item 12 report to the board of directors 26 january 2017 · page 1 of 19 report to the board of...

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Report to the Board of Directors – 26 January 2017

Report title HR Strategy Action Plan Q3 Report

Report from

Sally Storey, Director of Human Resources

Prepared by Sally Storey, Director of Human Resources Rick Witham, Workforce Information Manager Vanessa Donovan, Learning & Development Denise O’Meara, HR Business Partner

Previously discussed

at

Management Executive

Attachments None

Brief summary of report

The report is in four sections. The first section provides information on a successful bid for funds from the North Central London Sector Retention Fund to support a raft of initiatives to improve retention and reduce turnover. The second describes our Health and Wellbeing CQUIN (Commissioning for Quality and Innovation) and an innovative initiative to improve staff health and well-being, a Virtual Walk Around the World that involved over thirty teams of seven across the whole trust. The third provides key workforce performance indicators including mandatory training. The fourth and final section describes progress against the HR strategy action plan for the quarter. Key headlines from the indicators and the action plan are that the new clinical management structure is forming and the development programme to support it is ready for launch. Mandatory training and appraisal compliance has seen some improvement but there is still work to do.

Action Required/Recommendation.

The Board is asked to note the report.

For Assurance For decision For

discussion To note √

Item 12

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Improving retention and reducing turnover project

Introduction The trust has been successful in its bid to the North Central London sector Retention Fund for investment to support improvements to levels of retention and reduce turnover. The following sections summarise the proposals within the bid that have been supported. Background Moorfields enjoys a high level of workforce stability at 80% but turnover has fluctuated between 20% and 23% over the last 12 months, and vacancy levels are high at between 12% and 14%. Some of the factors underlying the high turnover are understood, but this understanding is patchy and there is a need to develop this understanding so as to focus the necessary remedial work. There are many factors that impact on our ability to retain staff, and a number of these are summarized below. The Moorfields Way is a major long term programme of cultural change at Moorfields, within which we have refreshed our values and embedded them throughout the organization. Progress is positive, with 95% of staff saying they have heard of The Moorfields Way, and 45% saying it’s making a positive difference in their part of the trust, and through the national staff survey, our people consistently tell us that they rate the trust highly as a place to work. However, a significant proportion of staff are also telling us still that we do not do all we can to help them progress their careers, and that they face bullying and harassment. We do not have robust exit intelligence, nor do we capture the detailed reasons that make staff want to stay at Moorfields. It is difficult for staff to understand what development opportunities exist within the trust beyond their immediate area of work. With 32 sites there are many more opportunities than staff get to hear about. Our leaders and managers have a key role to play in retaining staff, and we can do much more to prepare them for and support them in their role. We know that turnover is highest in the first year of appointment. Much work has been done in recent years on the process of on-boarding new staff, ranging from the creation of a dedicated recruitment team, the development on on-line work flows to streamline processes, a complete overhaul of induction and the successful shift to e-learning. But there is much more we can do in this area to become world class, making better use of technology and social media, starting with the way we engage

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with potential new recruits and running right through to robust conversations with new starters at three and six months checking that the role and environment is meeting their aspirations, and that their development needs are being met. This is especially important for new managers. Brexit poses a particular threat, and we are already seeing the impact in terms of increased uncertainty for our 400 current EU staff, and potential future EU recruits, upon whom we heavily rely. The opportunity to invest a significant amount in these areas is welcome. Project overview This project has a number of key strands:

Provision of in-depth intelligence about the reasons for high turnover at Moorfields, and to identify and implement strategies to reduce it.

Address three very specific, known reasons for turnover: career progression, through the implementation of a trust-wide career clinic and a career development resource pack; inadequate on-boarding, through the development of an effective on-boarding programme and website; and Brexit, through the provision of a legal and financial support package to the 400 EU staff who currently work at Moorfields to help them understand their options.

Support the implementation of the retention recommendations within the strategic nursing workforce review.

