The Screening for the Future Programme: Strategic Review Progress Update

Transcription

1 5.QSIC Screening for the Future The Screening for the Future Programme: Strategic Review Progress Update Author: Sarah Barnes, Programme Manager, Screening for the Future Date: 13 February 2018 Version: 1 Sponsoring Executive Director: Dr Quentin Sandifer, Executive Director Public Health Services and Medical Director Who will present: Dr Sharon Hillier, Acting Director of Screening Division Public Health Wales Date of Committee meeting: 27 February 2018 Committee/Groups that have received or considered this paper: None. The Committee is asked to: Approve the recommendation(s) proposed in the paper Discuss and scrutinise the paper and provide feedback and comments Receive the paper for information only X Link to Public Health Wales commitment and priorities for action: (please tick which commitment(s) is/are relevant) X Priorities for action include relevant priority for action(s) Date: 13 February 2018 Version: v1 Page: 1 of 3

2 5.QSIC Screening for the Future 1 Introduction This paper is being presented to the Quality, Safety and Improvement Committee to update on the progress to date of the Screening for the Future programme and to inform of future plans. The paper also contains the potential workstreams that will be developed to take forward the Screening for the Future programme. 2 Background An external review of the Screening Division was commissioned by the Executive Team of Public Health Wales in early 2016, which was completed in December A paper was submitted to the Committee on 2 May 2017 which provided an overview of the report findings, detailed the 20 recommendations included in the report and identified those that had already been addressed. The Screening Division Senior Management Team has reviewed the recommendations in January 2017 and there was broad agreement with many but some needed further scoping and detailed consideration. The Screening Division Senior Management Team proposed that the findings from the review and other drivers became part of a single programme of work to develop the Division. This is now referred to as the Screening for the Future Programme. The aim of Screening for the Future is to enable the Screening Division to design, manage and implement successful service development. There will be particular emphasis on making the division sustainable for the future in order to be more resilient and adaptable to taking on additional screening programmes or managing changes in scope of existing ones. At the end of May 2017, a series of staff engagement exercises were carried out across Wales with staff across all the screening programmes. These sessions were facilitated by the 1000 Lives team and aimed to include staff views to shape how the project was developed. The workshops were focused around four questions: How do we deliver the best programme for those invited to screening? How do we learn from each other so that we can deliver the best possible programmes? How do we ourselves in screening so that we can deliver the best programmes? How do we increase levels of trust, respect, support and feeling valued and make this a great place to work for staff? Date: 13 February 2018 Version: v1 Page: 2 of 3

3 5.QSIC Screening for the Future The staff engagement events were well attended and over 130 questionnaires, addressing the four questions above, were completed. All the questionnaires have been reviewed and grouped into themes. Many of these themes aligned with the recommendations of the external review and have supported the development of the programme workstreams and plans. 3 Timing A programme manager for the Screening for the Future Programme started a two-year secondment in August The Programme Manager will develop a plan of work until the end of July Any remaining work will be taken forward by the Division. 4 Description To date the following actions have been undertaken within the programme: A Programme Board has been set up and the first meeting was held on 22 November 2017 to scope the development of the programme. This meeting focused on setting the vision and direction for the programme. It also considered the supporting documentation including terms of reference, programme organisational and programme plan. The Screening Division Senior Management Team will act as the Programme Team in the first instance to support shaping the workstreams. Once the workstreams are established, the Programme Team membership will be reviewed. The recommendations have been reviewed by the Programme Team and progress against each recommendation has been documented. Those recommendations not yet addressed, alongside the staff feedback from the engagement events, have been scoped further to provide potential workstreams that will be taken forward as part of the Screening for the Future programme (Appendix 1). 5 Financial Implications To date the only financial implications have been the fixed term appointment of the Programme Manager. There is currently no additional funding attached to the delivery of the programme. Should any identified workstreams need additional funding a business case will need to be developed to support this and funding identified. 6 Recommendation The Committee is asked to NOTE the report and the supporting appendices. Date: 13 February 2018 Version: v1 Page: 3 of 3

