The Royal Wolverhampton NHS Trust

The Royal Wolverhampton NHS Trust Trust Board Report Meeting Date: 25 th April 2016 Title: Executive HR Report Executive Summary: The report provides an update on: Resourcing Update Medical Recruitment Management and Leadership Occupational Health and Wellbeing Action Requested: Report of: Author: Contact Details: Links to Trust Strategic Objectives Resource Implications: Equality and Diversity Assessment Risks: BAF/ TRR (describe risk and current risk score) Public or Private: (with reasons if private) The Board are asked to note the report Linda Holland Interim Director of HR & OD Catherine Griffiths Deputy Director of HR Tel 01902 695430 Email: Catherine.Griffiths7@nhs.net Objective 6 - To attract, retain and develop all employees and improve employee engagement year on year Revenue: N/A Capital: N/A Workforce: N/A Funding Source: N/A N/A N/A Public References: (eg from/to other committees) Appendices/ References/ Background Reading NHS Constitution: (How it impacts on any decision-making) In determining this matter, the Board should have regard to the Core principles contained in the Constitution of: Equality of treatment and access to services High standards of excellence and professionalism Service user preferences Cross community working Best Value Accountability through local influence and scrutiny Page 1 of 12

1. Resourcing Update 1.1 Number of all Vacancies advertised via NHS Jobs A total 1334 jobs were advertised via NHS Jobs over the last 12 months, the majority of which were for Admin & Clerical, followed by Nursing and then Medical posts. These figures include recruitment to the temporary staffing bank 1.2 Nursing Vacancy Position (as at 31 st March 2016) Qualified Unqualified / Total - Qual + Total - Qual + Others Nurses HCA HCA HCA + Others Div-1 79.63-0.95 78.68 2.47 81.15 Div-2 69.60-11.98 57.62 7.26 64.88 Midwives -10.66 4.75-5.91 0.35-5.56 Community 20.61 8.25 28.86-0.59 28.27 Totals 159.18 0.07 159.25 9.49 168.74 Qualified Unqualified / Total - Qual + Total - Qual + Others Nurses HCA HCA HCA + Others Div-1 19.64 5.00 24.64 1.80 26.44 Div-2 22.53 14.94 37.47 1.00 38.47 Midwives 8.44 0.00 8.44 0.60 9.04 Community 2.80 1.00 3.80 0.00 3.80 Totals 53.41 20.94 74.35 3.40 77.75 Total - All Unfilled Posts (Open Vacancies + Pending Starters) Qualified Unqualified / Total - Qual + Total - Qual + Others Nurses HCA HCA HCA + Others Div-1 99.27 4.05 103.32 4.27 107.59 (N.B. A minus indicates over-establishment) Vacancies - Open + Advertised Filled Vacancies - Pending Starters Not Yet In Post Div-2 92.13 2.96 95.09 8.26 103.35 Midwives -2.22 4.75 2.53 0.95 3.48 Community 23.41 9.25 32.66-0.59 32.07 Totals 212.59 21.01 233.60 12.89 246.49 There are currently 159.18wte qualified nurse vacancies across the Trust (previous month 169.47wte). Band 5 vacancies are decreasing except in Community where we have seen an increase in vacancies which is showing at 20.61wte (open and advertised). There has been an increase in Band 7 (1.00wte) and Band 6 (2.37wte) vacancies. Page 2 of 12

