workforce and od strategy 2019-20201. securing the supply of staff to deliver high quality...

Workforce and OD Strategy

2019-2020

15 March 2019 (Review 31 March 2020)

Version

Aintree University Hospital NHS Foundation Trust

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Contents Page

Introduction .............. ........................................... 3

Background and Context ...................................... 5

Aims and Objectives ............................................. 7

Implementation .................................................... 8

Evaluation and Metrics ....................................... 12


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Introduction Aintree University Hospital NHS Foundation Trust’s vision was established in 2014 after extensive

consultation with colleagues across the Trust as “to provide world class services for all our

patients”. This vision led to the development of our common purpose:

“Getting it right for every patient, every time”

In 2016, the Trust refreshed its strategic vision and objectives, building on the ‘Fit for the Future’

work undertaken in 2014 to ensure that these remained valid for the way forward for the

organisation for the next five years. Its refreshed vision is:

“to be a leading provider of the highest quality health care”

The Corporate Strategy document sets out the context in which we operate and the strategy we will

follow as an organisation to enable us to achieve our vision over the period to 2020. This corporate

strategy informs and sets the framework for delivery of our:

• Strategic Priorities

• Operational Priorities; and,

• Enabling Priorities

These priorities are identified as part of our Annual Business Planning process and form the

foundation of our Annual Operational Plan submission to our regulator, NHS Improvement.

This Workforce and OD Strategy sets out an approach to enabling the Trust to achieve its vision by

aligning our people, strategy and processes to deliver excellent patient care. The principle way it

aims to do this is by improving Aintree as an employer, establishing Aintree as a ‘Best Place to

Work’, by enhancing engagement with staff, listening to their feedback and views on how to

improve, responding to their concerns and increasing transparency. The knowledge, skills,

attitudes and behaviours of our staff will be the key determinant in the delivery of this vision in

providing safe, effective care and a positive experience to patients, their families and friends. This

one year Strategy sets out how we will improve our culture and work to attract, develop and retain

a workforce that believes we are an “employer of choice” for staff and a “provider of choice” for

patients.

The next three years will be a period of significant change as Aintree merges with RLBUHT, and it

will be essential to support the workforce to remain motivated and engaged throughout. It is

essential that during this time our people understand and are supported and equipped to cope with

their changing work environment, that we take opportunities to learn from the challenges before us

and that we do so with care and compassion.

The McKinsey 7S Model identifies the 7 key elements of an organisation:

Staff

Systems (& Processes)

Organisational Structure

Organisational Skills & Competence

Style (Leadership Capability)

Strategy

Culture (Shared values)


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This model has been modified (see Figure 1) to support the implementation of an OD plan that has

been drafted, following the outcomes of a cultural diagnostic exercise that took place in 2018/19

across RLBUHT and Aintree as part of preparation for merger.

(Figure 1)

This one year Workforce and OD Strategy is therefore informed by the need to provide ‘business

as usual’ services as well as those required to prepare for merger. At its heart it also recognises

any opportunity that allows Aintree to improve workforce engagement and wellbeing, increase

quality of service and improve efficiency.

CULTURE

ASPIRATION

S

STRATEGIES

• CLINICAL

BENEFITS

• BETTER PLACE

TO WORK

• SAFETY

ORG. SKILLS, COMPETENCE &

EDUCATION

LEADERSHIP

CAPABILITY

STAFF SYSTEMS ORGANISATIONAL

STRUCTURE


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Background and Context

Three drivers for the strategy content have been identified as set out below:

A. National Priorities – National Health and Care Workforce for England to 2027

The national draft workforce strategy sets out the following priorities for the NHS:

1. Securing the supply of staff to deliver high quality healthcare

2. Enabling a flexible and adaptable workforce through our investment in educating and training

new staff

3. Providing broad pathways for careers

4. Widening participation in NHS jobs so that people from all backgrounds have the opportunity

to contribute and benefit

5. Ensuring the NHS and other employers in the system are inclusive modern employers

6. Ensuring that service, financial and workforce planning are intertwined, so that every

significant policy change has workforce implications thought through and tested

The NHS Long Term Plan places a strong focus on improving and supporting the workforce. The

plan recognises the single biggest workforce challenge lies in Nursing and Midwifery professions.