4 Screening for the Future Defining Workstreams Programme Manager: Sarah Barnes, Programme Manager Senior Responsible Owner: Dr Quentin Sandifer, Executive Director Public Health Services Date: 12 Feb 2018 Version: 1a Publication/ Distribution: Screening for the Future Programme Board Screening for the Future Programme Team Screening Division Senior Management Team Quality, Safety & Improvement Committee Purpose and Summary of Document: This document highlights the progress against each of the External Review of Screening Division recommendations. It also provides a list of potential workstreams to be developed to take forward the Screening for the Future programme. Work Plan reference: Priority 6; Supporting the development of a sustainable health and care system focused on prevention and early intervention 1

5 Introduction The table below highlights the progress against each recommendation and possible actions to be undertaken to take those not currently addressed forward. The feedback from the staff engagement events has also been included in this exercise as this will also need to form and underpin the Screening for the Future work. There are currently three levels of work operating within the Screening Division. The ongoing operational work (day to day), the development and improvement projects to meet updated UK National Screening Committee and Welsh Screening Committee recommendations (e.g. HPV test as screening test for cervical screening and introduce faecal immunochemical test as screening test for bowel screening ) and the Screening for the Future work (e.g. making the Division more sustainable and resilient to change and future development). Development of potential workstreams Some of the overarching themes that came from both the external review and the staff engagement events are highlighted below. Structures & Function Delivery models Quality Assurance Workforce planning & staff development Engagement and Communication (Internal) Engagement and Communication (External) Corporate Identity Pathways Modernisation A summary of the workstreams identified from the review and staff engagement to be taken forward are identified as Develop an Internal Engagement Strategy and Communication plan for the division Scope how screening ensures uses technology to improve service users ability to engage with services and uptake their invitation Develop the team to ensure staff feel engage, listened to and able to contribute to developing the service Scoping exercise to review the senior leadership Review Diabetic Eye Screening Wales to ensure fit of purpose 2

6 Scope admin and pathway functions and review the appropriate line management. Mapping exercise to look at senior manager roles look at the core competencies and functions needed for the role Workshop with the nurses to scope benefits/dis-benefits of being line managed within the programme or within the Head of Nursing. Scope the Quality Assurance input and requirements for each programme to ensure consistency of approach and robust quality assurance Scope core regional Feasibility study to scope the merit of regional teams working within regional offices Workforce planning for the division and development of sustainable multidisciplinary staffing with staff development routes Workforce development o Training & career development o Links to staff survey action plan o Staff management o Staff recognition 3

7 Appendix 1 Review of progress made against recommendation in the external review and identified further action Theme Sub Theme Recommendation Has this Rec been addressed? If Yes, explain how. Structure Screening division Recommendation 7: To manage the core Public Health Wales functions of HR, IT, Communications, and Finance as part of the Public Health Wales core functions and consider integrating the Engagement Team Most of the core functions that were within the Screening Programmes are now within the PHW core functions. The remaining IT staff that are within DESW will be based in CQ2 as part of the overall IT team from Apr 18. PHW currently does not have a core Engagement Team, although local public health teams link closely and have an engagement function in their location. The Screening Engagement team to remain part of the Screening Division as their role is vital to work to reduce inequities & improve accessibility of screening. PHW has published an engagement strategy and it is clear how this team fits within the overall function. What needs to be done? No further action to be taken Structure Structure Screening division Screening division Recommendation 8: Recruitment of new Director of Screening with clear strategic leadership and managerial focus and public health / population screening expertise Recommendation 10: Review of senior leadership Director of Screening strategic lead with fewer direct reports New for the management of all Heads of Programmes In Progress An Acting Director of Screening is currently in the role. The substantive post is currently out to advert and will be appointed to in Q4 2017/18. In progress This will be reviewed once the substantive Director is in post. Action in progress therefore no further action to be taken This recommendation will need further scoping. The initial work can be started before the Director is appointed, but final decision will wait until the post has been filled on a substantive basis. A scoping document will be written up outlining the feasibility of addressing this recommendation. This will include: Benefit review and options Map out what this will potentially look like What posts will be affected by this change 4

