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Meeting Title
Mid and South Essex Acute Trusts Joint Working Board (meeting in public)
Meeting Date 6th June 2108 Agenda No 11
Report Title
Nursing and Midwifery Retention Strategy and Action Plan
Lead Executive Director
Diane Sarkar – Chief Nursing Officer
Report Author
Diane Sarkar – Chief Nursing Officer
Action Required
Decision □ Discussion □ Monitoring □ (please tick)
Background / Context The purpose of these two documents is to provide a dynamic Nursing
& Midwifery retention strategy that compliments the Mid Essex, Southend & Basildon people and organisational development strategies and aligns with the group corporate values, vision and objectives including the recruitment strategy.
The overall strategic objectives are to improve the retention of Nursing & Midwifery staff supported by the following:
Reduce the Trust reliance on bank and agency staffing
Improve overall job satisfaction
Establish a robust recruitment & retention governance
framework
To become an Employer of Choice
To create a modern, flexible
High performing staff become the norm for the MSB group
The above is underpinned by five strategic principles that will drive forward a modern, flexible, innovative workforce that is able to meet the service needs of our population both now and in the future.
1 Culture, Values and Engagement
2 Career Pathways
3 Education and Development
4 Innovation & Transformation
5 Leadership/Succession Planning/Talent Management
The strategy has been developed by a number of focus groups with
nursing and midwifery staff, Matrons, Heads of Nursing, Deputy
Directors of Nursing, Directors of Nursing, HR Leads and some
external support including NHSI.
The strategy document is supported by key performance indicators
and quality metrics that will need to be aggregated at ward level to
establish the trajectories.
The action plan has been populated utilising the five strategic
principles and have designated leads to support delivery, these are
also in alignment with the nursing and midwifery strategy.
It is also important to note the work from the NHSI retention action
plans, which have been reviewed collaboratively with NHSI, will
continue as will local site based actions. A substantial number of
pieces of work have already been completed (appendix 3) and many
more are already in progress.
Given the history and track record of delivery of improvement in
retention rates, the scale and pace of this challenge is significant. In
order to ensure compliance with delivery of the action plan,
governance and monitoring arrangements have been established but
will need to have some additional support of a PMO structure, a band
8A and a band 3 admin.
There is overwhelming enthusiasm by staff to support all initiatives, innovations and developments to ensure a sustainable nursing and midwifery workforce both in the short and longer term.
Key Issue 1 The workforce challenge has transposed locally with currently 730 (March 2018) Nursing & Midwifery vacancies across the group with a 16.66% turnover in the last twelve months. On top of this approximately 13% of the nursing workforce is eligible to retire now with a further 36% in five years’ time. If this was to happen together with the MSB group turnover KPI of 9.5%, this would equate to approximately 1596 staff leavers.
Timescale for Benefits to be Realised
September 2018
Assessment of Implications
Financial Does this proposal have revenue (recurrent or non-recurrent) implications for the Trusts? Not currently
Risk
Inadequate oversight of strategic risks and lack of consistency and standardisation increases the overall risks collectively and demonstrates poor governance arrangements.
Freedom of Information
No exemptions apply (i.e., information is in the public domain) OR The following exemption(s) apply to this paper :
Other Implications Identified
Regulatory impact may be evident
Recommendation The Joint Working Board are invited to: Approve the strategy and supporting action plan
1
Mid Essex, Southend and Basildon Hospitals
Nursing and Midwifery
Retention Strategy and Plan
Following the Path to Professional Excellence
May 2018
Diane Sarkar, Chief Nursing Officer
Tracey Collins Associate Director of Nursing Workforce
Torbay & South Devon NHS Foundation Trust
Final version 30/05/18
2
Table of Contents 1.0 Introduction ...................................................................................................................................... 3
1.1 The MSB Group Values..................................................................................................................... 3
1.2 The MSB Group Vision/Objectives .................................................................................................... 4
1.3 Vision ................................................................................................................................................. 4
1.4 Local and National Context ............................................................................................................... 5
2.0 Workforce Data ................................................................................................................................. 6
3.0 Strategic Retention Objectives ......................................................................................................... 7
3.1 Strategic Recruitment & Retention Objectives ................................................................................. 8
4.0 Strategic Principles ............................................................................................................................ 9
5.0 Key Performance Indicators (KPI’s) ................................................................................................... 9
5.1Quality Metrics: ............................................................................................................................... 10
6.0 Strategic Principle: .......................................................................................................................... 10
6.1 Culture, Values, Engagement .......................................................................................................... 10
7.0 Career Pathways ............................................................................................................................. 10
7.1 Promote Flexible Careers ................................................................................................................ 11
7.2 Promote Flexible Working .............................................................................................................. 11
8.0 Education & Development ............................................................................................................. 11
9.0 Innovation & Transformation ........................................................................................................ 12
10.0 Leadership & Succession Planning ................................................................................................ 12
11.0 Governance and Monitoring ......................................................................................................... 13
12.0 Recommendations ........................................................................................................................ 13
13.0 Links to Key documents………………………………………………………………………………………………………… 14
Appendix 1: Associated Strategies ........................................................................................................ 15
Appendix 2: The Nursing and Midwifery Vision .................................................................................... 15
Appendix 3: Completed NHSI three month actions .............................................................................. 15
Appendix 4 : Governance arrangements .............................................................................................. 15
..................................................................................................................................................................
