Workforce Performance Report March 2013 Jayne Halford Deputy Director of HR Caring, safe and excellent 1

Headline HR KPIs Turnover Turnover has remained relatively flat over recent months with a slight increase over the latter 3 months of the financial year and an overall increase of 2% (119 head count) on this point last financial year. Stability has been consistent at around 85% throughout the year meaning that the workforce is essentially stable. Two TUPEs in – from the PCT and from OCC have increased headcount this month which will be negated by the transfer out of the Bullingdon healthcare staff. The MARS scheme has continued and the release of 30 staff out of 66 applications has been agreed. Bank and Agency Usage An increase in Bank and Agency usage continues to be driven by the impact over the year of increasing levels of absence and turnover. Whilst there has been a reduction since the spike in January, increased staffing levels due to the opening of escalation beds to support discharge from the JR are still required and usage in Community Hospitals is 4% above target. The reduction of usage within Specialist Mental Health has been maintained. Both OCS and Specialised Services have seen increases of 2 and 1% respectively. Sessional usage has remained relatively flat throughout the year other than a peak at the beginning of the financial year. Live vacancies There has been a significant decrease in budgeted vacant posts since October 12. The vacancy rate remains stable over the last 2 months. 2

3 Headline HR KPIs Recruitment Solutions is an internal agency focussing on recruiting administrative staff. The chart above shows the impact on savings by utilising this internal resource rather than using external agencies..

Workforce Performance Report August 2012 Headline HR KPIs Sickness /Absence The top 2 reasons for sickness absence remain anxiety, stress/depression, other psychiatric illnesses (25% of sickness) and cold, flu etc. Musculoskeletal, back problems, gastrointestinal and chest/respiratory are also significant reasons for sickness absence particularly in Community Services. The absence rate at 4.2% has dropped slightly on last month but is above the 2012 February rate (3.66%) and therefore the 12 month average will remain above last year. The HPA report that the incidence of Norovirus was 5% up on last season. Short-term sickness rates other than in Community have decreased which corresponds with moving out of the season for colds, flu etc. In most instances Long-term sickness (LTS) absence has been variable during the year ending, other than in specialised roughly on a par with the start of the financial year. 4

Workforce Performance Report August 2012 Headline HR KPIs Casework Management: The casework profile remains reasonably flat. Conduct cases continue to form the majority of cases with the increase in disciplinary cases making this the second highest type of caseload. There have been no new whistleblowing cases. The charts shows accumulated cases since January 2012 with March 2013 detailed below. Number of new cases in March =7 Number of closed cases in March =7 The focus has been on progressing and closing cases in a timely manner in line with policy and guidelines and as can be seen in the first chart this continues to be a highly effective approach. 5

SPECIALIST MENTAL HEALTH SERVICES - PERFORMANCE AGAINST TARGET – ALL INDICATORS 6

7 Sickness: Sickness is at 5.00% which is a reduction from previous month’s figure and includes 33 staff on long-term sick, 22 of which are on-going. Areas of concern are as follows: OA Chiltern 18.54% (8 staff) - An experienced Adult CMHT manager has been seconded to the team with one of the priorities being to resolve the LTS (12.13%) (2 staff) and robustly manage the short and medium term sickness. North West CMHT 12.35%(5 staff) of which 11.76% (2 staff) is long term. One LTS case is being resolved through retirement at the end of March. A Modern Matron for Community is supporting the manager with LTS in partnership with HR. Cromwell Ward – 9.60% (7 staff) of which is 6.33% (2 staff) is long term. Historically this ward has had sickness below the KPI but has two staff who are recuperating from surgical operations. Allen Ward 13.22% (14 staff) of which 4.8% (2 staff) is long term. Extra resource has been identified to focus on reducing sickness levels. Sandford Ward 13.49% (8 staff) of which 9.33% (3 staff) is LTS. A Modern Matron is currently covering the Ward Manager role. 2 cases are going to medical discharge. Portland Ward and Kimmeridge Ward are both reducing their sickness levels. Portland currently have 10 staff on informal sickness management who have reached the triggers. Fiennes is reducing its sickness level since having a new substantive manager appointed who is being coached and supported by the HR team. Recruitment The second tranche of central advertising closed at the end of March and having changed the advert text and split out locations and patient type we had 492 applications compared to 39 on the first tranche. Some of these will be duplications but the indications so far are that Bucks Adults successfully recruited to all their Band 5 qualified staff and had others that could have been appointed and are willing to work in Oxford. Those involved reported that the quality of candidates was excellent. HCA interviews take place on the 15 th April for the Bucks role. Oxford Qualified and Unqualified interviews are taking place at the moment. Tranche 3 has already closed so we anticipate that all wards will have enough staff to fill vacancies and over recruit where appropriate, Due to the large uptake in future the adverts will run monthly rather than fortnightly. While staff are going through the recruitment process the inpatient wards in Oxford have had agreement to employ agency staff on 3 month contracts through NHSP or external agencies. This will increase the agency spend but there will be a larger decrease in the substantive pay bill to compensate. In March 2013 Sessional usage was at wte – in view of the above recruitment we will see a reduction in months to come. Casework Open cases number 3 in Bucks and 4 in Oxon. 4 cases were closed in March – 2 of these went to appeal stage but the appeals were unsuccessful. In one case the individual resigned before the investigation started. In a 4 th case there is to be no further action.

