1. Workforce Performance Report March 2013 Graeme Armitage Director of HR & OD Caring, safe and excellent 1

2. Headline HR KPIs Turnover Turnover has increased slightly in February, following a period of stability and is now higher than 6 months ago, although only by 0.1%. The steady trend above target of 12% continues as it has done across this Financial Year. Forecasts continue to indicate that turnover could reach 13% in the next 2 to 3 months, slightly less than predicted earlier in the year. Staffing stability has increased slightly again to 85.6%. This indicates that the organisational staffing core remains stable, and is supported by the reduction in the vacancy rate through recruitment to permanent posts. Bank and Agency Usage Increase in Bank and Agency usage continues to be driven by the impact over the year of increasing levels of absence and turnover, and despite a significant reduction in budgeted vacancies over the last quarter. 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. There has been a significant reduction of 50% usage external (non NHSp) within Specialised Services, Specialist Mental Health and OCS in February 13. Live vacancies Vacancy rate trends over the last 3 months continue to show a significant decrease in budgeted vacant posts of 1%, with a cumulative reduction of over 2% since October 12. This has been significantly due to recruitment turnaround times and stabilisation of turnover 2

3. Workforce Performance Report August 2012 Headline HR KPIs Sickness /Absence Whilst staff absence through sickness remained at 4% or below through 2012- 13 to October, the last 4 months continue to show a steep increase in sickness absence of up to 0.5%, although the rate appears to have decreased for sickness reported during February 13. The cost to the organisation of all sickness absence over the current financial year has been £4.1 million (including all staff groups and salary grades, based on an individuals salary at the point of sickness absence). Outturn cost of sickness absence for Financial Year 12-13 remains estimated to be £5.5 million. This cost does not include spend on backfill then required to maintain service delivery. This equates to a total of 79,194 calendar days lost, or an average of 6600 days or 303 WTE per month across the organisation, now a significant increase of 100 WTE on the rolling average across the last 12 months, driven by the increase in absence since October 12. The top 3 reasons for sickness to end January 13 continue to include anxiety and stress. Cold and flu related sickness, along with an increase in reported Gastrointestinal problems make up the top 3 reasons in this month. There has however been no formal notification of a return of the Norovirus or variant from the HPA. 3

4. Workforce Performance Report August 2012 Headline HR KPIs Casework Management: The casework profile remains reasonably flat. The exception is an increase in disciplinary cases however there is no one underlying reason for the increase nor is it concentrated in any one area. 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 focus has been on progressing and closing cases in a timely manner in line with policy and guidelines and as can be seen in graph 2 this continues to be a highly effective approach. 4

5. SPECIALIST MENTAL HEALTH SERVICES - PERFORMANCE AGAINST TARGET – ALL INDICATORS 5

6. 6 ANALYSIS: Turnover Turnover has increased slightly – 10.64%:10.2% but with no specific underlying causes. All areas are under the trust target of 12% except Bucks Adults of working age who are slightly above target at 13.84%. Sickness Sickness levels have decreased to 5.21% a slight decrease on last month but above the Trust target of 3.5%. Complex Needs are well below the target at 2.7%. Bank and Agency Despite staffing issues on wards bank and agency remains below Trust target and staff shortages are largely being covered by sessional workers partly because agencies are unable to provide the appropriate type of worker. The highest user of bank and agency – Oxford Older Adults is still below the Trust target. Vacancies The vacancy rate is below the Trust target overall, being over target only in Complex Needs. ACTIONS: Recruitment to inpatient wards is being done through centralised recruitment as described in the January report– there has been a high level of interest which is being sifted in March; future reports will report on the efficacy of such an approach. The high level of sickness in the Chilterns Team is being addressed; a new manager has been installed and the impact of this is being monitored. IMPACT: The impact of the centralised recruitment on vacancy levels and hence sickness rates will not be seen until future months.

7. Oxfordshire Community Services –Performance against Target – All Indicators 7

8. Oxfordshire Community Services – Performance against Target – All Indicators- 8 ANALYSIS: Turnover Turnover is very slightly up on last month (0.45%) but the only significant increase is in local community teams with no particular underlying reason. Sickness Sickness has also increased slightly over last month from 4.45% to 4.7% – the biggest increase being in Urgent Care (1.79%) with no particular underlying issue although there was one dismissal for ill-health reasons. Bank and Agency Bank and agency spend has shown a significant decrease this month (4.76%:2.5%) despite sickness levels increasing although vacancy rates decreased slightly; at 2.5% bank and agency usage is well below the Trust target and the Trust’s average. The exception is in community hospitals where increased staffing is required for winter emergency beds. Vacancies The vacancy level is down from 7.06% to 6.7% with Urgent Care continuing to show a high vacancy rate at 23.7%. However the majority of driver/receptionists are zero/small number of contracted hours and work their hours as additional hours so that hours worked are in line with budgeted hours. Vacancies in Urgent Care have increased due to one dismissal. ACTIONS: The HR team takes a highly proactive approach to case management discussing sickness absence data with Ward Managers which increases proactive management of cases. In February there was one dismissal for ill-health. HR facilitated an afternoon on workforce issues with Urgent Care. IMPACT: See above – 1 dismissal for ill-health reasons.