The scope will encompass all staff groups at Moorfields but will have a particular focus on the clinical and technical workforce. Key activities Analysis of turnover and preparation of detailed report, recommendations and action plan

Implementation of action plan and evaluation

Programme of exit and retention interviews

‘Leading for retention’ development programme

Career development advice clinics

Career development resource pack

On-boarding programme, pack and website

Brexit support programme

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Deliverables/outputs The deliverables will include the following:

A clear understanding of all the factors that contribute to the unacceptably high turnover at Moorfields, through retention interviews as well as more traditional exit interviews

A measurable action plan to address those factors, including leadership development for retention

A career clinic running for 12 months in the first instance providing tailored advice and support to staff who wish to develop their career but cannot see an obvious way to do so at Moorfields

A resource pack for use beyond the 12 months for any future staff who seek career guidance

A series of presentations on the implications of Brexit, followed up by a number of individual sessions to provide support on applications for residency

And through these outputs:

A reduction in turnover to 15% in year 1 and 10% in year 2

A reduction in vacancy levels to 10% in year 1 and 7% in year 2

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Health and Wellbeing CQUIN and the Global Corporate Challenge Virtual Walk

Around The World

Introduction CQUINs (Commissioning for Quality and Innovation) were introduced in 2009 to

make a proportion of health care providers’ income conditional on demonstrating

improvements in quality and innovation in specified areas.

Public Health England puts the cost to the NHS of staff absence due to poor health

at £2.4bn a year – around £1 in every £40 of the total budget and higher than the

public sector average. Evidence from the staff survey and elsewhere shows that

improving staff health and wellbeing will lead to higher staff engagement, better staff

retention and in turn better clinical outcomes for patients.

Working in the NHS can be physically, emotionally and psychologically demanding.

There is much the NHS can do as an employer to improve staff health and wellbeing

and the goal of the CQUIN on staff health and wellbeing is to improve the support

available to NHS Staff to help promote their health and wellbeing in order for them to

remain healthy and well.

As part of the Health and Wellbeing CQUIN for 2016-17 trusts have to introduce a

set of employer led schemes for staff around physical activity, musculo-skeletal and

mental Health.

Promoting physical activity – GCC virtual walk around the world

The virtual walk around the world is a well-established world-wide programme, the

idea being that people get together in teams of seven to challenge each other, and

teams within and beyond their organisation, to walk as far around the world as

possible in 100 days. The programme is web based, and as you clock up the miles,

you reach a series of international destinations and learn about them. There are

mini challenges and trophies along the way to motivate and spur you on to even

more activity. It does not have to be walking, other physical activity including running,

swimming or cycling counts, but all are converted to steps for the purpose of

measurement.

On 8 September 2016 33 teams of 7 within Moorfields set off, competing with teams

across the globe, and armed with a pedometer and a determination to get as far

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around the world over a period of 100 days. Each team had a captain whose role it

was to maintain motivation and raise levels of competitiveness between teams.

Mini-challenges along the way included target number of steps between the whole

team over a defined period, or exceeding your personal best on a particular day. As

an example, the first mini challenge required each team to clock up 100,000 steps in

one day. This is about 40 miles. 22 of the teams met this challenge. There were

some highly impressive efforts on the part of the most competitive teams, including

cycling round the M25 in a day, clocking up over 160,000 steps.

Participants have reported dusting off their cycles, leaving their cars at home and

walking, in some cases a number of miles, to their station, walking between satellite

sites, and shaming each other into taking the stairs not the lift. Staff have

downloaded the Couch to 5K challenge, and have joined local running clubs, along

with trying out other sporting activities to get their steps up, including trampolining,

rowing, fitness classes, Park Runs and simply getting out at lunch time for a walk.

The CEO was also known to have had a ‘walking meeting’.

A web site for bloggers has been a source of team spirit and encouragement as

participants from all around the world have commented on each others’ posts: Here

are just three of the entries from Team Moorfields:

“What a lovely day to start my steps today, I am feeling good energetic happy

heart. I was a little down in myself this last few weeks did not really know why.

I was then asked if I wanted to join the global challenge 100 day journey, so I

taught why not give it a go. The first few weeks were great but then I started

to lose a bit of interest . when I saw the lovely trophies my team were getting

that gave me my strength and motivation back .I wanted these trophies so

here I am back with energy and this is going to be the best challenge ever”

“Walking over 10 miles around the beautiful Ashdown Forest ... I did it I beat

my PB and got the trophy 🏆”

“I wanted to end on a personal challenge so I attempted to do 30,000 steps

last Saturday. I did it- 30,101. What a eye opener this has been and I have

definitely changed some habits for good. Thank you Denise for all your

encouragement. As team captain it was hard to keep the team going. And

that's why we're called Estates Mates. Over and Out.”

Final results

Moorfields’ daily step average was 13,421 (5.3 miles per day) - higher than

the GCC average of 12,433

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The teams walked over 282 million steps, covering over 112,000 miles, which

is about 4.5 times around the world.

