SALISBURY NHS FOUNDATION TRUST HUMAN RESOURCES STRATEGY UPDATE REPORT

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1 SALISBURY NHS FOUNDATION TRUST PAPER: SFT 1900 TITLE: HUMAN RESOURCES STRATEGY UPDATE REPORT PURPOSE OF PAPER: To highlight the main areas of progress made against the Trust s Human Resources Strategy Working Together for Better Patient Care. EXECUTIVE SUMMARY: 1) The update report gives a summary of the development of the HR Strategy, and the context within which the strategy was designed to operate. 2) The report goes on to highlight some of the main areas of progress made in the last six months since last update of April 2008, and briefly describes the activities that have led to that progress. 3) The update concludes that although in general considerable and valuable progress has been made, the strategy now needs reviewing and updating to reflect the changes that have happened in the environment in which we undertake our business and the possible future changes to how we deliver our services ACTION REQUIRED BY THE BOARD: 1) To note the report. 2) To agree a review of the HR strategy is required and should be undertaken before the end of the current financial year Name: Position: Alan Denton Director of Human Resources

2 HUMAN RESOURCES STRATEGY UPDATE REPORT Introduction The Trust s Human Resources (HR) Strategy Working Together for Better Patient Care was developed during the second half of 2005 specifically in support of the application process for Foundation Trust Status. It was agreed and introduced in early Within the strategy it was recognised that the Trust operated within an evolving NHS environment in which there were a number of policy initiatives and key strategic drivers. Some of these addressed changes to service delivery or organisational configuration, some specifically addressed staff, their working lives, skills development or terms and conditions of employment. The Trust also operated and continues to operate within a particular South Wiltshire locality, within a larger Southern England geographical region, and in addition is are subject to local, regional and national labour market and general economic trends. Our strategy for Human Resources had to address these issues, as they all impacted upon staff and their ability to deliver our services into the future. Becoming a Foundation Trust added additional dimensions to the strategy. The creation of a new type of organisation with little track record or history added an element of uncertainty. The transition over time for staff from being employees to also being members and in some cases governors of the organisation they worked for was an exciting prospect, but it was not easy to understand where that transition would lead. The purpose of the HR Strategy was summed up as follows: - (the page numbers refer to the version of the HR Strategy available on the Trust s Intranet) This Human Resources Strategy aims to illustrate how the Trust intends to recruit, retain, develop and deploy its staff in order to deliver its service plans within a framework of high quality governance arrangements over the next five years. In short, the purpose of this strategy is to show how the Trust s people will be enabled to deliver high quality services, working together for better patient care. (p1) The strategy went on to illustrate various aspects it was relevant to describe in order to set a context within which the proposed strategic themes would exist. To that end, the strategy described the make up of the workforce (p2), our partnership working with Trade Unions (p6), the Trust environment (p7), our Service Development Strategy (p8), governance arrangements (p9), systems reforms that would impact on the Trust (p10), and our partners, stakeholders and the local population. (p12). Having set the context, and identified issues that arose in relation to each aspect of the Strategy, a set of four Human Resources Strategic Themes were developed, identifying those matters to be addressed by the Strategy, and describing how those matters would be addressed.

3 The Strategic Themes are: - 1. An employer of choice. 2. Modernising systems to support careers. 3. Sharing goals. 4. Building HR Management Capability and Capacity. The remainder of this update report addresses how some of the initiatives proposed have been taken forward since the last update report (SFT 1845) which came to the board in April Update Report This section reports on progress since the last HR Strategy update of April The numbers refer to the paragraph numbering in the HR Strategy available on the Intranet. Theme One An Employer of Choice 2.1.c Equality and Diversity In June 2008 the Board received the first comprehensive annual report on Equality and Diversity which met the Trust s statutory obligations to publish a range of monitoring information relating to patients and staff. The report highlighted work undertaken in respect of the six equality strands and described steady progress being made across the Trust as well as summarising work still to be done. On 7 August the REACH group (BME and other staff) celebrated their first birthday with a lunch time party attended by several members of the Board. The group have had a successful first year and have established a useful presence and role within the Trust, not least as a focus for consultation on policies and procedures in terms of equality impact assessment. The Trust s three equality schemes (Race, Gender, Disability) will in future be amalgamated into a single equality scheme covering these three themes and the other equality strands. The draft version of the Trust s Single Equality Scheme is currently going through a period of full consultation prior to coming to the Board for final approval later in the year. The Trust has expressed its support and commitment (in partnership with staff representatives) for the SCAR initiative (Salisbury Coalition Against Racism) and will be participating in aspects of the initiative during the coming months. 2.1.d Staff Well Being An organisation wide project started in June 2008 with the purpose of developing staff well-being initiatives. This project has funding identified from the surplus generated last financial year over and above that planned for. Research has shown that staff who are well managed and developed and who have job satisfaction deliver better care to patients, also that there is a direct relationship between good management practice and patient mortality/morbidity. Staff well being is an integral part of good management