1.3 Qualified Nursing Starters, Leavers and Turnover Trends 1.3.1 Qualified Nurses Bands 5 to 7 As at end of March 2016, the vacancy rate for qualified nurses has reduced to 13.33% (14.53% in January/February). The turnover rate (i.e. leavers from the Trust) for the rolling 12 months has increased very slightly to 10.16% (previous month 10.12%). The starters/leavers variance has unfortunately declined again in month and reflects the increase in vacancy levels for Band 6 and 7 nurses. 2500 Established Nurse Posts - Filled and Vacant 2000 Number of Posts 1500 1000 500 Vacant Posts Nurses in Post 0 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 % 16 14 12 10 8 6 4 2 0 Vacancy and Voluntary Resignations - Turnover Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 12 Month T/O rate % Vacancy rate % Number of Posts 10 5 0-5 -10-15 -20-25 Starters/Leaver Variance Mar 15 Apr 15 May 15 Jun 15 Jul 15 Aug 15 Sep 15 Oct 15 Nov 15 Dec 15 Jan-16 Feb-16 Mar-16 Starter/Leaver Variance 1.3.2 Band 5 Nurses As at end of March 2016, the vacancy rate for Band 5 nurses has reduced further to 17.73% (compared to 18.66% in February and 19.93% in January). The turnover rate (i.e. leavers from the Trust) for the rolling 12 months has increased in month back to 12.77% (February was 12.48%). Some of that is reflected in the increase of vacancies in Community Nursing and therefore the starters/leavers variance increased again slightly in March. Page 3 of 12

Established B5 Nurse Posts - Filled and Vacant Number Of Posts 1400 1200 1000 800 600 400 200 0 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Vacant Posts B5 Nurses in Post Number of Posts 22 20 18 16 14 12 10 8 6 4 2 0 Band 5- Vacancy and Voluntary Resignation - Turnover Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 12 Month T/O rate % Vacancy rate % Number of Posts 10 5 0-5 -10-15 -20-25 B5- Starters/Leaver Variance Mar 15 Apr 15 May 15 Jun 15 Jul 15 Aug 15 Sep 15 Oct 15 Nov 15 Dec 15 Jan-16 Feb-16 Mar-16 Starter/Leaver Variance 1.4 Recruitment/Career Fairs We are attending an Expo event in Dublin on the weekend of 23 rd of April 2016 and are also offering interviews slots for the 24 th to 26 th April in Dublin. A team of 9 will be at the event in order to enable recruitment at source. Further updates will be provided next month. 1.5. Process Streamlining A meeting is taking place w/c 18 th April with key stakeholders to agree a further streamlined process for recruitment, including setting up regular co-ordinated interview panels for both Divisions and to agree implementation of the Internal Transfer Pool framework. Page 4 of 12

1.6. International Nurse Recruitment 1.6.1 NMC Registration status European Nurses: Cohort 5 out of the European nurses that arrived at the Trust in January 2016, a breakdown on status is shown below: EURES MEDIPLACEMENTS 6 have fully registered NMC pins 4 have fully registered NMC pins 2 are still in NMC process 4 are still in NMC process: 1 at stage 2 (replacement documents) 3 at stage 4 (admitted) 1.6.2 Recruitment from the Philippines Two nurses arrived at the Trust on Monday, 11 th April and one further nurse is to arrive week commencing 18 th April 2016. A full induction plan is in place including accommodation arrangements with the University of Wolverhampton. 1.6.3 International Nurse Forecast Numbers A summary of the current candidate pipeline is provided below: Visa in process provisional arrival date agreed 18 th April - 1 Visa in process arrival date not agreed due to Irish Registration - 1 Assigned COS awaiting NMC Decision - 4 NMC in process - COS applied for on 4 th April - 6 For renewal of UK Pin - 1 Passed IELTS; to take CBT Test - 15 Waiting IELTS Result 32 Booked to take IELTS Test April 23 May - 5 Target date to take IELTS April/May/June - 298 Request for remarking - 4 Australian Pin - 1 Therefore there are 30 candidates in the current pipeline who have passed IELTS. Page 5 of 12

1.7 Nurse Bank/Agency Requests and Fill Rates Demand continues to increase: In March, there were 6964 requests (an increase of 427 duties requested compared to February). There were 1518 more duties requested in March 2016, compared to March 2015). Over the last 12 months (April 2015 to March 2016) a total of 67,342 shifts were requested (an average of 5612 shifts per month). The rate at which we fill shifts via the temporary nurse staffing bank overall remains consistent at around 85%. The fill rate for qualified nurses has increased somewhat to 84.83%, (compared to 69.46% in February and compared to an average fill rate over the last 12 months of 76.37%). Page 6 of 12

