Board of Directors Meeting 6 April 2016 Agenda item 31/16 Title Sponsoring Director Author Purpose Executive Summary: Recruitment Update Mary Foulkes, Director of OD and HR Niki Butler, Interim Resourcing Manager To provide the Board with an update on progress The Trust vacancy rate in February was 8.06% which is an increase on previously reported in January of 7.86%. This is primarily as a result of new roles being created, and some positions no longer being on hold. The numbers at interview stage have increased e.g. scheduled nursing interviews have increased from 14.00 to 51.48 in one week. The recruitment team are continuing to support the Managers with their establishment structure and identifying whether vacancies are to be kept on hold. The action plan attached as Appendix 1 was previously presented to the CMT and has been updated to include additional measures to improve our marketing to potential applicants, recruitment incentives, improvements to the recruitment process to remove any avoidable delays and increasing our partnering with specialist agencies to source applicants for hard to fill roles. Appendix 2 and 3 provides of an update of progress against the Trajectory for nursing and doctors recruitment respectively. Date Reviewed by the Executive 24 March 2016 Related Trust Objective Corporate Objective 1 Patient Focus keep getting better. Risk 1,2,3 Corporate Objective 2 Staff feel proud to work here and keep making a difference. Risk 1 & 2. Legal implications / regulatory requirements Quality impact assessment Equality impact assessment Recommendations: Approve Assure Note x Our regulators expect organisations to ensure that staffing capacity and capability are appropriately funded, monitored and maintained. Permanent staffing levels need to be at an adequate level to provide safe nursing care. Monitoring recruitment levels will enable us to understand the impact of any permanent staffing deficit on care
Introduction This report provides the Board with an update regarding the current level of staff vacancies and the actions that are being taken to reduce the gap between the approved staffing establishment and the number of staff in post. In order to provide continuity of safe and effective patient care the Trust engages workers from its own Bank or from agencies to cover relevant vacant posts. However, the cost of agency staff is a significant financial pressure to the Trust and patient care is best served by a stable staffing situation. This has been made more difficult by the introduction of the first round of Agency Rate Caps on 23 rd November 2015 and subsequent one on 1 st February resulting in some shifts not being covered, agencies playing hard ball with specialist nursing roles e.g. Paediatrics and charging band 6 rates for band 5 roles and some continuous booking arrangements being cancelled. The next scheduled date for further reduction in agency rate caps is 1 st April 2016 which will provide us with additional challenges for coverage. General and Specialist Recruitment Campaigns 56 SKYPE interviews have been booked with nurses from the EU or already in the UK some with NMC clearances. We have offer jobs to 22 nurses with start dates in March and April. There are plans in place to travel to Italy in April to recruit Band 5 nurses for across all Directorates. We are already well into a procurement process for a further 40 nurses from Non- EU countries. The tender responses will be in the week beginning 21 st April 2016. We are also looking overseas for specialist hard to fill consultant s posts with a number of interviews scheduled and offers made most recently for ED. Recent Successes Increased focus on nurse recruitment with an additional 37 interviews scheduled in the UK. To support this open days have delivered 12 unqualified and 6 qualified nurses with the next Open Day scheduled 16 th April. Skype interviews completed with 22 offers made to date Non-Qualified Nurses 5 started in March with a further 20 offered for September start dates A focus on Nurse Bank recruitment increasing to 91 at offer stage (23 of which are qualified nurses) Bank recruitment in total has resulted in extra 94 cleared candidates since November. Focus on ED nurse recruitment has delivered 5 nurses with confirmed start dates with a further 2 awaiting clearances. Further ED nurse interview date scheduled for 23 rd March 1 Clinical Specialist for ED offered and 1 Clinical Fellow ST3 also offered Agency Rate Cap On the 20 th November all NHS Trusts received notice that Monitor and the NHS Trust Development Authority (NHS TDA) have introduced caps on the hourly rates paid for all agency staff, which took effect from midday on the 23 rd November 2015. The price caps apply across all staff groups doctors, nurses and all other clinical and nonclinical staff. The price caps do not apply to: substantive/permanent staff bank staff (both in-house banks and outsourced banks) overtime payments to substantive/bank staff staff employed by a trust on a fixed-term contract 2
As a result of this a number of agencies eventually reduced their rates to the new caps. However for specialist nursing especially Paediatrics at Band 5 level, we have been unable to keep to the cap rates. This has impacted on the projected coverage and there has been a requirement to use the breakglass opt out. There are also some historical bookings which have been honoured whilst looking for a solution long term. These are included in the return to Monitor We moved to phase 2 of the Agency Rate Caps on 1 st February which has resulted in a reduction of the rates even further. We will be working with our agencies to ensure that we are still able to book the shifts. All framework providers (Health Trust Europe H T E for Southend University Hospital NHS Foundation Trust) are now working with the agencies to ensure that they supply under capped rates. We have responded to their request to ensure that we only use these agencies. We continue to be compliant with the use of framework agencies for all bookings. From 1 April 2016, all trusts in scope of the agency rules will be required to use Monitor/TDA approved frameworks for the procurement of all agency staff (nurses, doctors, and other clinical and non-clinical staff). This is an extension of the existing requirement to procure all nursing staff via approved framework agreements. We ensure that we use Framework Agencies