4 practice and helps the Trust to ensure staff are properly supported to deliver high quality patient care in an efficient way A Health MOT Roadshow for staff was held on 4 th June 2008 and was a great success. Just over 200 staff visited the road show to find out more about what they can do to become healthier and to access the tests and assessments that were available. The most popular test was able to show people what damage excess sun or smoking would do to their face over the years, although the people measuring staff s blood pressure and body fat also did a very brisk trade. Those who attended the roadshow were asked to give their ideas or suggestions of what they would like to see the Trust provide or make available for staff. Over 30 suggestions were received which are being considered and in most cases progressed by members of the project Steering Group. These include the following. A group of staff are developing walking routes around the hospital, some internal and some external, identifying and proposing developments to quiet areas accessible to staff along the way. Maps will be available once the group has concluded its work. The Ramblers Association have also been in touch and are keen to develop links to publicise their walks to staff. The Trust running club has been publicised together with other local running clubs being set up by the District Council. A tax efficient salary sacrifice cycle purchase scheme is now available for staff A bid has been made to improve the showers in the Staff Club Occupational Health now review the blood pressure and BMI of all new starters as a regular part of their induction A weight management programme has just begun for those staff with a BMI of 30 or over and more are planned. Staff could get their BMI measured as part of this Sessions open to any member of staff to have their blood pressure checked will be available shortly BMI scales have been purchased for the Occupational Health department and Staff Club to use The staff restaurants are looking into healthier food options for staff and trialling items such as fresh smoothies The complementary therapists services available free to staff have been extended for a further 6 months

5 Another Health MOT Roadshow will be held in January f Staff Security and Personal Safety The Local Security Management Specialist (LSMS) has continued with a programme of initiatives to improve security on site, including CCTV cameras. A security company has been engaged on a as and when required basis to provide additional reassurance when particular risks are identified, their usage authorised by an Executive Director on each occasion. Regular conflict resolution training (CRT) for diffusing aggression has been provided for front line staff, and now breakaway training provision has been introduced targeted at certain areas, which has received positive feedback. However, the total number of frontline staff who have completed conflict resolution training remains comparatively low at around 400 representing around 20% of Trust frontline staff. The nationally set target is 100% by 31 March 2008, and the reported achievement by Trusts nationally averages 66%. NB CRT must be delivered to standards set by the national body CFSMS to meet the required standard, and is a full one day interactive course. As a result of the comparatively low numbers of staff who have completed this training a decision has been taken that the number of courses available should be increased from the current provision, and front line staff who have yet to undertake the training identified so that they can be targeted to receive the training via their personal development plan by their line managers. 2.1.g Childcare The childcare voucher scheme introduced in July 2006 has had 76 staff sign up over the period, with 43 members of staff currently active in the scheme. A review of the scheme held in September 2008 found that 80% of respondents rated the scheme as an excellent benefit, with only one respondent expressing dissatisfaction (in respect in this case of the local tax office and their lack of knowledge of child care vouchers and their treatment for tax purposes). 2.1.h Flexible Working and Work/Life Balance The 2007 staff survey results show that the Trust is in the top 20% of acute trusts for both quality of work life balance and percentage of staff using flexible working options. 2.1.k NHS Pension Scheme 2.1.l The new NHS pension scheme provisions were implemented on 1 April 2008 without any particular matters arising of concern expressed by staff locally. There will be a further requirement for publicity at a later date as there will be a period during which existing staff can exercise an option to switch to the new scheme if they wish. New arrangements for ill health retirement were also introduced in April 2008 for NHS staff. It is expected that within the next year or so there will be some form of passing of the costs risks of ill health retirement to employers, though what final form this will take is as yet unclear.

