NLG(16)235. DATE OF MEETING 31 May Trust Board of Directors Public REPORT FOR

DATE OF MEETING 31 May 2016 REPORT FOR Trust Board of Directors Public REPORT FROM Dr Karen Dunderdale, Deputy Chief Executive and Jayne Adamson, Specialist Human Resources Lead CONTACT OFFICER Dr Karen Dunderdale, Deputy Chief Executive SUBJECT Monthly Staffing Report BACKGROUND DOCUMENT (IF ANY) None REPORT PREVIOUSLY CONSIDERED BY & DATE(S) Resources Committee 25 May 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 Maintaining adequate safe staffing levels ACTION REQUIRED BY THE BOARD The Board is asked to note the contents of the Staffing Report

DATE 31 st May 2016 REPORT FOR Trust Board of Directors Public REPORT FROM Dr Karen Dunderdale, Deputy CEO and Jayne Adamson, Specialist HR Lead CONTACT OFFICER Dr Karen Dunderdale, Deputy CEO SUBJECT Monthly Staffing Report BACKGROUND DOCUMENT (IF ANY) None REPORT PREVIOUSLY CONSIDERED BY & DATE(S) Resource Committee 25 th May 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? 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 The Board is asked to note the contents of the Staffing Report

DEPUTY CHIEF EXECUTIVES OFFICE MONTHLY STAFFING REPORT Dr Karen Dunderdale, Deputy Chief Executive Jayne Adamson, Specialist HR Lead May 2016 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 _ 2 of 42 pages

Board Report Staffing Summary May 2016 Contents 1.0 Introduction 4 2.0 Board Action 4 3.0 Recommendations 4 4.0 At a Glance 5 5.0 Vacancies and Staff Movements 6 6.0 Recruitment Activities 23 7.0 Cover Arrangements 27 8.0 Supporting Activities 39 _ 3 of 42 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 2015/16 and reports on these indicators to the Resource Committee and ultimately the Trust Board. For the 2015/16 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 _ 4 of 42 pages

4.0 At a Glance Northern Lincolnshire and Goole NHS Foundation Trust STAFFING INDICATORS AT A GLANCE: May-16 2015/16 Indicators Indicator Time period / RAG Comparator Target VACANCIES AND STAFF MOVEMENTS Apr-16 Previous Trends (less than) VSM1 Trustwide Vacancy rate 0.15% 7.11% R 6.96% 7% VSM2 Medical Vacancy Rate 2.09% 18.42% R 16.33% 12% VSM3 Nursing Vacancy Registered 0.52% 9.69% R 9.17% 6% Unregistered -1.18% -1.62% G -0.44% 2% VSM4 Scientific and Therapeutic Vacancy Rate 0.29% 6.87% R 6.58% 5% STABILITY AND TURNOVER Change Apr-16 Previous Trends Target Number of leavers within 2 years of Service (% of VSM5-0.1% 0.12% G 0.25% Workforce) VSM6 VSM7 Turnover Exit Interviews and Questionnaires All staff -0.10% 0.71% G 0.81% 9.4% Exc Medical -0.10% 0.72% G 0.82% 9.4% Return rate 0.00% 19.00% G 19.0% 50.0% Staff Engagement - - G - To be developed To be developed SICKNESS Change Mar-16 Previous Trends Target VSM8 Sickness Rate -0.13% 4.65% R 4.78% 4.1% VSM9 Days lost due to Sickness -329 7741 R 8070 Indicator RECRUITMENT ACTIVITIES (targets in Working days) Change Time period / RAG Apr-16 Comparator Previous Trends Target (Working Days - less than) Authorisation - Time taken for vacancy to be authorised by RA1 0.90 16.30 R 15.40 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 0.41 24.61 R 24.20 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 4.2 63.7 R 59.5 58 being made. Indicator Change Time period / RAG Prev 12 mths COVER ARRANGEMENTS Apr-16 Previous Trends Target (WTE - less than) CA1 Internal Locum usage (WTE) 0.05 51.82 R 51.77 45.00 CA2 Registered Nursing Bank usage (WTE) -10.81 64.92 R 75.73 55.00 CA3 Unregistered Nursing Bank usage (WTE) -15.03 52.38 G 67.41 60.00 CA4 Allied Health Professional Bank usage (WTE) 0.02 0.21 G 0.19 1.00 CA5 Medical Agency usage (WTE) 1.66 86.32 R 84.66 70.00 CA6 Registered Nursing Agency usage (WTE) -8.26 57.65 G 65.91 65.00 CA7 Unregistered Nursing Agency usage (WTE) 0.00 0.00 G 0.00 0.00 CA8 Allied Health Professional Agency usage (WTE) 1.93 18.23 R 16.30 11.00 Change Apr-16 Previous Trends Target CA9 Registered Nursing agency spend as % of total spend -0.04 5.42% G 9.59% 6% CA10 Registered Nursing bank spend as % of total spend 0.01 5.23% G 4.04% 8% CA11 Medical locum spend as % of total spend 0.00 10.00% R 10.09% 8% CA12 Medical agency spend as % of total spend 0.00 17.00% R 16.56% 15% CA13 AHP bank spend as % of total spend 0.00 0.00% G 0.00% Not yet available 4% CA14 AHP agency spend as % of total spend 0.00 0.00% G 0.00% Not yet available 4% Page 5 of 42 pages

