% 2.06% 1.69% 0.06% 1.31% 1.43% 0.00% 0.28% 1.87% 2.13% Strategy and Planning 2.14% 2.27% 2.97% 3.96% 3.76% 4.89% 3.38% 3.81% 2.88% 3.64% 3.95% 3.60% Target 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% Monthly Total 4.42% 4.17% 4.61% 4.78% 4.88% 4.65% 4.34% 4.29% 4.52% 4.96% 4.83% 4.70% Sickness % by Staff Group Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Additional Prof Scientific and 5.39% 4.09% 4.29% 4.93% 5.31% 2.37% 3.23% 4.67% 4.32% 5.91% 5.16% 3.88% Additional Clinical Services 5.51% 6.62% 6.43% 6.88% 6.81% 6.78% 6.32% 6.27% 6.13% 6.50% 6.32% 6.14% Administrative and Clerical 3.20% 3.38% 4.07% 3.99% 4.32% 3.57% 3.42% 3.55% 3.78% 4.26% 4.19% 4.08% Allied Health Professionals 3.99% 3.40% 3.26% 2.03% 2.78% 4.31% 3.73% 2.80% 3.28% 4.22% 4.44% 3.06% Estates and Ancillary 6.60% 5.61% 5.30% 6.28% 7.31% 5.59% 6.06% 5.66% 5.17% 6.59% 6.40% 5.26% Healthcare Scientists 3.26% 2.33% 2.31% 2.53% 3.18% 3.89% 3.74% 3.04% 3.56% 3.82% 2.39% 2.33% Medical and Dental 1.43% 1.55% 1.00% 0.97% 1.47% 1.37% 1.25% 1.39% 2.20% 2.02% 1.87% 2.26% Nursing and Midwifery 5.09% 5.16% 5.21% 5.38% 4.76% 4.93% 4.27% 4.34% 4.86% 5.02% 5.04% 5.54% Target 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% Monthly Total 4.42% 4.17% 4.61% 4.78% 4.88% 4.65% 4.34% 4.29% 4.52% 4.96% 4.83% 4.70% Comments: September saw another decrease in total sickness rate. The largest increase was within Chief Nurses Office. The largest decrease within a directorate was within Estates and Facilities. The Staff Group which saw the largest decrease was Additional Professional Scientific & Technical. Actions: A significant amount of work is being undertaken with HR in relation to sickness absence. This forms part of the Sustainability plans and a work stream specific to Absence has been created to review current absence procedures and processes, identify hotspot areas with highest level of sickness absence against backfill, and implement appropriate interventions including Occupational Health and other management support. E-Rostering will in future be more widely used by line managers in order to gain a more up to date picture of sickness absence across the Trust. However, this will initially only relate to the clinical workforce, although the roll-out of E-Rostering to the wider workforce is under consideration. Page 18 of 40 pages
VSM9 Days Lost Due to Sickness New Indicator for 2016/17 Page 19 of 40 pages
Sickness (FTE) by Directorate Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Chief Nurses Office 113.60 89.53 103.36 163.65 116.84 56.35 63.64 64.46 80.88 52.39 102.01 134.72 Deputy Chief Executives Office 11.00 3.48 25.00 13.09 30.91 84.76 68.60 59.30 32.00 41.83 33.00 35.79 Estates and Facilities 888.81 780.54 817.20 1027.33 1087.14 844.94 870.19 843.89 745.41 961.23 930.83 740.06 Finance 77.33 98.96 105.40 150.98 140.17 129.52 96.10 67.83 72.20 87.65 31.49 23.12 Medical Directors Office 23.40 34.16 39.60 5.44 19.68 26.96 19.00 27.72 32.00 15.00 5.00 11.47 Operations Clinical Support 895.09 900.56 1124.32 874.07 828.50 746.56 645.29 740.42 715.62 875.24 1005.66 822.21 Operations Community & 991.10 902.79 918.65 1003.87 946.13 1112.57 938.61 855.18 948.79 1128.81 1199.24 1414.97 Operations Medicine 1857.95 2008.40 2146.14 1941.46 1685.53 1752.38 1537.86 1698.09 1771.29 1954.36 1884.04 2012.47 Operations Surgery & Critical Care 1324.26 1445.43 1287.92 1390.38 1411.61 1323.75 1258.58 1308.57 1372.12 1528.21 1522.78 1048.57 Operations Women & Childrens 685.99 566.43 716.84 878.29 643.33 820.71 867.31 921.19 954.33 1060.93 822.89 845.77 People & Organisational Effectiveness 39.49 41.80 51.96 45.22 68.40 75.09 82.60 21.50 64.17 34.00 4.00 10.00 Path Links 327.55 328.33 346.36 360.02 372.32 547.31 387.82 387.16 393.77 411.27 351.47 355.41 Governance 4.81 43.20 37.20 34.52 26.11 1.00 21.81 25.00 0.00 5.00 32.80 36.20 Strategy and