..................................................................................................................................................................
3
1.0 Introduction
The NHS is going through unprecedented change at pace and scale that’s never been seen
before. In order to ensure we have a sustainable workforce that is fit for the future, it’s
imperative robust workforce planning is undertaken to identify the gaps both now and over
the next five years along with determining key priorities to ensure success and sustainability
to deliver a first class Healthcare service across the Essex STP.
With an ageing workforce, competitive market and demographic challenges, providing safe,
high quality compassionate care depends upon recruiting and retaining the right people with
the right skills. Values based recruitment helps to attract staff with personal values and
attributes aligned to those of the NHS Constitution which contributes to a reduction in staff
turnover. “Ensuring staff are recruited with the right values and right fit for the organisation
creates a positive work environment, boosts morale and enables staff to feel more valued ”
(NHS Employers, 2018).
This document will provide a dynamic Nursing & Midwifery retention strategy that
compliments the Mid Essex, Southend & Basildon (MSB) group People and OD strategy,
and aligns with the group corporate values, vision and objectives shown below and in the
word cloud. It is also essential that there is alignment with the following strategies (Appendix
1):
People and Organisational Development
Staff Culture and Engagement
Recruitment Strategy
Health and Well Being
Education
Nursing and Midwifery
Talent and Leadership
Quality Improvement
It is underpinned by five strategic principles that will drive forward a modern, flexible,
innovative workforce that is able to meet the service needs of our population both now and in
the future.
4
1.1 The MSB Group Values
1.2 The MSB Group Vision/Objectives
1.3 Vision
The Strategy provides a framework for delivering the nursing and midwifery vision statement in Appendix 1 which gives direction and focus and helps provide inspiration for marketing, recruitment and retention of our nursing and midwifery staff which will ultimately have a positive impact on other staff as well as improving patient care. This plan will also provide a structure for progression and development for nurses and midwives in their clinical, professional and personal growth. It is recognised that we cannot rely on traditional models of care to deliver NHS changes as outlined in the 5 year forward view. Therefore this is the time to be bold to support of the future nursing and midwifery workforce with new ways of working through new roles to support new models of care.
5
1.4 Local and National Context
The MSB group consists of three district general hospitals: Basildon & Thurrock, Southend
and Mid Essex employing over 14,000 staff and serving a population of approximately 1.2
million across Mid and South Essex and the surrounding counties. These consist of five
Clinical Commissioning Groups (CCG), three local Authorities, Mental Health and
Community providers.
The group is also part of the Essex Sustainability and Transformation Partnership (STP)
redesigning clinical and corporate services across mid and south Essex to ensure the best
possible outcomes are delivered to the rising number of people needing our services.
Recent analysis by the Nuffield Trust (2017) showed the national Registered Nursing
vacancies being as high as 42,000 with recent figures published by the NMC (2018) showing
more nurses leaving the register than joining. In January 2018, NHS Digital reported 33,000
Nurses and Health Visitors left the NHS within the year equating to 10% of the profession.
(3,000 more than what joined).
The profession also has an ageing workforce with half of Nurses and Midwives being older
than 45 and 13.6% between the ages of 55 and 64 and therefore eligible to retire. Coupled
with this, the numbers of applicants for Nursing & Midwifery degree programmes have also
dropped by 23% since the removal of the education bursary. Less than 60% of nurse training
places commissioned in 2016 (8000 of 14,417) are expected to result in a student entering
the NHS workforce on qualification
Evidence shows the main reasons staff leave is due to poor career opportunities and
development, lack of engagement, staffing levels and pressures of the job and not enough
time to care, poor line management, feeling unsupported particularly in the early years after
qualifying, lack of flexibility and poor work life balance.
According to NHSI (2017) quarterly NHS performance figures, this workforce challenge has
subsequently led to the NHS spending £2.9 billion on agency staff. Locally the increased
reliance on bank and agency staff has contributed to a group overspend of approximately
£44m with £26.4m being on agency nursing alone.
The workforce challenge has transposed locally with currently 730 (March 2018) Nursing &
Midwifery vacancies across the group with a 16.66% turnover in the last twelve months. On
top of this approximately 13% of the nursing workforce is eligible to retire now with a further
36% in five years’ time. If this was to happen together with the MSB group turnover KPI of
9.5%, this would equate to approximately 1596 staff leavers (More than the budgeted
nursing establishment of both Basildon and Mid Essex hospitals).
The geography of all three trusts poses individual challenges with students travelling from
East London to study in Essex prefer the easier commute to Basildon or Mid Essex and
those who live in London return to London to take up employment. Disparity between pay
arrangements across the three sites and the high cost living allowance paid for Basildon staff
6
imposes a further local pressure that may influence the retention rates and leads to
competition between each site.