Indicator Change Time period / RAG Prev 12 mths SUPPORTING ACTIVITIES Change Apr-16 Previous Trends SA1 HR - Number of open cases -123.00 222.00 G 345.00 Target Reduction of 0.42% per month (5% over the year) SA2 HR - Number of cases closed in month 1.00 32.00 R 31.00 45 SA3 HR - Age of oldest case under investigation (Weeks) 33.00 114.00 R 81.00 <26 weeks This Section 5.0 VACANCIES AND STAFF MOVEMENTS Vacancies Turnover Exit Interviews Sickness Page 6 of 42 pages

5.0 VACANCIES AND STAFF MOVEMENTS Northern Lincolnshire and Goole NHS Foundation Trust 4.0 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 4361.53 4015.28 346.25 7.94% 7.38% Path Links 389.83 358.14 31.69 8.13% 8.13% Facilities 528.00 496.77 31.23 5.91% 5.42% Corporate 492.75 491.58 1.17 0.24% 4.02% Totals 5772.11 5361.77 410.34 7.11% 6.96% Budgeted WTE Contracted WTE Vacancies WTE Vacancy Factor Previous Month Staff Group Nursing (Registered and Unregistered) 2345.05 2201.03 144.02 6.14% 6.10% Medical & Dental 613.83 500.77 113.06 18.42% 16.33% Scientific, Therapeutic, 1068.68 995.23 73.45 6.87% Technical 6.58% Admin & Clerical 1226.83 1183.15 43.68 3.56% 4.60% Maintenance 49.00 50.00 (1.00) (2.04%) (8.70%) Support Staff 466.03 428.90 37.13 7.97% 7.82% "Other" 2.69 2.69 0 0% 1.10% Totals 5772.11 5361.77 410.34 7.11% 6.96% Page 7 of 42 pages

Comments: The Trustwide vacancy position has increased by 0.15% in April Medical and Dental continues to be the staff group with the highest vacancy rate, followed by Registered Nursing Unregistered nursing vacancy position has improved dramatically over the past 3 months and is now fully established Actions: Discussions have commenced with each Directorate and department to discuss current staffing challenges and begin data collection ahead of the LETB workforce data collection which is due to be received on 3 rd May. Following on from this data collection, a Trust workforce plan will be created following the Six Steps approach. Tools and mechanisms such as the Calderdale Framework will then be utilised to support the transformational work required across the Trust. Page 8 of 42 pages

VSM2 Medical Vacancies Vacancies by Grade. Target <10% Source: Finance, Monthly Vacancy Report Budgeted Contracted Vacancies Vacancy Previous WTE WTE WTE Factor month Consultant 224.16 194.53 29.63 13.22% 11.71% SAS 121.47 96.97 24.50 20.17% 17.43% Other-Training 218.80 172.07 46.73 21.36% 20.86% Other-Non-Training 49.40 37.20 12.20 24.70% 14.35% Medical and Dental Total 613.83 500.77 113.06 18.42% 16.33% Comments: Vacancy rates across Medical and Dental remain outside of target, and have increased slightly during April Other Non-Training Grades has deteriorated again during April, by 10.35%. This equates to a total of 12.20 WTE vacancies. Establishments have however increased from 42.20 WTE in February to the current 49.40 WTE Actions: Please see Recruitment Activities (RA) for actions being taken to address vacancies Section 6 Page 9 of 42 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 567.62 482.35 85.27 15.02% 15.18% Clinical Support Services 61.87 57.03 4.84 7.82% 0.70% S&CC 424.80 379.59 45.21 10.64% 10.28% C&TS 174.69 162.35 12.34 7.06% 3.99% W&CS 318.11 313.36 4.75 1.49% 1.47% Corporate 61.87 58.32 3.55 5.74% 9.20% Registered Nursing Total 1,608.96 1,453.00 155.96 9.69% 9.17% Comments: The overall vacancy rate for Registered Nursing has declined slightly during April There has been an improvement across all specialties, apart from Community and Therapies which has declined slightly. Clinical Support Services has increased by 7.12% which represents 4.84 WTE vacancies Actions: Please see Recruitment Activities (RA) for actions being taken to address vacancies section 6 Page 10 of 42 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 317.03 325.20 (8.17) (2.58%) (1.19%) Clinical Support Services 80.76 74.31 6.45 7.99% (0.39%) S&CC 160.57 171.29 (10.72) (6.68%) (1.11%) C&TS 64.23 62.93 1.30 2.02% 4.33% W&CS 113.50 114.30 (0.80) (0.70%) (0.17%) Unregistered Nursing Total 736.09 748.03 (11.94) (1.62%) (0.44%) Comments: April has seen a further increase in the over establishment of unregistered nursing vacancy rates. Community and Therapies have a reduced vacancy rate from 4.33% last month Actions: Please see Recruitment Activities (RA) for actions being taken to address vacancies Section 6 Page 11 of 42 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 25.67 2.69 9.49% 12.15% S&CC 52.26 70.19 (17.93) (34.31%) (36.37%) C&TS 335.51 303.76 31.75 9.46% 8.99% Clinical Support Services 298.82 268.58 30.24 10.12% 9.14% Pathlinks 338.93 313.03 25.90 7.64% 7.65% Corporate 1.80 1.00 0.80 44.44% 20.00% Facilities 13.00 13.00 0.00 0.00% 7.69% Scientific, Therapeutic and Technical Total 1,068.68 995.23 73.45 6.87% 6.58% Comments: The overall vacancy rate across this staff group continues to increase, and has increased by 0.29% during April The corporate vacancy rate only in fact accounts for 1 vacancy 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 42 pages

