Board of Directors. Action/Decision Assurance Information. Sickness Absence

Transcription

1 AGENDA ITEM 14 Meeting / Committee: Board of Directors Meeting Date: 31 March 2015 This paper is for: (Only 1 column to be marked with x as appropriate) Title: Action/Decision Assurance Information Sickness Absence X Purpose: The purpose of this report is to provide an update action plan to support a reduction in the rates of sickness absence across the organisation. The paper details the steps being taken to manage poor attendance due to sickness and to consider approaches that are being implemented in other organisations. Summary: The paper provides information on: Trust levels of sickness absence Trust s approach to managing sickness Comparison data Best Practice Prepared By: Rachael Metcalf Assistant Director of Human Resources Presented By: Rachael Metcalf Assistant Director of Human Resources Recommendation: The Board of Directors is asked to note the contents of the report Implications (mark with x in appropriate column(s) Legal Financial X Clinical Strategic Risk & Assurance X Page 1 of 11

2 BOARD OF DIRECTORS 31 MARCH 2015 SICKNESS ABSENCE 1. Introduction A paper was produced for the Board of Directors in August 2014 detailing the sickness absence rates across the Trust. This paper provides an updated position and details the work which has been undertaken to seek to reduce the sickness absence rates. The paper will compare sickness rates across the organisation looking at each centre and staff group and compare these with those at national and regional levels. Progress made against the action plan will also be discussed and best practice from neighbouring Trusts will be considered. 2. Current Trust Position In the period from September 2014 February 2015, sickness absence rates have increased slightly month on month from 4.34% to 5.04%. The sickness absence rate in February 2015 is the highest reported in the Trust since January Month Abs FTE Absence % Short Term Short as % of FTE Abs % Short Term Long Term Long as % of FTE Abs % Long Term March 9, % % 2.13% % 2.09% April 9, % % 1.58% % 2.44% May 9, % % 2.02% % 2.27% June 9, % % 1.72% % 2.54% July 10, % % 1.77% % 2.72% August 9, % % 1.72% % 2.54% September 9, % % 1.97% % 2.37% October 10, % % 2.08% % 2.24% November 10, % % 2.22% % 2.37% December 11, % % 2.13% % 2.66% January 11, % % 2.83% % 2.13% February 10, % % 2.52% % 2.52% The graph below reports the sickness rates by Centre for the period April 2014 March The overall Trust average is 4.50% against a target of 3.9%. Ward based centres have a higher sickness absence rate with speciality medicine ranked the highest with an average of 5.38% followed by Tertiary Services at 5.21% and Integrated Medical Care at 5.02%. Page 2 of 11

3 Average Sickness Absence Percentage By Centre April 14 to March % 5.00% 4.00% 3.98% 3.58% 5.02% 5.38% 4.69% 5.21% 4.60% 4.24% 4.50% 3.00% 2.63% 2.00% 1.00% 0.61% 0.49% 0.00% Balance Sheet Chief Executive Clinical & Diagnostic Services Finance & IT Integrated Medical Care Quality Assurance & Academic Specialty Medicines Surgical Services Tertiary Services Trauma And Theatres Women And Children Trust The graph below maps the number of sickness absence hearings which have occurred across the organisation during Q1,2 and 3 against the average sickness rates for each centre. As can be seen the highest number of sickness absence hearing have taken place in tertiary services and no sickness absence reviews have taken place in specialty medicine. Page 3 of 11

4 There are 2 elements to considering sickness absence reasons: 1) Reasons associated with the number of episodes of sickness absence 2) Reasons associated with the number of days lost due to sickness absence For quarters 1, 2 and 3 of this financial year, the most common sickness absence episode is reported to be due to gastrointestinal, as can be seen in the chart below. This is consistent with previous reports and has been the position in the Trust for a number of years. The second most common sickness absence episode is reported to be due to cold and flu followed by stress and anxiety. 2,500 Sickness Episodes By Reason - April - December ,000 1,500 1, The table below analyses the most common reported reasons for sickness (fte) days lost. As highlighted the most common reason is stress and anxiety, followed by musculoskeletal and then back problems. Again, this is a similar position to previous reports. Page 4 of 11