8 Theme Sub Theme Recommendation Has this Rec been addressed? If Yes, explain how. Structure Screening division Recommendation 14: Review of clinical input for each programme a) Are all posts required, should there be more concentrated expertise b) Identify single clinical advisor/director to each programme (?All-Wales lead) In Progress This will be taken forward as part of the Screening for the Future programme. Plans are already underway with BTW to address point c). The QA function will be scoped under the Screening for the Future programme. What needs to be done? a.) & b) will be looked at together. Each programme can describe what they currently have as their QA input. This can be done by defining what is needed and map what we already have in order to improve consistency. QA processes need to avoid a single point of failure d. ) Reviewing the QA processes can be built into the Screening for the Future programme plans. c) Strengthen nonmedical programme expertise to lead initiatives and address shortages of consultant roles d) Continually review to ensure consistency and sustainability Structure Screening division Recommendation 15: Management of programme specific administration functions to be within programme teams, including newborn hearing/newborn bloodspot screeners/coordinators In progress This will be explored further as part of the Screening for the Future programme. Work is currently taking place on workforce planning within Maternal and Child Screening Programmes. There needs to be clear definition within programmes around what is administration and what is pathway management. The narrative from the review needs to be looked at in more detail and discussed further with the Programme Team. A scoping exercise will be carried out to identify the benefits of the functions within the programme and review the line management functions to best practice. 5

9 Theme Sub Theme Recommendation Has this Rec been addressed? If Yes, explain how. Structure Screening division Recommendation 16: Management of screening division core administration functions to remain with the Head of Administration (Operations) Management of regional or national call / recall, failsafe/pathway management No change to the current model, but some work will need to be done to explore defining the roles more clearly. This can be addressed alongside Recommendation 15. The Head of Administration is temporarily leading DESW admin team to establish fail safe processes and ways of working. What needs to be done? This will link with recommendation 15. Scoping out what is Administration and what is Pathway Management. A change of job titles and generic job descriptions may make this distinction clearer and HR will need to be involved in this process. Recommendation 1: The Screening Division should ensure an All-Wales approach for all programmes, based on standard operating procedures, and work towards regional teams within regional offices Regional Screening Centres In progress Implementing an All Wales approach is addressed. SOPs are currently being developed for DESW to bring in line with the other programmes. The recommendation about working towards Regional teams will be explored further. The focus will remain on delivering an equitable, all Wales service. A feasibility study will be conducted to scope the merit of regional teams within regional offices. This piece of work can explore the use of PHW owned buildings for clinics and to look at the possibility of screening centres. Need to link with the North Wales Our Space project. Structure Programme Recommendation 11: Review of programme s a) All HoPs should have the same job description HoP have the same Job Descriptions across all programmes. A mapping exercise will be conducted to review JDs and look at core competencies within roles. This can review common managerial functions, and core and specific programme functions and duties. To include programme specific nursing and administration roles Structure Programme Recommendation 12: All nursing and midwifery posts to be operationally managed by their respective Head of Programme In progress This is currently happening in MAC, DESW and BTW. This will be explored further with the other programmes. Engagement with nurses will need to occur when addressing this recommendation. To hold a workshop with nurses across the programmes on what the benefits and disbenefits would be of having nurses line managed within each programme. This will need to cover suitable reporting mechanism and professional accountability. 6