Oxfordshire Community Services –Performance against Target – All Indicators 8

9 Sickness Sickness remains above Trust target in all areas of the Division apart from Oxon Community Management and is highest within District Nursing at 5.5 % of which 12.48% is notable in the south-east locality. Management of sickness absence continues to be a high priority for the Divisional HR team. HR are also attending Community Nursing locality meetings to provide support to managers regarding sickness absence levels and two separate absence management training sessions have been delivered as part of the action plan to address sickness absence within the service. To date all Band 7 staff in the service have received this training and the HR team continue to work towards delivering this to all Band 6 staff. Further training from HR has also been provided in March though delivery of training on Managing Performance at the Community Hospital’s Deputy Ward Manager development day and the presentation regarding recruitment partnership working was also shared with Community Hospital Unit managers. The HR team also provided input into the Countywide Services away day regarding partnership working between HR and services. Absence management continues to be a priority within the Division with decisions in March that seven staff will exit the Trust in March due to proactive formal management of ill health situations. Six of these staff were from Community Hospitals and one from Community Nursing. They are evidence of a proactive formal approach to management of long term sickness across the Division. We continue to manage five staff formally regarding long term sickness absence and manage 2 disciplinary processes. Agency levels continue to rise within the Division and HR are working with Unit managers to monitor this situation and focus attention on recruitment and sickness absence management Turnover The Division remains slightly over the Trust target at 12.58%; however this does incorporate some areas where turnover warrants supplementary analysis and action, specifically within some Community Nursing Teams. Analysis is currently taking place and actions will follow from this. Turnover remains a concern within some of the Community Nursing teams. The overall turnover for the service is 14.7% however there are particular high spots, with the West locality being at 26% and the South East locality 24.4%. Bank and Agency Bank and Agency spend is below the Trust target. Usage continues to be predominately within Community Hospitals. Community Hospitals used 97 shifts during the week ending 31 st March 2013, representing 37% of the total shifts used with 14 shift requests (11%) due to escalation beds and 48 shift (39%) requested due to sickness absence. Overall performance YTD averages 49.5 shifts per week, which is below the Trust target of 60. Didcot and Wallingford continue to be the highest users. Vacancies The number of vacancies has continued to rise to currently 139 of which 69 are at offer accepted and 27 cleared to start. Casework There are 18 open cases in the Division which are being proactively managed. 11 of these are ill health capability cases and in 5 of these cases the employee has been dismissed with notice on the grounds of capability. There are 4 Capability Performance cases where formal action plans are in place. There is 1 Dignity at Work/Grievance case which is about to be closed with further informal action to follow. There are 2 Discipline and Conduct cases which are at the investigation stage. There is 1 Employment Tribunal claim which relates to withdrawal of an employment offer and Disability Discrimination is being cited.