In January 2018, the MSB group formed part of the NHSI retention cohort to work in
collaboration to increase nurse recruitment & retention. A site specific action plan together
with an overarching three month action plan was submitted to NHSI with a number of actions
which have subsequently been completed. These are listed in Appendix 3.
2.0 Workforce Data
Approximate Registered Nursing & Midwifery Vacancies, Age Profile & Turnover (March 2018)
Trust Budgeted FTE Actual FTE Vacant FTE Variance %
BTUH 1,569.75 1,320.99 248.76 15.85%
MEHT 1,542.80 1,223.96 318.84 20.67%
SUH 1,268.53 1,106.04 162.49 12.81%
Total 4,381.08 3,650.99 730.09 16.66%
Trust FTE Leavers FTE LTR FTE %
BTUH 1,330.53 158.62 11.92%
MEHT 1,206.56 225.10 18.66%
SUH 1,099.57 148.64 13.52%
Total 3,636.66 532.36 14.64%
AGE PROFILE
BTUH MEHT SUH MSB
GROUP
Up to 20 0 0 1 1
20 – 25 86 138 58 282
26 - 30 208 246 158 612
31 - 35 252 187 132 571
36 - 40 203 169 164 536
41 – 45 249 168 213 630
46 - 50 175 145 158 478
51 - 55 145 173 150 468
56 - 60 96 108 139 343
61 - 65 37 38 65 140
Over 65 9 6 14 29
Grand Total 1460.00 1378.00 1252 4090.00
WTE 1321.99 1200.08 1086.45 3608.52
Retirement Data
Retiree's Eligible: Now
142 152 218 13%
Retiree's Eligible: in 5 Years
462 470 526 36%
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3.0 Strategic Retention Objectives
To improve the overall retention of Nursing & Midwifery staff through the underpinning strategic principles shown below, excellent working conditions and the quality of staff’s working experience supported by their personal development and contribution to patient care.
Reduce the Trust reliance on bank and agency staffing, thus reducing overall
workforce costs and ensuring the provision of consistent high quality care
Improve overall job satisfaction through flexible working, regular Listening into
Action (LiA) and staff engagement opportunities
Establish a robust recruitment & retention governance framework by creating a
Nursing & Midwifery Workforce Programme Board & performance dashboard. The
Group recruitment committees’ action plans relating to nursing and midwifery will be
reported and monitored at the programme board.
To become an Employer of Choice through reinvigorating the MSB brand and
marketing strategy, identifying the group USP to create a positive image both locally,
nationally & internationally
To create a modern, flexible workforce with the right skills at the right time that is
able to meet the needs of the population and the future care model within the STP
through robust career pathways, including rotational posts, education and
development opportunities
High performing staff become the norm for the MSB group and working life is
rewarding and are committed to delivering the clinical and professional vision through
embedding a culture of collaboration, engagement, and recognition of its staff
8
3.1 Strategic Recruitment & Retention Objectives
The diagram below interlinks both the strategic recruitment and retention objectives to ensure both are aligned to deliver a sustainable flexible modern workforce for the future.
9
4.0 Strategic Principles
The strategy is underpinned by five key principles identified below:
1 Culture, Values and Engagement
2 Career Pathways
3 Education and Development
4 Innovation & Transformation
5 Leadership/Succession Planning/Talent Management
5.0 Key Performance Indicators (KPI’s)
The strategy will be measured by the following KPI’s & Quality Metrics which also are reflected in the recruitment plan:
Increase retention rate by 2.5% - annual
Reduce Turnover to 9.0% over 5 years (1 – 1.5% annual)
Reduce Vacancy gap by 5.0% - annual
Reduce Sickness Absence levels by 1%
Improve exit interview response rate by 20% of base rate measure
Increase Staff Survey engagement scores in line with peer trusts to 3.81.
To be GOOD for CQC well led
To increase retire & return by 10%
10
5.1 Quality Metrics:
Reduce patient complaints
Reduce patient falls, Pressure Ulcers, Medication Errors
Red flags in line with NQB recommendations
Ward Accreditation performance
6.0 Strategic Principle:
6.1 Culture, Values, Engagement
“Developing organisational values and creating a positive workplace culture improves
patient outcomes and staff retention (NHS Employers, 2017). National evidence has shown
that putting efforts into embedding a culture of transformational change helps to focus on
what’s important to patients and staff. Creating values that staff relate to and which they can
apply on a daily basis, will help to build an organisational culture that staff enjoy being part
of.
Together we will deliver Excellent, High Quality Compassionate Care and ensure our
organisation lives its core values and beliefs in line with the NHS Constitution. Together we
will:
Develop a collaborative culture where staff feel valued and can live the vision, values
& beliefs of the organisation
Act upon what we say
Understand the MSB culture, demographics and population needs to ensure the right
staff are the right fit for the group
Ensure alignment with the recruitment strategy to undertake values based
recruitment from the start
Lead by Example
Create an MSB brand and become and exemplar Trust where staff are proud to work
Ensure poor performance & behaviours are managed accordingly
Ensure our staff have a healthy work life balance
Hold to account
7.0 Career Pathways
We are committed to support our Nursing & Midwifery students and staff to grow and reach
their full potential along with being an employer of choice to our students from local schools
& colleges. With the lack of career opportunities and development being one of the key
themes staff leave, the MSB group will embed pathways and opportunities across all roles
including the development of Assistant Practitioner and Nursing Associate roles through the
Apprenticeship route.