5.2 Stability and Turnover VSM5 Number of Leavers with 2 Years if Service. * Excludes those on fixed term contracts Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 Additional Clinical Services 6 9 4 4 5 6 6 4 5 5 5 5 2 Administrative and Clerical 1 4 0 1 3 2 2 0 0 1 4 2 1 Allied Health Professionals 2 4 2 1 4 4 2 0 1 1 2 1 0 Estates and Ancillary 0 0 1 0 4 0 1 1 0 2 0 3 0 Healthcare Scientists 0 0 0 0 1 0 0 0 0 1 0 0 2 Medical and Dental 0 1 0 0 2 1 0 1 1 0 1 1 0 Nursing and Midwifery Registered 9 19 9 8 7 3 3 5 10 4 4 3 2 Scientific, Therapeutic and Technical 0 1 0 0 1 1 0 0 0 0 0 0 0 Total 18 38 16 14 27 17 14 11 17 14 16 15 7 Total Workforce* 5866 5812 5784 5788 5777 5783 5829 5874 5861 5865 5912 5960 5989 Percentage of Workforce 0.31% 0.65% 0.28% 0.24% 0.47% 0.29% 0.24% 0.19% 0.29% 0.24% 0.27% 0.25% 0.12% Comments: The ongoing trend shows a continued decline in the number of staff who are leaving within 2 years of employment Peaks during April and August of 2015 can be attributed to consultations ongoing across the Trust at the time, such as the Clinical Admin Review. The two staff groups that account for the most leavers within a two year period are Additional Clinical Services and Nursing. Actions: Please see actions under Turnover section (VSM6) Page 13 of 42 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 Page 14 of 42 pages

April-16 Staff Group Leavers Additional Clinical Services 9 Administrative and Clerical 6 Allied Health Professionals 3 Estates and Ancillary 3 Healthcare Scientists 3 Medical and Dental 0 Nursing and Midwifery Registered 20 Scientific, Therapeutic and Technical 1 Total 45 Comments: Overall turnover has decreased again in month from 0.81% to 0.71% - the second consecutive decrease. IN-month turnover is now at the lowest it has been in over 12 months. Nurse turnover has decreased slight in terms of percentages during April due to the increase in staff in post. However, there has still been 20 nurses leave during April. The Medical turnover has again decrease and is the lowest it has been in over a year. Actions: March s report outlined the findings of Februarys published NLG national staff survey 2015. Since then a detailed and comprehensive staff survey action plan has been created. The plan has a minimum of three actions aligned to each of the 32 key findings. The plan has been consulted on with the CEO, QPEC and the Resource Committee. Communication of the plan has commenced with all staff, and work on the deliverables within the plan has commenced in priority order, the main priorities being: 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 KF26 % of staff experiencing harassment, bullying or abuse from staff in the last 12 months Page 15 of 42 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 45 leavers reported in April. Of the total leavers, 8 forms were returned 19% Leavers Number Exit questionnaire received % Exit interviews returned 45 8 19% From which following reasons for leaving were given: Reason for Leaving Number of leavers Death in Serivce 5% TUPE 3% End Fixed Term Contract 5% Flexi Retirement 3% Retirement (Normal/Early) 40% Voluntary Resignation Reason not known 23% Voluntary Resignation Better job/promotion 21% Total 100% Drilling into exit data reveals: 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? In month change -0.4-1.0-0.3-1.3-1.1 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 Oct-15 7.1 5.5 8.4 6.3 7.4 Sep-15 5.7 5.8 7.2 5.6 6.3 Aug-15 6.2 6.4 6.7 6.3 6.5 Jul-15 6.3 7.1 7.5 7 6.4 Jun-15 5.9 6 7.2 6.2 5.8 May-15 5.6 5.9 7.3 6.1 6 Page 16 of 42 pages