9. Childrens & Families Services - Performance against Target– All Indicators 9

10. Childrens & Families Services – Performance against Target – All Indicators 10 ANALYSIS: Turnover Turnover has seen a slight increase over January (13.35%:13.52%) ( mainly due to increases in Psychological Therapies and Liaison and in Eating Disorders. Eating Disorders have traditionally had a high turnover rate particularly Highfield Swindon where there is a high ratio of unregistered to registered, the former being more likely to move on for better opportunities, also Band 5 are likely to seek promotion to Band 6. Psychological Therapies have recently undergone organisational change. Sickness In most areas sickness decreased in February as winter viruses recede even in those areas which are showing as red. At 3.45% the overall Directorate sickness is below the Trust target of 3.5%; the exception being Eating Disorders which is due to temporary sickness and this should show a decrease next month. Bank and Agency Bank and agency spend has decreased again and remains below the Trust target and the Trust average of 3.8%; this correlates with a decrease in sickness absence and stability in the vacancy rate. Agency spend has reduced from 2.3% to 1.9%. The short term intervention to allow use of overtime (with tight controls ) continues – for bands 5 & 6 instead of using expensive agency. The division is looking to adopt a trust wide process for the booking of bank and agency which includes the above as a possible approach to staffing shortages. Vacancies The vacancy rate remains constant, reflected in the bank and agency figures above. Recruitment activity for the division is 156 posts. HR has worked closely with the Recruitment advisor to escalate start dates. The number of accepted offers awaiting start dates has seen an improvement compared to last month and currently stand at 93, of which 33 have been cleared to start. ACTIONS: HR attend Modern Matron meetings to understand the reasons for Turnover and to formulate an action plan. An R and R application may be considered for Eating Disorders. The new Highfield Unit at the Warneford may make a difference to turnover and this will of course be monitored. Psychological Therapies are beginning to grow their own trainees to seek better retention rates rather than training and then losing trainees to other organisations. Managers are supported by a number of in-house HR

11. Specialised Services – Performance against Target – All indicators 11

12. Specialised Services – Performance against Target – All Indicators 12 ANALYSIS: Turnover Bullingdon figures are included this month; as the service is due to TUPE out at end March figures for April will be significantly different. These figures are included to demonstrate the impact of this service and its TUPE out. Divisionally turnover is above the Trust norm largely due to the Bullingdon effect. Sickness Sickness is also above the Trust target again largely due to sickness absence in the prisons. Both Forensic Mental Health Services and Specialsied Community Services are below the Trust target. Bank and Agency Bank and agency spend has increased by 1.32% which correlates with an increase in sickness absence and an increase in the vacancy rate. The organisational change in Bullingdon has impacted on turnover and sickness and has had a correlating effect on bank and agency. Bank and agency usage in Specialised community services is well below the Trust target Vacancies: Are increased to 8.8% but largely affected by the transfer of the Bullingdon service. ACTIONS: A high level of casework continues to be managed working closely with Occupational Health. There are 3 staff on suspension and 3 staff not in their substantive posts due to professional registration and capability issues- this has an impact on agency staffing. On e ill-health case is awaiting ill-health retirement approval IMPACT: One long-term sickness case has returned to work. One ill-health case was resolved as the member of staff left.

13. 13 Statutory Training - Trust Actions Additional facilitated support has been given to some ward areas to enable the completion of e-learning through staff attending groups sessions within the L&D Centre. Comparison of classroom attendance for statutory & mandatory training in the first 3 quarters of 2012/13 with the previous year shows a 38% increase i.e. more than 5000 extra sessions attended as part of the drive to meet higher performance standards. Delivery of training at more local venues is being increased, particularly with the scheduling of refresher training in ‘blocks’ for ward based staff and other groups (e.g. re-ablement service) where absence from service delivery makes completion of scheduled training less convenient Dedicated L&D staff resource is focused on the completion of local and Trust induction through approaches to individuals and their managers where training gaps have been identified. Trust performance - February 2013 Overall performance has remained flat at 83%. OCSD performance reduced by 1% to 79% with continued pressure on service levels across the whole Oxfordshire healthcare system during the winter months. It is expected that performance will remain at this level during March with the increased use of annual leave in the final month of the year.