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7.1 Promote Flexible Careers With the demands of today’s modern life, it is imperative the NHS balances service needs
and creates a work life balance for its staff which is key in retaining a skilled & experienced
workforce. This can be done in a variety of ways locally, across the group and STP
including:
Rotational programmes
Promoting “Windows of opportunities” enabling staff to express interest prior to
external adverts
Internal Transfer Schemes
Secondments including across the STP
Acting up/Shadowing opportunities
Role Redesign/Pushing Professional Boundaries
Retire & Return opportunities
Step Down to a different Role
Clinical Excellence Fellowships
7.2 Promote Flexible Working
A key way to demonstrate commitment to improving staff experience and promoting a work
life balance is through flexible working. This may include:
Part time contracts
Job Shares
Annualised Hours
Compressed hours
Shift Redesign
Career breaks
Implementing Allocate Healthroster to reduce cost, variation & increase efficiency to release time to care
8.0 Education & Development
Having a skilled flexible workforce that is sustainable and fit for the future is paramount to
meet the needs of patients, service users and to be able to embrace new ways of working.
Having the right skills in the right place at the right time is fundamental in delivering safe
quality care whilst enabling staff to develop and flourish throughout their career pathway.
With the workforce challenges, removal of the Student Nurse Bursary and the reduction in
student nurse applications, reviewing establishments and skill mix is imperative in designing
new roles and pushing professional boundaries. Replacing “like for like” is no longer an
option and ensuring a sound education and development framework is in place to meet the
needs of the future workforce is essential.
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This will be achieved by:
Undertaking an establishment and skill mix review to identify needs and gaps
Producing an appraisal process to ensure meaningful conversations which influence
the individual development pathway and potential talent management opportunities
Creating a career/education framework to enable healthcare assistants, assistant
practitioners, nursing associates, nurses & midwives to develop and transition
through their careers and meet service needs
Protecting the Education budget and required study time out of practice to enable
staff to develop
Designing new roles and having the confidence to challenge the status quo to push
professional boundaries ensuring a fit for purpose workforce that can deliver care
that supports clinical redesign
An early years support and mentorship programme is in place for our newly qualified
nurses
9.0 Innovation & Transformation
“Your most important assets are your employees, take care of your employees; they will take care of your clients. “Employees will stay when they are: Paid well, Mentored, Challenged, Promoted, Involved, Appreciated, Valued, On a Mission, Empowered and Trusted.” (Vishnepolsky, 2018) Recognising the need for staff to shine and feel empowered to make a difference, the MSB group will:
Create space and time for staff to innovate and bring ideas to fruition
Give permission to “Get on & do it.”
Support staff to undertake improvement projects within their clinical areas
Empower staff to make decision and influence change
Allow staff to learn from mistakes by a collaborative approach
Support & encourage those “On a mission” to explore avenues, undertake tests of change and lead on projects they are most interested in
Adopt a tested model of change
Using Appreciative Inquiry as a new model for staff engagement and innovation
10.0 Leadership & Succession Planning
The MSB group recognises the need to retain much needed skills and experience and leadership and succession planning is essential to ensure a sustainable healthcare provision for the future. Developing compassionate, inclusive leadership qualities, improvement leadership skills and system leadership strengths as well as the specific management skills is a priority for today and tomorrow. “Compassionate and inclusive leadership creates an environment where there is no bullying and where learning and quality improvement becomes the norm.” “Continuous improvement depends when staff feels safe and empowered to apply improvement methods where leaders act with compassion, staff feel valued, engaged and enabled to show compassion themselves. They feel obliged to speak up when something is wrong and empowered to continuously improve.” (NHSI, 2018).
13
The MSB group will:
Ensure the MSB vision and values are translated into daily life by understanding
Ensure Board visibility at all levels Refresh the senior leadership team uniform /dress code policy to lead by example and promote Nursing & Midwifery
Enable leaders to develop their own and their staff skills, behaviours & capabilities to make continuous improvements
Work collaboratively with local leadership academies to enable staff in leadership roles to develop skills and capabilities to succeed
Create a Leadership and Management Framework to manage talent across all levels including form newly qualified nurses through to aspiring directors
11.0 Governance and Monitoring
Assurance and delivery of the strategy will be through the formation of a Nursing & Midwifery recruitment and retention programme board (NMRPB). The board will report directly into the overarching Workforce & OD group and subsequently to the MSB Joint Working Group (JWB). The NMRPB will consist of five work streams aligned to each strategic principle which will be overseen by an accountable officer. The Director of Nursing group will feed into the NMRPB and provide exception reports for each work stream supported by the programme management office. The board will meet six weekly prior to the Workforce & OD group and will produce an exception report on the delivery of each work stream
12.0 Recommendations Based on the local ESR data & local/national evidence produced by NHSI, Staff Survey and NHS Employers the key recommendations to improve staff retention are to:
Data cleanse to ensure full accuracy of figures ( one MSB workforce planning team)
Prioritise the focus on staff eligible for retirement both now and in 5 year’s time
Review Nursing establishment and skill mix to inform an education framework and role redesign
Review leadership behaviours and capabilities from board to ward
Refresh staff engagement sessions to re brand the MSB group and review vision, values and core beliefs
Reduce agency spend and remove unqualified agency.