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? 0.2 0.5-0.5 0.7-0.2 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 Oct-15 7.1 5.5 8.4 6.3 7.4 Sep-15 6.7 5.7 8.1 6.4 7.2 Aug-15 6.7 5.6 8.4 6.2 7.2 Jul-15 6.6 5.5 7.6 6.5 7.4 Jun-15 7.5 6.4 8.3 7.1 8.2 May-15 7 5.5 8.1 7 7.3 Apr-15 6.6 5.8 7.5 6.7 8.2 Comments: The exit questionnaire return rate remains the same as March, and of those who completed a questionnaire with deterioration across most metrics measured. Page 17 of 42 pages

Actions: Research has begun in to options for the Online Exit Interview solution. Once a number of potential options have been identified, these will be compared and where necessary, a demonstration arranged with suppliers. The target completion date remains the end of November. The previously notified staff engagement exercises with registered nurses have concluded. From this a bespoke RN Retention Plan 2016/17 has been created and approved by the Trust s sustainability Stocktake Meeting. The OD team is now engaging with stakeholders and beginning the implementation phase to enact the associated action plan. The action plan focuses intervention in the areas of: 1. Shift allocation and family friendly working practices 2. RN two-way staff engagement and SMT support 3. Reward and recognition (including remuneration) 4. Staff facilities 5. Training and career progression 6. Socialisation and team building 7. Other RN sector retention initiative A comparable exercise to above has started with SAS grade medical staff with the view to creating a bespoke medical retention plan; this work is planned for June with a draft plan being presented from the end of June 2016. Page 18 of 42 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 those areas where the sickness rate is above target. The number of areas now above target has increased again for the third month running. Page 19 of 42 pages

Sickness by Staff Group Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Additional Prof Scientific and 3.78% 3.84% 4.90% 4.98% 4.44% 6.05% 5.39% 4.09% 4.29% 4.93% 5.31% 2.37% Additional Clinical Services 5.10% 5.39% 5.51% 5.52% 5.24% 5.62% 5.51% 6.62% 6.43% 6.88% 6.81% 6.78% Administrative and Clerical 2.81% 3.10% 2.35% 2.39% 2.92% 2.98% 3.20% 3.38% 4.07% 3.99% 4.32% 3.57% Allied Health Professionals 2.57% 2.40% 2.01% 2.98% 3.28% 3.51% 3.99% 3.40% 3.26% 2.03% 2.78% 4.31% Estates and Ancillary 5.74% 5.43% 6.73% 6.25% 5.54% 5.58% 6.60% 5.61% 5.30% 6.28% 7.31% 5.59% Healthcare Scientists 3.47% 2.60% 1.53% 2.03% 2.33% 3.00% 3.26% 2.33% 2.31% 2.53% 3.18% 3.89% Medical and Dental 1.06% 1.22% 0.83% 1.19% 1.31% 1.55% 1.43% 1.55% 1.00% 0.97% 1.47% 1.37% Nursing and Midwifery 4.97% 4.83% 4.34% 4.47% 4.76% 4.82% 5.09% 5.16% 5.21% 5.38% 4.76% 4.93% 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 4.01% 4.05% 3.82% 3.90% 4.00% 4.24% 4.42% 4.17% 4.61% 4.78% 4.88% 4.65% Sickness by Group Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Chief Executive & Chairman's 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.64% 0.00% 0.00% 0.00% 0.00% Chief Nurses Office 4.18% 5.24% 6.04% 5.49% 4.06% 5.32% 4.63% 4.30% 4.33% 6.79% 5.56% 2.37% Deputy Chief Executives 5.13% 2.55% 0.00% 0.39% 0.00% 0.42% 1.39% 2.57% 2.74% 1.43% 3.54% 8.65% Estates and Facilities 5.85% 5.46% 6.76% 6.09% 5.00% 5.12% 5.86% 6.05% 5.41% 6.49% 7.61% 5.50% Finance 0.08% 1.27% 0.92% 1.39% 1.86% 1.79% 2.89% 1.63% 3.92% 5.46% 5.44% 4.72% Medical Directors Office 1.78% 3.07% 0.00% 0.86% 1.32% 1.71% 1.20% 1.19% 3.54% 0.36% 1.88% 2.38% Operations Clinical Support 5.29% 4.87% 4.38% 3.78% 4.60% 4.68% 4.87% 4.72% 6.21% 4.70% 4.83% 4.07% Operations Community & 3.31% 3.81% 4.20% 4.08% 4.32% 4.47% 5.03% 4.20% 4.64% 4.76% 5.20% 5.54% Operations Medicine 4.97% 5.30% 4.60% 4.49% 4.17% 5.11% 5.13% 4.85% 5.31% 5.40% 4.94% 4.75% Operations Surgery & Critical 3.65% 3.33% 2.95% 3.62% 3.73% 3.72% 4.42% 3.95% 4.40% 4.61% 4.98% 4.34% Operations Women & 4.04% 4.55% 4.02% 4.24% 4.21% 4.66% 3.73% 4.09% 3.78% 4.77% 3.73% 4.39% Organisational 0.24% 2.34% 2.68% 0.50% 2.45% 0.85% 2.18% 2.01% 2.89% 2.22% 4.14% 4.23% Path Links 2.07% 1.71% 1.12% 2.68% 3.57% 3.27% 2.84% 2.48% 3.09% 2.94% 3.43% 4.83% Governance 3.51% 1.46% 0.95% 0.40% 0.75% 0.86% 0.32% 1.28% 2.26% 2.06% 1.69% 0.06% Strategy and Planning 0.94% 1.19% 1.67% 2.50% 2.80% 2.57% 2.14% 2.27% 2.97% 3.96% 3.76% 4.89% 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 4.01% 4.05% 3.82% 3.90% 4.00% 4.24% 4.42% 4.17% 4.61% 4.78% 4.88% 4.65% Comments: March has seen a decrease in total sickness rates. The largest decrease is within Additional Professional Scientific and Technical staff, seeing a decrease of 2.94% and bringing them within target for the first time since May 2015. Allied Health professionals have seen a marked increase in sickness during March, from 2.78% to 4.31% Estates and Facilities sickness rate, whilst remaining one of the highest, has seen a decrease when compared to February of 1.72% Actions: A significant amount of work is currently being scoped up within HR in relation to sickness absence. This is forming 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 20 of 42 pages

