Remuneration and staff report

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 2022 and 31 March 2023, there were four meetings of the Remuneration Committee.

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 bonus 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.
8. E Baylis was awarded a backdated pay increase for 2021/22 (contributing to total salary value) of between £10-15k in 2022/23. NHS England have been conducting a pay review of NHS Trust Chairs across the country in order to align them to the size and income of each individual trust, this backdated pay increase was awarded on the basis of those findings and national and regional NHS England approval.

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: The NHS Pension Scheme allows for individuals who have opted out of the scheme due to pension tax issues to use the employer element as additional payments to salary.
3. Since July 2019 Mr Morgan has been on secondment at United Lincolnshire Hospitals Trust (ULHT). The costs of his employment are recharged to ULHT and therefore the net cost is nil. Mr Morgan opted out of the pension scheme in 2019 and permanently left LCHS in July 2021. There is a difference in presentation due to his secondment ending in year.

* 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.

* Dr Owen is not a member of the NHS Pension Scheme in relation to employment with LCHS.

• Note: Cash equivalent transfer value (CETV) figures are calculated using the guidance on discount rates for calculating unfunded public service pension contribution rates that were extant on 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 20.68% of pensionable pay (2022/23: 20.68%). Staff are able to make additional voluntary contributions alongside their regular contributions.

• 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.

This value does not represent an amount that will be received by the individual. It is a calculation that is intended to convey to the reader of the accounts an estimation of the benefit that being a member of the pension scheme could provide.

The pension benefit table provides further information on the pension benefits accruing to the individual.

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.

LCHS has a Remuneration Committee. The purpose of the committee is to agree on 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 of working to the NHS Improvement.

The Trust has not made any compensatory payments on early retirement for loss of office in 2022/23.

The Trust has not made any payments to past directors in 2022/23 (2021/22: also nil).

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 2022-23 was £160-165k (2021-22: £155-160k - an increase of £3.49%). This was 5.08 (2021-22: 5.05) times the median remuneration of the workforce, which was £32,934 (2021-22: £31,549 - an increase of 4.39%).

In 2022-23 one employee received remuneration in excess of the highest-paid director (2021-22: 0).

Remuneration ranged from £767.97 to £167,452.95 (2021-22: £767.97 to £159,343.59)

The 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.

The following table notes exit packages from 1 April 2022 to 31 March 2023.

Staff sickness

Whilst overall sickness absence has fluctuated across the year, it has consistently been above the 5% target for 11 of the 12 months in this period, peaking at 6.57% in December 2022 with a low of 4.52% in August 2022. This pattern does follow the usual seasonal variations with sickness absence being highest in winter and lowest in summer.

The increase during the last 4 months for example from December to March 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 (for example mental health reasons) being in the top three 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 much of the year, increasing to 3.86% in February 2023 and with a low of 2.71% in April 2022. In addition, to mental health reasons, in the first half of the year there was also higher absence due to ‘other musculoskeletal problems’ and in the second half of the year absence due to ‘heart, cardiac and circulatory problems.

For short-term absence, this has varied throughout the year, with it being below the 2% target for five out of the 12 months. This peaked at 3.09% in December 2022 and was at a low of 1.15% in August. Short terms absence across the year has mainly been attributed to anxiety/stress/depression, infectious diseases (covid 19) and gastrointestinal problems.

Staff turnover

The graph above shows staff turnover throughout 2022/23 based on a rolling 12-month period.

Rolling turnover was consistently below the Trust threshold of 15% in the first 4 months of 2022, however, this peaked in August 2022 at 15.4% due to the Transfer of Undertakings (Protection of Employment) (TUPE) out of LCHS of 54 staff from the Sidings GP practice. Since that period it has steadily been declining again to a low of 13.8% in January 2023. The turnover figure for March 2023 included 16 staff who had their fixed-term contracts ended as a result of the changes to the vaccination centres. Overall, turnover will take some time to decrease back to the previous year’s lower levels as this is calculated on a 12-month rolling basis so the August high will remain in these figures until August 2024.

Appraisals

The Trust’s usual appraisal window of 1 April to 30 June each year was extended for all areas to the end of July, with a further one-month extension to the end of August for some specific clinical teams where there was particularly high staff sickness absence and staffing level issues.

As at the end of the official reporting period, LCHS achieved 90% (against a 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.

Proportion of temporary staffing

For the majority of the year overall temporary staffing costs were above the 5% target, with highs of 8.17% in April 2022 and 8.0% in October 2022. For two months of the year this has been below the target at 3.27% in September 2022 and 4.28% in March 2023.

Whilst it has been above the 5% target consistently, there has been a decrease in agency costs moving to an increase in bank costs, which are more proportionate. The increased spend is due to the Trust continuing to be agile in response to the pandemic (early 2022 and then winter 22/23), summer pressures and supporting the Lincolnshire system with surge beds and due to a number of vacancies whilst substantive recruitment campaigns were underway for new services that were taken on at pace. The increase during 2022/23 of both short-and-long-term staff sickness absence at times has also resulted in additional requirements for temporary staff. This spend is now decreasing again.

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 has in post as of 31 March 2023 is 2022.95.

Staff costs

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 57%. This is a decrease of 5% from the 2021 survey and is the same as the average response rate for our national benchmarking group.

The overall Staff Engagement Score (SES) and morale scores were the same in 2021 and were average when compared to our national benchmarking group. In comparison to the 2021 National Staff Survey results, we stayed the same in six areas, we declined in one area and we improved in two areas. In relation to the People Promise, we were average in three areas, we were below average in two areas and above average in two areas, in comparison to our benchmarking group.

Of the nine areas of the People Promise and additional themes, LCHS has eight out of nine areas which are closer to ‘best in class’ than ‘worst’; only ‘We work flexibly’ is not.

Of the 11 directorates and divisions, community hospitals and the Integrated Urgent Care saw the greatest improvements when compared to 2021 results.

The Workforce Race Equality Standards (WRES) and Workforce Disability Equality Standards (WDES) have seen improvements across the majority of areas.

Health and safety at work

The accident figures for 2022/23 were consistent with a normal operating year. There were 105 staff accidents in the year as opposed to 123 last year and 91 the year before (was very low that year due to restricted services and homeworking in the pandemic).

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

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

There were 100 patient injuries reported that were almost all low harm. 9 resulted in moderate (short-term harm). This was an increase on the 87 of last year and 99 of the year before. The majority of 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 two 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, working closely with Infection Prevention and Control, estate and facilities providers and contractor management.

Key activities included:

• Water quality - regular sampling of outlets, supporting our third-party landlords and implementing controls to ultimately engineer out risks from legacy pipework and systems
• New workplace/area risk audit form – addressing CQC advice on how to improve our processes and documentation. Increased understanding of statutory estates-based aspects and staff-based aspects
• Gainsborough, John Coupland Hospital, Scotter Ward - advising on the monitoring of structural defects and the design and construction of the new ward in the location of Morton Suite
• Providing health and safety advice and assurance for the Sexual Health service in central Lincoln, Grantham, and Gainsborough
• Outpatient department, Gainsborough, John Coupland Hospital – Working with the Infection Prevention and Control team to support and address concerns. Then working with NHS Property Services as the landlord to mitigate and rectify any issues
• Assisting in a fire audit undertaken by the Trust’s Authorising Engineer Fire
• Supporting the review of all fire risk assessments across the Trust estate
• The Trust continued to support the mass vaccination sites.