Implement check and challenge processes to reduce agency & temporary staffing overspend
Review the continuous improvement strategy to ensure staff and patients are the drivers
Align with the recruitment strategy to get it right first time
Review rostering processes and efficiencies through the new Allocate Health roster/Safe care system
Establish the Nursing & Workforce Program Board to monitor KPI’s and report to the Workforce Subcommittee of JWB.
Recruit 1 wte band 8 to oversee the delivery of the retention strategy and action plan
PMO support for monitoring of the strategy
14
13.0 Links to key documents: Nurse Retention Best Practice Guide AUKUH Deputy Directors of Nursing Group
NHS Employers 2018 Guys & St Thomas’ NHS Foundation Trust Career progression toolkit
Northern Devon NHS Healthcare Trust Recruitment & Retention Strategy 2015-2018
NHS Employers Improving Staff Retention- A guide for Employers
MSB Integrated Performance Report 2018
Southend NHSI nursing retention programme proposal 2018
MSB group 3 month NHSI action plans
NHSI Retaining your clinical staff a practical improvement resource
NHSI staff retention: supporting staff in their career pathway
NHSI staff retention: using staff insight to retain staff
NHSI staff retention: staff engagamenet & benefits
Institute of Helathcare Management the Joy of work framework
Vishnepolsky, 2018 LinkedIn Employers stay when they are:
The IHI Joy in Work Framework 2018
15
Appendix 1: Associated Strategies
Appendix 2: The Nursing & Midwifery Vision
Our ambition is:
To be a dynamic and inspirational workforce.
To proactively support professional development, to enable staff to work at the top of their skill set.
For nurses and midwives to maximise opportunities to be innovative in practice.
For nurses and midwives to develop their scope of practice to exceed the changing needs and expectations of patients and their profession.
That nurses and midwives feel nurtured in a supportive, well led, professional environment.
That all nurses and midwives enjoy their work, flourish in their roles and are proud to work in our hospitals.
Strategic Objectives
NHSI
NHSE People and OD
Strategy
LWAB
Staff Culture &
Engagement
Strategy
Nurse and
Midwifery
Retention
Strategy
Workforce
Recruitment
Strategy
Health and
Wellbeing
Strategy
Education
Strategy
Quality
Improvement
Strategy
Nursing and
Midwifery
Strategy
Talent and
Leadership
Strategy
16
Appendix 3
Completed NHSI three month actions: 1. Group establish across MSB to review retention 2. Meeting with NHSi 3. Each site has developed a local recruitment and retention action plan with
local governance structure 4. Ward diagnostics on 2 wards per site carried out 5. CNO meets with students and AHPs quarterly on each site 6. Established foundation programme on each site 7. HoN have once a fortnight drop in sessions 8. Celebrated Nurses Day 9. Study days 10. Recruitment events both individually and collective 11. Focus groups 12. Exit interviews (although not consistent) 13. Nursing and Midwifery Conference 14. Joint working with local HEI 15. Card developed to capture nursing and midwifery staff’s views of what makes
them proud and want to stay in their trust. 16. Nursing and Midwifery newsletter 17. Nursing and Midwifery vision established 18. Nursing and Midwifery strategy group developed 19. Group DoN, HoN, Matrons, CNS and Senior Sister meetings established to
share best practice 20. Development and implementation of band 5, 6 and 7 competencies 21. Consistent induction package has been developed but hjas yet to be finalised
and implemented 22. Career MOT has been developed and is on the intranet on each site 23. Career pathway ona page, Bands 2 – Band 8 in draft format for final sign off
week comencing 18th June 2018 24. “Retire and Return” policy developed to be implemented across all three sites
17
Appendix 4.
Nursing & Midwifery Recruitment & Retention Programme Board Governance Structure
Contents 1. Culture Values and Engagement2. Career Pathways3. Education and Development4.Innovation and Transformation5. Leadership and Succession Planning
Final version 300518
9 - 12 Months
MSB Nursing & Midwifery Retention Action Plan
KEY Timescales0 - 3 Months3 - 6 Months6 - 9 Months
Strategic Principle
Accountable Lead
Objective Actions Nominated Lead Timescale Monitoring/ Assurance RAG Rating
Undertake Cultural Barometer Test across all clinical areas POD Team 3 Months Hotspot areas identified
Analyse Data and create action plan to support “hot spot” areas POD Team 3 Months Action plan/ward support programme
in place
Monthly ward based “Weather Watch” engagement sessions & evaluate feedback
DoN/CNO 3 MonthsWeather Watch sessions in place. Theme's & trends identified. Action plans in place. Feedback to staff
Utilise the IHM “ Joy” at work framework in staff engagement sessions
DoN/CNO 6 MonthsFramework published and utilised in engagement sessions and Stay Interviews
Use Appreciative Inquiry Model as part of staff engegament DoN/CNO 6 Months
Appreciative inquiry questions incorporated into staff surveys and published
Involve staff in “What does Good Look Like.” CNO 3 Months Staff feedback Improves. Staff
Engagement sessions well attended.