VSM9 Days Lost Due to Sickness New Indicator for 2016/17 Page 21 of 42 pages

Sickness by Group Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Chief Nurses Office 101.17 132.57 151.40 143.79 104.33 132.27 113.60 89.53 103.36 163.65 116.84 56.35 Deputy Chief Executives Office 34.96 18.00 0.00 3.00 0.00 3.00 11.00 3.48 25.00 13.09 30.91 84.76 Estates and Facilities 859.37 829.93 997.56 921.27 748.64 735.72 888.81 780.54 817.20 1027.33 1087.14 844.94 Finance 2.00 35.09 24.53 37.60 49.85 45.60 77.33 98.96 105.40 150.98 140.17 129.52 Medical Directors Office 20.72 37.00 0.00 10.00 15.00 17.40 23.40 34.16 39.60 5.44 19.68 26.96 Operations Clinical Support Services 906.95 854.76 747.41 673.02 823.24 814.63 895.09 900.56 1124.32 874.07 828.50 746.56 Operations Community & Therapies 638.79 758.73 784.47 803.95 840.78 845.57 991.10 902.79 918.65 1003.87 946.13 1112.57 Operations Medicine 1761.20 1890.68 1557.19 1585.23 1462.56 1764.31 1857.95 2008.40 2146.14 1941.46 1685.53 1752.38 Operations Surgery & Critical Care 1052.57 987.40 846.08 1070.46 1104.91 1054.72 1324.26 1445.43 1287.92 1390.38 1411.61 1323.75 Operations Women & Childrens 736.72 854.44 729.69 800.24 811.36 838.68 685.99 566.43 716.84 878.29 643.33 820.71 Organisational Development/HR 4.20 41.63 45.49 9.00 44.32 14.93 39.49 41.80 51.96 45.22 68.40 75.09 Path Links 223.65 192.25 121.54 299.72 399.73 353.52 327.55 328.33 346.36 360.02 372.32 547.31 Governance 52.60 22.55 13.91 6.20 11.30 12.33 4.81 43.20 37.20 34.52 26.11 1.00 Strategy and Planning 38.00 49.65 69.16 106.42 119.40 105.95 92.75 128.05 132.35 181.82 156.35 219.04 Target Monthly Total 6432.90 6704.68 6088.43 6469.90 6535.42 6738.63 7333.13 7371.66 7852.30 8070.14 7533.02 7740.94 Comments: Trends across this area show a steady upwards trend in the number of days lost to sickness since April 2015 Surgery and Critical Care has seen the largest increase over the period Medicine accounts for the greatest loss of days across the groups The staff group Additional Clinical Services accounts for the greatest loss of days across organisation Actions: The Managing Attendance Sustainability Project group will be focusing on areas and initiatives to improve attendance and decrease sickness occurrence across the Trust Page 22 of 42 pages

