Remuneration and Staff Report

Board members and senior management remuneration (subject to audit)

The Remuneration Committee is a formal committee of the Board. The purpose of this committee is to advise the Board on all

aspects of the remuneration and terms of conditions for the chief executive and executive directors reporting to the chief executive

making sure these properly support the objectives of the trust, represent value for money and comply with statutory requirements.

The committee’s members are the non-executive directors of the trust and the committee is chaired by the Trust’s chair. Between 1 April 2023 and 31 March 2024, there were eight meetings of the Remuneration Committee.

Salaries and allowances for the year ending 31 March 2024 (subject to audit)

1. Pensions related benefits are based on the NHS Manual of Accounts methodology and the pension data is provided by the Pensions Agency. The benefits calculated incorporate 20 times the annual real increase in pension and do not represent actual payments made. Non-Executive Board members do not receive pensions as part of their remuneration.
2. Pension Restructuring Payments column added as: Employers have the option of using any unused employer contributions to make an additional pay offer to individuals that opt out of the NHS Pension Scheme. The overall net cost to the organisation remains the same whether the employee remains in the NHS Pension Scheme or takes the employer contributions as additional salary.
3. Professor Karen Dunderdale has split her time equally between United Lincolnshire Hospitals and Lincolnshire Community Health Services NHS Trust for the period 17 October 2022 - 31 March 2023 as the Director of Nursing. United Lincolnshire Hospitals have retained the responsibility for payroll and all the associated returns, Invoice from April 2023 to the end of March 2024 total £66,000. The total salary for Karen Dunderdale across both Trusts is in the banding £200k-£205k.
4. Andrew Morgan has split his time equally between United Lincolnshire Hospitals and Lincolnshire Community Health Services NHS Trust for the period 01 April 2023 - 31 March 2024 as the Group Chief Executive. United Lincolnshire Hospitals have retained the responsibility for payroll and all the associated returns, Invoice from April 2023 to the end of March 2024 total £77,304. This is after a correction of an overpaid invoice of 84,000 which a credit note was raised for and £77,304 was re-invoiced. The total salary for Andrew Morgan across both trusts is in the banding £250k-255k.
5. Reva Stewart is Chief Operating Officer for LCHS and has been seconded to the Trust since August 2022 from Berkshire Healthcare NHS Foundation Trust who have retained the responsibility for payroll and all the associated returns and left her role in May 2023. Invoice secondment from April 2023 to the end of May 2023 total £23,471.76.
6. Claire Low, Director of People and Innovation, new to post from October 2023, an accrual for salary recharge of £35,831.38 until the invoice is raised to LCHS. United Lincolnshire Hospitals have retained the responsibility for payroll and all the associated returns. The total salary for Claire Low across both trusts is in the banding £145k-£150k,
7. Taxable expenses and benefits in kind are expressed to the nearest £100. The values and bands used to disclose sums in this table are prescribed by the Cabinet Office through Employer Pension Notices and replicated in the HM Treasury Financial Reporting Manual.
8. Elaine Bayliss left LCHS trust on 31/03/2023 so has not been included in the report as she is on ULHT payroll subsequently. She is currently the group chair for financial year 2024-2025 and should be expected to be in the next annual remuneration report.
9. Julie Frake-Harris was a shared resource with ULHT. Her salary is shown in full in this remuneration report however, LCHS has been reimbursed by ULHT by £45,118. The cost to LCHS was £61,382, the total salary for Julie Frake-Harris across both Trusts is in the banding £105k-£110k.
10. Malcolm Burch was appointed as Chair from 1 April 2023. The Lincolnshire Police and Crime Commissioner (LPCC) were reimbursed for a proportion of his time. The total remuneration is in the banding £40k-£45k.
11. Marie Fosh left the trust in 2023 and her remuneration value includes an exit package shown as staff costs in the Annual Accounts, which is disclosed on Page 63, "Compensation on early retirement or loss of office”

Salaries and allowances for the year ending 31 March 2023 (subject to audit) 

