Wrkplace unin representatives in the British health care sectr: evidence frm the 2011 Wrkplace Emplyment Relatins Survey (WERS) This briefing analyses independent research cmmissined by the Ryal Cllege f Nursing frm Prfessr Nick Bacn f Cass Business Schl and Prfessr Kim Hque f the University f Warwick n the ecnmic value f facility time in British public sectr health care (PSHC), including: an assessment f the number f representatives in the public health care sectr, an evaluatin f the number f wrkplace unin representatives spending all, r nearly all, f their time n their representative duties. the prprtin f public sectr health care wrkplaces that have Unin Learning Representatives (ULRs) cmparisns against ther sectrs an assessment f the extent t which unin representatives are engaged in partnership wrking with managers. The analysis draws n data frm a representative sample f British wrkplaces in the 2011 Wrkplace Emplyment Relatins Study (WERS 2011). 1 Assessment f the number f representatives in the public health care sectr shws: 12 per cent f all PSHC wrkplaces have a unin representative. This is cmpared t 38 per cent f ther public sectr wrkplaces (such as lcal gvernment and civil service) While nly 12% f PSHC wrkplaces have a unin representative, 75% f their wrkfrce is emplyed in a wrkplace in which a unin representative is present Unin representatives in public sectr health care tend t be fund in particularly large wrkplaces, with ne representative fr every 80 emplyees (cmpared t ne fr every 40 elsewhere in the public sectr, and ne t 66 in the private sectr). Nick Bacn and Kim Hque, Prfessrs f HRM cnclude that: It is difficult, therefre, n the basis f these figures frm the gvernmentspnsred WERS survey, t justify the claim that there are t many wrkplace unin representatives in the public healthcare sectr. In wrkplaces where representatives are present, there are nly half as many representatives per emplyee in the public healthcare sectr than in nn-health public sectr wrkplaces, and there are fewer representatives per emplyee than in nnhealthcare private sectr wrkplaces. Lking at the presence f full-time representatives: Given unin representatives in public sectr health care tend t be fund in particularly large wrkplaces, 11% f PSHC wrkplaces have representatives that 1 WERS is c-spnsred by the Department fr Business, Innvatin and Skills (BIS), Acas, the Ecnmic and Scial Research Cuncil (ESRC), the UK Cmmissin fr Emplyment and Skills (UKCES) and the Natinal Institute f Ecnmic and Scial Research (NIESR). 1
spend mst r all f their time n unin duties (cmpared t 7% in the rest f the public sectr and 9% in the private sectr) The average number f emplyees in wrkplaces with a full-time representative in PSHC is 2,500, cmpared with a figure f 371 fr wrkplaces with a nn full-time representative. Where representatives wrk n a full-time basis, they d s in larger wrkplaces and are respnsible fr representing a greater number f members with a wider range f cmplex emplyment relatins issues t deal with. Unin Learning Representatives (ULR) Only 4.1% f PSHC wrkplaces have a ULR, cmpared with 4.9% elsewhere in the public sectr Each ULR cver 455 emplyees in PSHC, cmpared t 175 elsewhere in the public sectr Bacn and Hque cnclude that: One pssible interpretatin f these figures is that ULRs in public sectr healthcare are rganised in a particularly cst effective manner, given the ptential fr each ULR t imprve training and skills fr a large number f emplyees. Hwever, there might als be a case fr the recruitment f greater numbers f ULRs, given that each ULR is currently required t cver a lt f emplyees in public sectr healthcare, and this may dilute their impact. Partnership wrking in the NHS Partnership wrking between emplyers and unin representatives is widely recgnised as essential fr imprving patient care and safety in the NHS. 2 One imprtant rute by which unin representatives participate in partnership wrking is via jint cnsultative cmmittees (JCCs). Amng wrkplaces with unin recgnitin, 30% f PSHC wrkplaces have a cmmittee, cmpared t 14% elsewhere in the public sectr and 12% f private sectr health care wrkplaces. Further analysis shws that in thse wrkplaces with a JCC, unin invlvement is higher in PSHC wrkplaces than in ther wrkplaces, indicating a high level f engagement in partnership wrking. 91% f management respndents in PSHC wrkplaces in which unin representatives are present agree that unin representatives can be trusted t act with hnesty and integrity. This cmpares with 86% f managers in public sectr nn-healthcare wrkplaces, 70% f managers in private sectr nn-healthcare wrkplaces, and 68% f managers in private sectr healthcare wrkplaces. 90% f unin respndents in PSHC wrkplaces agree that managers can be trusted t act with hnesty and integrity. This cmpares with 69% in public sectr nn-healthcare wrkplaces, 70% in private sectr nn-healthcare wrkplaces, and 68% in private sectr healthcare wrkplaces. 2 Department f Health (2012) Partnership Agreement: an agreement between DH, NHS Emplyers and NHS Trade Unins 2