Identify Quick Wins Create “ You said we did” poster boards DoN/CNO 3 Months Feedback poster boards
updated/Comms strategy in place
Develop real time confidential 'Just Ask' online forum with Executive Directors to provide response
Comms/Responses form relevant Executive 6 Months Online forum in place/Responses
posted online
Involve staff in creation of MSB group values and logo JEG 12 Months New Organisational Values & Logo
published
Promote role of 'Freedom to speak' guardians HR/Comms 3 Months
Freedom to speak guardian reports to board, contact details published on MSB Intranet
JEG (Joint Executive Group) Lead CNO - Diane Sarkar
Culture, Values & Engagement
To understand the current cultural climate
To enhance staff engagement
Review/Appraisal/Achievement Review to incorporate “Stay” interviews HR 6 Months
Increase Achievement review KPI. Theme's & trends analysis of Stay interviews
Set up Social Media training sessions for Chief Nurse/DON’s/Senior Nurses
Comms/Senior Leadership Team 3 Months Increased Twitter use from Senior
Nurses
Set up a “ Day in the life” blog& “Proud to Care” promotion video for staff newsletter/promotion
Ward Managers/HoN/Comms 6 Months
Video blogs on Intranet/MSB Website. Staff Newsletter published weekly
Arrange 6 Monthly celebration of success awards ceremony Comms/DoN/CN 6 Months 6 Monthly awards ceremonies. Local
media publications
Develop annual “Pride of MSB” nomination award JEG 12 Months Annual Award ceremony in place
Refresh & Rebrand Marketing Material for the MSB group Comms/marketing team 6 Months Refreshed brand/materials
Standardise and professionalise recruitment campaign & MSB group material
Comms/Marketing 3 Months New material being used/ banners/Booklets
Improve the quality of materials produced to include career pathway booklets and literature
Comms/Marketing 3 Months Refreshed Materials/Feedback
Revamp the MSB website and working for us campaigns Comms/Marketing 3 Months Increased Website hits
Incorporate addressing performance issues into Ward Manager training Matrons/HoN/HR 3 Months
Increased Ward Manager leadership and confidence. Sickness absence reducing. Morale & perform and in ward patient safety metrics. Recruitment & retention improvement
Review Staff Survey results on Bullying & Harassment HR 6 Months Staff Survey results improved
To promote the MSB group as the Employer of
Choice
To enable Senior Nurses to address poor
performance and behaviours
Review Zero Tolerance Policy/terminology HR 6 Months Staff Survey Feedback
Promote staff counselling/occupational health services
Comms/HR/Occupational Health 3 Months
Counselling service accessible/Sickness absence levels improve
Explore opportunity to provide Mindfulness/Yoga/Indian Head Massage/Reflexology sessions for staff
Occupational Health/Health & Wellbeing team 6 Months
Staff wellbeing relaxation sessions offered. Staff take up and feedback. Sickness absence Rate improve
Review staff benefits scheme such as Gym membership, Child Care, Cycle to work scheme, Car scheme E.G Tusker, Electronic devices scheme for PC’s IPhones, IPAD’s etc
Health & Wellbeing/Procurement 6 Months Staff benefits scheme in place and
well published
Engage with local Housing Schemes to identify rental opportunities. I.E one month’s accommodation paid for staff
Procurement 6 Months Accommodation availability improved
Agree Terms of Reference and Membership of the group. Board to report into the MSB group Workforce & OD committee, (sub committee of JWB)
Chief Nurse 3 Months Programme Board in place
Workstreams to feed into the programme board to include: Culture, Values & Engagement, Career Pathways, Education & Development, Innovation & Transformation, Leadership & Succession Planning
DoN's/POD/Chief Nurse 3 Months6 weekly meetings in place, ToR agreed/Exception reporting in place/Minutes of meeting
To meet Monthly, Chaired by Chief Nurse/DoN Chief Nurse 3 Months Dates set across the year
Ensure the group promotes equality of opportunities and values diversity HR 3 Months E&D policy reviewed/WRES action
plan in place
To develop a Nursing Workforce Recruitment & Retention Program Board
To ensure the Health & Well-being of staff is
prioritised
Implement agency and temporary staffing check & challenge to control overspend and temporary staff use
HoN/DoN 3 Months
Weekly Check & Challenge meetings in place. Authorisation of temporary staffing through HoN/DDON. Thornbury use authorisation from Executive on call only
Create further develop authorisation process for agency use HoN/DoN 3 Months
Agency authorisation process reviewed. Flowchart published. Review staff enhanced payments
Implement HCA/Unqualified nurse agency ban HoN/DoN 3 Months No agency use for HCA
Strategic Principle
Accountable Lead
Objective Actions Nominated Lead Timescale Monitoring/ Assurance RAG Rating
Develop a Career Progression Map & Toolkit (ref GSTT)
POD Team/DDoN 6 Months
Visual career Map in place. Career guidance published and toolkit devised