Planning 92.75 128.05 132.35 181.82 156.35 219.04 147.25 171.20 125.60 165.80 183.20 162.56 Target Monthly Total 7333.13 7371.66 7852.30 8070.14 7533.02 7740.94 7004.66 7191.51 7338.18 8324.72 8108.40 7653.32 Comments: September saw a drop of 455.08 days lost due to sickness compared to August. Medicine accounts for the greatest loss of days across the groups, making up 26.29% of the sickness absence. Actions: The Managing Attendance Sustainability Project is currently focusing on areas and initiatives to improve attendance and decrease sickness occurrence across the Trust. Page 20 of 40 pages
This Section 6.0 RECRUITMENT ACTIVITIES Medical Recruitment Nursing Recruitment Page 21 of 40 pages
6.0 RECRUITMENT ACTIVITIES 6.0 RECRUITMENT ACTIVITIES 6.1 Recruitment Dashboard Consultant Recruitment Forecast Comments and Actions: 47 posts are now in the pipeline pending start dates following successful pre-employment checks, and work is being undertaken to convert these into start date. Current adverts include Consultants in Gastroenterology and Anaesthetics, Specialty Doctors in General Medicine and Paediatrics, and junior doctors in Emergency Medicine and Trauma & Orthopaedics Medical Starter and Leavers (all grades) Vacancy & Pipeline Information Page 22 of 40 pages
Staff Group Consultants Vacancy @ 31.10.16 32.61 Vacancy Rate @ 31.10.16 14.40% Starters Oct 2.00 Leavers Oct 1.00 Recruitment in Progress 6.00 Pipeline Vacancy Figure 122.56 Pipeline % 11.74% Nursing Recruitment Nursing Recruitment Forecast Comments and Actions: Recruitment for newly qualified nurses has achieved 68 confirmed start dates across the Trust against a target of 50. 52 of these have received their NMC PIN numbers. Engagement campaigns continue with these newly qualified nurses to ensure retention. The next nursing open day date is in November 2016. Current Nursing Pipeline is 27. *between 5% & 9% fill rate represent a maintained fill rate against target. Page 23 of 40 pages
Nursing Starters & Leavers Vacancy & Pipeline Information Registered Staff Group Nursing Vacancy @ 31.10.16 149.56 Vacancy Rate @ 31.10.16 939.00% Starters Oct 15.36 Leavers Oct 14.19 Recruitment in Progress 27 Pipeline Vacancy Figure 26.61 Pipeline % 7.69% Page 24 of 40 pages
This Section 7.0 COVER ARRANGEMENTS Bank Usage (including Internal Locum) Agency Usage Bank and Agency Spend Page 25 of 40 pages
7.0 COVER ARRANGEMENTS 7.0 COVER ARRANGEMENTS Managing the gaps in rotas and establishments through the use of bank, agency and locum staff 7.1 Bank Usage CA1 Medical Bank Usage WTE (Internal Locums). Target <45 INTERNAL LOCUM '000 % Total 1617 YTD 1617 YTD Vacancy 3,301 80% Sickness 234 6% On Calls 180 4% Micro (no reasons) 127 3% Additional over establishment 86 2% Covering Absent Colleague On Call 47 1% Maternity Leave 32 1% Novice 23 1% Induction 23 1% Annual Leave 17 0% Paternity Leave 9 0% Special Leave 9 0% Rota Gap 6 0% Compassionate Leave 6 0% Study Leave 3 0% Restricted duties 2 0% ITU Relocation 1 0% Capacity 1 0% Strike 0 0% Audit 0 0% Patient Transfer 0 0% Shadowing 0 0% 4,107 100% Page 26 of 40 pages
CA2 Nursing Usage. Target <55 Bank WTE Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Medicine 25.48 17.57 23.97 23.97 31.52 26.09 28.77 25.81 28.43 29.02 30.38 32.47 Clinical Support Services 1.45 2.42 2.03 2.03 1.51 1.16 1.22 1.15 1.44 1.29 1.31 2.04 S&CC 14.85 10.58 15.56 15.56 19.85 16.14 17.8 19.13 18.26 20.45 20.3 22.67 C&TS 2.57 2.11 2.2 2.2 3.9 2.88 1.98 2.72 2.32 4.12 3.65 4.28 W&CS 13.61 13.6 13.82 13.82 18.7 18.26 16.01 14.42 15.81 12.8 15.66 16.19 Corporate 0 0 0 0 0.25 0.39 0.53 0.56 0.66 0.29 0.67 0.97 Estates & Facilities 0 0 0 0 0 0 0 0 0 0 0 0 Pathlinks 0 0 0 0 0 0 0 0 0 0 0 0 Total 57.96 46.28 57.58 57.58 75.73 64.92 66.31 63.79 66.92 67.97 71.97 78.62 Comments: Medicine group continues to be the highest user of bank and agency across the Trust. Top reasons for Nursing Bank Usage BANK- REGISTERED NURSING '000 % Total 1617 Vacancy/Backfill 1,336 60% Sickness 418 19% Other 486 22% Unknown 0 0% Total 2,240 100% Page 27 of 40 pages
