Workforce and Organisational Development
Report – May 2015
Author: Ruth Davies, Director of Workforce & OD; Hywel Daniel, Assistant
Director of Workforce; Claire Barley, Head of Professional and
Organisational Development.
Date: 5th May 2015
Version: 1
Publication/ Distribution (on completion):
 Public Health Wales Executive Team
 Public Health Wales Board
 Public Health Wales Intranet
Purpose and Summary of Document:
The purpose of the paper is to provide the Public Health Wales Board and
Executive Team with a report and update on key issues from the Director of
Workforce and Organisational Development.
Date of Executive Team Meeting: 13th May 2015
This paper is for:
Discussion
Decision
Information
X
X
Public Health Wales NHS Trust
1
Director of Workforce and OD Report – May 2015
Workforce Analysis
The key messages from an analysis of workforce metrics are as follows:
1.1 Staff in Post
As at 5th May 2015, Public Health Wales had 1,462 directly employed staff,
which equates to 1,286.09 contracted full time equivalents (FTE).
1.2 Turnover
The staff turnover rate for the period 1st April 2014 to 31st March 2015 was
10.68%; which compares with a turnover rate of 9.32% for the period 1st April
2013 to 31st March 2014. Following on from last month’s report, in which the
evident increase in turnover was first identified, a brief report has been
prepared in relation to this as Appendix 1 to this report.
1.3 Sickness Absence
The sickness absence rate for the period 1 April 2014 to 31st March 2015 was
3.74%. The annual sickness target set by the Welsh Government is 3.25%. A
brief report into current levels of sickness absence and actions being taken to
address is included as Appendix 2 to this report.
1.4 Employee Relations Activity
Public Health Wales currently has 14 live Employee Relations cases. These
are:- 4 disciplinary investigations; 7 grievances; and 3 dignity at work (or
bullying and harassment) cases. As previously discussed, this is a high
caseload for an organisation of this size, and a review is currently underway of
existing cases and systems, to ensure appropriate and timely conclusion.
2
Significant Workforce Change Projects
A number of strategic workforce modernisation initiatives are continuing and
being supported by the Workforce and OD Team. Areas of significant input or
high risk are highlighted below:
2.1 Microbiology - North Wales
Following discussion at the last Microbiology Programme Board, the North
Wales service has agreed the establishment of the North Wales Microbiology
Service Modernisation (Re-Design) Phase 2 Project. Objectives for this phase
are focussed on establishing the service delivery model; implementing
workforce changes; maximising operational efficiency; and realising benefits.
2.2 Microbiology South and West Wales
Staff and services from Princess of Wales, Bridgend, were consolidated with
Singleton, Swansea, on 30th March 2015. New working patterns are being
trialled, and are due to be reviewed alongside service requirements in May
2015.
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2.3 South East Wales Microbiology Modernisation Project
Cwm Taf (Royal Glamorgan) and Aneurin Bevan (Royal Gwent) are now in
discussion with Public Health Wales in respect of consolidation of services. A
senior manager has been identified from July 2015 to lead the South East
Wales Microbiology Modernisation Project.
2.4 Changes to the Executive Team / Organisational Structure
The Trust has consulted on proposals with its trades unions and with individual
staff affected. Filling the structures proposed by the appropriate Directors will
now begin, and this will require support in the development of job descriptions
and job matching; working with Directors to identify staff affected by the
proposed changes in accordance with the OCP; and ongoing support for those
affected by changes.
3.
Learning and Organisational Development
3.1
The POD team have produced an end of year report (Appendix 3)
highlighting key achievements and challenges encountered in 2014-15. Current
work includes the development of the lead officer training programme 201516, work based learning and advanced practice (public heath) accreditation
scheme pilots and continuation of statutory and mandatory training
programme.
3.2 Individual Performance Development Review
The final draft performance development review process “My Contribution”
(formerly appraisals) has been completed with implementation stage
commencing June 2015.
3.3 UK Public Health Skills and Knowledge Framework
The POD team facilitated the consultation event for the UK Public Health Skills
and Knowledge Framework which is currently under review by the Department
of Health.
4.