1. Pensions related benefits are based on the NHS Manual of Accounts methodology and the pension data is provided by the Pensions Agency. The benefits calculated incorporate 20 times the annual real increase in pension and do not represent actual payments made. Non-Executive Board members do not receive pensions as part of their remuneration.
2. Pension Restructuring Payments column added as: Employers have the option of using any unused employer contributions to make an additional pay offer to individuals that opt out of the NHS Pension Scheme. The overall net cost to the organisation remains the same whether the employee remains in the NHS Pension Scheme or takes the employer contributions as additional salary.
3. Dr Y Owen also provided Out of Hours practitioner services to the Trust as an independent contractor to 31st May 2019, disclosure of the value of these payments can be found in the related parties disclosure of the Trust Annual Accounts 2022/23
4. Dr Karen Dunderdale has split her time equally between United Lincolnshire Hospitals and Lincolnshire Community Health Services NHS Trust for the period 17 October 2022 - 31 March 2023 as the Director of Nursing. United Lincolnshire Hospitals have retained the responsibility for payroll and all the associated returns, Invoice to the end of March total £33,000
5. Reva Stewart is Chief Operating Officer for LCHS and has been seconded to the Trust since August 2022 from Berkshire Healthcare NHS Foundation Trust who have retained the responsibility for payroll and all the associated returns. Invoices to the end of March 2023 total £85,838.60.
6. These relate to the benefit in kind associated with lease cars obtained through the Trust Salary Sacrifice Lease Car Scheme or via the Trust Standard Lease Car scheme. Expense Payments relate to reimbursement for travel, subsistence and where appropriate re-location expenses. Figures presented are shown gross, before tax.
7. M Fosh's performance payment was agreed by Remuneration Committee and represents NHSE recommendations to move back to a split salary arrangement of consolidated salary and non-consolidated performance related pay to bring Chief Executive salary in line with the VSM published Median benchmark.

Pension benefits for the year ending 31 March 2024 (subject to audit)

1. Dr Anne Louise Schokker is not a member of the NHS Pension Scheme in relation to employment with Lincolnshire Community Health Services NHS Trust during the reporting year.
2. Professor Karen Dunderdale, Andrew Morgan and Claire Low are employed by United Lincolnshire Hospitals NHS Trust and their payroll and pensions contributions are reported in their annual accounts.

Pension benefits for the year ending 31 March 2023 (subject to audit) 

*Dr Y Owen and T Pilcher are not members of the NHS Pension Scheme in relation to employment with Lincolnshire Community Health Services NHS Trust during the reporting in the year. 

NHS pensions data

Pension benefit notes

Note: CETV figures are calculated using the guidance on discount rates for calculating unfunded public service pension contribution rates that was extant at 31 March 2023. HM Treasury published updated guidance on 27 April 2023; this guidance will be used in the calculation of 2023-24 CETV figures

• As non-executive directors do not receive pensionable remuneration, there will be no entries in respect of pensions for non-executive directors
• The above information is based on data provided by the NHS Pensions Agency.
• The employer's contribution rate to pension benefits is 23.7% of pensionable pay (2022/23: 20.68%).
• Staff are able to make additional voluntary contributions alongside their regular contributions.

Cash Equivalent Transfer Values

• A Cash Equivalent Transfer Value (CETV) is the actuarially assessed capital value of the pension scheme benefits accrued by a member at a particular point in time. The benefits valued are the member’s accrued benefits and any contingent spouse’s pension payable from the scheme. The benefits valued are the member’s accrued benefits and any contingent spouse’s (or other allowable beneficiary’s) pension payable from the scheme. CETVs are calculated in accordance with SI 2008 No.1050 Occupational Pension Schemes (Transfer Values) Regulations 2008.

Real increase in Cash Equivalent Transfer Values

• This reflects the increase in CETV effectively funded by the employer. It does not include the increase in accrued pension due to inflation or contributions paid by the employee (including the value of any benefits transferred from another pension scheme or arrangement).
• The value of pension benefits accrued during the year is calculated as the real increase in pension multiplied by 20, less, the contributions made by the individual. The real increase excludes increases due to inflation or any increase or decrease due to a transfer of pension rights.
• The pension benefit table provides further information on the pension benefits accruing to the individual.

Exit packages (the figures incorporated within the note below are subject to audit)

NHS Organisations are required to disclose details of any exit packages agreed in the year. The tables below are subject to audit and set out the number and cost of exit packages agreed by the Trust in 2023/24.

Relationships between the remuneration report and exit packages, severance payments and off-payroll engagements disclosures

In respect of the relationship between individuals in the remuneration report and links to exit packages, severance payments and off payroll engagement disclosures, the following information is applicable:

* Exit packages – no relationship                     

* Severance payments – no relationship                     

* Off Payroll Engagements – Dr Y. Owen has previously provided Out of Hours practitioner services to the Trust as an independent contractor until 31 May 2019. The value of this can found in the related parties’ disclosure of the Trust Annual Accounts 2019/20.  