CA3 Support staff Bank Costs and Usage. Target <60 Bank WTE Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Medicine 48.57 39.74 44.11 44.11 44.52 34.23 40.70 39.52 41.14 38.28 31.76 35.38 Clinical Support Services 1.65 4.89 5.03 5.03 4.93 4.07 5.08 6.19 4.9 6.87 8.88 9.19 S&CC 16.93 9.66 14.11 14.11 8.71 6.15 6.10 9.22 8.57 9.58 9.79 12.2 C&TS 1.1 2 1.44 1.44 2.33 1.15 1.37 1.04 1.25 2.98 2.75 2.89 W&CS 5.05 3.72 6.14 6.14 6.92 6.78 7.04 3.89 4.97 6.34 5.92 5.95 Corporate 0 0 0 0 0 0.00 0.00 0 0 0.02 0.05 0 Estates & Facilities 0 0 0 0 0 0.00 0.00 0 0 0 0 0 Pathlinks 0 0 0 0 0 0.00 0.00 0 0 0 0 0 Total 73.3 60.01 70.83 70.83 67.41 52.38 60.29 59.86 60.83 64.07 59.15 65.61 Comments: As with Registered Nursing, Medicine continues to be the highest user of Unregistered Bank staff BANK- UNREGISTERED NURSING '000 % Total 1617 Vacancy/Backfill 380 35% Sickness 351 33% Other 342 32% Unknown 0 0% Total 1,072 100% Page 28 of 40 pages
CA4 AHP Bank Usage. Target < 1.00 Comments: October sees a decrease of 0.64 WTE in AHP bank usage. Page 29 of 40 pages
7.2 Agency Usage CA5 Medical Agency Usage. Target <70 Top Reasons for usage EXTERNAL AGENCY '000 % Total 1617 YTD 1617 YTD Vacancy 6,737 83% Additional over establishme 478 6% Sickness 290 4% Annual Leave 189 2% Man Fee 153 2% Maternity Leave 113 1% On Calls 50 1% Special Leave 37 0% Study Leave 31 0% Induction 17 0% Novice 17 0% Rota Gap 14 0% Management Fee 13 0% Covering Absent Colleague O 10 0% Paternity Leave 8 0% Compassionate Leave 2 0% 8,159 100% Page 30 of 40 pages
CA6 Nursing Agency Usage. Target <65 Agency WTE Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Medicine 57.6 52 59.71 59.71 51.08 43.68 83.52 36.16 41.39 37.8 35.27 33.47 Clinical Support Services 0 0 0 0 0 0.00 0 0 0 0 0 0 S&CC 10.36 13.69 10.69 10.69 13.33 13.42 23.92 13.62 9.2 10.37 9.6 8.25 C&TS 0 0 0 0 0 0.00 0 0 0 0 0 0 W&CS 0.88 1.79 1.27 1.27 1.5 0.55 1.47 0.56 0.43 0.38 0.08 0.42 Corporate 0 0 0 0 0 0.00 0 0 0 0 0 0 Estates & Facilities 0 0 0 0 0 0.00 0 0 0 0 0 0 Pathlinks 0 0 0 0 0 0.00 0 0 0 0 0 0 Total 68.84 67.48 71.67 71.67 65.91 57.65 108.91 50.34 51.02 48.55 44.95 42.14 Comments: The Medicine Group continues to be the highest user of nursing bank & agency spend although usage continues to decrease. Top reasons for usage: AGENCY- REGISTERED NURSING '000 % Total 1617 Vacancy/Backfill 1,434 82% Sickness 217 12% Other 87 5% Unknown* 16 1% Total 1,754 100% Page 31 of 40 pages
CA7 Support/Unregistered Agency Usage. Target <0.00 Agency WTE Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Medicine 0 0 0 0 0 0 0 0 0 0 0 0 Clinical Support Services 0 0 0 0 0 0 0 0 0 0 0 0 S&CC 0 0 0 0 0 0 0 0 0 0 0 0 C&TS 0 0 0 0 0 0 0 0 0 0 0 0 W&CS 0 0 0 0 0 0 0 0 0 0 0 0 Corporate 0 0 0 0 0 0 0 0 0 0 0 0 Estates & Facilities 0 0 0 0 0 0 0 0 0 0 0 0 Pathlinks 0 0 0 0 0 0 0 0 0 0 0 0 Total 0 0 0 0 0 0 0 0 0 0 0 0 Comments: There continues to be no spend on Unregisted agency usage. Page 32 of 40 pages
CA8 AHP Agency Usage. Target < 1.00 Comments: October sees a decrease of 3.77 WTE compared to the previous month. Page 33 of 40 pages
7.3 Bank and Agency Spend CA9 and CA10 Registered Nursing Agency Spend as % of Total Spend Comments: Both bank and agency usage have decreased in month Page 34 of 40 pages
CA11 and CA12 Medical Agency and Locum Spend as % of Total Spend Comments: Internal locum usage has decreased within October by 2.43% however external agency usage continues to show an upward trend, rising 3.18% since last month. Page 35 of 40 pages
CA13 and CA14 Unregistered Nursing Agency and Locum Spend as % of Total Spend Agency spend remains nil and bank spend has increased in the month of October by 0.2% Page 36 of 40 pages