Management and Leadership Development
We have now run Managing People which is a course familiarising people with
HR policies but from the standpoint of having the confidence and capability to
address issues as they arise. It also addresses how to deal with issues
informally without resorting to a formal process as well as exploring the
managers role and that of the HR Advisors. The full programme of
Management and Leadership modules for 2015/2016 has been published and
already all Personal Leadership places in North and South Wales have been
taken and there is only one space left in West Wales. We have a substantial
wait list for 2016/17.
We have been able to negotiate the licence for Alchemy (the on line toolkit) for
all staff not just for managers, at no extra cost.
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We have worked with BMA colleagues to design and run the first Job Planning
training session in North Wales. It was well received and we have a further 5
events planned over May and June with two more in September. These are
aimed at all medical and dental staff and their line managers.
We have been supporting senior recruitment (director and consultant
positions) through designing and running assessment centres based on the
new management and leadership framework . These have received very
positive feedback from the panels and the faculty.
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Public Health Wales NHS Trust
Director of Workforce and OD Report – May 2015
Appendix 1
Staff Turnover – Briefing for Executives
May 2015
Situation
The April 2015 Workforce & OD report noted that the organisation’s staff
turnover for the period 1 March 2014 to 28 February 2015 was 10.14%, which
was an increase from the previous year. Turnover rates are now available for
the full year from 1st April 2014 to 31st March 2015, and these rates show a
further increase to 10.68%. This compares with a turnover rate of 9.32% for
the period 1st April 2013 to 31st March 2014, which itself is at the high end of
an acceptable range.
The table below shows a summary of these leavers by reason for leaving:PHW Leavers Summary (1st April 2014 to 31st March 2015)
Leaving Reason
Death in Service
Leavers
2
Dismissal - Capability
2
Dismissal - Conduct
2
Employee Transfer
7
End of Fixed Term Contract
15
End of Fixed Term Contract - Completion of Training Scheme
1
End of Fixed Term Contract - End of Work Requirement
2
End of Fixed Term Contract - Other
2
Has Not Worked
1
Mutually Agreed Resignation - Local Scheme with Repayment
2
Retirement - Ill Health
2
Retirement Age
27
Voluntary Early Retirement - no Actuarial Reduction
4
Voluntary Early Retirement - with Actuarial Reduction
5
Voluntary Resignation - Better Reward Package
2
Voluntary Resignation - Child Dependants
3
Voluntary Resignation - Health
4
Voluntary Resignation - Lack of Opportunities
2
Voluntary Resignation - Other/Not Known
28
Voluntary Resignation - Promotion
13
Voluntary Resignation - Relocation
16
Voluntary Resignation - To undertake further education or training
Voluntary Resignation - Work Life Balance
7
7
Grand Total
156
As a result of the evident increase in turnover, further analysis has been
undertaken to explore the reasons for leaving for those who did not specify a
reason. At the time of this work being completed, the number of staff who left
the organisation, but for whom a reason for leaving was not specified was 27,
with 1 additional leaver being added during March 2015. A member of the HR
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Director of Workforce and OD Report – May 2015
team attempted to contact each of these 27 leavers, to ask them the following
short questions:1) Why did you leave Public Health Wales?
2) Would you return to Public Health Wales?
3) What might have encouraged you to stay at Public Health Wales?
Analysis
6 of the 27 leavers were incorrectly coded, and in fact left due to: 3 ended
fixed term contracts; 2 return to country of origin; and 1 change of career.
This reduced the number to 21.
Of the remaining 21, only 10 were contactable. The reason for leaving for
these individuals is shown in the table below.
Leaving Reason
End of Fixed Term Contract - End of Work Requirement
Leavers
1
Voluntary Resignation - Lack of Opportunities
6
Voluntary Resignation - Promotion
2
Voluntary Resignation - Work Life Balance
1
Grand Total
10
Of the 10 individuals successfully contacted, 6 said that they would return to
the organisation. Of those who answered the question around what might have
encouraged them to stay within Public Health Wales, the following themes
emerge:


A perceived difficulty in working across multiple sites;
Poor communication between managers and staff;
A perceived negative atmosphere within teams, and a perception that
complaints / problems were not appropriately dealt with – resulting in a
general dissatisfaction with line management. This issue was
particularly prevalent within Screening Services, and Stop Smoking
Wales.
