Executive Workforce Report

Executive Workforce Report (v2) Safe & Effective Kind & Caring Exceeding Expectation Agenda Item No: 9.3

The Royal Wolverhampton NHS Trust Trust Board Report Meeting Date: 27 th November 2017 Title: Executive Summary: Executive Workforce Report This report provides updates on progress on the delivery of the People and Organisation Development Strategy 2016-2020, and specifically: Action Requested: 1 Engagement & Culture 2 Future Workforce Nursing Workforce Summary Medical Workforce Summary 3 Organisation Development 4 Workforce Intelligence and Planning 5 Underpinning Workforce Assurance The Board are asked to note the report. 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) Director of Workforce 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: Capital: Workforce: Funding Source: - - 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 11

People and Organisation Development Strategy 2016-2020 Executive Workforce Report - November 2017 Summary The People and Organisation Development Strategy 2016 2020 sets out the framework for the effective management of resources and reporting on outcomes achieved and metrics aims to assure the Trust Board and Trust Management Committee that action is being taken to mitigate strategic risk one on the Board Assurance Framework. 1. Employee Relations a. The National Staff Survey is a full census this year with corporate and non-clinical areas responding via an electronic survey. As at 17 th November 2017, the response rate stands at 37%, the National Staff Survey will close on 4 th December 2017. b. The first Equality, Diversity and Inclusion Event Every Voice Matters took place on 3 rd November 2017, it was very well received by staff and evaluated very positively. Work has started on planning an Equality, Diversity and Inclusion Conference for 2018. As part of the approach, the Trust has committed to introducing Cultural Ambassadors and to introducing Employee Voice Networks in early 2018. Tremendous event, fantastic turnout, well organised There is a real buzz about the Trust around diversity c. The Trust has achieved the Ministry of Defence Employer s Recognition Scheme, bronze award and is currently working towards the silver award. The Trust has signed a Step into Health campaign, which is the national NHS campaign to support exiting service personnel to transition into NHS employment. The Trust has met the criteria for this and is the first in the West Midlands to do so. Page 2 of 11

d. Although absence rates have shown a slight reduction overall, the Trust is still an outlier for Sickness Absence Rates on Model Hospital Portal with its current rates of absence, which are shown below. There is targeted work taking place within the Divisions to look at long term absence and to target hotspots showing high levels of absence. The Workforce Wellbeing Action Plan phase 1 has been delivered and phase 2 is planned. The Workforce and Organisation Development Committee will receive a review of the approach to Managing Attendance at Work which has now been operational for 6 months. Absence rates July 17 Aug 17 Sep 17 Trust Total 4.35% 4.30% 4.22% Div 1 - Surgical 4.28% 4.24% 4.09% Div 2 - Medical 4.87% 4.45% 4.10% Estates & Facilities 4.32% 5.66% 5.95% Corporate 3.54% 3.48% 3.95% Primary Care 0.86% 0.77% 1.91% Trust absence rates continue to run at around 1% above the target of 3.24%. The figures have followed the usual pattern of a slight downward trend in the period July September 2017; in previous years we have then seen a rise over the autumn months due to seasonal illnesses. For comparison, the Trust rates for the same months in the previous year were; Jul 16 4.78% Aug 16 4.89% Sep 17 4.25% 2.1 Advertising Summary NHS Jobs At 30 th October 2017 A total of 99 vacancies were advertised in October, most (32) related to Nursing Roles, 12 of which are on-going adverts (Band 5) and 28 related to administration and clerical roles. There has been a slight reduction in the number of Nurse Vacancies open across the Trust from 177.78 to 170.59 WTE. The main hot spots for Nursing roles are Paediatrics, Stroke, Oncology, and Orthopaedics. Refer to Appendix One for summary of current unfilled vacancies Page 3 of 11