Create Visual picture career map & question guide for staff. POD Team/DDoN 6 Months
Visual career Map in place. Career guidance published and toolkit devised
Develop Career Coaching Training for senior staff POD Team 6 Months
Coaching programme in place. Staff attendance
Provide Career coaching sessions for all newly qualified Nurses & Midwives POD Team 6 Months
Session in place. Improved Staff feedback/Retention rates
Provide on line career MOT advice and career advice email address POD Team
3 months 3 months
To be piloted for 3 months - number of requests to be monitored
Set up fortnightly Career Drop in sessions HoN/DDoN 3 Months
Date in place for the year
Create Talent Pool Register Develop Internal Transfer Guidelines/Protocol
HoN/DDoN 3 MonthsRegister in place. Skills & competencies identified. Staff redeployment numbers
Develop clear visible Apprenticeship pathway from band 2 - band 8 to also incorporate Specialist foundation degree pathway POD Team 6 Months
Visible pathway identified and published
Establish a clear understanding of the role of the Assistant Practitioner/Nursing Associate & Technician roles fit within the skill mix HoN/DDoN/DoN/CN 6 Months
Roles identified and skill mix reviewed
Career Pathways
Wendy Matthews (Director of Nursing)
Enable Career Progression for
Nurses & Midwives
Develop Pre retirement programme and flexible career opportunities
HR/POD Team 3 MonthsOpportunities and flexible working identified
Identify staff eligible to retire and invite to pre retirement sessions
Workforce Planning/DDoN 3 Months
Pre Retirement sessions in place. Attendance monitored. Retention rates identified
Promote senior nurse mentorship programme support/pastoral ward support opportunities POD Team 3 Months
Monitor Senior Mentorship numbers/Feedback/Retention rates
Collate flexible working requirements opportunity discussions HR/HoN 6 Months
Flexible roles identified. Skills and competencies mapped
Expand Nurse Alumni scheme across the group to include leavers, retirees, closed Facebook group Comms/POD 6 Months
Alumni set up. Letters posted to all group and recent leavers. Monitor response rates/engagement on FB
Design the Rotation Nurse programs to incorporate MSB group and the wider STP. DoNs 6 Months
Rotation programme implemented. Staff feedback/Recruitment & Retention rates
Create General rotation to include, Medicine, Surgery and Community setting DoNs 6 Months
Rotation programme implemented. Staff feedback/Recruitment & Retention rates
Create Specialist Rotation to Include Burns ITU, General ITU ( Inc Paeds) & Cardio Thoracic ITU DoNs 3 Months
Rotation programme implemented. Staff feedback/Recruitment & Retention rates
Create Emergency Rotation Program to Include A&E, MIU, Theatres, CCU
DoNs 6 MonthsRotation programme implemented. Staff feedback/Recruitment & Retention rates
Develop the band 5 Chief Nurse Excellence in Care junior Fellowship Initiative Chief Nurse/DoN/POD 6 Months
Fellowship program advertised and in place. Staff Feedback
Enhance Partnerships with local Schools, Colleges & Universities
CNO/POD 6 MonthsImproved working relationship/ Recruitment from colleges/Universities
Develop Salary advance/staff loan to enable staff to access modules/courses Finance 3 Months
Loan facility in place. Monitor staff take up
To enhance partnership working
Improve Engagement with staff eligible to
retire over the next 5 years and staff
leavers
To create robust rotation programmes
Review Study Leave Policy to ensure fair & equitable process HR 3 Months
New Policy Reviewed. Staff side feedback. Ratified and published
Engage with local University to develop accredited Critical Care course to incorporate the three specialist units CNO 6 Months
New course set up. Monitor applicants & recruitment rates
Strategic Principle
Accountable Lead
Objective Actions Nominated Lead Timescale Monitoring/Assurance RAG RatingRefresh and review current TNA in line with establishment review requirements (including specific review of hard to recruit and high turnover areas)
AG 6 Months MSB TNA undertaken
Identify gap analysis and plan of action (This will be used to inform planned utilisation of NMST and LBR monies from HEE)
AG 6 Months Gap analysis undertaken & action plan in place
Refresh Preceptorship programme to incorporate year 2 NQ nurses POD Team 3 months
Preceptorship programme expanded to cover first two years from qualifying/Feedback obtained. Retention rates improve
Review Mentorship capabilities/Register/Review feedback of CLIP model POD Team/DDoN 3 Months
Mentor/supervisor register in place. Feedback from students/new starters improves. Staff survey. Staff feel supported
Develop the role of Clinical Tutor Role in conjunction with the Chief Nurse Legacy Nurse retiree mentorship role
CNO 3 MonthsClinical tutor support rolled out across ward areas. Students feel more supported
Review Induction Programme/Welcome Packs for new staff to include Welcome meeting by the Chief Nurse/DoN’s.