Next Steps
In order to prevent further non-reporting of reasons for leaving, a step has
been added in to the Exit Questionnaire process to prompt the HR team to
check that a reason has been entered onto ESR, and has been included on the
Termination Form. If this has not happened, this will be followed up with the
relevant line manager, to ensure accurate reporting of data.
Findings of the analysis of this information will be shared in detail with the
relevant HR Business Partners, to enable discussion with Divisions and
Directorates in relation to turnover trends, and reasons for leaving. Relevant
support from OD colleagues will be sought in terms of assisting departments to
respond to this data positively.
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It is recommended that the organisation continues to monitor its turnover rate,
and act upon emerging trends across the next financial year.
Appendix 2
Sickness Absence – Briefing for Executives
May 2015
Current Position
Public Health Wales is currently running at a cumulative rate of sickness
absence of 3.74% for the period April 2014 – March 2015 (March 2015
currently being the latest available data from ESR). The overall sickness rate,
however, has been on a steady incline since April 2014, when it sat at 3.34%,
to its current level of 4.29%. The table below compares sickness rates for the
period specified above, against rates for the 2013/14 financial year.
April
2013
March
2014
April
2014
March
2015
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
3.66%
3.27%
2.75%
3.38%
3.23%
3.56%
3.82%
3.00%
3.41%
4.04%
3.97%
3.65%
Down
Up
Up
Up
Up
Down
Down
Up
Up
Up
Up
Up
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
3.34%
3.73%
3.72%
3.74%
3.24%
3.07%
3.61%
3.91%
3.92%
4.29%
4.08%
4.26%
The graph below shows sickness performance for 2014/15 against the 3.25%
Welsh Government target. Sickness absence is a ministerial priority, and is
increasing across Wales as a general trend; therefore action is needed to
address this, and recover the position.
Month
2014 / 04
2014 / 05
2014 / 06
2014 / 07
2014 / 08
2014 / 09
2014 / 10
2014 / 11
2014 / 12
2015 / 01
2015 / 02
2015 / 03
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Absence %
(FTE)
3.34%
3.73%
3.72%
3.74%
3.24%
3.06%
3.60%
3.89%
3.85%
4.26%
4.13%
4.29%
Public Health Wales NHS Trust
Director of Workforce and OD Report – May 2015
Occurrences of sickness absence within Public Health Wales are predominantly
episodes of between 1 and 3 days, suggesting significant opportunities to
manage short-term sickness more effectively, however the organisation also
has significant occurrences of long-term sickness absence between 29 days
and 6 months. Numbers of episodes beyond 6 months decrease significantly,
suggesting cases are being managed to a conclusion, or return to work occurs,
more often than not before the 6 month mark. This could be for a variety of
reasons, not least due to terms and conditions. The graph below shows this
data in some more detail.
Absence
Band
(Days)
0-1
2
3
4
5
6
7
8-14
15-21
22-28
29 Days-6
Months
6 Months12 Months
> 12
Months
# Absence
Occurrences
322
266
159
103
109
59
74
85
62
38
184
19
2
Public Health Wales would appear to be the trend across NHS Wales, with a
more significant issue with long-term sickness than short term sickness. The
long-term sickness rate within Public Health Wales is over double the shortterm sickness rate, as shown in the graph below.
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Actions Being Taken to Address
Public Health Wales has undertaken a number of actions in order to manage its
sickness absence. These include the following:




Accurate, Timely Workforce Information – significant progress has
been made in this regard. The organisation has been able to cleanse its
data, which has seen it move from 7th to 2nd in the NHS Wales league
tables for data quality, with significant gains also made in national
league tables. This is beginning to result in accurate reports for
managers and the Executive Team, which has enabled a greater
understanding of issues which need to be tackled specifically in relation
to sickness. Public Health Wales continues to have issues with the
recording of “reasons for absence” within ESR, previously not recorded
within Public Health Wales Again, significant progress has been made
to address this, but it remains the case that over half of absences are
recorded without a reason for absence.
Work is currently being
undertaken to pick this up directly with local managers via their HR
Business Partner, with a view to getting to a position where we are
aware in all cases of the reasons for absence. This will inevitably result
in better management of sickness absence, due to an increased
awareness of what the problem is;
Performance Structures – availability of accurate, timely workforce
information has enabled discussions around sickness absence to form
part of internal performance discussions with Directorates and Divisions.
