Healthcare Improvement Scotland

Workforce and Equalities Monitoring Report 2015-2016

Lead Officer: Dougie Craig/Fiona Murray Executive Lead Officer: Tony McGowan Last updated: 24 October 2016 Review date: 1 April 2017 Status: Final Issue number: 1.0

Printed copies should not be considered the definitive version.

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Contents

1 Introduction, scope and definitions ............................................................................. 3

2 Actions and progress from previous reporting period ................................................. 5

3 Staffing profile ............................................................................................................ 6

4 Workforce by protected characteristics ...................................................................... 8

5 Recruitment and selection .........................................................................................16

6 Turnover ...................................................................................................................26

7 Applications for training .............................................................................................27

8 Staff benefiting or suffering detriment as a result of appraisal systems ....................30

9 PDR and PDP activity by protected characteristics 2014-2015 ................................31

10 Discipline and grievance procedures .........................................................................34

11 Future steps ..............................................................................................................34

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1 Introduction, scope and definitions

1.1 Healthcare Improvement Scotland is the national healthcare improvement organisation for Scotland. We are now well-recognised nationally and internationally as a strong contributor to the ongoing development of quality improvement and quality assurance within healthcare settings. As the scope of the organisation grows to include supporting improvement within social care, it is more important than ever that we continue to strive to achieve a rich, inclusive and diverse workforce.

1.2 As an organisation, we are fully committed to embracing diversity, delivering equality

of opportunity and treating everyone with respect to enable all staff to be themselves, to contribute to the best of their ability and to work together to reach organisational objectives. To support this commitment and also satisfy our legal requirement, we produce and publish an analysis of our workforce equality monitoring data each year. This report provides information on the profile of our workforce, recruitment, selection and staff development.

1.3 Some progress has been made against recommended actions from last year (as

detailed in Section 2) involving Age and Disability, as well as encouraging an increase in disclosure of equality characteristics. This will be ongoing over the next Financial Year and the profile of this work is expected to increase significantly.

Context

1.4 Our organisational context is set in a continuing challenging economic environment, where the demand for our services is increasing. Internal efficiency and effectiveness programmes serve as a focal point for thoughts and ideas to assist in delivering lasting cost savings, and this work continues as the organisation balances service delivery with available resources.

Scope

1.5 This report covers the period 1 April 2015 to 31 March 2016. It provides monitoring data for the equality protected characteristics of age, disability, gender, gender reassignment, race, religion and belief, and sexual orientation.

1.6 The Equality Act 2010 extends equality protected characteristics to include marriage

and civil partnership and pregnancy and maternity. We are unable to report on all the extended protected characteristics since this data is not collated through current NHS systems. The new NHSScotland employee self-service system (e:ESS) may improve the ability to report on all categories in the future. In any event, we have committed to collate data on pregnancy and maternity from the 2016-2017 reporting period onwards.

1.7 Where available, data for previous reporting periods has been shown and compared

with external benchmarking across the seven key equality strands. The latest versions available at the time of writing the report have been included, that is the 2011 census data and 2014-2015 sample data from other Special Health Boards.

Definitions and data quality

1.8 The data within the report refers to Healthcare Improvement Scotland (also referred to throughout the report as ‘the organisation’) and its constituents including the Scottish Health Council.

1.9 The report includes data relating to permanent and fixed-term staff only within the

organisation and does not include staff recruited to seconded posts, temporary

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agency staff, self-employed contractors or sessional staff providing specialist clinical or technical expertise.

1.10 All data quoted in the report refers to the position as at 31 March in any given year

unless otherwise stated. Some external comparator data cannot be shown to protect the anonymity of staff in certain categories where the numbers are relatively small or are not available.

1.11 Data used within the report is drawn from various sources, including SWISS (Scottish

Workforce Information Standard System)/e:ESS (national employee self service system), our Resource Management System (RMS) and e:KSF. External benchmarks are also shown in the report using data from similar sized NHS Special Health Boards and the General Registry Office for Scotland (Scottish Census data).

1.12 The source of the data used is clearly identified within the report. When data is not

available or the comparator datasets are not a direct read-across, it will be noted in that particular section. It is noted that some data consistency issues may exist across national documents and systems (currently the NHS Application Form and Staff Engagement Form are national documents that populate national systems). Healthcare Improvement Scotland has its own version of the Application Form which was developed to fit our automated recruitment management system (RMS).

