Workforce Performance Report November/December 2014 Jayne Halford Deputy Director of HR Caring, safe and excellent 1

Headline HR KPIs Turnover – Target 12% - Actual 12.91% The downward trend in turnover is continuing since the peak in August Turnover in December 2013 was 12.17% so there were 40 more (avoidable) leavers in 2014 than in 2013; starters in November were double the number of leavers. The main reasons for leaving over the last 3 months remain voluntary resignation and retirement; of those that we can control voluntary resignation is the main reason. Sickness – Target 3.5% - Actual 4.36% The sickness absence rate has fallen slightly overall and is approaching the 2013 figure for December of 4.01%; the 2012 figure was 4.45% (but in that year flu levels were higher). Unsurprisingly the main reason for short-term sickness absence is coughs, colds etc. In terms of long- term sickness absence stress etc. now accounts for one- third of sickness absence. The stress management policy is currently being reviewed. Bank and Agency- Limit 5% Actual 6.63% Bank and agency usage continues to be above the previous year whilst vacancy rates have fallen yet again. One issue is the underperformance of the new agency framework introduced in April 2014; contracted staff in December was at its highest level since March Vacancies: Limit 9% - Actual 5.31% The number of posts advertised has been declining steadily in the last quarter partly due to seasonal reduction but in line with turnover coming down. It is anticipated that this will rise again slightly in the coming quarter.. 2

Headline HR KPIs - Sickness 3 Sickness Reasons Stress continues to be the highest reason for sickness overall although as stated overleaf accounting for over one third of long term sickness absence. Long term sickness absence as a percentage of all sickness dropped this month which is in line with the increase in short and mid-term term sickness related to seasonal illness. Mindfulness days have been held throughout the Trust. E-WIN (Workforce Information Network ) reports a range of 3% to 7.27% sickness (a Trust in the North-West) for October. Oxford Health at 4.56% for October is mid-range of those who take part in this benchmarking. The HR Department has been assessing the possibility of contracting FirstCare, a sickness management system staffed by clinical staff with in-built notification to managers. A paper including costings has been completed and is under consideration. Short Term Sickness Adult Services is bucking the trend being the one division that has had an increase in short-term sickness absence. The trend for short-term sickness shows a drop for 2 months running which is contrary to what one might expect given the season.

Directorate Performance – Headlines 4

C&YP Directorate : Turnover December 12.0% V 12.0% Trust Target We have seen a slight increase in turnover from last month of 0.4%, turnover remains lowest % across all Directorates except Corporate. Highest turnover is within Dental Services at 21.56% followed by Swindon, Wilts and Banes at 13.16% and Specialist Services at The increase in turnover in Dental is a reflection of the management of longstanding ER cases, mostly sickness related. Sickness December 2.9% V 3.5% Trust Target Sickness absence has seen a decrease from last month of 0.28% and remains the lowest % across the Trust. Long term absence is currently 1.24% - a reduction from last month of 0.14%. This equates to WTE days 929 lost (last month 1048). Dental sickness absence had previously been high but is now decreasing, reaching 4.19% having been 5.79% last month. Bank & Agency December 5.0% V 5.0% Trust Target Agency accounts for 5.0% and this remains reasonably stable across the Directorate. 5 Directorate Performance – Headlines

Adults Directorate Turnover December 13.5% V Trust Target 12% We have seen a very small decrease in turnover since last month. The turnover in driven by the yearly intake of PWP trainees in Psychological Therapies in April and September. The training attracts candidates from throughout the country so when the training ends staff leave to take up roles closer to home. We are assisting with the next intake of trainee PWPS at the recruitment open day on Feb 6 th and we will look to employ the best candidates but particularly focussing on those who live in the Aylesbury area. Sickness December 4.76% V Trust Target 3. 5% There has been a slight in months increase in sickness absence, mainly in the inpatient areas in Oxford and the Forensic pathways. Bank & Agency December 7.84%V Trust Target 5% High agency spend in Bucks due to inpatient wards using the framework when previously there has been minimal requirement. The increase also reflects cover required for the 2 AMHT’s who since the restructuring have had difficulty in recruiting a new night team and to fill vacancies in the assessment and treatment functions due to the increase of referrals from GPs. The services have been recently reviewed and a decision will be made about staffing levels. In Psychological Services the service relies on agency staff. The spend decreases post September (as above) but there is still some spend to cover administrative vacancies. These roles are call handlers and without enough cover the service cannot achieve its targets for seeing referrals for IAPT. 6 Directorate Performance – Headlines