It is anticipated that the attention being given to sickness in this way by
the Executive Team will have a positive impact upon the management
of sickness, and therefore sickness absence rates themselves;
Occupational Health – Public Health Wales is continuing to review its
SLAs with its OH providers to ensure value-for-money, and that the
right level of input is being received to enable it to manage its cases
effectively. Discussions are underway to undertake a formal review of
these arrangements in this context in the next couple of months, with a
view to arriving at an improved position. Historically, Public Health
Wales has received OH services from several different Health Boards,
with inconsistent levels of service;
HR Case Management Support – the HR Department continues to
take a proactive role in assisting managers to manage complex, long
term sickness cases in particular. Managers have access to training and
development, and expert advice in relation to how cases should be
handled, along with advice on the All Wales Sickness Absence Policy;
Leadership & Management Development – Public Health Wales is
currently in the process of rolling out its Leadership & Management
Development Programme; a comprehensive programme, the aim of
which is to provide managers with the knowledge, skills and confidence
to better manage their roles as leaders and managers within Public
Health Wales. The early parts of this programme have been very well
received, and it is anticipated that this will impact positively upon the
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
Director of Workforce and OD Report – May 2015
quality of leadership / management input within Public Health Wales
Alongside this, Public Health Wales is also developing a series of “how
to” guides for managers, one of which will be specifically focused
around managing sickness absence. This guide will be used to promote
good, proactive management of sickness absence, as well as Public
Health Wales health and well-being initiatives. Public Health Wales will
also be providing managers with a Sickness Absence Toolkit as part of
this work;
Wellbeing – Public Health Wales is undertaking significant work around
wellbeing, along the lines of five main strands of work. These are:- Developing an open supportive culture where staff can raise
issues and problems safe in the knowledge that they will be
supported and effective solutions implemented. This will be founded
on a partnership approach underpinned by clear expectations of
both employer and employee and the principle of fairness based on
equitable but not necessarily equal treatment and consistency but
not uniformity;
- Providing support to enable our staff to live healthy lives. This
means making available to our staff a range of services and support
networks equivalent to those that we promote externally and
through working collaboratively with staff, identify other initiatives
that are useful to them in supporting physical and mental wellbeing;
- Rethink how we support ill health and resulting absence from work
to enable staff to return to work and make a contribution in line with
their capability and where possible regain full health;
- Support balance between life in work and life outside work. When
people are at work they still have their other responsibilities and
worries, we recognise that we need to treat people as whole human
beings not just as employees and will continue to build our offer to
support people with childcare, eldercare, financial planning and
other issues so that they can fulfil their potential while at work;
- Giving something back – we will improve our approach to social
responsibility and seek ways to enable our staff to get involved with
wider environmental and social projects which have mutual benefit.
Further Actions to Remediate Current Position
The following further actions are being considered with a view to recovering
the current position of sickness absence increasing:



Sickness Audits – use of regular sickness audits to measure local
compliance with the All Wales Sickness Policy and Procedure in relation
to both long and short term sickness;
Further action on “reasons for sickness” to ensure greater compliance;
Sickness Management Panels to support hot spot areas and to develop
action plans to recover the sickness position;
Actions to improve employee engagement falling out of work between
Workforce & OD and Internal Comms around staff engagement;
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

Director of Workforce and OD Report – May 2015
Producing internal league-tables to promote the profile of sickness
absence rates within the organisation;
Review of current long-term sickness cases, with a view to ensuring
cases that can be moved on to the next stage are being, and that
opportunities for individuals to return to work in some capacity are
being maximised.
Reporting Reasons for Sickness
With current levels for sickness absence as they are, and with sickness being
considered a ministerial priority, it is of significant importance that actions are
taken to address the current situation.
Vital in this, is having a clear
understanding of the problem.
In order to understand the issues there needs to be a clear understanding of
why people are absent from work due to sickness. Public Health Wales is
currently the only NHS organisation within NHS Wales that is not routinely
recording this data. The table below shows reasons for sickness across the
organisation.