6 2.1.m Careers Advice and Works Experience 2.1.n The Trust has continued to offer opportunities for school, college and mature students to undertake work experience placements throughout the hospital, both in clinical and non clinical settings. In the year there will be about 150 such placements supporting 30 schools/colleges in our catchment area. In addition we have arranged specific class visits, for instance the recent visit of science students to our laser and radiography services, undertaken mock interviews with students and attended a number of industry days in a variety of schools. We have also attended careers/jobs fairs and similar events locally. 2.1.p Recruitment Processes and Systems The Trust has maintained its very significant usage of the use of E- Recruitment to replace advertisements in journals and newspapers, which has led to a large reduction in expenditure on advertisements over the past few years. The Trust recently has been experiencing an unprecedented level of recruitment of additional staff which has placed some strain on resources due to the complexity of the recruitment process in terms of pre employment checks and contractual requirements. A major revision of the induction process for non medical staff has occurred during the period, and new members of staff now receive a considerable amount of the essential mandatory training they require, as well as completing their starters paperwork, on their first day of employment. The Chief Executive or another Executive Director attends the induction each week and meets new staff during their lunch period. (Also see 2.2.y and 2.2.z below) Theme Two - Modernising Systems to Support Careers 2.2.c Variations to AfC At national level unions representing the staff covered by AfC agreed a three year pay deal with NHS Employers. The first year of the pay deal was for an increase of 2.75%. This has caused problems for the Trust (and for other NHS employers) as it is well above the figure used to inflate the tariff for pay inflation, leaving the Trust with a financial shortfall against projected outcome. Years two and three of the deal were for lower increases, but a reopening clause was agreed if inflation should prove to be above treasury targets (inflation is currently well above the target). This leaves the next two years settlement uncertain, and therefore it seems at present that the hoped for benefits of a three year deal (i.e. an ability to plan for pay inflation based on three years of agreed uplifts) is in some jeopardy.

7 Working in partnership with Trade Unions representing staff the Trust has used the freedoms within AfC in the period covered by this report to do the following: determine after rigorous investigation to offer recruitment and retention premiums to certain classes of staff in certain closely defined shortage specialisms. Move all staff with effect from June 2008 onto monthly pay, i.e. to stop weekly pay. This means the Trust now does 12 main payrolls a year from 63 previously. An additional benefit is the ability to more accurately calculate deductions of NI and income tax for staff with multiple contracts e.g. nurses with substantive and bank contracts who were previously paid both weekly and monthly. Weekly paid staff were offered loans and other support measures to assist them in the change. No reported material problems have been experienced since the change. Agree a local policy for determining incremental dates on promotion 2.2.f Non-consultant career grade terms and conditions of employment New contract terms and conditions of employment for Staff and Associate Specialist (SAS) doctors have now been developed at national level and the Trust is currently introducing these locally, working in partnership with staff representatives nominated by our medical staff local negotiating group (LNC) 2.2.g 2.2.h Workforce Planning New Role Development After a period when workforce planning seemed to have lost some of its momentum locally, regionally and nationally recent activities led by the South West SHA are showing considerable promise in supporting workforce planning in a meaningful way. The Trust are fully engaged in this initiative at strategic and operational level, and have recently secured funds (via the Deputy Director of Nursing s efforts) to pilot the roll out in an acute Trust of a workforce planning model that enables line managers to make a major input into planning the workforce to meet service needs and local circumstances. A project is currently being initiated to deliver this initiative led by the Deputy Director of HR. Amongst a range of outcomes anticipated is more active examination of role development for band 4 (and other non-registered roles particularly in nursing) to bridge the gap between unregistered and registered professions at the hospital. 2.2.j 2.2.k 2.2.l 2.2.s 2.2.v Continuous Learning, Maximising the use of new Technology in Learning/ Training and Prioritise Training Delivery