10 Theme Sub Theme Recommendation Has this Rec been addressed? If Yes, explain how. Structure Programme Recommendation 17: Review specifically MAC group Consideration that HoP is managing multiple programmes Regional managers requires appropriate skills and grade for role Strengthen maternity leadership/manage ment in ASW Not addressed yet Although this recommendation refers to MAC, this will be taken forward as part of the structural development work of the whole Division. Some workforce planning work with MAC is currently underway. What needs to be done? A workforce planning review is currently being undertaken in MAC. The Head of Admin has already done some work that will bring about changes. This recommendation needs to be undertaken as part of the wider work on divisional. A scoping exercise will be carried out to assess the readiness of the division to take on another programme and how the division should be organised to do this. The learning from setting up new programmes and the experience of inheriting programmes needs to be considered when undertaking this work. Structure Programme Recommendation 18: Review specifically DESW management Consideration that line management needs to be implemented across all grades In Progress Work has been undertaken to review the current arrangements in DESW. There is work underway to develop a Quality Manual and fail safe processes. A workshop was held in Oct 17 to scope the development of a new organisational within DESW. New HoP starting 8 Jan 2018 and will lead on taking this work forward. This is currently underway and will remain part of the Screening for the Future programme. The new HoP will take the lead with support from the Screening for the Future Programme Manager. Structure Programme Consider the introduction of regional managers (one in North currently) Recommendation 19: WAAASP line manager should be under the same as other programmes In progress Part of Recommendation 10 See actions for recommendation 10. Delivery model (geograph y and Recommendation 11. b: b). All roles programmes to have core that formalises national and regional roles Not yet This will be scoped further as part of Screening for the Future. Not started yet. This work can be addressed alongside recommendation 10. CSW have recently implemented a regional. This needs to be reviewed when considering the possibility of core regional s. 7

11 Theme Sub Theme Recommendation Has this Rec been addressed? If Yes, explain how. managem ent) What needs to be done? A framework for managers will be developed. A benchmarking exercise needs to be conducted. Screening Pathways Recommendation 2: A review of screening pathways and programme standards to ensure they clearly identify the screening end point and hand over points In progress A dedicated member of the Business Team provides performance reports to one Health Board on a monthly basis. There is regular cross-programme meetings with the Health Board to explore if it improves performance. Work to continue to communicate clear end points. This work is currently underway and will be monitored to see if it improves performance. Resourcin g and Corporate links Business planning Recommendation 3: Business planning (including forward look) to be a fully integrated part of Public Health Wales business planning process No further action to be taken Recommendation 4: Three year forward planning should be maintained to ensure funding levels are appropriate, with reviews each year to overcome the difficulty in projecting future costs accurately No further action to be taken Finance Recommendation 6: Improve flexibility within the financial management to include phasing of budgets and enable, where possible virement across budget lines Budget planning taking place on a programme basis to ensure all parts of the budget explored. Vacancies scrutinised and vacancies without robust plans are removed. Clinically required posts funded across programmes from removed vacancies. No further action to be taken Recommendation 20: Review HPV Primary screen pilot plan and ensure source of funding is agreed and manage transition Work going well with planned implementation for Oct No further action to be taken 8

12 Theme Sub Theme Recommendation Has this Rec been addressed? If Yes, explain how. Recommendation 5: Re-baseline screening Funding project - secondment - all other resources within budget. No budgets following additional resources identified implementation of any agreed recommendations What needs to be done? No further action to be taken Human Resources Recommendation 13: All nursing and midwifery roles and functions to be review to ascertain divisional nursing grading. Some nursing roles are currently not very clinical Not to be addressed Nursing and midwifery roles follow Agenda for Change processes as other roles. This recommendation will not be implemented as it is not clear why this would be necessary if other roles within the programme are not reviewed. Engagement work with the nurses to be taken forward in conjunction with recommendation 12. This recommendation will not be taken forward, but the nursing roles will be included in recommendations to review overall s. Communicat ions and Engagement Recommendation 9: Screening documentation, web content and facilities to be dual branded with Public Health Wales and develop common styling and format of screening products Our products are dual branded and work with communications on publicly facing documentation. Inline with PHW documentation No further action to be taken. 9