This Section 6.0 RECRUITMENT ACTIVITIES Medical Recruitment Nursing Recruitment Page 23 of 42 pages

6.0 RECRUITMENT ACTIVITIES Northern Lincolnshire and Goole NHS Foundation Trust 6.0 RECRUITMENT ACTIVITIES 6.1 Recruitment Dashboard Medical Recruitment Comments and Actions: 230 225 220 215 210 205 200 195 190 185 180 175 Establishment Contracted Within the month of April our new starters included a Consultant Radiologist, Specialty Doctor in Paediatrics, and two Trust Grades in GDH General Medicine. Numerous posts across all grades are now in the pipeline pending start dates following successful pre-employment checks, and work is being undertaken to convert these into start dates asap. Current adverts include Consultant posts in Microbiology, Neurology, and Anaesthetics. In addition there are also posts advertised at Specialty Doctor and junior levels. A large number of appointments have been made recently as part of the MTI scheme including both middle grade and junior level. Work is ongoing to expand the use of the MTI scheme appropriately across the trust. Page 24 of 42 pages

Nursing Recruitment Comments and Actions: Assessment days have been held for student nurses who are due to qualify in September with a great uptake both locally and from further afield. Additional assessment days are planned in May and work continues to engage with these candidates via our social media sites. Feedback received from student nurses was very positive about our assessment centres with the process being much more interactive and engaging. 43 offers have been made to date against a target of 50 Establishment reviews have nearly been completed which will inform the recruitment team the skill gaps/experience needed to recruit for the Trust within 16/17 which will then form the recruitment plan for the year. 2016/2017 Mar April May June July August September October November December January February March Retirement 8.28 4.8 3 6 1 3 3 1 3 5 4 2 3 leavers Average (excl retirement) 6.79 9.12 10 10 10 10 10 10 10 10 10 10 10 Overall 15.07 13.92 13 16 11 13 13 11 13 15 14 12 13 Recruitment Plan/Actual 15.64 8.09 12 12 12 12 12 12 12 12 12 12 12 Risk adjusted 11.71% 0.00 0.00 1.41 1.41 1.41 1.41 1.41 1.41 1.41 1.41 1.41 1.41 1.41 RN Starts (adjusted for risk) 15.64 8.09 10.59 10.59 10.59 10.59 10.59 10.59 10.59 10.59 10.59 10.59 10.59 Brought forward vacancy Position 140.96 147.32 155.96 158.37 163.77 164.18 166.58 168.99 169.39 171.80 176.20 179.61 181.01 End of month postion Plan/Actual 147.32 155.96 158.37 163.77 164.18 166.58 168.99 169.39 171.80 176.20 179.61 181.01 183.42 % Against Establishment 9.20 9.69 9.85 10.19 10.22 10.36 10.51 10.54 10.69 10.96 11.18 11.26 11.41 Page 25 of 42 pages

April May June July August September October November December January February March April Northern Lincolnshire and Goole NHS Foundation Trust Starters and Leavers Summary and Pipelines Medical & Dental (includes rotational trainees) Nursing & Midwifery 180 160 140 120 100 80 60 40 20 0 Starters Leavers 50 45 40 35 30 25 20 15 10 5 0 Starters Leavers Page 26 of 42 pages

This Section 7.0 COVER ARRANGEMENTS Bank Usage (including Internal Locum) Agency Usage Bank and Agency Spend Page 27 of 42 pages

7.0 COVER ARRANGEMENTS Northern Lincolnshire and Goole NHS Foundation Trust 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 Comments Internal Locums for both F1 and F2 saw a slight reduction in month Page 28 of 42 pages

CA2 Nursing Usage. Target <55 Bank WTE Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 Medicine 25.48 17.57 23.97 23.97 31.52 26.09 Clinical Support Services 1.45 2.42 2.03 2.03 1.51 1.16 S&CC 14.85 10.58 15.56 15.56 19.85 16.14 C&TS 2.57 2.11 2.2 2.2 3.9 2.88 W&CS 13.61 13.6 13.82 13.82 18.7 18.26 Corporate 0 0 0 0 0.25 0.39 Estates & Facilities 0 0 0 0 0 0.00 Pathlinks 0 0 0 0 0 0.00 Total 57.96 46.28 57.58 57.58 75.73 64.92 Comments: Medicine group continues to be the highest user of bank and agency across the Trust. March has seen a fairly large decrease in Bank spend when compared to the previous month. Top reasons for Nursing Bank Usage Page 29 of 42 pages