1.13 Data is collated twice. The data requested at the point of job application is recorded

on RMS and informs our recruitment data. Data is requested again at the point of engagement on payroll forms and is recorded on SWISS and e:ESS, and informs our workforce data. There may be inconsistencies between data provided at these two points. For example, initial analysis suggests that there is more data supplied at the recruitment stage rather than at the engagement stage.

1.14 Further analysis is required in order to assess whether there is more that could be

done to encourage consistency, or to understand why there is variation.

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2 Actions and progress from previous reporting period

2.1 Recommendations arising from the 2014-2015 workforce equality monitoring report included a mix of actions specific to particular protected characteristics as well as those aimed at improving equality in general. The recommendations were as follows.

Age

2.2 We undertook to actively consider other initiatives to encourage more 16-24 year olds to apply and be appointed to the organisation in the coming year (such as evaluating the introduction of specific trainee roles and/or Modern Apprenticeships).

During 2015-2016, work has been done to agree the most suitable approach to

securing more applicants and appointments in the 16-24 age group. Preliminary discussions have taken place with Investors in Young People representatives, Modern Apprenticeship Scheme champions and others agencies. A working group reviewed options for possible internship schemes and a report was produced which will inform future steps. It is expected that this investigative work will come to fruition later in 2016/early 2017 and will form part of a long-term and ongoing strategy.

Disability

2.3 We undertook to build upon the good work already being done to promote our positive approach to disability/ability.

The HR and Communications Units have been working on a communication strategy

to publicise our approach to disability and this will be used in a variety of ways:

to promote Healthcare Improvement Scotland as an employer

to encourage staff to be open about disability/ability, and

to coach managers.

We are also working in partnership with other groups such as GCIL (Glasgow Centre for Inclusive Living), Healthy Working Lives and networks in other Special Health Boards.

Equality data

2.4 We have gained agreement from Stonewall Scotland to adopt their “What’s it got to do with you?” brochure and this has been included in our recruitment packs. This is an eye-catching document which aims to encourage completion of equality monitoring forms by providing reassurance on how the data will be stored and used. The Communications Unit has produced a corporate version of this which, once finalised, will be used in a variety of ways to encourage staff to provide equality data, and to keep it updated.

The HR Unit was ready to carry out an internal data verification exercise in early 2016

to encourage existing staff to bring their equality data up to date and to complete sections previously left blank. This activity was postponed on the understanding that an electronic self-service function would be operational by March 2017. In the event that insufficient assurances are given on a revised timetable for self-service, HR will carry out an internal data verification exercise early in 2017.

In advance of this and in order to test current workforce data, manual analysis was carried out in two sample categories: workforce by disability status and workforce by ethnicity. This identified inaccuracies in historic data and enabled improved and more accurate reporting in these specific categories for this reporting year.

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3 Staffing profile

3.1 Organisational headcount (HC) of 375 has increased by 8.7% in this reporting period (compared to the last), which is reflective of planned workforce increases in line with those outlined in the Local Delivery Plan and reflects the continued increase in demand for our services. The ratio of permanent roles and gender split across full and part-time work remains broadly unchanged to previous years.

In line with NHS terms and conditions and PIN guidelines, Healthcare Improvement

Scotland has a good track record at supporting and promoting family friendly working practices.

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3.2 In terms of gender and pay band, the workforce composition across most pay bands continues to be predominantly female which has

been typical over the previous reporting periods. The biggest differential is in the lower pay bands, most pronounced at Pay Band 4 made up of 17.93% female compared to 1.1% male.

The differential decreases overall as the pay band increases. The term ‘Senior Manager’ for the purposes of this report refers to those staff in

the Senior Manager/Exec Cohort pay arrangements. It is noted that the only categories with a higher male ratio are Medical Staff and Senior Manager.

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4 Workforce by protected characteristics

4.1 Workforce by Religion or Belief

For the purposes of this report, ‘declined’ and ‘unknown’ have been grouped together. Further analysis is being carried out to compare where members of staff are actively declining to supply the data, compared to those instances where the form is left blank, that is ‘unknown’.

Sexual Orientation and Religion or Belief are the two protected characteristics where staff are most frequently declining to answer.