Childrens & Families Services - Performance against Target– All Indicators 10

Childrens & Families Services – Performance against Target – All Indicators 11 Sickness Absence: 3.05% Lowest % across the operational divisions, including short/medium and long term %. We have seen a reduction this month of 0.4%. There are 3 areas above Trust Target: Bucks Community 5.25% (8 staff, 4 of which are long term sick) however a reduction of 0.18% from last month) and has continued to show a decrease over Dec 12 – Mar 13. C&SH 8.73%. relates to 8 staff, 3 long term and 5 short term absences. HR have worked closely with senior management, which has resulted in 2 long term cases returning to work in March, which should be reflected in next month’s figures. Of the 5 short term cases these have been identified as seasonal e.g. colds/flu. Psychological Therapies 4.19%, this relates to one long term illness which HR and OH have supported. Other absences are short term. Top reasons for absence: Anxiety/stress/depression/other psychiatric illnesses – 25.76% which is in line with Trust statistics, Benign and malignant tumours, cancers – 13.22%, Cold, flu = 10.71% Recruitment: Total number of vacancies has reduced and is the lowest number over the past 12 months, i.e.132 vacancies in the pipeline. 76 candidates have accepted an offer of employment, of which over 30% have confirmed a commencement date of employment. A number of negatives in vacancies figures derive from negative cost improvement savings i.e. Posts have been deleted but not allocated budget-wise to the appropriate cost centre. Initiatives: ER/Recruitment teams have continue to take a proactive, collaborative approach and have provided a number of bespoke training sessions and support to managers, this has reflected in the vacancy fill rates and low sickness absence rate. Casework: 10 formal cases are currently being managed and all have associated HR action plans: One is a Grievance; this is currently being investigated under formal stage 1. Five are Disciplinary; three involve suspensions. All are under investigation/investigation manager appointed report to be concluded within the next 2 weeks. One has progressed to a hearing which has been scheduled for April. Two are Capability; both relate to performance and are at the formal 1 st stage Two are ill Health and retirement applications have been completed and are now with Occupational Health/Pensions Agency.

Specialised Services – Performance against Target – All indicators 12

Specialised Services – Performance against Target – All Indicators 13 Sickness The main sickness absence issues in the Division concern long term cases. It is anticipated that absence should reduce as a number of cases start to return to work: Bullingdon Admin Team – 1 admin employee absent since 1/7/12. MARS application has been approved and she will therefore be leaving the Trust. Huntercombe Prison Healthcare – 1 HCA long term absence returned to work on a plan agreed between line management, Occupational Health and HR. Low Secure Forensic Service – 1 HCA absence since Sept 2011 will leave on Ill Health Retirement, 1 Occupational Therapist absent since August 2012 returning to work on a plan agreed by line management, Occupational Health and HR, 3 medium – long term cases returning to work on Wenric ward. Medium Secure Forensic Service – 1 Housekeeper absent since February 2012 has clearance from her GP and Occupational Health to return to work, 1 long term absence from Watling ward continues following an assault by a patient (employee has submitted Employer’s Liability claim) Specialised Community Services – 3 medium to long term cases in Salaried Dentistry Service are being managed appropriately. Turnover: The rolling 12 month turnover figure is inflated due to issues associated with Bullingdon Prison Healthcare, an organisational change in Harm Minimisation Service and a small number of leavers from Luther Street. There does not appear to be an underlying cause for concern in these areas. Bullingdon: The healthcare service and staff TUPE transferred to Virgin Care with effect from 1 April This will have an impact on the turnover and bank & agency statistics. Bank, Agency & Sessional Contracts: The Forensic Inpatient service rarely uses bank or agency, the first preference being Sessional contracts. The latest reports show that in Forensic Inpatient Services the totals were: Bank & Agency 2.7%, Sessional 9.3%. Sessional shifts are cheaper than bank or agency as there is no agency fee. However the pool of Sessional staff is small in some areas – particularly Milton Keynes. Working hours reports are reviewed to ensure staff are not working excessive hours. In Huntercombe healthcare service the use of bank and agency has been high due to high levels of absence. As sickness absence levels reduce in the service the use of agency should reduce. Discussions continue with the manager about establishing a pool of Sessional workers. Casework Casework levels in Specialised Services are higher than other Divisions (14 cases). The figures are inflated by 4 individuals involved in one specific issue that is being investigated on Thames House. The Investigating Officer has advised the investigation report will be completed by 14 April Discussions with senior staff suggest that the reasons for high level of casework include the number of rules and policies in Secure Services and high standards.

