1. Workforce Performance Report April 2018
Tim Boylin
Director of Human Resources

2. Temporary Staffing Spend
Total temporary staffing spend increased by £469K to £3.96m, 19.40% of payroll, the highest in year. This is likely to be due to increased rates of annual leave in March due to the end of the annual leave year and Easter. The Trust is planning to review the annual leave policy in 2018/19 to look at ways of ensuring annual leave is managed more evenly across the year. The centralisation of the management of all agency use has removed the traditional spike in agency spend in the last month of the financial year which was previously caused by accrual issues. In the 2017/18 financial year £34.876m was spend on temporary staffing, 15% of the Trusts total payroll spend. Of this £22.9m (10%) was spent on agency and £12.0m (5%) was spent on bank. The Trust’s agency spend was 57.79% above the NHSI ceiling of £11.6m. Excluding GP’s temporary Staffing Spend increased by £7.87m 30% in 2017/18 compared to the previous year. Agency Spend increased by £5m 22% and bank spend increased by £2.8m by 24%.
This Month: 19.40%
£3.96m
Last Month: 18.19%
£3.49m
Last Year: 18.23%
£3.36m

3. Temporary Staffing Spend
Bank spend (excluding GPs) continued to increase in March to £1.053m, £67.5k more than February. Use of bank for Healthcare Assistants rose by £80k and by £40k for registered nursing staff.
Agency spend increased by £338k to £2.5m in March, 12.27% of payroll. The greatest increase of £159k was in the Allied Health Professionals staffing group followed by £156k in Admin & Clerical and £127k in Registered Nursing. Healthcare Assistant agency spend fell by £135k. Agency spend has increased in all Directorates, most notably in the Older Adults at £151k. Agency spend was % above the ceiling set by NHSI. NHSI Agency rule overrides increased by 10% to 1,380 shifts in the 4 weeks of March. 54% of temporary staffing shifts booked through the WFMS were to cover vacancies.

4. HCA Agency Reduction Key Other Total Number of Agency Workers 125 260
In March 44 Pure Flexible offers were made with 37 workers able to start. 27 Substantive Flexible Worker assignments have been processed. Since the Work for us challenge started in September 188 new Pure Flexible Workers have started and 381 substantive Flexible Worker contracts have been issued. The Trust has committed to switching from using Agency staff to Flexible Workers for all non registered nursing roles on 14 May. This covers all inpatient units.
A project group has been established to overview the change which is closely monitoring risk. A contingency plan is in place should the group be concerned about any risk to patient safety.
Extensive work is being undertaken to persuade Agency Workers to move across to Staffing Solutions, the Trusts' internal bank. 87% of the shifts filled by agency workers in January was completed by 125 workers who are being specifically targeted to move across. 49 Agency Workers have now moved over to Flexible Worker contracts. The table below shows progress with this key group and with other workers.
This is in addition to the efforts to recruit new Pure Flexible Workers from other sources.
It is anticipated that the majority of the switch will occur in the last few weeks as:
Agency Workers who provide us with notice now cannot start work until 14 May
It is anticipated that to a certain extent the switch will be a game of brinkmanship
The graph below shows that in March significant progress has been made in the reduction of HCA agency use and increase in Bank use.
Key
Other
Total
Number of Agency Workers
125
260
385
Number Spoken to 88 59
147
Positive response 60 48
108
ESR assignment set up ready to commence work from 14 May or earlier 33 16 49
Negative response 12 2 14
Unsure 10 7 17

5. Roster Publication
Since the Autumn the Trust has been working to improve rostering for units on the Workforce Management System specifically :
Ensuring rosters are robustly reviewed prior to publication
Publishing rosters 6 weeks in advance.
Sending shifts that cannot be filled by substantive workers to bank as soon as possible.
Cancelling unrequired duties.
Through improvement in these areas it is anticipated that staff, patient and carers satisfaction and wellbeing will increase and efficiency savings will be made as:
A robust roster review process will support the effective management of unavailability and contracted hours whilst ensuring a safe skill mix and fair rostering.
Publishing rosters 6 weeks in advance will support staff to plan their work and home life and enable shifts that cannot be filled to be sent to bank earlier reducing agency use. Staff are unable to view their duties through Employee on Line (EOL) if rosters are not published.
Evidence suggests that sending shifts to bank earlier reduces agency spend by up to 50%.
Cancelling unrequired duties means that we can accurately report on risks associated with required duties that we are unable to fill.
54 out of the 99 rosters were published 6 weeks prior to being worked for rosters due to commence 21 May , 1 more than in the previous month. 35 remain unpublished at time of writing, 4 days after due. The black line denotes when work commenced on the improvement.

6. Lead Time Shifts sent to Bank
The graph below shows lead time for all duties sent to bank regardless of reason. The earlier duties are sent the more likely that are to be filled by Flexible Workers rather than agency and within price cap.
The number of duties sent bank more than 30 days before they are due to be worked increased from 54% to 61% in March which is positive. The number of duties sent at 7 days or less (which is more likely to be due to sickness or adverse weather) continued to fall. The earlier shifts are sent the easier it is to fill shifts through the bank and on framework and within price cap.
A further target is to send all duties to bank that are needed because of a vacancy at least 6 weeks before they are due to be worked as the requirement should be known at this point shifts with the reason for being sent to bank stated as vacancy were sent less than 6 week before they were due to be worked.

7. Sickness
Sickness has decreased significantly to stand at 4.15% compared to 5.21% last month. The decrease has been experienced across all directorates and has been driven by the end of the winter Cold and flu outbreak and a reduction in Stress sickness.
Target: 3.50%
This Month: 4.15%
Last Month: 5.21%
Last Year: 4.56%

8. Vacancy
The Vacancy rate has increased 13.8% in March from 11.0% in February. The increase has resulted from the addition of FTE to the Budgeted WTE figure and has been experienced across all directorates except Children & Young Peoples.
Target: 9.0%
This Month: 13.8%
Last Month: 11.0%
Last Year: 8.00%

9. Turnover
The Turnover figure has increased in March to stand at 14.92%. The increase has been driven by the Corporate and Adult directorates. However, the Older Peoples and Children and Young People directorates have displayed a long term decline over the last 6 months.
Target: 12.00%
This Month: 14.92%
Last Month: 14.76%
Last Year: 14.62%

10. WRES

11. WRES