5 30,000 Sickness FTE Days Lost By Reason - April - December ,000 20,000 15,000 10,000 5,000 0 The graph below demonstrates sickness absence rates by staff group from April 2014 February Estates and ancillary staff have the highest levels of sickness absence, followed by unregistered nursing and clinical staff. The picture is consistent with previous staff group analysis. 8% Sickness Rate By Staff Group - February % 6% 5% 4% 3% 2% 1% 0% Medical & Dental Healthcare Scientists allied Health Professionals Add Prof Administrative Scientific and and Clerical Technic Registered Nursing Unregistered Nursing & Clinical Support Estates and Ancillary Unregistered Nursing and Clinical Support include HCA, Assistant Practitioners, Therapy Assistants and Radiology Assistants Add Prof Scientific and Technical include ODP and Pharmacy staff Healthcare Scientist include Biomedical Scientists, Technicians and Audiologists Page 5 of 11

6 3. Current Regional Position Regional benchmarking data is collated on a quarterly basis from local NHS organisations and shared with participating trusts for benchmarking purposes. Against a regional sickness absence average of 4.46% the Trust had an average sickness absence percentage of 4.39% at the end of quarter 2, 2014/15. (Quarter 3 data has not yet been received). This places the Trust in 5 th place out of 11 local trusts. As can be seen, with the exception of Gateshead Health NHS Foundation Trusts, all other Trusts in the region saw an increase in their sickness absence rate. The table below provide a more detailed breakdown of the table above, showing the average sickness absence rates on a monthly basis for quarter 1 and 2 of 2014/15. Page 6 of 11

7 The graph below demonstrates the Trust s position in comparison to our 10 neighbouring Trusts. In August 2014 the Trust was ranked fourth, whilst the Trust may have improved its position regionally, this demonstrates that neighbouring Trusts are also seeing an increase in sickness absence rates. Sickness rate for NE Trusts - quarters 1 to / National Position The recent national figures show that North Central and East London, South London and North West London have the lowest regional sickness absence rates whilst the North East, North West and Wales have the highest sickness absence rates. This position remains unchanged over the last 12 months. 6.00% Regional Sickness rate December November % 4.00% 3.00% 2.00% 1.00% 0.00% Page 7 of 11

8 The table below highlights the Trust s position against our national peer group. 7% 6% 5% 4% 3% 2% 1% 0% December 13 to November 14 absence rate compared with national peer group 4. Action Plan A sickness absence action plan was developed to support the nursing sickness absence workstream work and following the change leader s event in October Audits One of the key initiatives implemented in November 2014 was the introduction of quarterly audits to the top 15 wards with the highest overall sickness absence rates for nursing staff (both qualified and unqualified). This take place on a quarterly basis and employee files are audited to ensure return to work interviews, absence review meetings and health improvement plans have been implemented. Evidence from the audits has highlighted some excellent practice in some ward areas, which we shared at a recent learning event, however, some practice is not in line with the management of attendance policy and in some areas return to work interviews are not completed and sickness is not escalated appropriately. We are providing dedicated support to some ward managers to ensure staff are at the correct place in the policy and that steps are taken when staff meet sickness trigger points. Detailed Monthly Reports In addition a much more detailed report is provided to each centre on a monthly basis, which highlights the individual employees with the highest number of episode and highest number of days lost. This should ensure focused consideration to support individuals but also to deal with staff appropriately should a pattern emerge. The table below is the Trust position at the end of January 2015 and shows which wards have the highest levels of sickness absence, broken down into long term and short terms sickness Page 8 of 11