Unin representative presence and labur turnver Calculatins frm WERS suggest that labur turnver (vluntary exit rate) is 3.4% in PSHC wrkplaces with a unin representative, in cmparisn with 9.5% in wrkplaces withut a unin representative 3. The difference in labur turnver allws the calculatin f turnver csts in wrkplaces with and withut unin representatin, thereby cntributing twards an assessment f the financial benefits f wrkplace unin representatin. The csts f turnver may be estimated in a number f ways ranging frm the calculatin f advertising, agency and search fees at the lw end f cst estimates, t estimates including the cst f lst utput and absrptin csts assciated with new emplyees. Using a methdlgy applied by the DTI 4 and the average f estimates frm the last 4 years f the CIPD s annual survey fr the median csts f advertising, agency r search fees assciated with staff appintments in the public sectr ( 1,875) 5, we can calculate the psitive impact f wrkplace unin representatives twards reducing csts fr the replacement f staff wh vluntarily leave. The annual savings fr the whle f the NHS in the UK are (see Appendix fr further details): 100,320,249 fr all Agenda fr Change staff including: 34,165,586 fr qualified nursing, midwifery and health visiting staff 11,547,808 fr health care assistants/nursing auxiliaries In a large teaching hspital NHS rganisatin, annual savings are estimated t be 1,190,625 fr all Agenda fr Change staff. Other frequently used estimates fr the cst f staff turnver accunt fr a brader range f csts including lst utput and recruitment/absrptin csts. Fr nursing staff, these are generally calculated as between 0.75 and 2 times the salary f the nurse that has left 6. As an indicatin f the savings invlved, we have calculated the ptential amunt just fr qualified nursing staff t be 385,114,487 per year (see Appendix fr mre details). 3 The leaving rate fr the NHS in England between August 2013 and 2014 was 8.1% 4 DTI (2007) Cnsultatin Dcument Wrkplace Representatives: A review f their facilities and facility time. URN 06/1793 5 CIPD (2015) Resurcing and Talent Planning www.cipd.c.uk/binaries/resurcing-talent-planning_2015.pdf 6 Health Educatin England (2014) Grwing Nursing Numbers http://hee.nhs.uk/wp-cntent/uplads/sites/321/2014/05/grwing-nursing-numbers-literature-review- FINAL.pdf 3
Illustrative differences in recruitment csts fr an NHS rganisatin given differences in turnver rates depending n the presence f wrkplace unin representatives Nn-medical staff (f which ) Administratin and estates Healthcare assistants and ther supprt staff Nursing, midwifery and health visiting staff Scientific, therapeutic and technical staff Ttal number N wrkplace unin representatives present Vluntary Replacement exits advertising, (turnver agency r rate 9.5%) search fees ( 1,875 per hire) Wrkplace unin representatives present Vluntary Replacement exits advertising, (turnver agency r rate 3.4%) search fees ( 1,875 per hire) Difference in recruitment csts 10,407 989 1,854,375 354 663,750 1,190,625 2,397 228 427,500 82 153,750 273,750 785 75 140,625 27 50,625 90,000 5,618 534 1,001,250 191 358,125 643,125 1,584 151 283,125 54 101,250 181,875 Bacn and Hque cnclude that: Given the psitive relatinship between unin representative presence and these utcmes, it is likely that any reductins in wrkplace unin representative numbers, r the facility time n which they rely, will harm rather than imprve NHS perfrmance. As such, the reprting requirements and reserve pwers in relatin t facility time in the public sectr cntained in the Trade Unin Bill 2015-16 may be regarded as particularly cncerning. The analysis presented here suggests they may well result in the impsitin f unnecessary csts n the NHS, and reduce the psitive impact that unin representative presence appears t have acrss a range f perfrmance utcmes. Csts and wider benefits The calculatins d nt make an assessment f the csts invlved f unin recgnitin and partnership wrking, such as the prvisin f facilities and facility time t wrkplace unin representatives. These csts include paid time ff fr representatives t undertake trade unin duties as well as the prvisin f ffices and equipment. This research has made a preliminary assessment f the savings made thrugh the psitive impact f wrkplace unin representatives n reducing csts t replace public sectr health care staff wh vluntarily leave. 4