At the present time, over half of all sickness within the
organisation is reported as “Unknown causes / Not specified” or “Other known
causes – not elsewhere classified”, some 54.7% of absences are classified in
this way.
Absence Reason
FTE
Lost
%
S99 Unknown causes / Not specified
8,321.33
47.8
S10 Anxiety/stress/depression/other psychiatric
illnesses
2,137.36
12.3
S98 Other known causes – not elsewhere
classified
1,195.62
6.9
S25 Gastrointestinal problems
1,000.33
5.7
S12 Other musculoskeletal problems
888.64
5.1
S13 Cold, Cough, Flu – Influenza
811.99
4.7
S11 Back Problems
535.75
3.1
S28 Injury, fracture
379.71
2.2
S21 Ear, nose, throat (ENT)
339.21
1.9
S26 Genitourinary & gynaecological disorders
285.52
1.6
In October last year, the issue of increasing compliance with reporting reasons
for sickness was raised once again. Governance concerns were addressed to
the satisfaction of the Information Governance Group, and the Director of
Workforce & OD issued an instruction for managers to begin recording reasons
for sickness as a routine part of the management of sickness absence within
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their own areas. Significant progress has been made, however this needs to
continue.
Over recent weeks, the issues of information governance and confidentially
concerns have been raised again. Concerns would appear, predominantly, to
be around the following issues:-
Individuals’ information governance rights – what information will be
collected, and how it will be used;
How sensitive data will be stored / disposed of, and by whom it will be
seen;
The view that some sickness information is “too sensitive” to be
recorded;
What is in place to secure confidentiality where data might be recorded
in such a way as to indentify individuals.
All of these issues, without exception, have been previously addressed. Both
via discussions with Public Health Wales’ Information Governance lead, who
was satisfied, and also to the satisfaction of the Information Governance Group
itself, in October 2014. In order to allay concerns which would appear to
continue to exist, the following is proposed to address these concerns, but also
to confirm Public Health Wales’ approach to this issue:1. Executives to determine the organisation’s position on recording
reasons for sickness;
2. For this position to be communicated directly to managers within the
organisation;
3. A communiqué to be sent out explaining to staff why this information
needs to be recorded, and addressing concerns around data
governance;
4. The organisation will also need to determine, if it is decided that
reasons for sickness will be recorded, how this issue is performance
managed with managers and individual members of staff.
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Appendix 3
Professional
and
Organisational
achievements 2014-15
Development
team
The team arranged over 45 continuing professional development Events,
including:
 Office management skills (Chairing meetings, project management,
business and speed writing etc.)
 Professional development opportunities (British Sign Language and Deaf
Culture, motivational interviewing, Learning Needs Analysis and
Evaluation and appraisal)
 Service user skills (Engaging Seldom Heard Communities, Ethics, Results
Based Accountability, Social Determinants and Inequalities, Applying
Behavioural Insights and Health Impact Assessment)
The POD manager supported the event planning for the introduction of the new
Management and Leadership Development Programme, which saw nine
modules being offered including, Powerful Conversations, Personal Leadership,
Managing the Business, Developing People and Effective Relationships.
The team continues to support the promotion of improving compliance rates
and has delivered the following Statutory and Mandatory Training
Sessions:
 Fire safety (x23) and Fire warden (x11)
 Health and safety (x20) and Manual handling training (x17) Emergency
first aid in the workplace (x5), DSE Assessor (x6)
 Violence and Aggression Module B & C (x4)
 Equality and Diversity (x13)
 Safeguarding Level 2 (x9), Safeguarding level 3
 Information governance (x25)
 HealthWRAP (x16) and Counter fraud (x5)
 Customer Care (x5)
The ongoing Lead Officer Training programme (now in its thirteenth year)
saw three events:
 Best Guess or Strong Evidence? : The Use and Abuse of Epidemiological
Data
 Ebola event
 Giardia : A Parasitic Protozoan
A number of Consultations were undertaken throughout the year, including,
the new appraisal Process, Advanced Practice (Public Health), Work Based
Learning for Advanced Practice (Public Health) and the Public Health Skills and
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Knowledge Framework Review. In addition, a number of papers and guides
were produced and shared, including, E learning trouble shooting guidance and
E-Learning Overview, revalidation of Public Health Practitioners, core Induction
Programme, Work Experience Task and Finish Group and the Safeguarding
Training Strategy.