Commentary

This protected group has been showing a year on year increase in those not wishing or declining to disclose information compared to previous years whilst other groups remain broadly similar to previous reporting periods.

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4.2 Workforce by Sexual Orientation

Commentary

This reporting period shows a decrease in the reported ‘Heterosexual’ group compared to previous years. The percentage of those not wishing to disclose information, or leaving the section blank, has risen whilst other groups remain broadly similar to previous reporting periods. Note: there is no data within the main 2011 Census Report for this protected characteristic.

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4.3 Workforce by Disability

Commentary

The number of staff reporting a disability within this protected group has increased from previous years. Healthcare Improvement Scotland is positive about disability and will continue to promote this using the ‘two tick’ symbol in all advertisements. We provide support and implement reasonable adjustments for new recruits with disabilities or for staff developing a disability during employment in collaboration with our Occupational Health provider. We are increasingly gaining in confidence in our approach to this, focusing on ability rather than disability, and seeking input from a wide range of external bodies. This work will increase and gain greater visibility over the next 12 months. *The closest data set within the 2011 Census is for ‘economically inactive people aged 16 to 74 who are long-term sick or disabled’. This wider definition of including long-term sick may account for a higher reported ‘Yes’ category with the 2011 Census data than would be expected if only those with a disability were surveyed, thus making it difficult to draw comparisons between Healthcare Improvement Scotland and this data set.

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4.4 Workforce by Gender

Commentary

There has been a slight decrease in the proportion of female staff within the organisation over the last year and a slight increase in the proportion of male staff; however this gender imbalance has remained fairly consistent over recent years. This picture is broadly representative of other health bodies and Special Health Boards and achieving a gender balance remains a national challenge.

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4.5 Workforce by Age

Commentary

Our employee profile by age group remains broadly consistent with previous years with one exception in the 20-24 age category where we have started to see an improvement. We are committed to continue to build on this and improve representation in the under 25 age category in future years.

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4.6 Workforce by Ethnicity

Commentary

Our ethnic composition is broadly reflective of previous reporting periods but with a slight increase in White Scottish. Note: the 2011 Census does not have an option for declining to provide information for this characteristic. The ethnicity categories shown are ungrouped (showing current and previous staffing in each) and compared against the specific category within the Census data.

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4.7 Workforce by Gender Reassignment/Transgender Status

Commentary

Gender Reassignment/Transgender Status is nil for this and previous reporting periods (0.0%). Given the NHSScotland Workplace Equality collaboration with Stonewall running from July 2016 to July 2017, we would anticipate a well-supported approach to the transgender and sexual orientation protected characteristics to be developed in future. See Section 11.4. Note: the 2011 Census does not provide a data set for this category and the Other NHS Special Boards only record/publish a ‘Yes’ category. National NHS Application forms survey Gender Reassignment’ compared to the national NHS Staff engagement forms which surveys ‘Transgender Status’. Where Healthcare Improvement Scotland has been able to provide a consistent approach to terminology, we have done so in our own forms.

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Protected characteristics - workforce data summary

4.8 Benchmarking the diversity of our workforce against external comparators is made more difficult when there are high numbers electing not to disclose information, where the data has been grouped differently or not directly available for the characteristic we are measuring (for example Census data for disability only), and where data is being collated from a variety of sources. However, the HR Unit is committed to developing greater understanding of our data and what can be assessed from it so that we can create meaningful action plans and gain optimum benefit from collaboration with the right people and groups.

As in previous years there continue to be challenges remaining for our workforce

during 2016-2017, including:

achieving an increase in staff within the organisation aged under 25 (particularly the 16-19 age group – Section 4.5)

increasing the number of males within the organisation to create a more gender balanced workforce (Section 4.4)

gathering benchmark data, and

encouraging more staff to disclose equality information to enable more accurate monitoring.

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5 Recruitment and selection

The following recruitment and selection data shows the key stages of the applicant journey through the selection process for protected characteristics, with each stage showing a percentage of those progressed from the previous stage. To enable some context of the percentages shown in the applicant journey, a summary of actual activity/numbers of applications, interviews and offers made is provided below for reference. Whilst this includes both temporary and permanent promotions undertaken as part of a formal recruitment process, it does not include posts filled internally on a temporary acting-up basis or via informal expressions of interest. We need to consider use of these approaches in future and how we might gather and monitor equality data in these instances. We note that only 17% of internal candidates applying for promotion are successful, and we will analyse this further to identify the main factors and suitable interventions as appropriate.