CA3 Support staff Bank Costs and Usage. Target <60 Bank WTE Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 Medicine 48.57 39.74 44.11 44.11 44.52 34.23 Clinical Support Services 1.65 4.89 5.03 5.03 4.93 4.07 S&CC 16.93 9.66 14.11 14.11 8.71 6.15 C&TS 1.1 2 1.44 1.44 2.33 1.15 W&CS 5.05 3.72 6.14 6.14 6.92 6.78 Corporate 0 0 0 0 0 0.00 Estates & Facilities 0 0 0 0 0 0.00 Pathlinks 0 0 0 0 0 0.00 Total 73.3 60.01 70.83 70.83 67.41 52.38 Comments: As with Registered Nursing, Medicine continues to be the highest user of Unregistered Bank staff Page 30 of 42 pages

CA4 AHP Bank Usage. Target < 1.00 Comments: AHP Bank usage remains steady, April sees the lowest bank usage in 12 months, AHP agency usage is the highest in the last 12 months Page 31 of 42 pages

7.2 Agency Usage CA5 Medical Agency Usage. Target <70 Comments: Compared to March the reported position on agency locum cover has shown an increase of 42.5k & Internal locums usage has an increase of 112K Page 32 of 42 pages

CA6 Nursing Agency Usage. Target <65 Agency WTE Nov- 15 Dec- 15 Jan-16 Feb- 16 Mar- 16 Apr-16 Medicine 57.6 52 59.71 59.71 51.08 43.68 Clinical Support Services 0 0 0 0 0 0.00 S&CC 10.36 13.69 10.69 10.69 13.33 13.42 C&TS 0 0 0 0 0 0.00 W&CS 0.88 1.79 1.27 1.27 1.5 0.55 Corporate 0 0 0 0 0 0.00 Estates & Facilities 0 0 0 0 0 0.00 Pathlinks 0 0 0 0 0 0.00 Total 68.84 67.48 71.67 71.67 65.91 57.65 Comments: There is a continued reliance on bank and premium agency to fill substantive vacancies. Registered agency has decreased 49K in month. The Medicine Group continues to be the highest user of nursing bank & agency spend. Page 33 of 42 pages

CA7 Support/Unregistered Agency Usage. Target <0.00 Comments: Agency WTE Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 Medicine 0 0 0 0 0 0 Clinical Support Services 0 0 0 0 0 0 S&CC 0 0 0 0 0 0 C&TS 0 0 0 0 0 0 W&CS 0 0 0 0 0 0 Corporate 0 0 0 0 0 0 Estates & Facilities 0 0 0 0 0 0 Pathlinks 0 0 0 0 0 0 Total 0 0 0 0 0 0 There continues to be no spend on Unregisted agency Usage Page 34 of 42 pages

CA8 AHP Agency Usage. Target < 1.00 Comments: AHP Bank usage remains steady, April sees the lowest bank usage in 12 months, AHP agency usage is the highest in the last 12 months Page 35 of 42 pages

% of Pay Budget Northern Lincolnshire and Goole NHS Foundation Trust 7.3 Bank and Agency Spend CA9 and CA10 Registered Nursing Agency Spend as % of Total Spend Registered Aug Sept Oct Nov Dec Jan Feb Mar Apr Bank 3.41% 3.49% 3.60% 3.69% 3.66% 3.75% 3.85% 4.04% 5.06% Agency 11.32% 11.33% 10.98% 10.44% 10.16% 9.97% 9.81% 9.59% 5.23% 12.00% Registered Nursing - Agency and Bank as % of Pay Budget 10.00% 8.00% 6.00% 4.00% 2.00% 0.00% Aug Sept Oct Nov Dec Jan Feb Mar Apr Bank 3.41% 3.49% 3.60% 3.69% 3.66% 3.75% 3.85% 4.04% 5.06% Agency 11.32% 11.33% 10.98% 10.44% 10.16% 9.97% 9.81% 9.59% 5.23% Comments: There is a continued reliance on bank and premium agency to fill substantive vacancies. Registered agency has decreased 49K in month. There continues to be no spend on agency at HCA level. Bank has increased by 78K for Registered and an increase of 30K in month for HCA bank. The Medicine Group continues to be the highest user of nursing bank & agency spend. Page 36 of 42 pages

CA11 and CA12 Medical Agency and Locum Spend as % of Total Spend Comments: A slight variation can be seen in comparison with March 16 with a.9% decrease for internal usage and.44% increase for external usage. Page 37 of 42 pages