Remuneration policy for directors and senior managers

LCHS has a Remuneration Committee. The purpose of the committee is to agree appropriate remuneration and terms of service for the chief executive, executive directors and other directors including all aspects of salary, provisions for other benefits, arrangements for termination of employment and other contractual terms working to NHS Improvement.

Compensation on early retirement or loss of office

The Chief Executive left on 31 July 2023 and the Trust’s Remuneration Committee approved a settlement agreement:

In addition to the above were payments for annual leave accrued but not taken (£15,239) and TOIL earned but not taken (£3,110). Whilst the Trust was in receipt of professional advice and guidance on this matter (including the necessary approvals) at the time, it has since been confirmed that the necessary approvals were not in place. The Trust is currently in the process of seeking the necessary approvals retrospectively.                            

Payments to past directors

The Trust has not made any payments to past directors in 2023-24 (2022-23: also nil).

Fair pay disclosure (subject to audit)

Reporting bodies are required to disclose the relationship between the remuneration of the highest-paid director in their organisation and the median remuneration of the organisation's workforce.                                                                                                               

The banded remuneration of the highest paid director in Lincolnshire Community Health Services NHS Trust in the financial year 2023-24 was £175-180k (2022-23: £160-165k - an increase of 12.82%). This was 5 (2023-24: 5) times the median remuneration of the workforce, which was £36,590 (2022-23: £32,934 - an increase of 12.97%).                                                                                                     

In 2023-24 one employee received remuneration in excess of the highest-paid director (2022-23: 1). While the Chief Executive's entire remuneration in year is the highest value, it includes severance payments that have been omitted to improve comparability.

Remuneration ranged from £767.97 to £185,231.72 (2022-23: £767.97 to £167,452.95)          

"Total remuneration above includes salary, non-consolidated performance-related pay and benefits-in-kind. It does not include severance payments, employer pension contributions and the cash equivalent transfer value of pensions.

Payments made to agency staff have been excluded as these mainly relate to payments made to cover absences of existing employees whose whole time, full year equivalent remuneration has already been included in the calculation of the median. Agency costs also include elements for travel, national insurance and the agency’s commission which are not separately identifiable and would serve to distort the overall figures." 

For all off-payroll engagements as of 31 March 2024, for more than £245 per day:

For all off-payroll engagements between 1 April 2023 and 31 March 2024, for more than £245 per day:

1. A worker that provides their services through their own limited company or another type of intermediary to the client will be subject to off-payroll legislation and the Departments must undertake an assessment to determine whether that worker is in-scope of Intermediaries legislation (IR35) or out-of-scope for tax purposes.

For any off-payroll engagements of board members, and-or senior officials with significant financial responsibility, between 1 April 2023 and 31 March 2024

1. There should only be a very small number of off-payroll engagements of board members and/or senior officials with significant financial responsibility, permitted only in exceptional circumstances and for no more than 6 months
2. As both on payroll and off-payroll engagements are included in the total figure, no entries here should be blank or zero.

In any cases where individuals are included within the first row of this table the department should set out:

* Details of the exceptional circumstances that led to each of these engagements

* Details of the length of times each of these exceptional engagements lasted

Staff Sickness Absence

Whilst overall sickness absence has fluctuated across the year, it has consistently been above the 5% target for the majority of the year, peaking at 6.03% in January 2024 with a low of 4.47% in March 2024. 

The increase during the period August to January has been due to a combination of long and short term sickness, with the short term absence mainly being attributable to infectious diseases (covid 19), cold/cough/flu and gastrointestinal problems.  A common theme throughout the year is anxiety, stress and depression (ie mental health reasons) being in the top 3 reasons for sickness absence and this is consistent for both short and long term sickness.

Long term sickness absence has remained above the 3% target for the majority of the year, increasing to 3.68% in August 2023 and with a low of 2.28% in March 2024, which is below the target.  In addition, to mental health reasons, the other main reasons for absence were ‘musculoskeletal problems’, and ‘heart, cardiac and circulatory problems’.