7 Older Peoples Directorate : Turnover December 13.67% V 12.0% Trust Target Turnover in the Directorate is the highest overall across the Trust. There may be historical reasons for this in some services (such as high vacancy levels and absence rates which impact workload and morale of the rest of the staff group). Attempts are being made to address root causes (initiatives to assist staff suffering from MSK, back pain and stress / anxiety which form the majority of sickness absence) and recruitment of trainees in some areas. These initiatives are still being developed and it is likely that there will be a lengthy lead time before these initiatives are embedded and resulting in an improvement in the KPI Turnover in Community Nursing is highest at 16.5% and a group in the service are looking at some of these issues, involving HR as necessary (for example in the development of contracts for trainee District Nurses) The figure for Management of 16.1% appears high but is actually 1 leaver from a relatively small group. Likewise in Older People’s Mental Health where there were 5 leavers (2 retirements, 1 redundancy resulting from the Mental Health Remodelling and 1 relating to HR casework) Sickness December 5.47% V 3.5% Trust Target Sickness absence has seen a decrease from last month of 0.65% but remains the highest across the Trust. This results from large reductions in absence levels (most notably in Community Hospitals and Urgent Care) and HR casework as well as individuals returning to work The Directorate is attempting to work up processes to support staff with MSK and stress / anxiety. However these are at an early stage and it will be some time before these are implemented Bank & Agency December % V 5.0% Trust Target Agency accounts for 7.07% and has increased since last month The figure of 17.5% in Community Hospitals appears to result from an adjustment made to costings in Finance. The Service Head has also advised that they have experienced an increase in patients with cognitive issues that require “specialing” i.e. that is only work with one patient to keep them safe. Agency is not just about vacancies or sickness but acuity of patients

8 Directorate Performance – Headlines Corporate Directorates : Turnover December 11.6% V 12.0% Trust Target Overall turnover is under target, however turnover in some of the corporate directorates is high (albeit in teams with small WTE staff numbers) R&D which is a normal profile for this area and HR where loss of occupational health staff is an ongoing issue. National shortages of trained OH practitioners is an issue affecting recruitment and retention. Sickness December 3.2% V 3.5% Trust Target There has been a small increase overall in month in sickness absence. However some focussed work undertaken by HR team working with Pharmacy, is beginning to deliver some improvements. This work is ongoing and further reductions are being worked on. Other high sickness areas will be prioritised for attention. Bank & Agency December 4.85% V 5.0% Trust Target Agency spend continues to run high in 2 Corporate areas: Decision Support (Cube) but this has reduced in month and is expected to reduce further and will continue to be monitored. Estates & Facilities has seen further increase in agency use, due to the organisational change. Pending the final outcome of the plans recruitment into posts is not being undertaken but this will reduce as the new organisation is agreed and posts are confirmed.

Directorate Performance The following graphs can now be available for all cost centres and will provide additional information to see where there is a correlation between sickness and or vacancies and bank and agency usage and will provide dat with which to support manager’s staffing needs. 9

ACAP06 Highfield Oxford WTE Difference By Subjective Code

Example: APTC40 Healthy Minds – Absence and WTE Shortage

12 Recruitment Data EventDate Milton Keynes Job Show23rd January am-6pm Milton Keynes Job Show24th January am-6pm Cherwell School Careers Fair 22nd January pm-8pm Adult Mental Health Services 24th January pm-5pm Community Children’s Nursing Services 28th January pm-6pm London Job Show6th February am-7pm London Job Show7th February am-7pm Highfield Unit12 th February pm-7pm Whiteleaf28th February 2015 There was the usual seasonal reduction of vacancies in December, the number of applications received also reflect a reduction in number again due to the Christmas period. During January and February the Trust will be attending several national job fairs as well as holding local open days, the details of these are: There will be representatives attending from all Directorates for the national job shows in Milton Keynes & London as well as resourcing team members. The local open days will be attended by representatives of the relevant services as well as the resourcing team.