Scoping work has also been completed on a new corporate induction, student
work experience and placements and a proposal to develop IT skills across the
organisation, as well as engagement activities to measure the compliance and
quality of appraisals.
The Public Health Practitioner Support Programme continues to grow with
23 new practitioners recruited to the scheme 2015-16. A series of projects /
programmes were facilitated in support of the scheme, including, two
introduction portfolio development days, three commentary writing workshops
and three Learning sets, verification panels, Assessor and Verifier refresher
training and more formal UKPHR Assessor training and a new contract let for
the provision of learning set facilitator (three years).
The team have produced a separate review of the High Cost training
application process 2014-15, which received 29 applications.
The team have supported a number of development sessions throughout the
year with the Head of POD supporting the following external events:
Team
Welsh
Government
workforce Conference
Event
National Sickness absence review
October 2014
Consultation on Advanced Practice Scotland
Conference
October 2014
CIEH National Conference
Nottingham
October 2014
Facilitated Expert Advisory Group Cardiff
Review
November 2014
People
in
UK
Public
presentation on Wales
UKPHR Consultative Forum
Health August 2014
Birmingham April 2014
October 2014
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Aneurin Bevan Local Public Health Development Sessions
Team
Contributions on groups 2014-15
The team support a number of working groups, committees and interest
groups, which include:
UK








National Public Health Practitioner Scheme Coordinators Group
(Professional Development Manager)
People in UK Public Health (Head of POD)
Public Health England Workforce Development Group (Head of POD)
UK Public Health Skills and Knowledge Framework Steering Group (Head
of POD)
PHORCaST Project Board (Head of POD)
UK Public Health Register and respective working groups (including
training and education, risk and audit, practitioner development,
European standards et al.) (Head of POD)
Department of Health Minimum Dataset (Head of POD)
Faculty of Public Health Membership Review Group (Head of POD)
Wales
 Environmental Incidents Management Training Steering Group
(Professional Development Manager)
 Lead Officers in Communicable Disease Training Steering Group
(Professional Development Manager)
 Assistant Directors of OD (Head of POD)
 NHS Strategic Workforce Planning Group (Head of POD)
 NHS Wales Careers advisory group (Head of POD)
 IQT Steering Group (Learning and Development Practitioner)
 NHS Wales Strategic OLM Group (Learning and Development Manager)
 NHS Wales Operational OLM Group (Learning and Development
Practitioner)
 NHS Wales Learning & Development Managers Group (learning and
Development Manager)
 NHS Wales Operational Group for the Development of HCSWs (Learning
and Development Manager on behalf of Head of POD)
 Chairing NHS Wales Health and Wellbeing Project Team (Head of POD)
 NHS Wales Health and Wellbeing Steering Group (Head of POD)
 NHS Wales Working Longer Review Group (Head of POD)
 Welsh Government Health Professional Education Investment Review
(Head of POD)
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Public Health Wales
 Making Every Contact Count (Head of POD and Professional Development
Manager)
 Nurse Revalidation (Head of POD)
 Revalidation of Public Health Specialists (Head of POD)
 Senior Operational Management meeting (Head of POD)
 Strategic Development Group (Head of POD)
 Safeguarding Group (Learning and Development Manager)
 Equality Group (Learning and Development Manager)
There were a number of challenges encountered through the year, not least in
relation to staff resources, including maternity leave of POD Manager
(professional development) April – September 2014 and the lack of
administrative support as one recruit failed to start and the second left quickly
for personal reasons.
The biggest challenge to the team was the lack of dedicated financial resources
or internal learning and development which were partly overcome by utilising
the professional development budget to fund internal learning and
development, at the cost of delays to planned professional development
projects.
The team continues to work with challenges to reporting of statutory and
mandatory training compliance (ESR rollout and data accuracy, ESR-Moodle
updates) and the team have had to dedicate their 0.6 administrator to purely
maintain the statutory and mandatory database and booking sessions.
The lack of engagement in the Strategic Development Group has meant
challenges in reviewing and approving the high-cost applications and
development of a robust learning and development strategy.
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