2. Medical Workforce Update 2.1 Medical Workforce Summary The tables below provide a high level overview of medical post establishment vs. vacancies across the Trust, taking into account establishment changes: Division 1 Grade Establishment Vacancies % February 2016 Consultant 224 16 7.14% 5.88 SAS Grades 51 8 15.69% 15.69 Training Grades 189.6 24 12.66% 10.55 Non-Training Grades 65 15 23.08% 23.08 Totals 529.6 63 11.90% 10.63 Division 2 Grade Establishment Vacancies % February 2016 Consultant 124.2 16.6 13.37% 13.26 SAS Grades 19.5 5 25.64% 25.64 Training Grades 156 20 12.82% 12.18 Non-Training Grades 16 3 18.75% 12.50 Totals 315.7 44.6 14.13% 13.45 (Figures as at 4th April 2016) Division 1 A slight increase in vacancies overall, recruitment is on-going for non-training grades to cover gaps and meet service needs. Division 2 a slight increase in training vacancies however recruitment is on-going with the Junior Fellow recruitment which is rolling out over medical specialties to ensure continuity of service 2.2 Recruitment Update Consultants the following consultants are due to commence (substantive unless otherwise stated): Specialty Date Name Anaesthetics TBC Dr Saibal Ganguly Anaesthetics 04 May 16 Dr Dinesh Meesala Acute Medicine April 16 Dr Chipo Ndlovu Respiratory TBC Dr Rachid Berair Diabetes & Endo TBC Dr James Young Diabetes & TBC Dr Khalid Jadoon Endo Diabetes & Endo TBC Dr Pappachan Joseph (currently Locum Cons at RWH) Page 7 of 12

Specialty Date Name O & G (Locum) TBC Dr Sabita Nair O & G (Urogynae) TBC Dr Amina Douglas Haematology TBC Dr Richard Whitmill Haematology TBC Dr Khawaja Jahanzeb Clinical Oncology TBC Dr Ravi Dandamudi Neonates TBC Dr Sophie Reynolds Neonates TBC Dr Richard Heaver Recruitment continues in the following specialties: Specialty WTE Comments Dermatology 1 To be readvertised at a later date ICM 2 College approved, awaiting VCP to advertise Cardiology 1 Awaiting College Approval Clinical Chemistry 1 Advertised 04 April Interview 03 June 2016 CT Anaesthetics 1 Awaiting College Approval Ophthalmology 1 To be advertised at a later date Clinical Oncology 1 Interview 10 May 2016 (joint post with Sandwell) Medical Oncology 1 Interview 10 May 2016 (joint post with Sandwell) Medical Oncology 1 Advertised 31 March interview 10 May 2016 SAS Grades - Interviews are being held later this month for a Haematology post. We are still awaiting further instructions for SAS post in Urology, the department are reviewing the JD following a poor response to previous adverts. We have received a few applications via agencies for the Anaesthetic SAS posts to cover the Cannock rota. We are currently arranging preliminary interviews via SKYPE while we await the approval of the JD. The posts will then have to be advertised to meet RLMT. Training Grades - There has been a slight in vacancies of 2.17% over both divisions. Recruitment is on-going to fill gaps on a fixed term basis in both divisions. We are awaiting the final plans for the arrangements for the new rotation to cover the surgical FY2 posts that will be lost in August. Interviews are on-going for the Junior Fellows to provide cover for the training gaps in April for division 2. Foundation Year 1 - We have been notified of the names for the August 2016 FY1 programme. Currently all posts have been filled. This may change if anyone fails their final exams. Non-Training Grades - The advertisement has now been placed for the Clinical Fellowship Programme which is on going for Division 2. The team are working on interviews and MTI arrangements. We are awaiting further instructions regarding rolling the programme out to Division 1. In the meantime we Page 8 of 12

continue to recruit Fellows to cover gaps in Cardiology, CT Anaesthetics and Trauma & Orthopaedics 2.3 Locum Framework & Management System The LMS has now been implemented and regular reviews are taking place with Holt and the internal project team. 2.4 Streamlining Project The PMETB Project Board has now awarded the Lead Employer Trust (LET) contract for GP trainees with a proposed timeline to be in place for 2nd August 2016, this being the next major rotational date. The contract has been awarded to St Helen s and Knowsley NHS Trust, who are currently a lead employer trust. 2.5 New Junior Doctors Contract Medical Staffing are liaising with departments and requesting the rotas and work schedules for the new contract. Work schedules now have to be included in the appointment packs. As soon as the schedules are complete Medical Recruitment will send out the job offers and start to arrange pre-employment checks. Page 9 of 12