9 absence. The table also ranks the wards over the previous 6 months, so it is possible to see if an improvement or decline has occurred. Guidance Documents Short and succinct guidance documents and flow charts have been developed to support mangers to navigate through the Management of Attendance Policy. These are available on the intranet and are one page documents which managers can pick up to save time reading through the whole policy. Consistency in HR advice A number of sessions have been held with the HR team to consider frequent sickness absence related situations to ensure a consistent approach is taken. Sickness absence scenarios form part of the monthly operational HR meeting and internal communications have increased. Occupational Health Consultant Currently occupational health consultant capacity is contracted from North Tees and Hartlepool Foundation Trust; this is costly and allows for limited sessions. A recent advert to appoint our own substantive consultant in occupational health resulted in nil applications. There is a need to review the market and consider a further advert or to engage with a recruitment agency to identify possible applicants. Learning event Page 9 of 11

10 A learning event was held in February aimed at ward managers and directorate managers. The event was successful with approximately 50 delegates. The focus was on best practice HR relating to managing sickness absence and 3 managers attended and presented their personal story about their experiences of managing sickness absence. There have been a number of requests to run another learning event for ward managers who were unable to attend but also to open the event up to managers from non-nursing areas this will be arranged for April. Collaborative working Discussions have taken place with neighbouring Trusts to identify any learning we could adapt particularly Newcastle and Northumbria Foundation Trusts. Newcastle Upon Tyne NHS Foundation Trust A similar sickness absence policy is in operation, though there seems to be a more robust implementation of the escalation process. Northumbria Healthcare NHS Foundation Trust Recently a temporary redeployment pilot has been set up to encourage staff to return to work, who may be able to return to work for some duties, but not yet their substantive role. Any staff (not just clinical staff) who are able to return to work support the Trust s patient feeding programme. Another pilot initiative which has recently been introduced is to triage staff who report sick for duty as a consequence of stress/anxiety/depression. Staff are quickly escalated through to occupational health and receive a phone call the same day from an occupational health nurse with the option of fast track counselling. A similar pilot is also being considered for musculoskeletal sickness absence. Tees, Esk and Wear Valleys NHS Foundation Trust A dedicated HR team was set up 2 years ago to focus on long term sickness absence. Once a member of staff has been absent for 4 weeks to responsibility for managing their sickness absence transfers to the HR team, who manage the sickness. TEWV advised that their statistics demonstrate a reduction in the total sickness absence rate and the long term sickness percentage. Stress/depression is the most common reason for absence, it is positive that the average length of time which a member of staff is absent for this reason has significantly reduced. Amended sick pay scheme Plans were in place to progress with a new employment contract for new starters to the NHS from April 2015, however, due to the election this has been moved back slightly to implementation from August North Tees and Hartlepool NHS Foundation Trust have indicated that they would like to work together on a joint approach. The intention is to remove sick pay for new starters for the first 3 days and to cap the sick pay at 3 months for full pay and 3 months at half pay. 5. Next Steps Aquarius Management Consultancy will shortly be producing their final report relating to sickness absence. Through discussions with Aquarius they are recommending that the policy and sickness absence process within the Trust is not broken, significant work has been undertaken to improve the way sickness absence is being managed. The key issues identified are all focused on long term sickness. It is recognized that multiple initiatives exist to address health and wellbeing of staff within the Trust. Page 10 of 11

11 Addressing sickness absence levels within the Trust is not a process issue, enhancements to the process will not significantly impact upon sickness absence levels within the Trust. The Trust needs to develop and support management capability to ensure the effective management of sickness absence. Aquarius are recommending that the Trust will benefit from a coherent Health and Wellbeing Strategy that drives synergy and efficiency. This needs to: Be owned at Board level by a nominated Director and supported by HR Be aligned to the Trust s Strategy and the People Strategy to focus resource and gain real traction Utilise resources from within the Trust, other Trusts, the Council and other organisations. The slide below illustrates the recommendations so far from the Aquarius review. Page 11 of 11