Workforce Performance Report March 2013 Graeme Armitage Director

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

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

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

Oxfordshire Community Services –Performance against Target – All Indicators 7

Oxfordshire Community Services – Performance against Target – All Indicators. ANALYSIS: 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 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. 8

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

Childrens & Families Services – Performance against Target – All Indicators ANALYSIS: 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 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 10

Specialised Services – Performance against Target – All indicators 11

Specialised Services – Performance against Target – All Indicators 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 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. 12

Statutory Training - Trust performance - February 2013 Statutory Training 100 60 40 Statutory 20 Feb-13 Jan-13 Dec-12 Nov-12 Oct-12 Sep-12 Aug-12 Jul-12 0 Jun-12 • 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. 80 May-12 • OCSD performance reduced by 1% to 79% with continued pressure on service levels across the whole Oxfordshire healthcare system during the winter months. 81 82 84 83 83 74 70 71 75 78 Apr-12 • Overall performance has remained flat at 83%. 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. 13

Statutory Training by Division Activity Equality & Diversity Staff Trained Booked Gap Fire Staff Trained Booked Gap H&S Staff Trained Booked Gap Induction Corporate & Jnr Doc Staff Trained Booked Gap Local Workplace Induction Staff Trained Booked Gap MHSD 93% 1165 1078 11 76 79% 1163 913 67 183 69% 55 38 6 11 82% 130 106 9 15 69% 132 91 0 41 OCSD 81% 1803 1457 20 326 74% 1807 1330 107 370 63% 143 90 4 49 82% 339 277 17 45 44% 376 164 0 212 SSD 93% 524 485 8 31 81% 524 423 29 72 95% 20 19 0 1 70% 61 43 7 11 42% 60 25 0 35 C&FSD 92% 1399 1291 20 88 81% 1397 1136 60 201 77% 13 10 3 0 84% 204 171 13 20 74% 206 152 0 54 Corp 92% 623 571 3 49 79% 619 488 15 116 70% 145 101 9 35 68% 100 68 3 29 58% 48 28 0 20 Activity Infection Control Staff Trained Booked Gap Moving & Handling Staff Trained Booked Gap PMVA Staff Trained Booked Gap Resuscitation Staff Trained Booked Gap Safeguarding (adults/children) Staff Trained Booked Gap MHSD 81% 2137 1731 67 339 78% 1161 903 89 169 75% 1770 1324 301 145 68% 1821 1247 94 480 80% 2160 1727 153 280 OCSD SSD C&FSD 80% 81% 83% 3546 1012 2650 2831 822 2202 68 72 89 647 118 359 77% 73% 84% 1770 523 1397 1370 383 1174 83 49 43 317 91 180 55% 78% 67% 394 1030 1062 216 802 711 14 135 173 164 93 178 71% 74% 76% 2962 922 2332 2112 684 1767 126 50 131 724 188 434 74% 81% 87% 3259 1015 2934 2419 822 2542 122 81 162 718 112 230 Corp 76% 501 380 5 116 81% 623 502 9 112 60% 251 151 20 80 49% 334 164 10 160 81% 426 347 12 67 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 14

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. Course Performance Total Staff Training % Staff Trained required Already Booked Action required Places available in next 3 months 309 Fire Awareness 78 840 659 182 32 Book 150 places & attend Induction - Local Workplace 51 97 49 48 0 Managers to input date on OTR Infection Control - Classroom 88 840 736 104 32 Book 147 places & attend 340 Infection control - Workbook 76 753 571 182 0 PMVA Full Course Teamwork 93 260 242 18 3 Completion of workbook by individual Book 15 places & attend 28 PMVA Full Course Recertification 73 208 152 56 29 Book places & attend 31 PMVA Short Course Teamwork 78 97 76 21 8 Book 13 places & attend PMVA Short Course Recertification 59 83 49 34 11 Book 23 places & attend Short course being phased out and replaced with full course Resuscitation Assessment ABLS & AED Resuscitation e. Learning ABLS & AED 71 839 598 241 70 Book 171 places & attend 229 74 839 621 199 0 Completion of e. Learning 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. 15

Mandatory Training Target Staff Care Programme Approach 90% 85% 652 588 28 36 60 places available Clinical Risk Assessment & Management 80% 85% 1094 872 33 189 Course under review - facilitator shortage in Nursing & Clinical Standards Directorate Complaints 86% 85% 37 32 3 2 36 places available Dual Diagnosis Tier 1 80% 70%* 1351 1079 n/a 272 e. Learning available Falls Awareness 54% 70%* 1138 617 102 419 Capacity increased from January 2013. New e-Learning solution from February Food Hygiene 82% 85% 1483 1212 96 175 291 places available Information Governance 76% 70%* 5412 4123 65 1224 e. Learning or classroom Managing Risk 56% 85% 52 29 n/a 23 e. Learning Medicines Management 39% 85% 129 50 0 79 e. Learning solution in Q 4 Mental Capacity Act 80% 85% 1361 1085 101 175 67 places available Mental Health Act 84% 85% 3617 3024 144 449 203 places available Safe & Supportive Obs (new starters) 47% 85% 38 18 n/a 20 Online competence assessment available Supervision 70%* 3904 2718 0 1186 Activity Not Trained Booked booked Notes (places available within next 3 months shown) Trust Achieved e. Learning 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 16

PDRs 80 71 83 88 89 91 91 90 91 92 92 Feb-13 Jan-13 Dec-12 Nov-12 Oct-12 Sep-12 Aug-12 Jul-12 Jun-12 May-12 PDRs Apr-12 100 90 80 70 60 50 40 30 20 10 0 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 17