2.2 Promotion and Attraction activity A number of actions are being progressed to address vacancies including a Recruitment Event on 18 th November. The focus will be on attracting qualified Nursing staff across all specialties but there will be a particular interest in sourcing candidates with experience of or interest in working on the Stroke Unit. Plans are in place to interview and assess suitably qualified nurses on the day and issue conditional offers to those who are successful. The HR Resourcing Team has been working with Global Communication to develop a radio advertising campaign to advertise the event. The advert is being aired on Capital Radio from 6 th to the 17 th November. The advert invites interested listeners to use an NHS text back option. Responses will be measured by Global and reported back to the Trust for evaluation. The number of Nurses attending the recruitment event and number of offers that arise will also be used to measure the success of the campaign and the event. The Communications Team have been proactively engaged in promoting the event preparing appropriate communications including press releases and updates via social media platforms. The Trust will also be exhibiting at the Future Fest Recruitment event on 15th November 2017. This event is hosted by Staffordshire University and taking place at their Telford Campus. Representatives from Stroke and Nurse Education will be in attendance and will be taking the opportunity to promote the Trust and publicise the recruitment event that is taking place on 18th November 2.3 International Recruitment Start dates for the remaining 4 Philippine nurses are being finalised with arrival anticipated late November. 2.4 Temporary Staff Bank: - As at 31 st October 2017 5,257 requests for shift cover across the Trust were processed and 89% of the requests were filled. Hot spots included Emergency Department, A9 (Surgical), A12 (Surgical), A5 (Surgical), A6 (Surgical) where there is a combination of vacancies and sickness. The Temporary staff bank has continued to actively recruit and have completed the following interviews during October. Internal External Nurses 12 5 HCA 4 28 Admin 1 10 Total 17 43 Page 4 of 11

2.5 Medical Workforce Update at 31 st October 2017 An overview of the establishment vs. vacancies can be found at Appendix 2. A summary of key current recruitment activity is detailed below: Division One Interviews for a Locum Consultant CT Anaesthetics are scheduled for 24/11/17 Advertisements for Consultant posts in Paediatrics and CT Anaesthetics are being finalised and will be published shortly. Division Two A number of Consultant posts are currently out to advert including: Stroke, Diabetes, Haematology, Emergency Medicine and Gastro. Interviews have been scheduled during December 2017 and January 2018. Interviews are scheduled in November for Senior Clinical Fellow roles in Urology and Cardiology and for a Specialty Doctor in Oncology. Clinical Fellow Programme Nigerian Candidates Division One Update on shortlisted candidates All 5 of the candidates shortlisted for General Surgery failed to attend interview. Three shortlisted candidates for T&O will be interviewed on 14 November Interview dates for ENT and Cardiology are being finalised. Appointment for CT Surgery pending. Awaiting confirmation regarding 2 Obs & Gynae applicants as to whether they will be accepted for MTI then offers will be made. The Department are currently reviewing 8 applications for Anaesthetics. Division Two Offers for the 15 Nigerian candidates are in progress, start dates have not been finalised but are expected to be between January and March 2018 2.6 Temporary Medical Staffing - Agency There were 2181 shifts requested in the period ended 31 st October 17. A total of 963 shifts were filled by Agency workers, 489 were filled by Bank staff and 21 were unfilled. The overall fill rate of 92% was lower than last month which was 97%. The Trust is in process of recruiting to a number of posts which are currently covered by utilising temporary medical staffing arrangements. Page 5 of 11