13 Recruitment Data

14 Recruitment Data

15 Recruitment Data This and the previous charts show a trend of continuous improvement in terms of meeting turnaround times for recruitment processes

Recruitment Update Nov 14 – Jan 15 Values Based Recruitment A draft Values Based Behavioural Framework has been produced and was informed by the results of the staff interviews conducted last summer. This was shared with Directors and Non-executive Directors at the Board Summary in December. Sign off of the framework is expected in January. Work has begun on updating recruitment materials and our website pages. Training materials are currently under development with the first group of managers due to be trained before the financial year end. Recruitment Action Plan The Recruitment Action Group has met twice during the last quarter. The main focus of the group has been discussing candidate attraction strategies. Further detailed work has commenced on identifying temporary accommodation for new staff ; developing closer links with Universities; recruitment fairs/open days; career progression for HCA’s plus equity in banding; career progression; and recruitment website/social media. 16 Recruitment Data

Casework Data 17 Total open cases in the Trust number 97; this has increased over the year. The number of staff on suspension is currently 11 and each suspension is reviewed regularly. Casework slowed in December except in Older Peoples where the management of sickness absence continues to be a priority. As can be seen overleaf noteworthy is that all Whistleblowing cases are in Adults and open cases number 4, the one Employment Tribunal is in Older People ; of 3 Bullying and Harassment cases 2 are in Childrens and Young People and the third is in Older People. Casework duration is noticeably improved over 2013; the one exception is capability (performance); the Capability policy has just been reviewed to, amongst other things, further streamline the process.

CASEWORK 18

19 CASEWORK

Health Checks 25 members of staff had their free NHS Health Checks at the Whiteleaf Centre on 15 and 18 December delivered by ToHealth on behalf of Buckinghamshire County Council. Engagement and feedback from staff has been encouraging and very positive. A summary of feedback will be put together and will be available from February. London Welsh Rugby Tickets London Welsh generously donated 200 free rugby tickets for a European game at the Kassam Stadium on 25 January as a thank you to Oxford Health NHS FT staff members. A further 200 tickets were secured as the original 200 tickets went within 3 hours. H2Go During January we are encouraging staff to drink more water and supporting Dry January (to give up alcohol). The H2Go button on the main intranet page signposts staff to useful resources on how much water they should be drinking and tips on how to increase their fluid intake. Posters which have been requested by staff to put up on wellbeing boards and wards across the trust were designed by the Communications team. 20 Staff Health and Wellbeing

Activity Referral by Manager105 IHR1 Reviews50 Self Referrals10 WHA113 received WHA Appointments44 Immunisations298 BBV/NSI8 Physiotherapy12 Work Station assessments1 Case Conferences3 Triage1470 appointments Total activities KPIs for the month have all been with set targets The activities above exclude the following: GP and Specialist request letters Transfer of care or Urgent/immediate responses required by Managers (in which there was an increase throughout the month of December) In addition to the above appointments the following activities were undertaken: Drop-in Flu clinics daily at Littlemore, all peripatetic clinics and 3 specific flu clinics (550 flu vaccines given) = 63.2% of front line staff to date. Partnership working with Older peoples directorate re Fast track Physiotherapy pilot has commenced and due to be rolled out February Occupational Health Benefits of an effective Occupational Health Improving productivity Contribution towards reduction in sickness costs Improvement of patient outcomes (healthier staff equals improved standards of care Improves morale and staff health Reduction in risk of litigation against the Trust.

Occupational HealthOccupational Health 22 Occupational Health Strategy Compliance – to ensure no breach of legislation or law and that no harm shall come to employees or the Trust. Health and wellbeing of all employees Contribute to sickness absence management Move to a proactive service by: Improving partnerships (HR, managers, employees, MDT, external stakeholders) Education (the role of OH, legislation and responsibilities) Exploring smarter ways of delivery in line with an aging workforce, including joint working with other OHDs who are of SEQOHS standards. Occupational Health

23 This will be achieved by: SEQOHS accreditation Best Practice, gold standard for OH (premier league), attractive status for income generation Standardisation of services – right skill mix Calderdale model – Allied Health Professional case management CALM model – capturing and maintaining main health issues to target specific health and wellbeing resources Stress management Greater use of technology i.e. intranet Occupational Health