It has an ambition “to build a modern working culture where all staff feel supported, valued and

respected for what they do, and where the values we seek to achieve for our patients – kindness,

compassion, professionalism – are the same values we demonstrate towards one another.”

This follows the recommendations of the Francis Report in 2013 which stated:

“It is not the system itself which will ensure that the patient is put first day in and day out. It is the

people working in the health service. A fundamental culture change is needed.” Building on this,

Dean Royles, former Chief Executive of NHS Employers stated: “The NHS has just been handed

what must rank as the world's largest Organisational Development challenge”.

Building and sustaining capacity to support change is a key challenge. Aintree has responded to

this context and in 2018 commenced a cultural diagnostic exercise which is the fundamental basis

for our workforce and OD strategy going forward. The Trust has recently consulted staff on a

revised set of behaviours which will inform our values as we approach merger. Going forward we

seek to work jointly with RLBUHT to develop a shared values set.

The Board of Directors, Council of Governors and Senior Leadership Teams believe that by living

the values and working together, Aintree University Hospital will deliver its common purpose and

achieve its strategic vision (see Figure 2)


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B. Quality and Safety

The Trust’s Quality Strategy 2018 - 2020 was approved by the Board in September 2018. The

Strategy recognises that “it is important to aim for excellence and that quality must be the

cornerstone of our values” and so aims “to create a culture of continuous quality improvement … to

become a learning organisation in which every member of staff understands their role in delivering

this strategy and works towards that aim every day.”

The Trust further recognises the vital link between having the right people with the right skills in the

organisation with the delivery of excellent patient care by seeking to address the following risks

identified on the Board Assurance Framework with an ambition to embed a culture of excellence

and to build capable and confident leaders at all levels.

The Trust has also communicated its intention to develop a Safety Culture through its Safety First

Programme, making it easy for staff to do the right thing and harder for them to do the wrong thing,

improving safety for both patients and staff.

C. Merger with RLBUHT

The integration plan for the Royal Liverpool and Aintree Hospitals sets out the plans to merge to

create a single organisation by 2019. The vision is for a: “Centralised Hospital Campus with a

single service, system wide delivery, delivered through centres of clinical and academic

excellence”. This will require services to be reconfigured across the two hospitals, to establish a

combined workforce delivering standardised patient pathways; consistent, high quality services

delivered to best practice standards and enhanced clinical leadership.

Figure 2: Aintree’s Strategic Pyramid


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The workforce strategy and OD plan for the new organisation have been developed for the Full

Business Case led by the Directors of Workforce and the PMO for Transaction and Integration.

This has commenced in preparation for reconfiguration of Trauma and Orthopaedic services and

will test the model for this important workforce transformation for the city.

It is within this wider context and in response to these challenges that the Trust has developed this

People and Organisational Development Strategy for 2019-2020 to lead the organisation through

to merger.

Aims and Objectives

We want to be an organisation where all our people understand what is expected of them, are

capable of doing it and, critically, choose to do so. As an enabler for the Trust’s Corporate

Strategy this Workforce and Wellbeing Strategy has as its overall aim:

“Enable Aintree to be the best and safest place to work by attracting and growing a

competent workforce”

To help us achieve this aim we have set the following strategic objectives:

1 To embed a values-based, safety-centred culture

2 To develop capable, confident and compassionate leaders and managers across the

organisation

3 To develop as a centre for excellence in education

4 To undertake workforce planning to build flexible, responsive and sustainable services

5 To enable workforce transformation to improve service efficiency and quality


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Implementation

For each of these strategic objectives a number of key priorities have been identified. These will

be delivered through a set of High Impact Improvement Objectives as part of the Trust’s Annual

Planning process.