3.1 Leadership and Workforce Development 3.1.1 Education, Training and Leadership: The Education, Training and Leadership Strategy (2014-17) is currently under review. The progress around the Education, Training and Leadership strategic implementation plan (2014-17) has been reported through WOD and the Academy Steering Group, with all but one action (coaching delivery plan) completed. This item will be carried forward into the revised strategy for 2018-20 3.1.2 Mandatory training: OP41 (Induction and Mandatory Training policy) has been reviewed, and will now include the induction process for temporary workers following the de-escalation of HR04 (Temporary Workers), and volunteers. This was approved at November Policy Committee. The changes to the delivery model of Basic Life Support levels 2 and 3 training will result in a reduction of face to face training time, and thus less time away from patient care. A proposal to change the RAG compliance threshold from 95% to 85% for mandatory training, induction and appraisal will be discussed at the Academy Steering Group (ASG) in November. A risk around patient moving and handling training has been identified due to long term sickness of one of the trainers. However an action plan is in place and being monitored. The annual review of the TNA for mandatory training topics will be completed by 31 st March 2018. 3.2 Health Wellbeing and Resilience The 2017/2018 campaign is being managed through the Trust s Flu Board; OH&WB is represented on the Board, with Infection Prevention & HR involvement. This year s focus is that the campaign is led by directorate managers. By 14/11/2017-38% of frontline staff had been vaccinated. The health surveillance work programme continues in line with the annual schedule. OHWB s are working with both the Health & Safety Team and Hotel Services in regards to new health surveillance requirements. This could potentially affect recruitment processes. Page 6 of 11

Health surveillance coming up: o December 2017 (All questionnaires to be submitted to OH by 28/02/2018) Night worker questionnaire will go out to all staff who potentially work night duty o December 2017 (All questionnaires to be submitted to OH by 28/02/2018) Skin surveillance o December 2017 TB Surveillance letters to all staff who have contact with TB patients The OHWBS is continuing to review and refine its operational processes and maximise the benefits of using the Cohort system including linking this with an OH audit / benchmarking system (MoHawk). During October, two hundred Health Assessment forms were submitted to OHWBS. One Hundred and seventy eight new employees were occupationally cleared to commence employment within 10 days of either the department receiving their form or from their initial appointment. Twenty two were cleared after OH&WB received the forms. This has been related to incomplete health assessment forms, new employees not wanting to undergo a blood test and requesting results from their previous employer or extended wait for chest x-ray results. 4.1 Trust Targets The Trust has a sickness target of 3.24% currently the overall in month sickness percentage for September 2017 stands at 4.22%. The Trusts 12 month turnover target figure has recently reduced from 13.5% to 10.5%. The Trust turnover is currently at 11.0%. The normalised* turnover figure is currently at 9.82%. (*excludes students, fixed term contract ends) We have introduced an employee starters and leaver s target, in which the leavers target will be based on what is required in order to achieve a turnover of 10.5% across the Trust. The starters target will be based on introducing 10% more starters than leavers each month; this will enable us to continue the stability of the workforce. (See Appendix 3 for Workforce Metric data) Page 7 of 11

5. Underpinning Workforce Assurance 5.1 The first meeting of the Workforce & Organisational Development Committee was held on the 18 th October 2017, the minutes from the meeting will be presented to the Trust Board in November. Page 8 of 11

Appendix 1 Nursing Workforce Summary. Update on Unfilled Nursing Posts at 31st October 2017 Total - All Unfilled Posts (Including those with offers in progress) Qualified Nurses Unqualified / HCA Total - Qual + HCA Others Total - Qual + HCA + Others Div-1 87.78 12.99 100.77 7.70 108.47 Div-2 64.73 39.06 103.79 11.02 114.81 Midwives 4.93 11.72 16.65 0.04 16.69 Community 13.15 3.12 16.27-1.80 14.47 Totals 170.59 66.89 237.48 16.96 254.44 The table indicates there are fewer whole time equivalent vacancies (WTE) 170.59 registered nurse vacancies open across the Trust (including those who are starting not yet in post) this is a reduction on September figures which were 177.78. *The negative figure for Community indicates they are slightly over established. Appendix 2 Medical Workforce Establishment 31st October 2017 Division 1 Grade Establishment Vacancies Sep 17 Oct 17 Consultant 236 20 8.47% 8.47% SAS Grades 50 9 18.00% 18.00% Training Grades 182 20 10.99% 10.99% Non Training Grades 79 20 27.63% 25.32% TOTALS 547 69 12.93% 12.61% Division 2 Grade Establishment Vacancies Sep 17 Oct 17 Consultant 126.2 22.2 17.59% 17.59% SAS Grades 22.72 7 30.81% 30.81% Training Grades 163 12.2 7.44% 7.48% Non Training Grades 39 4 32.43% 10.26% TOTALS 350.92 45.4 15.13% 12.94% Page 9 of 11