Summary of recruitment stages activity during the reporting period

2015-2016 Total

Total applications received 1,430 Total shortlisted for interview 313 Total offered a position 108

Internal candidates applying for promoted posts 69 Internal candidates shortlisted for promoted posts 33 Internal candidates offered promoted posts 12

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5.1 Applicant journey by Ethnicity

Commentary

This year’s ethnicity data indicates that applications were received from candidates across all ethnic groups as well as a wide cross section of these progressing to interview. Although those offered posts were represented from many groups (predominantly white, in keeping with the current workforce profile), none of the African, Asian-Bangladeshi, Asian-Other, Asian-Pakistani, Caribbean or Black groups that were interviewed received job offers. The relative size of our organisation may mean that we are not always able to fully represent all groups at offer stage, however it is noted that those of white ethnic origin make up over 80% of all applications received. It is also noted that the next biggest category is declined/unknown at 6.8%. We must work to encourage greater disclosure of ethnicity in order that we can assess whether we are more, or less, representative than current data shows.

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In comparing success rates at promotion compared to % workforce, ‘White – Other’ proportionately do better, for example 16.7% of promotions offered during 2015-2016 were ‘White – Other’ compared to 11.6% applications for promotion.

Note: The NHSScotland Employee Staff Engagement form equality data was revised in recent years to expand on categories of ethnicity, but the NHSScotland application form equality section was not subject to a corresponding change. Therefore at the point of application, 14 ethnic groups are offered but at the point of engagement staff select from 19 ethnic groups provided on the staff engagement form.

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5.2 Applicant journey by Disability

Commentary

Similar ratios of those declaring a disability progressed through shortlisting to interview (over 4%), with slightly less receiving a job offer (3.7%). This is indicative that the early stages of the recruitment process appear fair and equitable.

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5.3 Applicant journey by Religion or Belief

Commentary

The percentage of applications received for each ‘Religion and Belief’ group is broadly reflective of the previous year’s data and comparable with the current organisational profile, with a broad cross section of groups progressing through each stage. A similar group profile had applied for internal promotion and all groups who did were all relatively successful in obtaining interviews and job offers.

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5.4 Applicant journey by Sexual Orientation

Commentary

The percentage of applications received for each Sexual Orientation group is broadly reflective of previous years’ data and comparable with the current organisational profile. Although no job offers were received by those declaring in the Bisexual or Lesbian groups in this period, the comparative size of our organisation and the relatively small numbers of applications within those groups can result in this outcome at times. Whilst our job advertisements include a “We Welcome Diversity” statement, we will consider whether there is more we could do to positively encourage representation from across the different groups.

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Only those in the ‘Heterosexual’ and ‘Prefer not to say’ groups applied for internal promotion, with both groups being successful at shortlisting and job offer stages. Given the small number of staff in the other groups, it is difficult to draw useful conclusions but we are confident that our recruitment procedures would not disadvantage protected groups.

5.5 Applicant journey by Gender

Commentary

The number of applications received from male applicants and interviewed has remained broadly consistent to previous years. However, there appears to be a lower ratio of males applying for internal promotion, being shortlisted or offered promotion. This could be partly explained by the greater numbers of males already working at a more senior level in the organisation compared with a high percentage of females in Band 4 roles where a career progression route is clear.

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5.6 Applicant journey by Age

Commentary

The percentage of applications received for each Age Range group is broadly reflective of the previous year’s data and the job offers made are generally reflective of the current organisational profile. The age ranges most active in applying for promotions are 25-39 but of the cross section of age groups applying for internal promotion, there were successful outcomes in each category. The highest proportion of offers was in the 33-39 age group. We are keen to tackle the high proportion of applicants opting not to divulge data, in this instance 7.6% of applicants whose age category is unknown.

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5.7 Applicant journey by Transgender status/Gender Reassignment

Commentary

This category is unrepresented in the workforce presently and over the course of 2015-2016 there was a low number of applicants declaring transgender status. This is in keeping with previous years. The number of applicants not completing equality data may have a bearing on this and we will continue to work to find ways to encourage applicants to provide this data, as well as addressing lack of data for existing staff.