74% of staff exceeded 10,000 steps (4 miles) daily compared to 21% pre the

challenge

We lost 135 kilos in weight

102 staff completed a questionnaire at the end, with the following results:

74% said the challenge had helped then take more personal accountability for their own health

71% said their increased activity levels had become a habit

74% reported having a better understanding of what it takes to lead a healthier lifestyle

41% reported getting family and friends out walking more

63% said they are more aware of the trust’s commitment to health and wellbeing

52% reported an increase in their productivity or concentration

38% of staff were in the overweight category (18% obese)

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Workforce metrics

Headlines and overall KPIs

The rolling annual sickness rate remains at 3.1%, keeping us well below the Trust KPI Target of 4%.

The turnover rate has remained steady at 22%, whilst stability is also unchanged at 81%. Both figures are affected by the large number of staff on short-term contracts, such as trainees and clinical fellows, whose departure is planned.

Overall Headcount and FTE have dropped slightly in Quarter 3.

The vacancy rate has levelled out at 14%. Vacancy hotspots are the subject of close scrutiny within management teams, supported by their HR Business Partners.

Please note: The figures provided in this section of the report include all paid employees including locums, and exclude contractors, unpaid honorary contract holders and volunteers.

Key workforce metrics: Summary

KPI Target Q1

2016-17 Q2

2016-17 Q3

2016-17 Trend RAG

Full Time Equivalent (FTE) N/A 1830 1827 1815

Headcount N/A 2157 2197 2165

Vacancy Rate N/A 12% 14% 14%

Turnover N/A 24% 22% 22%

Stability N/A 79% 81% 81%

Sickness (quarterly) 4% 3.2% 3.2% 3.2%

Sickness (rolling annual) 4% 3.1% 3.1% 3.1%

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Key workforce metrics: By KPI

Sickness Absence

The rolling annual sickness rate has remained steady over the past 12 months and is currently at

3.1%, keeping well below our target rate of 4%. The rolling quarterly figure has also remained

constant at 3.2% over each of the past three quarters. Monthly sickness rates are reflected by

the dotted blue line in the chart above.

Retention

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

Sickness Absence

Sickness (monthly) Sickness (rolling annual)

10.0%

15.0%

20.0%

25.0%

30.0%

Turnover

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Turnover has remained stable throughout Quarters 2 and 3, currently at 22%. Future reports will

also look at Voluntary Turnover, as well as turnover rates by Staff Group. This will strip out the

staff who are engaged on fixed term contracts of a year or less, such as trainees and clnical

fellows, whose planned departure inflates the turnover figure.

Voluntary Resignation was the main reason for leaving during the 12 months to the end of

Quarter 3, accounting for over half of leavers. However it should be noted that the reason for

leaving was not recorded for nearly a quarter of leavers.

¹Where known

Relocation was the man reason for Voluntary Resignation, followed by Better Reward Package

then Work-Life Balance. Unfortunately nearly half of our voluntary leavers had their reason

recorded as ‘Not Known’ (these have not been included in the chart above). We therefore need

53%

24%

10%

5%

4% 4%

Reasons for Leaving Jan 2016 - Dec -2016

Voluntary Resignation

Not recorded

End of Fixed-Term Contract

Retirement

Employee Transfer- TUPE

Other

31%

19% 17%

16%

8%

5% 4%

¹Reasons for Voluntary Resignation Jan 2016 - Dec 2016

Relocation

Better Reward Package

Work-Life Balance

Promotion

Lack of Opportunities

Undertaking furthereducation/training

Child/Adult Dependants

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to ensure managers are reminded of their responsibility for completing Leavers’ information

accurately and wholly, so that we can carry out more meaningful analysis of the information.

Staff Group ¹Average Leavers’

Tenure (years)

Additional Clinical Services 3

Additional Professional Scientific and Technical 3.5

Administrative and Clerical 2

Medical & Dental 1

Nursing and Midwifery Registered 1.5

Trust Overall 2

¹Calculation based on the Median figure. Figures exclude Students and Doctors in Training

The average (median) tenure of leavers over the 12 months to the end of this quarter was 2

years. The were variations between staff groups, for example Nurses were most likely to leave

during their second year of service, whilst Professional Scientific/Technical staff (e.g.

Optometrists) tend to stay with us for longer.

Our Stability rate remains at 81%. The Stability rate is a method of measuring staff retention, by

calculating the proportion of ‘stayers’ who were with us a year ago and are still here today – i.e.

those who have stayed with us for at least 12 months. Looking at longer-term retention, our

current 2-year Stability rate is 70% which is only marginally lower than it was at the start of 2016.