Appendix 3 DRAFT: Workforce Information & Metrics - Board Data Effective 31st October 2017 Full Trust 61.29 53.12 56.78 67.69 74.22 89.82 53.74 0.00 0.00 0.00 0.00 0.00 456.65 Workforce Profile 2016-17 Position Target Y TD Cha nge sinc e 3 1st Ma r 17 Substantive Staff WTE 7150.11 7135.38 7137.14 7136.91 7144.72 7147.22 7201.33 7252.61 103 Substantive Staff Headcount 8300 8293 8294 8295 8302 8301 8358 8417 117 Bank Staff Only Headcount 1192 1239 1271 1258 1289 1314 1318 1375 183 % Staff from a BME background 25.48% 25.64% 25.96% 26.03% 26.22% 26.43% 26.63% 26.67% 1.19% Vacancy Rate 8.70% 10.32% 10.21% 9.98% 9.78% 10.21% 9.70% 9.68% 0.98% Data Owner: Workforce Planning & Business Information Workforce Profile by Staff Group 2016-17 Position Target Y TD Cha nge sinc e 3 1st Ma r 17 Starters WTE - 10% > Leavers 56.61 51.96 40.84 66.02 36.20 90.77 88.95 431.35 Leavers WTE - 55.72 48.29 51.62 61.54 67.47 81.65 48.85 415.14 Internal Changes WTE - > than 0.00-15.62-1.91 10.56 3.33 33.77 44.99 11.18 86.29 TUPE Starters WTE - 8.60 0.00 0.00 7.61 0.00 15.36 17.35 48.92 TUPE Leavers WTE - 1.00 1.00 0.00 0.00 0.00 0.00 0.00 2.00 Data Owner: Workforce Planning & Business Information 5.572 4.829 5.162 6.154 6.747 8.165 4.885 0 0 0 0 0 41.514 Workforce Profile by Staff Group 2016-17 Position Target Y TD Cha nge sinc e 3 1st Ma r 17 Additional Professional, Scientific, and Technical 231.51 230.06 231.87 230.07 230.72 229.72 229.58 231.94 0.43 Additional Clinical Services 1242.02 1240.89 1233.77 1244.66 1250.93 1241.10 1262.24 1241.54-0.48 Administrative and Clerical 1537.87 1528.91 1532.26 1526.02 1541.13 1541.08 1554.30 1578.33 40.46 Allied Health Professionals 401.77 396.14 389.64 386.44 382.16 387.19 391.27 393.88-7.89 Estates and Ancillary 559.13 559.48 561.59 555.95 556.60 557.27 555.79 557.55-1.58 Healthcare Scientists 239.88 243.01 244.01 245.60 249.00 253.43 252.15 252.15 12.28 Medical and Dental 768.38 767.43 765.39 767.87 771.65 786.64 802.75 814.35 45.97 Nursing and Midwifery Registered 2129.56 2128.46 2143.42 2146.11 2128.52 2116.79 2123.24 2151.88 22.32 Students 40.00 41.00 35.19 34.19 34.00 34.00 30.00 31.00-9.00 Data Owner: Workforce Planning & Business Information Inc Permanent, Fixed Term, & Locums with WTE on Payroll Inc Bank Only with 0.00 WTE on Payroll Staff in Post in ESR vs Budgeted in Finance as reported to NHSi Exc Rotational Doctors Exc Rotational Doctors Inc Change of Hours, Bank to Substantive Identifies change in WTE due to TUPE Identifies change in WTE due to TUPE Inc Permanent, Fixed