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Recruitment journey summary

5.8 Across most protected characteristics there are some groups that have not been successful in obtaining a job offer during this reporting period, but may have done so in previous years, therefore no trend is evident of a particular group being disadvantaged as a result of the recruitment process.

There are a few key points that remain a challenge for Healthcare Improvement

Scotland over the coming year, the organisation needs to:

attract and appoint more staff under the age of 25 (particularly the 16-19 age group - Section 5.6)

increase the number of males appointed to the organisation (Section 5.5)

continue to promote the organisation as an employer with a positive approach to disability

continue to encourage applicants to disclose equality information as far as possible, in order that comparisons can be made with other benchmark data, and

continue to promote the message that all staff has the same opportunity to achieve promotion as other staff members, to encourage a wide cross section of ethnicity and those with a disability to apply for promotion.

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6 Turnover

Commentary

Organisational turnover has declined slightly in 2015-2016 to 11.6%. It is anticipated to remain steady over the forthcoming year. It is worth noting that as a project-based organisation using a significant number of fixed-term contracts, turnover will always be inflated somewhat compared to other organisations. We have a proactive approach to managing the end of fixed-term contracts and in using redeployment where possible. In addition, exit interviews are offered to all leavers. As a relatively small organisation, we are able to monitor turnover on an individual basis and our good line manager/staff/HR relationships mean we can be confident that there have been no issues related to protected characteristics leading to resignation. In future, if we are able to increase the quality and quantity of our baseline data, we will aim to capture a more detailed breakdown and analysis to ascertain if there are any latent trends.

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7 Applications for training

Applications for training

7.1 Healthcare Improvement Scotland received a total of 12 applications for the Continuing Education Bursary Fund in the year 2015-2016. These numbers are insufficient to enable meaningful statistical analysis within each of the protected characteristics categories.

Staff are required to complete and return to OD and Learning, monthly training logs

incorporating space to report if an applicant has been turned down for training. We have not received any reported incidents in the period 2015-2016.

Reported access to training

7.2 From the information we have available, the reported access to training for 2015-2016 is broadly in line with the demographic profile of our staff. There were, however, a few exceptions noted as follows.

Sexual Orientation: For those reporting as ‘Heterosexual’, the proportion of staff reporting access to training is 10.2% less than the associated proportion of organisational headcount. For those reporting as ‘Declined/Don’t Know’, the proportion of staff reporting access is 10% higher.

Gender: For those reporting as ‘Male’, the proportion of staff reporting access to training is 5.4% less than the associated proportion of organisational headcount, whilst the proportion reporting as ‘Female’ reported 5.4% more.

Religion: For those reporting as having ‘No Religion’, the proportion of staff reporting access to training is 5.5% lower than the organisational headcount whilst ‘Declined/Don’t Know’ reported 9.8% more.

Whilst these exceptions could suggest that some categories of staff are not accessing training to the same extent as others, there is a risk that our current recording process for training access, which is manual and reliant on staff self reporting, is not capturing the full extent to which staff are accessing training and/or learning opportunities. This should be addressed by the introduction of a new electronic reporting system planned for introduction in 2017.

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Access to Training by protected characteristics

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8 Staff benefiting or suffering detriment as a result of appraisal systems

When comparing data over a 3-year period from 2013-2016, there has been an increase year on year in the percentage of all staff having a Performance and Development Review (PDR), representing a total increase of 17.4% (or almost 20% for the adjusted figure).

(Adjustments: Number of Individuals unable/ineligible to participate within the organisational

PDR process at this time as a result of having been on or recently returned from a period of long term leave, employment secondment or being new to post.)

% of Staff with a PDR

Adjustments* Adjusted%

2013-2014 67.1% 53 80.4%

2014-2015 79.7% 68 99.4%

2015-2016 84.5% 51 100%

There has been a similar trend in the percentage of staff with a Personal Development Plan (PDP) in place over the 3-year period, representing an increase of 34.5% over the 3 years from 2013-2016, (or 39% for the adjusted figure).

% of Staff with a PDR

Adjustments* Adjusted%

2013-2014 46.1% 21 49.3%

2014-2015 76.8% 68 96.5%

2015-2016 80.6% 29 88.3%

Although there is still a way to go, these results reflect positive progress towards achieving our goal of all staff having both a Personal Development Review (PDR) and a Personal Development Plan (PDP) in place. It also offers a stronger base from which to consider any differences between particular groups of staff.