8 A separate report on progress made against the Trust s Lifelong Learning Strategy will be given to the Board by the Head of Learning Development at their October 2008 meeting. Overall, the 2007 staff survey showed Trust staff are above average for the amount of job relevant training they perceive they received in the last year. 2.2.y 2.2.z Registration Checks Pre and Post Employment Checks The Trust s system for on line checking of registrations is now well established and a policy describing the process with an associated flow chart was developed for the NHSLA standards for better health visit during the period and deemed satisfactory. Continuing recent trends the NHS is now subject to much more stringent levels of both pre and post employment checks on prospective and existing members of staff, 2008 seeing the introduction of further standards for checking previous employment, qualifications and references etc. This has led to agreement for an additional member of staff in the HR department whose job will mainly be concerned with carrying out these checks for prospective employees on a very stringent basis. The Trust s practices in relation to this issue were the subject of scrutiny during the recent NHSLA visit, and no issues were identified. The coming year (2009/2010) will see the introduction of a vetting and barring scheme for those who work with children and vulnerable adults which Trust staff will be subject to. What additional demands this will make on the Trust, its staff and applicants for posts is as yet unclear. The system of applying for work permits for non EEA (European Economic Area) staff is changing from November 2008 onwards. The Trust is applying to become licensed to be a sponsoring organisation to sponsor migrants to take up skilled posts that cannot be filled by the resident labour force of EEA citizens. It is essential that the Trust obtains sponsor status as we employ a considerable number of staff in this category, not least medical staff. From 1 March it has been an offence punishable by a fine of 10,000 on each breach for organisations to employ individuals who are not entitled to work in the UK. An assessment visit by the UK Border Agency is taking place on 8 October 2008 which will determine if we will be granted a license to issue letters of sponsorship to job applicants. 2.2.cc Conduct, Capability and Competence A revised general Disciplinary Policy and Procedure was agreed and introduced during the period which makes changes to existing practice in the light of experience of running the existing policy over the last year. The Trust s current Capability Procedure for non medical staff is currently being reviewed. The new Attendance policy, introduced in 2007/2008 is also being reviewed after a year in operation. Certain cases dealt with under this

9 policy feed into the capability policy, or are dealt with as ill health in a similar way. Theme 3 Sharing Goals 2.3.a Values and Beliefs 2.3.e Focus Groups As part of the development of the new Trust OD strategy it was felt to be a good opportunity to revisit the current values and beliefs statements. A cross-section of staff joined together as a reference group to undertake this process. After a series of consultative and developmental meetings with various groups of staff a revised set of values and beliefs statements were developed and were approved by the Board in April These have been adopted across the Trust and are used in a variety of ways, not least in the dissemination of the Trust story as part of communications about the OD strategy Striving for Excellence, and in the talks given by Executive Directors at induction of new staff. 2.3.d Staff Survey The 2007 staff survey results showed that the Trust continues to be in a relatively strong position compared with other NHS acute trusts across the range of indicators measured. The Trust has chosen this year to participate in the Healthcare 100 survey, sponsored by Health Service Journal and Nursing Times, in association with NHS Employers. The Healthcare 100 is open to organisations providing healthcare in the UK. The aim of the survey is to identify the 100 best Healthcare organisations to work for. 2.3.f Celebrating Staff Success. The use of part of the additional Trust financial surplus to fund the Wellbeing project (see above) has been well received. Other initiatives in the period include publicising achievements via Health News Weekly, the cascade brief and the annual review, long service awards (June), volunteers day celebration in June, and a variety of other initiatives. 2.3.h 2.3.i Partnership Working with Trade Unions IR Systems and Structures The Trust continues to enjoy excellent relations with Trade Unions locally, and a staff representative sits as a full member of the Operational Management Board and another is in attendance at public Trust Board meetings. Recent significant work includes the implementation of the move to weekly pay only for all Trust staff (affecting nearly 2000 staff in total) and a joint expression of commitment to SCAR, the Salisbury Coalition Against Racism, both mentioned above under separate headings.

10 Although out of the main headlines now, staff side and management nominated job evaluators and matchers continue on a regular basis to meet to grade new or changed jobs for placing into AfC bandings. This work is carried out entirely in partnership, and has worked so well that it is generally forgotten that it goes on. It is an important grading control mechanism. It is hoped to take part in some additional training opportunities for job matchers being offered via the strategic health authority in the next few months so as to keep up the number of individuals able to fulfil this vital role and replace numbers of matchers lost due to turnover etc. As part of the 2008 three year pay deal for AfC staff a new set of standards for Time off and Facilities for Trade Union Representatives was agreed nationally for local implementation. As reported in the previous period a revised Recognition agreement had been signed with trust trade unions which includes the structures within which consultation (Joint Consultative Committee) and negotiation (Joint Negotiating Committee and Joint Negotiating Groups) will be conducted. At the same time a revised Facilities agreement was signed. This described the arrangements that will exist for such matters as time off for Trade union activities and duties, the use of Trust facilities such as computers, telephones, the post, meeting rooms etc in order to carry out the work of trade union representatives locally. It was found that in almost every respect the Trust s agreement met the new best practice standards, and at the time of writing there remains only a single outstanding minor issue for further discussion before a revised agreement is finalised. Theme 4 Building HR Management Capability and Capacity 2.4.a Training on HR Issues HR staff have worked with managers across the Trust to build capacity in such matters as Equality Impact Assessments, job design, description and person specification, using the e-recruitment system NHS jobs, best practice in recruitment and selection, the administration of the disciplinary and grievance processes, the management of attendance, informal dispute resolution, and dealing with contractual and terms and conditions issues. Additional Case Investigators are being trained via on the job training, and the HR department are currently leading on an investigation into developing mediation skills. 2.4.d Partnership Working with outside HR Organisations An unprecedented amount of close working with the Trust s legal advisors has been necessary over the period on a number of very complex staff issues, including cases involving disability discrimination claims, conduct cases, capability cases, equal pay claims, and claims of race discrimination all occurring recently. Unfortunately, this has resulted in an equally unprecedented increase in the Trust s legal bill for employment advice and support. The Trust is currently engaged in discussions with our legal advisors to ensure that we are able to access the advice and support we need, but at the same time we are fully aware of the costs we are incurring, and how we might best manage our relationship and processes to ensure expenditure is appropriate.