% of Pay Budget Northern Lincolnshire and Goole NHS Foundation Trust CA13 and CA14 Unregistered Nursing Agency and Locum Spend as % of Total Spend Unregistered Aug Sept Oct Nov Dec Jan Feb Mar Apr Bank 9.91% 9.89% 10.02% 10.14% 9.87% 9.94% 9.86% 9.96% 8.27% Agency 1.25% 1.03% 0.89% 0.77% 0.68% 0.61% 0.55% 0.51% 0.00% 12.00% Unregistered Nursing - Agency and Bank as % of Pay Budget 10.00% 8.00% 6.00% 4.00% 2.00% 0.00% Aug Sept Oct Nov Dec Jan Feb Mar Apr Bank 9.91% 9.89% 10.02% 10.14% 9.87% 9.94% 9.86% 9.96% 8.27% Agency 1.25% 1.03% 0.89% 0.77% 0.68% 0.61% 0.55% 0.51% 0.00% Comments: Medical Agency usage has varied slightly during the financial year, however the trend data shows an overall picture of remaining fairly consistent with no upward or downward trajectory. Following a dip August and October of last year, internal locum usage has again increased to around 10% and has remained fairly consistent since. Both Internal Locum and Agency spend remain outside of the target of 10% and 15% respectively. Across Registered and Unregistered Nursing, the percentage of spend on Bank and Agency has followed a downward trajectory during the past financial year. However, Registered Nursing remains outside of the target of less than 8%. Bank spend across Registered Nursing has gradually increased across the financial year. This could be attributed to the number of incentives which have been implemented across the Trust to drive up Bank take up and subsequently reduce Agency spend. Page 38 of 42 pages

8.0 SUPPORTING ACTIVITIES Northern Lincolnshire and Goole NHS Foundation Trust 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 Current Cases By Type Tribunal, 2, 1% Disciplinary, 22, 9% Disciplinary, 19, 6% Grievance - Formal, 1, 0% Grievance - Informal, 2, 1% Sickness - Long Term, 105, 34% 1 Grievance - Collective, (91 complaints) Sickness - 2nd Stage Formal, 19, 6% Sickness - 1st Stage Formal, 65, 21% Performance - Formal, 5, 2% Performance - Informal, 1, 0% Page 39 of 42 pages

Active Casework Chief Nurse Clinical Support Services Communities & Therapies Corporate Diagnostics Facilities Finance Medicine OD & Workforce Pathlinks Strategy & Planning Surgery & Critical Care Women & Childrens TOTAL Chief Nurse Clinical Support Services Communities & Therapies Corporate Diagnostics Facilities Finance Medicine OD & Workforce Pathlinks Strategy & Planning Surgery & Critical Care Women & Childrens Trustwide Northern Lincolnshire and Goole NHS Foundation Trust The table below illustrates the open cases by type and department. 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 2 0 0 0 0 0 0 Disciplinary 0 4 0 0 0 2 0 5 0 1 0 5 2 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 0 0 1 Grievance - Formal 0 0 0 0 0 0 0 0 0 0 0 0 1 0 Grievance - Informal 0 1 0 0 0 0 0 0 0 0 0 1 0 0 Performance - Formal 0 1 0 0 0 1 0 2 0 0 0 0 1 0 Performance - Informal 0 0 0 0 0 0 0 0 0 1 0 0 0 0 Sickness - 1st Stage Formal 0 11 7 1 2 9 0 15 0 3 0 10 7 0 Sickness - 2nd Stage Formal 0 2 1 0 1 4 0 5 0 1 0 3 2 0 Sickness - 3rd Stage Formal 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Sickness - Long Term 0 12 14 0 0 14 2 34 0 1 0 14 14 0 Tribunal 0 0 0 0 1 0 0 1 0 0 0 0 0 0 Total Number of Cases 0 32 22 1 4 30 2 64 0 7 0 33 27 222 The table below illustrates the number of suspensions in place for open cases within the Trust. Suspensions 0 1 0 0 0 0 0 1 0 0 0 1 0 3 Page 40 of 42 pages

Disciplinary Performance - Formal Sickness - 1st Stage Formal Sickness - 2nd Stage Formal Sickness - Long Term Performance - Informal Grand Total Northern Lincolnshire and Goole NHS Foundation Trust 8.2 HR Number of cases closed in the month SA2 Closed Cases by Type and Site. Case Type - Closed - April 2016 Community 1 1 1 3 DPoW 4 5 2 11 1 23 SGH 1 4 1 6 Total 5 1 10 2 13 1 32 None of the cases were referred to a regulatory body such as NMC, DBS etc. 8.3 HR Age of the oldest case unresolved (weeks). SA3 The longest current ongoing case is an Employment Tribunal (ET) relating to a termination of employment relating to Ill Health Capability which is 114 weeks. The progression of the ET has been delayed due to the complainant cancelling several times. The Trust is still awaiting a new date. Actions: As part of the HR redesign the function 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 review practice and adjust 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 41 of 42 pages

A bespoke briefing session for Facilities has been developed due to the increasing levels of incidents relating to employees failing to follow Trust Policies and Procedures, such as the use of mobile phones on duty and smoking onsite. This programme will be concluded by the end of June 2016 and included within the induction information for new starters. Page 42 of 42 pages