Health and wellbeing

The Holistic Health offer has continued to be reviewed and adapted to support employees including the system wellbeing hub and comprehensive health and wellbeing offer. Significant mental health support is available to staff which includes promoting emotional wellbeing support services available to employees (local, system and national offer), revising our approach to promoting health and wellbeing through virtual platforms and face-to-face options to connect with a champion/mental health first contact to try and encourage greater usage by employees, Mental Health First Aider training, a peer support group for existing Mental Health First Aiders, health and wellbeing conversation sessions for leaders, Holistic Health Champions and Mental Health First Contacts to help build the capability and offer tools to be able to hold these conversations effectively. In addition, the use of an EAP (Employee Assistance Programme) continues to be available to staff, through our provider, Health Assured. The Physiotherapist for You service has continued to support staff during this time both virtually and with the re-introduction of face-to-face clinics and maintaining a presence on all forms of communication including Facebook. 

The LCHS leadership offer - Leadership Development Programme - Behaviours (LDPB) continues to deliver alongside the Leadership Tube Map. This has a strong focus on leading with compassion, which spans 4 core modules: Self compassion and leadership, leading and embedding compassionate cultures, compassionate team leadership and compassionate leadership across boundaries. What was previously the enhanced health and wellbeing COVID-19 responsive offer has continued and now become ‘business as usual’ and the role of a non-executive director as a wellbeing guardian has been embedded into the Trust.

Staff health and wellbeing offer continues to be delivered with a blend of virtual and face-to-face options to encourage connection and create a sense of belonging.

‘Talk to TLT’ continues as a virtual platform for our executive and senior leaders to communicate with the organisation on a monthly basis. Our quarterly ‘Responsible Together’ events have re-launched face-to-face and consist of a variety of guest speakers, enabling up to 100 leaders to connect and engage with each other.

Staff survey

The survey response rate is 56%. This is a decrease of 1% from the 2022 survey and is 4% lower than the average response rate for our national benchmarking group. 

The overall Staff Engagement Score (SES) is 7.1 (out of 10) which is a decrease of 1% from 2022. This is the lower than the average score for our national benchmarking group at 7.3. The overall Morale score is 6.0 (out of 10) which is 1% lower than in 2022. This is the lower than the average score for our national benchmarking group at 6.2.

Of the seven People Promise elements, we have stayed the same in six elements and have seen a marginal decrease in one element from 2022. In comparison to our CT benchmarking group, we were the same as the average in two of the People Promise elements and below the average in five elements.

LCHS chose to focus on two of the People Promise elements to improve in 2023 and both elements have remained the same as last year.

LCHS Staff Survey Overview 2023

Staff Turnover

The graph above shows staff turnover throughout 23-24 based on a rolling 12 month period.

Rolling turnover was consistently below the Trust threshold of 15% throughout the period.  However, this saw a significant decrease from August 23 onwards as a previous tupe transfer of staff out of LCHS in August 22 fell outside of the rolling 12 month period, which had been impacting on this. Turnover increased again slightly from December 23, due to a further tupe transfer out of staff in relation to the Child Health Service.

Proportion of temporary staffing

Temporary staffing costs increased during May to August 2023 and have then seen a steadily declining position since September onwards. This is due to tighter controls on spend and a focus on driving down agency costs to meet agreed national rates (cap compliance) and ensuring that rosters are filled in the most efficient ways and agency is only used as a last resort when necessary.

Appraisals

The Trust’s has a set appraisal window of 1 April – 30 June each year and this is reset each year in April – hence the significant decrease in April which then increases during May and June. 

As at the end of the official reporting period, LCHS achieved 87.94% (against at target of 95%), although this continued to steadily increase during the remainder of the year.  Whilst the appraisal target was not achieved, this is still another strong performance under challenging times.

Staff numbers and costs

The following tables provide an overview of staff distribution across staff groups and seniority grading within the Trust for the full headcount for the Trust.  However, the overall number of whole-time equivalent (WTE) staff the Trust had in post as at 31 March 2024 is 2066.12. 

Number of employees (FTE) at 31/03/2024 & 31/03/2023

The table below gives the breakdown of the ethnicity of LCHS’ staff on a headcount basis. The majority of LCHS’ staff (2,033) are white – British.  However, LCHS has seen an increase in 23-24 of within the Asian or Asian British and Black or Black British ethnicity groups, which is due to a successful international recruitment campaign for both nurses and AHPs.