Thus our staff retention rates have remained stable.

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Stability

Stability (12 months) Stability (2 years)

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Workforce size

The size of the organisation’s workforce has remained steady over the past year.

Vacancy Rate

The Vacancy rate had increased over the previous quarter, but as at the end of Quarter 3 it had

levelled out at 14%.

0

500

1,000

1,500

2,000

2,500

Workforce size

Full Time Equivalent (FTE) Headcount

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

Vacancy Rate

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Workforce Metrics: Definitions/Calculations

Sickness

Absence

Sickness Absence is calculated based on the number of hours lost as a percentage of

the hours available within the specified period – either a month or a rolling year.

Rolling Annual Sickness is a standard NHS-wide measure that looks at total absence

over the past 12 months rather than just the current month. This provides a more

informed view of absence rates within the organisation because seasonal and other

fluctuations are ironed out.

Turnover

Turnover is calculated by taking the number of Leavers (headcount) in the specified

period divided by the average Staff in Post in that period. The intention is to exclude

fellows and doctors in training from this calculation in future.

Stability

Stability is calculated as the percentage of employees who were with us 12 months ago

who are still with us today.

The intention is to exclude fellows and doctors in training from this calculation in future.

Vacancy

Rate

The vacancy rate is calculated based on filled posts compared to the budgeted

estbalishment. This information is currently held within the Finance system.

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Mandatory training compliance

Mandatory training compliance in some subjects has shown a slight dip towards the end of

quarter 2. A variety of reasons lie behind these changes, and these are detailed below

along with remedial actions.

Subject Target Q3 2015-16

Q4 2015-16

Q1 2016-17

Q2 2016-17

Q3 2016-17

Appraisal 80% 61% 51% 73% 74% 79%

Adult Basic Life Support 80% 72% 68% 69% 65% 67%

Child Protection 1 80% 83% 83% 81% 82% 84%



Corporate Induction 60% 90% 90% 89% 89% 90%

Conflict Resolution 60% 81% 83% 86% 66% 73%

Equality & Diversity 80% 84% 91% 91% 91% 91%

Fire 80% 81% 82% 79% 80% 81%

General Health and Safety 70% 86% 88% 87% 87% 89%

Infection Control level 1 80% 84% 86% 86% 88% 88%

Infection Control 2 (Patient Areas) 80% 57% 83% 83% 75% 81%

Information Governance 95% 87% 94% 87% 89% 87%

Local Induction Checklist 60% 81% 86% 88% 86% 85%

Object handling 80% 72% 69% 77% 77% 76%

Paediatric Life Support 80% 59% 73% 63% 61% 61%

Patient handling 80% 79% 66% 69% 63% 76%

Prescribing Practice 80% 79% 84% 83% 78% 78%

Risk & Safety Management 70% 82% 75% 75% 72% 70%

Safeguarding Adults 80% 82% 82% 81% 82% 84%

e-Learning – e-learning packages are now in place for the ten highest volume core

mandatory subjects and from this month new starters are being asked to complete them as

part of their on-boarding process and before they start.

Appraisal has improved but is still below target and is the focus of renewed efforts from

executive level downwards.

Adult Basic Life Support and Paediatric Basic Life Support compliance levels are not

RAG rated because the data that feeds this table is still being worked on, and compliance

figures are depressed because staff who do not need this training will continue to be

included in the data until remedial work on the Insight system is completed.

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Conflict resolution has improved but is still below target, sessions are being widely

promoted to increase the uptake, and an on-line programme is nearly ready for launch..

Information Governance compliance requirements set at 95% nationally remain a

challenge. An updated version of our e-learning package is nearly complete and will be the

focus of a major publicity exercise.

Object handling training sessions have been increased. Availability of these has impacted

on the ability of staff to access the training.

Patient handling sessions have been limited in supply since they have been provided by an

external trainer, but a new arrangement involving newly appointed resuscitation trainer have

resulted in a dramatic improvement, though not suite yet to target.

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HR Strategy Action Plan

The following section provides an overview of HR activity in support of the Trust’s overall

vision and strategic objectives.

HR Action Plan 2016-17 – summary

and progress report Lead Q1 Q2 Q3 Q4 Comment on progress in

current quarter

TALENT MANAGEMENT

Refresh the organisation’s talent map,

develop our best people to lead our

organisation and identify gaps that we

need to address.