13 Appendix 2: The feedback from the staff workshops will also be incorporated into the Screening for the Future programme. The following themes will be embedded into the workstreams. Theme Staff Suggestions Detail of suggestions What actions need to be undertaken Modernisation more non-written information / stop developing more written info without finding out how we ensure it gets to its intended audience text reminders address poor Video Conference facilities appointments Paperless Electronic results Convenient opening hours for working people Education films There are ongoing development projects within the Division e.g. FIT, HPV Primary testing, PACS etc. This work needs to fit closely with existing improvement projects to ensure coordination and sequencing. Flexibility appointment times not flexible enough working people stop double appointment bookings have staff in base that can transport equipment to cover clinics at short notice work / life balance difficult and according to staffing programmes do not offer equitable service length of appointment stop screening in clinics that are not appropriate Better Engagement (Internal) encourage suggestions informal forums face-to-face with all screening programmes involvement in decision making engaging with patients passing on info about other programmes explain reasons for decisions staff may not agree, but if they understand they ll accept An Internal Engagement and Communications Strategy and Plan to be developed for the Division incorporating these themes. Communication (Internal) listen to staff / engage with staff before re- engagement integral to delivering best programme using engagement team More access to up to date information telephone numbers etc Forums / monthly newsletters to share information More regular feedback on the findings of these sessions and how the changes will improve things for both staff and service users Better communication Listening and acting on things Learn about targets and figures of other programmes Encourage suggestions No filtering down of information to staff To incorporate into the communication strategy for Screening for the Future. 10

14 Theme Staff Suggestions Detail of suggestions What actions need to be undertaken Devise and map a screening org chart with explanation of what we do particularly managers Marketing and Branding Website streamlined Website updating youtube of mammography Specific engagement with men particularly hard to reach groups (workingmens clubs, local pubs) Suggest subject for storylines into popular TV programmes to educate population Advertise more on public transport Go to local events / festivals let people see what van looks like This can be linked with Recommendation 9 SET to consider this as part of their work planning and approach. Identity with Public Health Wales I feel part of my small team but not Public Health Wales more interaction between services in Public Health Wales screening being seen as a resource by Public Health Wales crossover between screening and public health initiatives Some links with Marketing and Branding theme To incorporate into PHW values and behaviours into workstreams and ways of working to ensure staff recognise and work to these. Values & Behaviours invest in the right people respect & support place trust in employees look after your staff Cohesive Team Building Stop being so corporate have some fun More days where staff come together to discuss their roles More staff engagement Team building days At a staff meeting a talk from each of the screening teams and what they do More opportunities to attend events like this Team building days Meet up regularly with other colleagues Stop being so corporate have some fun Happy staff To link with the staff engagement and communication work plan to be developed. Better cross working Improve collaboration across programmes stop isolating teams and missing ideas stop working in silos Workforce Development Over arching view in what each screening service does why, by who and how? Look at what makes some services work well Some of this is being taken forward on an organisation wide basis in Priority 1 of the NHS Staff Survey action plan that has been developed in response to the Staff Survey 2016 results. 11

15 Theme Staff Suggestions Detail of suggestions What actions need to be undertaken Outside of Cardiff can feel distanced from PHW training provided equally in North/West of Wales Welcome induction for staff that are not based in Cardiff Induction events available in all regions not just South Wales Training allow programmes to plan training to fit around clinic times so not having to cancel clinics Last minute training session needs planning 3 months in advance More training days Shadowing across teams My contribution not suitable for all staff groups ESR too many courses to do Staff training and development allow programmes to plan training to fit around clinic times so not having to cancel clinics protected time for training advanced practice should be considered within programmes, where not already being used tailor things like My Contribution to level of staff and their personal wish to develop Staff Management Recognition and positive user engagement share management skills addressing poor morale some managers too inflexible to consider career development Sharing success stories Recognise thanks from patients / other staff log complaints Acknowledgement for a job well done feedback to staff members Compliments passed on to staff members Recognition of staff contribution This is being addressed by Priority 2 of the NHS staff survey action plan. Work in line with agreed actions. Screening Pathways Need to clearly define the cut-off between screening responsibility of Public Health Wales and diagnosis and whose responsibility it is better integration with health boards consistency of health boards working with screening Links to Recommendation 2 12