Agenda item

Charmaine Desouza (Chief People Officer, Oxford Health NHS Foundation Trust); Zoe Moorhouse (Head of HR, Oxford Health NHS Foundation Trust); and Amelie Bages (Executive Director of Strategy and Partnerships, Oxford Health NHS Foundation Trust) have been invited to present a report on the Oxford Health NHSFT People Plan.

The Committee is invited to consider the report, raise any questions and AGREE any recommendations arising it may wish to make.

Charmaine DeSouza (Chief People Officer, Oxford Health NHS Foundation Trust) (NHSFT); Zoe Moorhouse (Head of HR, Oxford Health NHSFT); and Amelie Bages (Executive Director of Strategy and Partnerships, Oxford Health NHSFT) were invited to present a report on the Oxford Health NHSFT People Plan.

The Chief People Officer presented the People Plan’s development, emphasising its importance for community transformation and alignment with trust objectives. The Head of HR overviewed workforce demographics, noting 80% female employees, 25% from a BAME background, and 7.4% with declared disabilities. Collaboration with universities was also highlighted. The Executive Director of Strategy and Partnerships explained the strategic context, referencing the NHS long-term workforce plan and Oxford Health strategy, and detailed the annual planning process and KPI monitoring by the People Leadership and Culture Committee.

The Committee examined how the Oxford Health NHSFT People Plan aligned with the NHS long-term plan, focusing on patient transitions, nurse support, and community transformation initiatives. The Chief People Officer mentioned that the workforce plan published in 2023 was expected to remain relevant despite any changes in the NHS long-term plan. The trust had already considered collaborations with OUH and prioritised community health and care.

The Chief People Officer emphasised the importance of providing district nurses with adequate resources and supporting those who assisted heart failure patients at home. The trust committed to optimising resource allocation to strengthen community health. The Executive Director of Strategy and Partnerships recognised the challenges in collaborating with OUH. Despite this, both executive teams worked together to review pathways, streamline processes, and utilise staff more effectively.

The Executive Director of Strategy and Partnerships highlighted the innovative elements of the Community Transformation Programme, such as multidisciplinary team collaboration and deploying district nurses to support the GP workforce during weekends. The trust advocated for an alternative delivery model to address ongoing pressures.

The Committee enquired about the core purpose and roles of the Oxford Health NHSFT. The Executive Director of Strategy and Partnerships, and Chief People Officer explained that the Oxford Health NHSFT provided mental health services across the BOB ICB region and physical health services, including community health in Oxfordshire. The trust offered community acute inpatient mental health services, GP out-of-hours services, urgent care centres, district nursing, and school nursing.

The trust placed emphasis on workforce planning, recruitment, and retention to support service delivery. They focused on ensuring a well-planned and stable workforce to maintain the quality and availability of their services.

The Committee inquired about how Oxford Health NHSFT supported continuous professional development (CPD) for clinical and administrative staff. For clinical staff, the trust provided CPD through a well-established education centre and collaborated with Oxford Brookes University for postgraduate and master's modules for nurses. They also offered apprenticeship schemes allowing staff to pursue further education, including leadership and management apprenticeships.

For administrative staff, various courses, webinars, and e-learning events were available through NHS offerings and internal programmes. Overall, the trust demonstrated a strong commitment to CPD, which contributed to improved staff retention.

The Committee reviewed the initiatives that had been undertaken to enhance staff empathy and compassion towards patients at the trust. Officers described how the "Kindness into Action" programme had been implemented for several years, consisting of five educational modules available to staff. Additionally, the principles of kindness and a compassionate, restorative approach had been incorporated into HR policies and protocols for managing mistakes and errors.

These initiatives had led to an increase in the informal resolution of staff grievances. Efforts were ongoing to establish a therapeutic environment on the wards, addressing the various challenges encountered in these settings.

The Committee inquired about the trust's support for staff mental health and its standing compared to other NHS trusts. The Executive Director of Strategy and Partnerships explained the trust had provided a 24/7 Employee Assistance Programme (EAP) and a robust occupational health service that was available for self-referrals or manager referrals. Health and wellbeing representatives in all teams offered proactive support.

In addition, the trust had implemented workplace wellbeing initiatives such as an outdoor gym and a meadow at the Littlemoore site for both staff and patients. Specialist psychological services were made available to staff experiencing trauma at work, including racist or physical abuse. Although the trust was actively enhancing staff wellbeing and mental health support with unique initiatives, it did not specify its rank compared to other NHS trusts.