There are als ther ptential benefits frm unin recgnitin and partnership wrking which have nt been quantified such as: The prvisin f a lw cst mechanism fr meaningful cnsultatin which usually leads t early reslutin f disputes, disciplinaries and grievances The reslutin f casewrk withut recurse t emplyment tribunal. The reductin f days lst t wrk-related illness and injury Prductivity gains thrugh helping staff acquire new skills 5
Appendix Abut the WERS 2011 survey WERS includes a survey f managers which is designed t be natinally representative f British wrkplaces with five r mre emplyees in all industry sectrs (with the exceptin f agriculture, hunting, frestry and fishing and mining and quarrying). Respndents t the survey are the mst senir manager in the wrkplace with respnsibility fr emplyment relatins, human resurces r persnnel. Out f 2,680 wrkplaces, the table belw shws the number relevant t this study. Managers survey respnses All Unin is recgnised fr cllective bargaining and with a representative present public sectr healthcare 169 124 public sectr nn-healthcare 653 437 private sectr healthcare 134 9 private sectr nn-healthcare 1,724 380 Managers in wrkplaces with unin representatives were als asked fr cnsent t interview ne trade unin emplyee representative and ne nn-trade unin representative. The interview was cnducted with the mst senir lay representative f the largest recgnised unin at the wrkplace, r the largest nn-recgnised unin if nne were recgnised. Unin representatives survey respnses All 797 private sectr healthcare 96 public sectr nn-healthcare 376 private sectr healthcare 7 private sectr nn-healthcare 281 Labur Turnver Calculatins The fllwing calculatins reprduce the prcedure used by the DTI (2007) 7. An average f estimates frm the last fur years f the CIPD s (2015) annual survey f the median csts f advertising, agency r search fees in the public sectr suggests csts f 4,500 t replace senir managers/directrs and 1,875 t replace ther emplyees 8. This cst may be calculated fr the NHS wrkfrce as fllws. The NHS has apprximately 1,167,932 Agenda fr Change staff (FTE) wrkplace representatives reduce turnver by 6.1 per cent average cst f replacing staff is 1,875 in advertising csts alne the psitive impact f wrkplace unin representatives n reducing csts t replace all AfC staff wh vluntarily leave is 133,582,223 per annum (0.061 x 1,167,932 x 1,875) As 75.1 per cent f the wrkfrce in public sectr healthcare is cvered by unin representatives the actual savings can be estimated t be 100,320,249 per annum. 7 DTI (2007) 8 CIPD (2015) 6
Turning t the nursing wrkfrce: The NHS has apprximately 397,757 qualified nursing, health visiting and midwifery staff (FTE) wrkplace representatives reduce turnver by 6.1 per cent average cst f replacing staff is 1,875 in advertising csts alne the psitive impact f wrkplace unin representatives n reducing csts t replace nurses wh vluntarily leave is 45,493,457 per annum (0.061 x 397,757 x 1,875) As 75.1 per cent f the wrkfrce in public sectr healthcare is cvered by unin representatives the actual savings can be estimated t be 34,165,586 per annum. The NHS has apprximately 134,440 health care assistants/supprt wrkers (FTE) wrkplace representatives reduce turnver by 6.1 per cent average cst f replacing staff 1,875 in advertising csts alne the psitive impact f wrkplace unin representatives n reducing csts t replace health care assistants/supprt wrkers wh vluntarily leave is 153,765,750 per annum (0.061 x 134,440 x 1,875) As 75.1 per cent f the wrkfrce in public sectr healthcare is cvered by unin representatives the actual savings can be estimated t be 11,547,808 per annum. Calculatin based n brader range f csts including lst utput and recruitment/absrptin: The salary fr a registered nurse ranges frm 21,692 t 98,453 Using the tp f Agenda fr Change band 5 ( 28,180) and estimating 0.75 f salary replacement cst f 21,135 If wrkplace unin representatives reduce turnver by 6.1 per cent amng 397,757 nurses The psitive impact f unin representatives n reducing csts t replace nurses wh vluntarily leave is 512,802,246 per annum (0.061 x 397,757 x 21,135) r 385,114,487 t reflect the 75.1 per cent f nurses estimated t be in wrkplaces with wrkplace unin representatives present. September 2015 7