14 Statutory Training - Trust Actions Alternative approaches are under review with the Re-ablement service to address the Risk Category 4 performance within OCSD. Additional induction events have been scheduled to reflect the recruitment of new staff and offer further places to those yet to attend induction. Facilitated support has been given to more ward areas to enable the completion of eLearning through staff attending groups sessions within the L&D Centre. In conjunction with Medical Education Supervisors, the low performance of Junior Doctors is being targeted, particularly following the February intake. Trust performance - March 2013 As forecast previously, the higher incidence of staff holidays during March and the continuing pressures on staffing resulting from increased demands on clinical services during the winter months, impacted on performance, reducing it to 81% in the month. Using the risk based reports, OCSD and performance within the lower risk category 4 (non-registered community staff) at 68% requires further attention. Despite the reduced performance, there continues to be a reduction in the overall ‘training gap’. Risk Groups

15 Statutory Training by Division Specialist Mental HealthSpecialised ServicesOxon Community Services Corporate ServicesChildren & Families Services Alternative approaches are under review with the Re- ablement service to address the Risk Category 4 performance within OCSD. In conjunction with Medical Education Supervisors, the low performance of Junior Doctors is being targeted, particularly following the February intake.

16 Statutory Training - Risk Level 1 – Ward Registered Staff The following courses have been selected as high risk for the highest risk group; All registered staff working on inpatient wards. CoursePerformance % Total Staff Staff Trained Training required Already Booked Action requiredPlaces available in next 3 months Fire Awareness Book 150 places & attend377 Induction - Local Workplace Managers to input date on OTRn/a Infection Control - Classroom Book 54 places & attend171 Infection control - Workbook Completion of workbook by individual n/a PMVA Full Course Teamwork Book 10 places & attend20 PMVA Full Course Recertification Book 31 places & attend26 - Additional Course (16) being Scheduled PMVA Short Course Teamwork Book 14 places & attendShort course being phased out and replaced with full course PMVA Short Course Recertification Book 26 places & attend Resuscitation Assessment ABLS & AED Book 147 places & attend405 Resuscitation eLearning ABLS & AED Completion of eLearning by individual n/a Actions: Dedicated L&D staff resource has worked with ward managers and their staff to ensure completion of eLearning. An eLearning solution for infection control has been developed with sections tailored for specific groups. A decision has been taken to require staff in Older Adult wards to have extended PMVA training in order to improve patient safety. Impact: Supporting staff on eLearning will provide an alternative to class-room attendance across several training subjects. Providing an alternative delivery method for infection control targeted at specific groups will enhance the relevance and completion of training. The extension of PMVA training for OA staff will necessitate increased training provision and may reduce performance against target during implementation of the change.

17 Mandatory Training Activity Trust AchievedTargetStaffTrainedBooked Not booked Notes (places available within next 3 months shown) Care Programme Approach90%85% places available Clinical Risk Assessment & Management80%85% Course under review - facilitator shortage in Nursing & Clinical Standards Directorate Complaints86%85% places available Dual Diagnosis Tier 180%85% n/a269eLearning available Falls Awareness55%75%* New e-Learning solution from Qtr1 Food Hygiene83%85% places available Information Governance75%85% eLearning or classroom Managing Risk64%85%3925n/a14 eLearning Medicines Management38%85% eLearning solution in Qtr1 Mental Capacity Act78%85% places available Mental Health Act84%85% places available Safe & Supportive Obs (new starters)53%85%3619n/a17 Online competence assessment available Supervision70%85% eLearning or classroom Notes: Activity - each subject area of mandatory training without showing individual course types Trust Achieved - actual performance level i.e. trained staff as proportion of all staff requiring training Target - unless indicated with * this will be 85%. * shows a current phased target. Booked - a committed place on a training course, i.e. a plan to achieve currency of training Not booked - the remaining ‘gap’ where no action has been taken to achieve currency of training

18 PDRs March – improved to 93%. This represents a significant change from the low point of 71% in Q1, i.e. a 31% improvement over the year. OCSD has improved to 89% i.e. 3% within the month. With the new PDR cycle starting from April, divisions need to complete all reviews by the end of Q1. Numbers Numbers