The Committee examined how the trust's People Plan had been co-produced with staff. The Chief People Officer explained how a bottom-up approach had been used, allowing teams and directorates to control their plans, which created a sense of ownership. Additionally, an annual review was conducted where teams reassessed and updated their plans to address challenges and set new goals.

Furthermore, plans were reviewed at the trust level for strategic alignment while ensuring that staff ownership remained intact. This coordination and feedback process ensured that the plans aligned with the trust’s overall strategy and goals, while still empowering staff through their involvement in plan creation and revision.

The Committee requested an update on CAMHS (Child and Adolescent Mental Health Services) waiting times and mental health crisis referrals. The Chief People Officer reported that 61% of children were seen within 4 weeks nationally, whereas in Oxfordshire, the figure was 53%. For very urgent mental health crisis cases, the target was a 4-hour wait, which the trust met for 76% of cases, surpassing the national average of 69%.

The Committee inquired about the mechanisms that facilitated or encouraged employees to lodge complaints or express grievances. Officers explained that the Trust had Freedom to Speak Up Guardians who were independent and could be confidentially approached by staff for issues such as patient care, safety, or personal treatment. It also adhered to a grievance policy in line with the Acas code of conduct, encouraging employees to resolve grievances informally and promptly with local management. Staff had the option to contact the Guardians and Human Resources advisors via email or phone to discuss their concerns.

The Committee raised queries about the reliance on overseas recruitment, and the balance with recruiting home grown carers. The Committee also questioned what effect recruitment had on patient care quality. The Chief People Officer and the Executive Director of Strategy and Partnerships explained that overseas recruitment had led to a diverse workforce within the trust. Since 2021, about 140 international nurses were trained. However, the high living costs in Oxfordshire resulted in a 20% turnover rate.

The trust had heavily relied on agency staff but aimed to reduce this by promoting permanent or bank roles. In the previous year, approximately 100 agency staff transitioned to permanent or bank positions. The goal was to fill 80% of shifts with bank staff by the next financial year.

To ensure patient care, agency staff were integrated into teams and provided with continuous professional development. This was done to uphold trust principles and maintain the quality of patient care. The focus remained on reducing agency usage for better team cohesion and improved patient care.

The Committee questioned the collaboration with other NHS bodies, particularly OUH and the ICB, as well as whether key worker housing and transport were being considered. The Executive Director of Strategy and Partnerships described how the trust had collaborated closely with OUH and the ICB, participating in local and system-wide programmes and planning discussions. Transport had been a key focus in the Community Transformation Programme, and housing had been addressed in the mental health programme, with the trust actively involved in planning and discussions.

Cllr Constance left the meeting at this stage.

The Committee examined technology's role in improving workforce efficiency, and how digitalisation impacts on patient care and interaction. The Executive Director of Strategy and Partnerships explained that the Trust found that integrated systems streamlined administrative tasks, enhancing staff satisfaction and efficiency by simplifying processes such as logging leave and training.

Regarding patient care digitalisation, the Committee noted improvements in electronic health records and the development of innovations like a wound care app for district nurses, which improved data access and supported staff.

In terms of patient interaction, the Committee emphasised the importance of balancing digital and face-to-face interactions to avoid excluding patients. Talking therapies were offered both digitally and in-person, with outcomes monitored to ensure effectiveness.

The Committee raised concerns about the use of Artificial Intelligence (AI) in the NHS, particularly regarding safety, governance, and safeguarding. They inquired about the trust's approach to implementing AI and ensuring patient safety. The Officers explained that the trust had been cautious about implementing AI, ensuring that any AI applications were piloted within a defined framework to avoid compromising safety or quality. An AI working group, chaired by the Chief Information Officer and Chief Clinical Information Officer, oversaw AI projects.

Regarding safeguarding and governance, the trust had not fully implemented AI for patient notes or clinical services but was exploring its potential through controlled pilots. They stressed the need for a robust framework for AI use to ensure patient safety and data security. In terms of patient interaction, the trust was aware of digital exclusion and ensured that digital tools were integrated with face-to-face services to maintain accessibility for all patients.

The Committee AGREED to recommendations under the following headings:

• To work toward reducing reliance on agency staff where possible. It was recommended that processes were in place to ensure that the quality of care provided by agency staff was appropriate and up to standard so as to ensure consistency in the quality of care for patients.

• To create a positive and supportive work environment for staff, and to foster an environment and processes where staff can easily make complaints or express legitimate grievances.

• To harness the use of technology to create a better and more efficient working environment for staff. It was also recommended that the Trust takes steps to avert the prospects of future IT outages in as much as possible, and to provide evidence of this.

• To work with system partners to campaign for an Oxford salary weighting.