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9 PDR and PDP activity by protected characteristics 2014-2015

Within the 2015-2016 statistics (see below), those staff with both PDR and PDP in place broadly reflect the demographic profile of our staff with the following exceptions:

Sexual Orientation: For those reporting as ‘Heterosexual’, the proportion of staff with a recorded PDP is 8.9% higher, and with a recorded PDR is 11.4% higher than the associated organisational headcount. Those reporting as ‘Declined/Don’t Know’, with a recorded PDP are 10.3% less, and with a recorded PDR is 12.2% less.

Religion: For those reporting as ‘Declined/Don’t Know’ the proportion of staff with a recorded PDP is 9.8% less and with a recorded PDR is 11.1% less than the associated proportion of headcount. As an additional 1.3% completed their PDP compared to PDR, it may well be that these staff were not due a PDR during this period due having been on a period of long-term leave, secondment or commencing a new role in the organisation.

Internal monitoring of PDR and PDP activity has shown that not all staff participating in the process are correctly recording completion of their PDR and PDP meetings on the electronic reporting system (eKSF) and that, consequently, the data may not be a true reflection of PDR and PDP activity. This may explain the apparent differences for the categories of ‘Heterosexual’ (Sexual Orientation) and ‘Decline/Don’t Know’ (Religion).

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10 Discipline and grievance procedures

Gathering data in relation to the areas of discipline and grievance has remained challenging as figures are too low to enable meaningful analysis or for conclusions to be reached. As a relatively small, improvement-focused professional organisation we seek to use informal, collaborative and supportive approaches to improve employee relations issues at a local level which allows us to reach a satisfactory resolution more quickly and effectively without the need for formal or punitive intervention. We have had an internal Mediation Service in place for our staff since 2012 and a Dignity and Respect Advisory network in place since 2014. As it is very rare for formal discipline or grievance procedures to be used or needed, no meaningful equality data in this particular area can be shown.

11 Future steps

Ongoing challenges

11.1 We are committed to continually monitor and improve the diversity of the workforce we attract, engage and develop. While progress has been made in some areas over the past year, there remain the following recurring issues.

The gender imbalance across the wider NHS. This perpetuates the imbalance in Healthcare Improvement Scotland as many of our candidates are recruited from within the NHS.

Those who prefer not to disclose personal information (compounded by people generally becoming more guarded about releasing such data).

National data consistency for collection and reporting of certain protected/extended categories.

Local testing of data has demonstrated that our electronic records are incomplete and that validation of our data is a priority.

We will continue to address these issues as best we can on a local basis and raise with national groups with responsibility for NHSScotland policy where the issue is NHS-wide, as appropriate.

Age

11.2 We recognise the important contribution that under 25s can provide to our organisation. We are committed to introducing a Modern Apprenticeship Scheme into the organisation during this Financial Year, and further expanding our commitment in future years through specific initiatives as well as through collaboration with internal colleagues working on young person engagement more widely.

We recognise that supporting an ageing workforce may present challenges in the future. We will continue to monitor this in order that we are prepared to support employees appropriately.

Disability

11.3 During 2015, NHSScotland agreed to a partnership with GCIL (Glasgow Centre for Inclusive Living), with each NHS board agreeing to host a disabled graduate on a 2-year professional development placement. Healthcare Improvement Scotland is

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entering year two of this placement and remains fully engaged and committed to the ongoing success of this project.

We continue to promote our commitment to being positive about disability as part of each recruitment campaign and to make full use of available expertise through Access to Work and other providers. We will continue to work in partnership with others in order to improve our approach.

A significant body of work is in progress to build on our capacity, capability and confidence in reaching, attracting and retaining staff across a wide spectrum of ability/disability and it is hoped that the benefits of this work can be reported on in the future.

LGBT

11.4 As part of a Scottish Government initiative, all NHS boards will collaborate with Stonewall Scotland until at least July 2017. During this time, Healthcare Improvement Scotland has been committed to work with Stonewall to benchmark against their Workplace Equality Index. The index is used to scrutinise practices around LGBT inclusion within organisations. Our work with Stonewall will lead to a better understanding of our approaches and where improvements can be made in relation to LGBT equality.