11 It can be easily observed that in many cases that the Trust is involved in at any level the staff member concerned has engaged a solicitor at an early stage in the dispute, whereas previously matters were dealt with at internal levels with either no representation, or a trade union representative or work colleague only supporting the member of staff. This has caused equal difficulty for our Trust and full time Trade Union colleagues, who have found that in some cases their client has also engaged a solicitor to represent their case. Their involvement has therefore been compromised and they are then unable to continue to represent the staff member in an appropriate and more traditional way. There have been a number of changes in employment and case law that have required Trust HR staff to attend updates and increase their knowledge, where our legal advisors have assisted and advised. The Trust has continued to work closely with Capita Health Service Partners who provide specialist HR advice to the Trust, in particular on pay and conditions of employment for Executive and non Executive Directors. 2.4.j Reporting Mechanisms The successful implementation in 2007 of the new NHS Personnel/Payroll system ESR (Electronic Staff Record) has provided the platform to collect and report on a variety of workforce data sets locally and nationally. Locally we now have a facility to collect and report on the six equality strands across our workforce, and this was in part the reason that a census of staff was conducted in the autumn of 2007 to add to and update the data we kept on our system. The annual equality and diversity report (June) and the workforce report 2007/2008 (August) to the Board illustrated the step change in the ability of the HR department to provide detailed information to trust managers. One of the most useful additions is the absence reporting system which has enabled detailed analysis of the reasons for absence to be made using standardised categories. This means the Trust can now target resources appropriately according to the size, nature and location of avoidable staff sickness absence. Conclusion The Trust has continued to make good progress to deliver its HR Strategy. However, the strategy is now almost three years old and whilst many of the themes and actions remain appropriate there have been considerable changes to the environment locally, regionally and nationally in the NHS and in the non NHS world we work within. At the time of writing there is major economic upheaval which will change the labour market considerably if current trends continue. High inflation and an economic downturn is a very unhappy combination. Whatever happens in the Trust, many of our staff will be affected by their family s experiences of the economy, with family job losses and economic volatility being unhelpful to a stable and committed workforce. Staying put and low workforce turnover has its upside for the Trust, but it can lead to incremental drift and to career structures becoming stuck.

12 How much pressure on public resources will be a factor in delivering the Trust s service plans (and the strategies including this strategy which support the service plans) is as yet unclear. The Darzi report ( High Quality Care for All and the supporting workforce report A High Quality Workforce ) obviously postdates our current HR strategy. The commitments to staff in the as yet draft NHS Constitution are not antipathetic to our strategy, but nor does our strategy address them as a planned response. Our OD Strategy, Striving for Excellence actually builds on the thinking of our HR Strategy, but inevitably Striving for Excellence is not referred to in our present HR strategy which predates the launch of Striving for Excellence by two years. The present financial year is an ideal time to review and revisit the HR strategy to make sure it reflects the developing environment within which the Trust operates, and our current local plans and strategies for service delivery and organisational development. There is no suggestion that any of our HR related activities and achievements are or have been inappropriate, and in fact a huge amount has been achieved. However, we must ensure the HR strategy remains fit for purpose and addresses the world as it is and looks likely to become, rather than the very different world of 2005/6. The strategy will be reviewed in the remainder of 2008/2009 to be more in line with the OD strategy Striving for Excellence and other internal and external drivers. Alan Denton Director of Human Resources Peter Hill Director of Operations October 2008