8.0 SUPPORTING ACTIVITIES This Section 8.0 SUPPORTING ACTIVITIES HR Number of cases open HR Number of cases closed HR Age of oldest case still open (weeks) 8.1 HR Number of cases open SA1 Current Cases by Type Page 37 of 40 pages
Chief Nurse Clinical Support Services Communities & Therapies Corporate Diagnostics Facilities Finance Medicine People & Organisational Effective Pathlinks Strategy & Planning Surgery & Critical Care Women & Childrens Trustwide The table below illustrates the open cases by type and department. The total of the current cases shown below differs from the KPI due to the KPI reporting date of the last day of the months, whereas the table below is as at the date the report is written which is affected by cases opened and closed in the interim. The Collective Grievance consists of 91 formal complaints regarding the Trust s Travel and Subsistence Policy Changes which came into force 1st July 2015. Active Casework Appeal 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Appeal - Trust Board 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Bullying & Harassment 0 1 0 0 0 0 0 5 0 0 0 0 0 0 Disciplinary 0 0 0 0 0 4 0 6 2 0 0 7 13 0 Freedom of Information 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Grievance - Collective 0 0 0 0 0 0 0 0 0 0 0 1 0 1 Grievance - Formal 0 1 0 0 0 0 0 0 0 0 0 0 0 0 Grievance - Informal 0 0 0 0 0 1 0 0 0 0 0 3 0 0 Performance - Formal 0 0 1 0 0 0 0 0 1 0 0 1 1 0 Performance - Informal 0 0 0 0 0 1 0 0 0 0 0 0 0 0 Sickness - 1st Stage Formal 0 11 6 1 0 20 0 20 0 2 0 14 8 0 Sickness - 2nd Stage Formal 0 1 0 0 0 6 0 7 0 1 0 2 1 0 Sickness - 3rd Stage Formal 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Sickness - Long Term 1 13 14 2 0 16 0 26 1 1 0 17 10 0 Tribunal 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Total Number of Cases 1 27 21 3 0 48 0 64 4 4 0 45 33 1 Page 38 of 40 pages
Active Casework Chief Nurse Clinical Support Services Communities & Therapies Corporate Diagnostics Facilities Finance Medicine People & Organisational Effective Pathlinks Strategy & Planning Surgery & Critical Care Women & Childrens Grand Total Bullying & Harassment Grievance - Informal Sickness - 3rd Stage Formal Appeal Tribunal Sickness - Long Term Sickness - 2nd Stage Formal Sickness - 1st Stage Formal Performance - Informal Performance - Formal Grievance - Formal Disciplinary The table below illustrates the number of suspensions in place for open cases within the Trust. Suspensions 0 0 0 0 0 0 0 1 1 0 0 3 0 8.2 HR Number of cases closed in the month SA2 Closed Cases by Type and Site. Community 1 2 3 DPoW 2 7 1 12 1 23 Goole 1 2 3 Lincoln 1 1 SGH 3 1 5 1 11 21 Total 5 1 2 14 2 26 1 51 Page 39 of 40 pages
8.3 HR Age of the oldest case unresolved (weeks). SA3 The longest current ongoing case relates to a Long Term Sickness case which is now at 56 weeks. Actions: As part of the HR redesign the team is looking at case management processes and procedures to continue to ensure cases are progressed in a timely and efficient manner. A particular focus is ensuring all exclusions from work are regularly reviewed in order to minimise the impact upon the service. The average length of exclusions for year 15/16 was 17 weeks. It is noted that on occasions the progress of some cases can be delayed where police investigation is required. The Employee Relations team regularly reviews practice and adjusts processes to reflect the changing needs of the organisation. As part of the Managing Attendance Project, work is currently taking place in conjunction with Occupational Health to facilitate earlier interventions for employees in the early stages of absence when they report with a mental health illness (stress, anxiety, and or depression) and also muscular-skeletal conditions (through access to the physiotherapy service). Page 40 of 40 pages