Key Priority 1. To embed a values-based, safety-centred culture

Key Delivery Areas

Key Success Measures

Develop a behavioural framework based on

Aintree’s values

Deliver major organisational change

through the proposed merger with RLBUHT

Improve staff engagement through cultural

diagnostic work with Clever Together,

aiming to become the Best Place to Work

Enhance partnership working

Improve staff health and wellbeing with

particular focus on proactively managing

workplace stress

Improve Equality and Diversity performance

meeting the Equality Act and Equality

Delivery System requirements

Develop HR/OD capacity and capability to

support the organisation

Refreshed value set based upon co-created

behaviour framework

Cohesive merger plan in place with high

levels of staff engagement

Improved staff advocacy scores to be in the

upper quartile to make the Trust the best

place to work and receive treatment

Revised partnership agreement

Develop MH wellbeing offer and evidence

engagement with wellbeing initiatives

Improved numbers of staff with protected

characteristics gaining promotion, higher

levels of BME staff engagement and

recruitment to senior posts.

HR/OD organisational analysis and activity

report

Key Priority 2. To develop capable, confident and compassionate leaders and managers

across the organisation

Key Delivery Areas


To integrate a revised appraisal process

with RLBUHT, supporting all staff to have

meaningful job reviews that are values and

behaviour led, and a Personal Development

Plan.

To develop leadership capability through

implementing and delivering a Leadership

and Management Framework with

development programme for all levels of

Improved compliance level of appraisals,

and increased staff satisfaction with

appraisal

Increase in numbers of managers trained at

all levels; Staff perception of senior

managers improves (via staff survey)


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Key Priority 2. To develop capable, confident and compassionate leaders and managers

across the organisation

Key Delivery Areas


managers and leaders, lining in with

RLBUHT

To embed the Trust’s accountability

framework, linked to a behaviour

framework, so all staff have clear roles and

responsibilities and accountability for

maintaining Trust standards

Develop talent management process

Delivering the ‘well led’ CQC KLOE

Performance management and

accountability framework in place, linked to

behaviour framework and values

Process in place by March 2020

Achieving a CQC good rating for the well

led domain

Key Priority 3. To develop as a centre for excellence in education

Key Delivery Areas


Implement the Education and Learning

Strategy by delivering high quality medical /

clinical education (including early

considerations of the Topol review)

To work with NHS England, the Deanery

and local universities to ensure we are able

to provide a first class learning experience

for all our students and trainees.

Ensuring that there is meaningful job

planning in place with quality systems and

processes

Timely revalidation (and appraisal) for all

staff with effective systems and processes

Support the development of a safe culture

by embedding the Human Factors

approach to learning from mistakes

Enable the development of a consistent

approach to QI in the organisation

To conduct an annual Training Needs

Analysis that reflects the Trust’s changing

learning needs

Improved student and junior doctor

feedback from surveys e.g. GMC Survey.

Positive external inspection outcomes

Robust annual job planning process with

good consultant satisfaction rates; Medical

staff engagement levels improve

Minimal numbers of staff failing to

revalidate

Project delivery evidenced through Safety

Culture Steering Group

Enable the development and delivery of QI

methodologies

Develop an annual training plan that meets

needs in accordance with available

resources and priorities


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Key Priority 3. To develop as a centre for excellence in education