Headcount by ethnicity

Fairness and equity

Lincolnshire Community Health Services fully embraces Equality, Diversity, and Inclusion across all protected characteristics. The Trust has a range of policies and procedures to support this. There are also legislative requirements that underpin the Trust’s practice, policy, and service developments. These are subject to regular scrutiny in the governance framework of the Trust.

During 2023, the Trust has had several successes including publishing the Equality, Diversity and Inclusion Annual Report as well as publishing the annual reports and action plans for the Workforce Race Equality Standard (WRES) and the Workforce Disability Equality Standard (WDES). One of the highlights for the LCHS WDES was the increase of staff declaring their disability status from 2022 at 5.8% to data in 2023 9.6% of staff declaring a disability. LCHS has completed the Equality Delivery System with key actions for the pilot teams of engaging with local communities and increase collection of patient equality data.  The next steps have been that all services will complete and self-assessment.

The Gender Pay Gap was published in line with the Public Sector Equality Duty as well as a succession of celebration webinars for LGBT+ History month, Carers Week, Black History month and Disability History month.  LCHS has started work on the NHS EDI improvement plan which includes looking at the Race Pay Gap.

The Trust’s Staff Networks have continued to increase the opportunity of access to all staff. The Black, Asian, Minority and Ethnic (BAME) and Allies staff network meets monthly and has now changed its name to CODE (Celebrating our diversity everyday), and the Mental and Physical Lived Experience (MAPLE) staff network now meets monthly and is aimed at staff with disabilities and long-term conditions, the Lesbian, Gay, Bisexual and Trans plus (LGBT+) staff network and the Carers . Other support staff networks have emerged –, , Women’s Group and Men’s Group (the Shed).  The Armed Forces staff network is also going forward in leaps and bounds with key involvement with Armed Forces Covenant and the Veteran Aware accreditation.  The Trust holds Disability Confident Employer status.

The Trust has strong links nationally, working closely with NHS Employers and NHS England. This has been supported by technology, accessing webinars, and being involved in discussions both regionally and nationally. The EDI programme has been embedded into the LCHS People Plan and work is in progress with the new nation Equality and Inclusion Improvement plan. The EDI team are continuing to roll out the Cultural Intelligence programme within LCHS.

We recognise from our staff survey data that staff who are in protected groups believe we could do more to ensure there is fairness in all aspects of the recruitment and management of staff. We need to do more to ensure that all staff groups are properly represented at all levels within the organisation. We know that staff with protected characteristics are underrepresented at more senior levels in the Trust (BME staff and staff with disabilities). Equality and Diversity is at the heart of our People Plan.

Health and safety at work

The accident figures for 2023/24 were consistent with a normal operating year. There were 109 staff accidents in the year as opposed to 100 last year and 119 the year before.

The types of injury are consistent with previous years, the majority resulted in no or low harm and included:

• needlestick (a needlestick injury is the penetration of the skin by a needle or sharp object), these have much reduced over the year.
• slips trips and falls.
• musculoskeletal (mainly sprains and strains and soft tissue damage).

There were 322 patient incidents reported for 2023/24. This is very much in line with the previous 2 years incidents. Of these, 88 patient injuries reported were all low harm and 4 reported as moderate (short-term harm). Most incidents were slips, trips, and falls and work continues to assess patients and implement control measures as they come into LCHS’s care. The statistics indicate that staff performed extremely well under very difficult circumstances.

There were three Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) accidents in the year (reportable to Health and Safety Executive). This is in line with previous years.

The health and safety input this year was focused on supporting the work ongoing throughout the Trust and wider group, working closely with Infection Prevention and Control, Estate and Facilities providers and external contractors.

Key activities included:

• Working closely with ULHT Estates and Facilities team on supporting a transition to the group model approach to fire safety and Health and Safety delivery.
• Supporting NHS Property Services with the Lincolnshire Fire and Rescue visit and audit of Skegness Hospital.
• Implementing a new portable appliance testing (PAT) contract within the Trust.
• Working with NHS Property Services on building audits for the Trust community hospitals.
• John Coupland Hospital, Scotter Ward - supporting the design and construction of the new ward in the location of Morton Suite.
• Providing health and safety advice for Boston Urgent Treatment Centre around the Accident and Emergency construction work.
• Commencement of a health and safety audit in conjunction with the Trust and wider group.
• Assisting in a fire audit undertaken by the Trust’s Authorising Engineer Fire.

Signed: A Morgan                             Date Signed: 30/06/2024