Term, & Locums with WTE on Payroll Turnover (Rolling Previous 12 Months) 2016-17 Position Target % Total Workforce Turnover 12.19% 10.50% 12.02% 11.91% 11.87% 11.68% 11.46% 11.09% 11.00% 11.00% Exc Rotational Drs (reflects NHS Digital Benchmarked data) % Normalised Workforce Turnover 10.89% 10.50% 10.89% 11.01% 10.95% 10.40% 9.82% 9.93% 9.82% 9.82% % Normalised: Additional Professional, Scientific, and Technica - 10.50% 11.48% 10.72% 10.73% 10.26% 10.81% 9.82% 9.28% 9.28% % Normalised: Additional Clinical Services - 10.50% 9.77% 9.80% 9.76% 9.46% 9.64% 10.01% 10.34% 10.34% % Normalised: Administrative and Clerical - 10.50% 10.20% 10.37% 10.09% 9.53% 9.18% 8.91% 8.94% 8.94% Exc Rotational Drs, Students, TUPE Transfers, End of Fixed Term % Normalised: Allied Health Professionals - 10.50% 10.43% 12.01% 11.14% 11.90% 10.15% 11.72% 11.95% 11.95% Contracts % Normalised: Estates and Ancillary - 10.50% 6.17% 6.16% 7.00% 7.22% 7.44% 7.56% 7.40% 7.40% % Normalised: Healthcare Scientists - 10.50% 10.21% 9.33% 8.58% 8.51% 8.22% 7.62% 7.56% 7.56% % Normalised: Medical and Dental - 10.50% 7.05% 7.90% 7.58% 8.85% 6.71% 6.61% 5.67% 5.67% % Normalised: Nursing and Midwifery Registered - 10.50% 11.06% 10.67% 10.97% 11.18% 11.62% 11.96% 11.76% 11.76% Data Owner: Workforce Planning & Business Information Retention Rate 2016-17 Position Stability Index (12 months) 89.60% 89.54% 89.77% 89.61% 89.82% 90.01% 90.29% 90.48% 90.48% No. Employees with 1 or more years service / No. Employees Stability Index (18 months) 85.46% 85.34% 85.38% 85.45% 85.28% 85.06% 85.13% 85.64% 85.64% employed 12m ago x 100. Exc Rotational Drs, Students, TUPE Stability Index (24 months) 81.22% 80.86% 81.00% 81.17% 81.21% 81.65% 81.58% 81.87% 81.87% Transfers, Clinical Fellows, & Fixed Term Contracts Data Owner: Workforce Planning & Business Information Sickness Absence (1 month in arrears) 2016-17 Position Target % Sickness Absence (In Month) 4.13% 3.24% 3.99% 4.08% 4.00% 4.35% 4.30% 4.22% 4.48% 4.48% % Sickness Absence (Rolling previous 12 months) 4.41% 4.38% 4.37% 4.36% 4.36% 4.36% 4.35% 4.32% 4.32% WTE Days lost to Sickness 113,628.07 8,512.89 9,002.91 8,563.52 9,621.96 9,531.70 9,087.81 10,032.52 10032.52 % Short Term Sickness 1.40% 1.14% 1.26% 1.34% 1.51% 1.20% 1.43% 1.59% 1.59% % Long Term Sickness 2.74% 2.84% 2.82% 2.66% 2.85% 3.11% 2.79% 2.89% 2.89% Estimated Cost of Sickness ( ) 8,786,713.00 662,632.39 690,175.23 657,476.71 733,244.03 739,204.24 721,183.94 792,374.78 792,374.78 Data Owner: Workforce Planning & Business Information