Key Delivery Areas


To increase mandatory training compliance

levels

Maximise the access to the Apprenticeship

levy

Improve mandatory and statutory methods

and compliance

Increased utilisation of the levy year on

year

Key Priority 4. Undertake workforce planning to build flexible, responsive and sustainable

services

Key Delivery Areas


Recruit to our agreed establishment and

maintain safe staffing

Improve the recruitment process, make it

values-based, reduce time to recruit and

provide a better employee experience

Develop a workforce plan aligned to

business plans, and agreed for delivery

Ensure medical staff are an integral

component of the workforce plans i.e. job

planning

Delivering ‘Safe Staffing’ levels in line with

key demand

Improved retention rates, specifically in

nursing

Reduction in premium spend

Increased satisfaction with employee

recruitment experience; Utilisation of the full

approval process on TRAC (recruitment

system)

Further development and implementation of

new roles, multi skilling and

apprenticeships; Improved recruitment and

retention in “hard to fill” areas; Increased

development opportunities such as “grow

your own” and new roles increased

Completion of job plans within agreed

window

Improved performance against Carter at

Scale and Model Hospital benchmarking

data


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Key Priority 5. To enable workforce transformation to improve service efficiency and quality

Key Delivery Areas


Collaborate and maximising opportunities

across all corporate and clinical support

services with RLBHUT (pre and post-

merger)

Post-merger single HR/OD services

function

Enable delivery of consistent approach to

change and improvement methodology

Support delivery of Workforce CIP

Programme

Ensuring value for money by utilising ESR,

Roster and linked systems controlling the

pay bill and discretionary pay (making every

£ count)

Implement Trust wide rostering software

(Allocate) to support all clinical areas with

rotas and rostering

Increased interdependencies between

corporate teams; Increased levels of

flexible working across sites

Achievement of sustainable and affordable

HR/OD service

Inclusion of leading and managing change

in leadership programmes

Achievement of those CIP schemes set for

Workforce

Robust review of payroll provision, and

management of pay transactions;

Demonstrate robust vacancy scrutiny and

process management and governance;

Maintain cap compliant rates for temporary

/ additional work; Recruit temporary staff to

support the rota gaps and maintain

increased fill rates; Increase bank numbers

to support less reliance on agency staff;

Align ESR, OLM and the Finance ledger

Support effective rostering practice to

ensure staffing is safe without additional

costs


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Evaluation and Metrics

Progress against these strategic priorities will be monitored and evaluated through Aintree’s

governance structure as follows:

Governance Body

Monitors and Evaluates:

Quality Committee

Assurance on strategic workforce priorities and risks and

overall delivery of this Strategy and the Communications &

Engagement Strategy

Workforce Executive led Group

Ensure operational delivery of Workforce Priorities.

Delivery of People and Organisational Development Strategy

Manage corporate workforce risk.

Wellbeing and Engagement

Group

Manage staff engagement and wellbeing risk

Delivery of Wellbeing and Engagement Strategy and Plan

(including Staff Survey Action Plan)

Education and Learning Group

Manage education and learning risks

Delivery of Education and Learning Strategy and Plan

Equality and Diversity and

Human Rights Group

Delivery of Trust E and D objectives within the Equality

Delivery System

Staff Optimisation Group

Delivery of Workforce Plans, Job Planning, implementation of

E-Roster (medical, nursing and bank staff), and use of ESR

Staff Partnership Group

Work in partnership with Trade Unions on issues relating to

staff

Local Negotiating Committee

Group (LNG)

Focusing on doctors and dentists terms and conditions of

service

Core metrics will be used to assess risks and the delivery of the Strategy, these will include:

Feedback responses from online conversation outputs assessing engagement, Staff

Survey, Staff Friends and Family Test


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Doctor and Nursing staffing levels

Vacancy Rates

Recruitment

Payroll Accuracy

Staff Sickness

Staff Turnover

Appraisal Rates

Mandatory Training Levels

Use of Bank and Agency Staff

Take up and evaluation of leadership and management development courses, including use

of 360 degree feedback

Delivery of outcomes identified within the Education and Learning and Wellbeing and

Engagement Strategies

Employee Relations reports

Raising Concerns (being open) Policy monitoring

Achievement against the workforce performance metrics will measure the success of the

interventions

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