only as best practise however this has now become a new rule that will be monitored. The Trust is working with our framework providers to ensure that all of our agencies supply under the new price cap. Any agencies that are unable to are referred to back to HealthTrust Europe (HTE) for them to negotiate the rates. The Trust has now sent a letter to all the new THE approved agencies and is working on engaging with them for agency supply. This will include the use of an agreed Service Level Agreement where they will be monitored on their performance fill rate and compliance with agency cap. The Trust expects that there will be occasions following the April 1 st move, that there may occasion to break glass above the cap rates however we will be working with the framework provider to minimise these whilst keep the Trust safe with the required staffing. Actions to Reduce the Vacancy Gap Since the Board report in October 2015 intensive work and consultation with the Clinical Directorates and some corporate functions has taken place to start the process of developing a recruitment plan for the majority of hard to fill vacancies. The recruitment action plan has been amended as outlined in Appendix 1 which lists some of the overarching actions which will impact positively to reducing our vacancy rate. The following actions have taken place since January 2016 The launch of TRAC an applicant tracking and recruitment management system on 12 th January 2016 There is a full support programme with a dedicated team based in TRAC HQ to assist all our teams in the various processes. The recruitment process could be reduced by up to 7 days. An enhanced outcome of using TRAC is that all vacancies will automatically be advertised not only on NHS Jobs however Linked In and HealthJobsUK UK widening our pool of potential applicants. Auto enrolment onto the bank for nurses has been launched. This will increase the numbers on the bank however an opt out opportunity is included 3
Increased activity of recruitment of all staff onto the bank. Strong focus on increasing the numbers and achieving their compliance with a more streamlined approach Essex Hub Collaboration Group update. Working pan Essex with neighbouring Trusts on joint overseas recruitment for Doctors, regional rates and relocation package standardisation. The recruitment of overseas nurses is underway with the SKYPE interviews taking place with a schedule of the dates until end April. First nurses arrived on 7 th March. 56 interviews have been scheduled with a total of 22 offers The procurement of an agency to supply 100 nurses from EU is complete with Synergy having been awarded. The Trust will send representatives to interview in Italy on 11 th April 2016, A further procurement exercise for non-eu nurses is nearing completion with award week commencing 14 th March The Trust has expanded the talent pool of HCA and extended this scheme to registered nurses with 7 per day being rostered. Risks and Mitigations The labour market remains very competitive and a risk is that we will be unable to attract sufficient suitably qualified staff to fill all vacancies. This report describes actions being taken anto mitigate this risk and the situation will be kept under constant review. 4
Appendix 1 Over Arching Objectives To recruit the right people at the right time in order to provide high quality patient care and improve the patient experience To promote the Trust as an organisation that is recognised as a quality employer in respect of working environment, leadership and creativity, thereby attracting and retaining quality high performing staff. Action Plan KPI/Target Target Date Ensure that the recruitment team has a balanced skills and experience mix in HR Reorganisation completed order to deliver an integrated recruitment service Launch LinkedIn and Twitter campaigns to maximise our benefits from social media as a tool for attracting applicants. All Recruitment Officers have access to post their vacancies on a rolling programme Develop a proposal for the implementation of a recruitment and retention allowance in targeted areas in Medicine and Radiography staff Finalise commissioning plans for the Hard to Fill vacancies and the known rolling recruitment activities for the financial year with the plans to recruit. Develop an overseas recruitment plan for hard to fill posts. Overseas nursing recruitment underway for Stroke with initial commissioning of 20 nurses via waiver 56 interviews scheduled. Procurement in process for mini completion for additional campaigns completed. Travelling to Italy in March All posts advertise on LinkedIn and Twitter. Radiography Proposal approved by Executive Team Plans agreed and timeframes developed for each campaign. Campaign achieves its target March 2017 Update the Trust s marketing materials by updating the Success by the Sea Downloadable from the Trust s website brochure and develop associated videos to focus on individual recruitment campaigns Develop a workforce plan For approval by the CMT May 2016 Introduce the recruitment system called TRAC which will minimise the time to hire Implement the TRAC recruitment system d Develop a recruitment and retention strategy Discuss at CMT and gain approval from OD and Education Board Develop a talent pipeline Apprenticeship scheme introduced A structured succession planning process is introduced Develop a benefits and compensation strategy Facilitate the recruitment and retention of a Q3/16 Draft d Q3/16 5
high workforce. That cash remuneration reflects the extent of the role and responsibilities of individual posts and their contribution to the Trust. Our workforce are not disadvantaged by being on local terms and conditions of employment To ensure that the remuneration of Directors and VSMs is justifiable and provides good value for money. To provide a transparent framework for determining senior level remuneration. Increase opportunities to proactively attract a diverse range of candidates Gain accreditation to use the two ticks symbol Develop and roll out competency and value based recruitment assessment process to recruit the best candidates Attend careers fairs and other community based events Organise open days - current programme devised until August 2016 The Trust s values are embedded in the recruitment selection process Value based assessment rolled out in at least two functions/directorates on-going Q2/16 Q3/16 6