Appendix 3 Agency Usage 2016-17 Position Target 2017-2018 Total Agency Costs (NHSi 2017/18 target) 16,047,976 11,319,000 1,316,578 999,751 983,280 1,136,463 976,202.57 705,347 783,203 6,900,825 Target uplifted by 719k as agreed with NHSi Total Agency Costs (RWT Target - NHSi Workforce Plan) 16,047,976 15,319,000 1,316,578 999,751 983,280 1,136,463 976,202.57 705,347 783,203 6,900,825 Target uplifted by 719k as agreed with NHSi Admin & Clerical 1,087,979 55,206 71,085 61,106 63,423 68,186.00 52,219 23,503 394,728 Ancillary 205,531 14,590 18,490 38,590 336 23,292.00-13,533 4,962 86,727 Scientific, Therapeutic, & Technical 1,497,295 74,702 98,770 88,574 81,187 96,365.00 29,661 29,502 498,761 Nursing & Midwifery 401,014 23,231 43,969 23,328 28,347 12,485.00 17,197 15,934 164,491 Medical & Dental: Consultants 5,336,394 383,245 386,389 338,585 438,271 329,589.00 250,771 202,812 2,329,662 Medical & Dental: Career & Other Grades 0 40,938 16,422 9,149 40,922 30,996.00-23,438 81,556 196,545 Medical & Dental: Junior Medical 7,519,763 724,668 364,626 423,947 483,978 415,292.00 392,470 424,935 3,229,916 Number of Shifts Off-Framework - 123 168 134 166 234 141 162 1128 Submission to NHSi - week ending in relevant month Number of Shifts breaching Agency Price Cap - 1367 1579 1389 1385 1390 1006 1362 9478 Submission to NHSi - week ending in relevant month Data Owner: Finance Bank Usage 2016-17 Position Target 2017-2018 Total Bank Costs 10,557,103 9,203,000 1,065,110 908,828 889,624 1,065,977 1,114,646 1,084,540 1,149,577 7,278,301 Admin & Clerical 643,431 62,311 44,505 46,928 62,311 53,589 56,056 78,159 403,858 Ancillary 1,596,079 166,357 118,390 126,738 140,297 142,274.67 143,278 136,472 973,807 Scientific, Therapeutic, & Technical 44,854 2,826 2,858 2,982 4,117 4,819 2,965 4,294 24,861 Nursing & Midwifery: Qualified Nurses 2,808,613 259,883 179,108 175,104 232,984 213,764 222,321 271,393 1,554,557 Nursing & Midwifery: Midwives 293,037 28,751 16,238 27,158 17,925 14,812 18,636 0 123,520 Nursing & Midwifery: Unqualified 3,840,761 393,554 250,493 246,309 335,480 280,350 266,233 317,060 2,089,479 Medical & Dental: Consultants 316,295 407,819 386,422 329,198 466,895 187,401 63,413 142,745 1,983,892 Medical & Dental: Career & Other Grades 1,014,032 0 0 0 0 7,484.52 39,924 19,008 66,417 Medical & Dental: Junior Medical 0 741,031 381,015 442,484 496,275 210,151.90 271,715 180,447 2,723,119 Data Owner: Finance e-rostering 2016-17 Position Target % Rotas Set 6 Weeks in Advance - Unused Hours - % Staff on Annual Leave - Open Employee Relations Cases - Number of Cases Open Bullying & Harassment Cases - Open Capability Cases - Open Disciplinary Cases - Open Formal Grievances Cases - Open Whistleblowing Cases - 2016-17 Position Target Freedom to Speak Up 2016-17 Position Target Data Owner: E-Rostering Data Owner: HR Employee Relations Data Owner: Freedom to Speak Up Guardian Reporting to commence in 2018/19 Apprenticeships 2016-17 Position Planned Apprentices - New Starters (Cumulative) - Actual Apprentices - New Starters (Cumulative) - Variance in New Starter Apprenticeships to Plan (Cumulative) - Target Data Owner: Apprenticeship Team Levy applicable from May 2017 onwards, all New Starters prior to 1st May 2017 excluded Education / Organisational Development 2016-17 Position Target Trust Induction - Local Induction - Mandatory Training - Appraisal - Agenda for Change - Appraisal - Medical Staff - Data Owner: Education & Training /19 after review