POD Team/Ward Managers 3 Months
Welcome meeting dates set. Agenda in place. Chief Nurse welcome. Welcome packs distributed to new starters
Implement “ Stay in Touch” sessions at 3 Months, 6, 12 ,18 and 24 for NQ staff. HR/DDoN 6 Months Programme in place. Dates set.
Evaluate feedback & action plans HR/DDoN 6 Months Theme's & trends identified. Action plans in place
Create Early Starter programme and competencies for NQ nurses awaiting PIN HoN/POD 3 Months New Starter rates increase/Retention
improves
Develop Bridging Programme including x1 day per week Language & Culture support for International nurses from UK Arrival to OSCE
POD Team/External Language & Culture support
6 Months
Programme in place. Dates set. Weekly L&C dates set. International staff feedback positive. Feel supported. Pastoral care in place
To ensure the education & development opportunities represent the right skills in the right place required to deliver the model of care
Education & Development
Alison Griffiths (AG) & Jayne Toplis (JT) (POD People & Organisational)
Develop bespoke Bridging Program for International HCA to RN transition to include IELTS/OET support, in partnership with the university
POD team/local Universities 6 Months
OSCE training programme in place. Plan in place to support HCA's through IELTS/OSCE. Increased retention of HCA staff
Create Mandatory Ward Manager Training to include expectations of the role, Leadership & Management (this should include all HR stuff too) links with objective 4 tab 1)
POD Team/HR 12 Months
Mandatory programme embedded. Ward Managers feel more confident in undertaking their row. Behaviours & performance improve
Create the Ward Accreditation Program DDoN 9 Months
Programme in place. Patient safety & quality metrics improve. Leadership/ownership on ward improves
Promote and access the Leadership Academy programmes to include the Edward Jenner programme / similar for all band 6's & 7's.
POD team 12 MonthsLeadership Academy programmes undertaken by ward Managers followed by band 6's
Develop a “ Fit for MSB" mandatory training for all staff to include values based training,& Customer Care & Equality & Diversity
PoD team 12 MonthsAll senior staff undertaken FFMSB
training. Staff engagement improves. Retention rates improve
Strategic Principle
Accountable Lead
Objective Actions Nominated Lead Timescale Monitoring/Assurance RAG Rating
Review Flexible working policy. DoN/HR 3 Months Reviewed Roster policy published
Quality Improvement sessions with Ward Managers to creating standardised practices across all areas. For E.G Handover, Safety Briefs, SAFER board rounds, SBARP
HoN/DDoN 9 Months Reviewed standards of practice across the MSB group
Revisit Productive ward methodology engaging with Ward Managers & Matron DDON 9 Months Reviewed standardisation/release time
to care
Review Rostering Practices to ensure fair & equitable work-life balance across clinical areas & create more time to care
E roster Project Lead/HR 12 Months New Allocate Health roster Embedded
Implement Allocate Safecare across the group Safecare Lead 12 Months
Safecare implemented across group. Senior Nurse Safecare review meeting in place daily. Used to determine skill mix and redeployment of staff. Reduction in bank & agency use
Engage Nursing staff in transformation projects/CIP schemes to identify staff opinions/quick wins/ " Every Penny Counts"
Transformation Teams 6 MonthsStaff Engagamenet sessions/ Transformations project reports. Clinical staff leading porjects
Enable nursing staff to lead on improvement projects utilising the QI methodology with support & guidance
Transformation Team 6 MonthsClinical staff taking the lead in improvemenet projects. Staff feedback/engagaement positive
Innovation & Transformation
Denise Townsend ( Director of Nursing )
Review Standardisation
Processes & remove variation
Strategic Principle
Accountable Lead
Objective Actions Nominated Lead Timescale Monitoring/Assurance RAG Rating
Develop In house Leadership programmes with support of Local Leadership Academy POD Team 9 Months Leadership programmes
available/Published. Staff attendance
Develop framework for staff to access NHS Leadership Academy programs . I.E Edward Jenner, Mary Secole, Elizabeth Garret Anderson & Nye Bevan
POD Team 9 Months Engagement with Leadership Academy. Staff nominated for programmes
Develop Apprenticeship in Leadership & Management programme POD Team 12 Months Apprentice Programme in
place/Applicants underway
Develop a coaching program and in house pool POD Team 12 Months Coaching programs in place & accessible
for staff. Staff use monitored
Staff in leadership roles to undertake 360 degree appraisal,MBTI & " What does it feel like to be on the receiving end of me" POD Team
9 MonthsAll senior staff to have undertaken 360 degree appraisal. Personal development plans in place from feedback
Senior Leadership team back to the floor days HoN/DDoN/DoN/CN 3 Months
Back to the floor days set in diary fortnightly
Uniform Policy reviewed and re launche to inlcude Senior Leadership Team DDoN/HoN
6 Months
New policy ratified and launched at Nursing Conference
Executive Leadership walkabouts with Matrons each month
JEG3 Months
Dates set in Diary. Feedback at Board/JEG
Leadership & Succession Planning
Dawn Patience (Director of Nursing)
To ensure leadership skills and capabilities rae translated across
all levels