14. 14 Statutory Training by Division Notes: Activity - each subject area of statutory training without showing individual course types 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 ActivityMHSDOCSDSSDC&FSDCorp ActivityMHSDOCSDSSDC&FSDCorp Equality & Diversity93%81%93%92% Infection Control81%80%81%83%76% Staff116518035241399623 Staff2137354610122650501 Trained107814574851291571 Trained173128318222202380 Booked11208 3 Booked676872895 Gap76326318849 Gap339647118359116 Fire79%74%81% 79% Moving & Handling78%77%73%84%81% Staff116318075241397619 Staff116117705231397623 Trained91313304231136488 Trained90313703831174502 Booked67107296015 Booked898349439 Gap18337072201116 Gap16931791180112 H&S69%63%95%77%70% PMVA75%55%78%67%60% Staff551432013145 Staff177039410301062251 Trained38901910101 Trained1324216802711151 Booked64039 3011413517320 Gap11491035 Gap1451649317880 Induction Corporate & Jnr Doc82% 70%84%68% Resuscitation68%71%74%76%49% Staff13033961204100 Staff182129629222332334 Trained1062774317168 Trained124721126841767164 Booked9177133 Booked941265013110 Gap1545112029 Gap480724188434160 Local Workplace Induction69%44%42%74%58% Safeguarding (adults/children)80%74%81%87%81% Staff1323766020648 Staff2160325910152934426 Trained911642515228 Trained172724198222542347 Booked00000 1531228116212 Gap41212355420 Gap28071811223067

15. 15 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 Awareness7884065918232Book 150 places & attend309 Induction - Local Workplace519749480Managers to input date on OTR Infection Control - Classroom8884073610432Book 147 places & attend340 Infection control - Workbook767535711820Completion of workbook by individual PMVA Full Course Teamwork93260242183Book 15 places & attend28 PMVA Full Course Recertification732081525629Book places & attend31 PMVA Short Course Teamwork789776218Book 13 places & attendShort course being phased out and replaced with full course PMVA Short Course Recertification5983493411Book 23 places & attend Resuscitation Assessment ABLS & AED 7183959824170Book 171 places & attend229 Resuscitation eLearning ABLS & AED748396211990Completion of eLearning by individual Actions: Dedicated L&D staff resource has worked with ward managers and their staff to ensure completion or booking of outstanding induction. An e-learning solution for infection control is in development with sections tailored for specific groups. The introduction of the resuscitation training strategy has resulted in feedback on the complexity of an e-learning solution which has been revised. Impact: Supporting managers on induction ‘gaps’ will reduce those with local induction showing as yet to be completed. Providing an alternative delivery method for infection control targeted at specific groups will enhance the relevance and completion of training. The introduction of a revised e-learning package for resuscitation enables content to be broken down into more relevant sections for particular staff groups. This will reduce the training time and increase take-up of e-learning prior to the class-room assessment.

16. 16 Mandatory Training Activity Trust AchievedTargetStaffTrainedBooked Not booked Notes (places available within next 3 months shown) Care Programme Approach90%85%6525882836 60 places available Clinical Risk Assessment & Management80%85%109487233189 Course under review - facilitator shortage in Nursing & Clinical Standards Directorate Complaints86%85%373232 36 places available Dual Diagnosis Tier 180%70%*13511079n/a272eLearning available Falls Awareness54%70%*1138617102419 Capacity increased from January 2013. New e-Learning solution from February Food Hygiene82%85%1483121296175 291 places available Information Governance76%70%*54124123651224 eLearning or classroom Managing Risk56%85%5229n/a23 eLearning Medicines Management39%85%12950079 eLearning solution in Q4 Mental Capacity Act80%85%13611085101175 67 places available Mental Health Act84%85%36173024144449 203 places available Safe & Supportive Obs (new starters)47%85%3818n/a20 Online competence assessment available Supervision70%70%*3904271801186 eLearning available 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

17. 17 PDRs February – maintained at 92%. Three of the four service divisions have achieved or maintained performance at 95%. The lower performance of OCSD at 86% reflects continuing pressures on the provision of services across Oxfordshire during the peak winter months. It is expected that the new cycle of PDRs which starts in April will see an improvement in performance over the first quarter.. Numbers 56 28 256 29 61 430 Numbers 6 0 5 12 23