RB G G G

12 month development

programme for new clinical

management structure leaders

commissioned, and detail

agreed ready for launch on 1

March. First executive

awayday took place in

December, which links with

the development programme

to ensure that the executive

team create the right

environment for the new

divisions to flourish as semi-

autonomous business units.

RECRUITMENT & RETENTION

Benchmark recruitment KPIs to ensure a

reduction in time to hire and that

customers’ needs are met. SM G A A

Unprecedented turnover in the

recruitment team has

impacted on business as

usual and development of

benchmarks will be picked up

once the team stabilises.

Identify recruitment and retention

hotspots, and develop action plans. HRB

Ps G A A

A successful bid has been

made for funds to support this

work, which will start early in

Q4

Increase the use of social media to

promote employment within the trust and

reach a wider audience. SM G A A

A successful bid has been

made for funds to support this

work, which will start early in

Q4

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current quarter

Review on-boarding processes to ensure

that staff effectiveness and engagement

is maximised. RB G G G

Positive feedback received on

induction process. Some

changes made in response to

suggestions. Further

development will follow as part

of the retention project.

CQC PREPARATION

Complete the review of HR polices

D

O’M G G G

HR policy reviews completed

on time and schedule up to

date.

Ensure robust contractual arrangements

support the trust’s use of other trusts’

staff in satellites

SS G A A

Recommendations still in

development

DEVELOPING THE ORGANISATION

Develop HR & OD strategy following the

trust’s strategy refresh. SS G G G

Refresh under way. Analysis

of HR and OD actions flowing

from Carter, STPs etc

complete.

Strengthen clinical engagement across

the Trust by implementing the clinical

management structure review

recommendations relating to our

structure, roles and governance

processes.

JQ G G G

Assessment centre and

interviews completed for all

but one of the senior posts in

the new structure.

Appointments made to start in

Q4. Not all posts filled in first

trawl, but interim

arrangements identified.

Embed The Moorfields Way (TMW) and

evaluate the difference it is making

through improved performance in the

friends and family test.

AC G G A

Q2 staff FFT results published

and the proportion of

respondents who have

reported that TMW is making

a positive difference has risen

from 36% in Q1 to 45%.

Record 50% response rate to

the national staff survey.

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current quarter

Implement the recommendations from

the 7 day services review.

SS A G A

The planning round for 2017-

19 launched in Q3 and service

plans will be expected to

incorporate plans for extended

(six and seven day) working

as appropriate.

JUNIOR DOCTOR CONTRACT

IMPLEMENTATION

Develop and implement plans to

introduce the new junior doctors’

contract. EJ G G G

Rotas assessed and two out

of six require amendment to

comply with anticipated

requirements. Guardian of

Safe Working post appointed.

EDUCATION STRATEGY

Recruit a Director of Education to lead

and develop an integrated education

directorate. SS G A R

Unsuccessful interviews in

December 2016. Discussions

taking place on 16 January

involving the IoO and the

search company to agree the

next steps.

Complete and gain approval for an

education business plan that describes

how education will develop and grow. SS A A R

This action is contingent on

the appointment of a director

to lead this work.

Develop an expanded apprenticeship

scheme of between 80 and 100

apprentices in preparation for the

introduction of the Apprenticeship

Levy in April 2017

RB G A G

Apprentice Programme

Manager started in Q3 and

has developed a programme

to expand the trust’s cohort of

apprentices to meet the

criteria to retain the levy.

EQUALITY, DIVERSITY & STAFF

WELL-BEING

Review the trust’s work to meet the

requirements of the workforce race

equality standard (WRES). TBC A A G

WRES data published and

plan reviewed for next Focus

on Inclusion publication.

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current quarter

Revisit trust statistics on discipline and

grievance by ethnic group and determine

whether further action is needed to

address any inequality of treatment

TBC A A A

Awaiting appointment to

vacant posts in HR before new

E&D lead can be assigned.

Develop and implement health and

wellbeing plan to secure CQUIN funding

in 2016-17.

D

O’M G G G

CQUINN plan well under way,

including a range of physical

and mental wellbeing

activities, a successful Health

and Wellbeing Week, and 33

teams trust wide signed up for

the Global Corporate

Challenge of a virtual walk

around the world in 100 days.

Red Significantly behind

target Amber

Progressing but behind

target Green

On target/complete

item 12 report to the board of directors 26 january 2017 · page 1 of 19 report to the board of...

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