3. Management and Leadership Development The revised suite of National Leadership Academy programmes continues to be offered, with reduced costs as previously reported. The National Strategy for Improvement and Leadership is being developed. Focus will be around: Talent Developing leaders Embedding improvement Creating supportive environment The new Organisational Talent Management (TM) engagement model has been launched. The Black Country Leadership Project development centres are now complete. The model will now be adopted across the patch to support sustainability and spread. RWT Medical Leadership programme - Work with the University of Wolverhampton is still in progress to map the proposed content to academic credits. Clinical Fellowship Programme - The group meets weekly and is progressing work to appoint Clinical Fellows. Recruitment processes are established and speciality information around rotations and experience is being compiled. Page 10 of 12

4. Occupational Health & Wellbeing 4.1 Health & Wellbeing Strategy Progress Report Initiatives outlined in the previous report are ongoing with the following updates: The workplace health & wellbeing charter project is now well underway and 2.5k of funding has been released in consultancy fees to support the work of the group. The project is due for completion and assessment during April 2016. A draft self-assessment submission was completed in March 2016 based on interviews with and information provided by work stream leads and supplemented by a review of online documents and policies and Trust e- communications. RWT was found to have a strong self-assessment position in most areas particularly around leadership, absence management, health & safety, mental health and smoking/tobacco where policies, procedures, learning and development, communications and support can all be evidenced. The weakest areas are healthy eating and physical activity, although both demonstrate areas of good practice through the education, referral and support services provided through the occupational health and wellbeing service (OHWBS) and Healthy Lifestyles. The challenge for the Trust is to develop a coherent cross-functional, wellcommunicated and proactive well-being ethos to staff which will support improvement of healthy eating and physical activity awareness and opportunities for employees. This should develop initiatives beyond the good work being done through healthy lifestyles and build on the draft policy statements for food and physical exercise. Overall, this initial assessment demonstrated that status achieved in five of the standard matched that of excellent and achievement for the remaining three. We now need to collect further supporting evidence for the assessors and plan out our proposed next steps prior to the assessment and this work, as a whole, will result in a robust revised Trust health & wellbeing strategy based on charter assessment outcomes and recommendations. The 2015/16 seasonal flu vaccination programme came to an end in March although the recent outbreak of new cases resulted in a slight increase of percentage uptake of frontline health care workers which brought the overall total up to 67.62% (3,384 headcount) in this category and 4,174 (50.93%) of all staff. The HSE Inspectorate visited the Trust on 10 th March to assess our management of sharps in the context of clinical practice. The visits went well but the Inspectors raised the following points for consideration when they next visit: Page 11 of 12

There should be a more robust directive to ensure that the use of safer sharps is the default position; Policy should reflect the need for risk assessment to be carried out aligning risk factors to the reason for use; The use of safer sharps should form a key focus in training; The Regulations should be properly referenced in the policy. Our SEQOHS accreditation is due for an annual assessment and renewal in May this year using the new criteria introduced recently. Evidence is now being collated in preparation for the process and will also be supported by a series of clinical and process audits, Retrospective clinical audits to evidence that our practice reflects NICE guidance will include the following: o Management of back pain; o Long term sickness absence in relation to signs of stress; o Record keeping standards. We will also conduct a customer satisfaction survey and all outcomes will be tabled at a future WAG meeting. 4.2 Pre-Employment Health Screening The COHORT data management system has enabled the team to accurately identify stages of the pre-placement process which could result in barriers to an efficient turnover rate. It has now become the established norm that the team achieve 100% no delay clearance. For this period we processed 199 questionnaires for the Trust in addition to our external work with no delays in the recruitment process.. ********** Page 12 of 12