Partnership Enabling Opportunities Performance Learning Equality DEVELOPING AND IMPLEMENTING THE WORKFORCE STRATEGY FOR NHS HIGHLAND

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1 DEVELOPING AND IMPLEMENTING THE WORKFORCE STRATEGY FOR NHS HIGHLAND July

2 TABLE OF CONTENTS Page(s) 1. INTRODUCTION 3 2. STRATEGIC CONTEXT 2.1 National Context 2.2 Local Context 2.3 Staff Governance Standard DRIVERS FOR CHANGE 3.1 Demographic, Epidemiological and Social Changes 3.2 Advances in Medical Research and Technology 3.3 Policy Changes Better Health, Better Care Action Plan Better Health, Better Care Planning Tomorrow s Workforce Today Delivering for Remote and Rural Healthcare NHS Highland Clinical Framework 3.4 Legislative Changes 3.5 Efficiency and Productivity 4. RESPONDING TO DRIVERS FOR CHANGE IMPLICATIONS FOR THE WORKFORCE WORKFORCE STRATEGY FRAMEWORK AND ACTION PLAN 5.1 Partnership Working Enabling Recruitment Opportunities for Retention Performance Management Learning and Equality and Diversity ROLES AND RESPONSIBILITIES GOVERNANCE AND PARTNERSHIP WORKING ARRANGEMENTS NEXT STEPS 39 APPENDIX I: Current Strategic Workforce Strategies and Plans 40 APPENDIX II: Human Resource Services 41 APPENDIX III: Partnership Structure 42 Acronyms 43 2

3 1. INTRODUCTION The development and implementation of the Workforce Strategy for NHS Highland will enable the Board s vision for how it intends to support, develop and manage its staff, now and in the future, in a coherent and integrated way, to be realised,. The Workforce Strategy will enable staff to help the people of the Highlands, to sustain and improve their own health, especially in disadvantaged communities and ensure better, local and faster access to high quality health care services, in line with the implementation of the NHS Highland Clinical Framework and Better Health, Better Care: Action Plan. The Board recognises, through its ambition, to have well trained, supported and valued staff to support the community s health and healthcare needs, that its staff are its most valuable asset. This Workforce Strategy supports the integration of service, financial and workforce planning and development, and promotes the human resources contribution to NHS Highland, by illustrating how the different activities associated with supporting, developing and managing people can enable the Board s strategy to be delivered more effectively. It is presented as a high-level strategic plan, which outlines the direction of travel and which builds on the existing Workforce Agenda, but aims to be responsive to the changing NHS Highland environment and new challenges. The purpose of the Workforce Strategy is: To ensure that NHS Highland has a local workforce strategy to support implementation of the Clinical Framework and the priorities within Better Health, Better Care: Action Plan; acknowledging the key drivers for change, which will impact on the Workforce, at both local and national level, now and in the future; To demonstrate the added value of supporting, developing and managing the workforce; in helping the people of the Highlands, to sustain and improve their own health, reduce inequalities in health and ensure better, local and faster access to health care, in a remote and rural setting and in helping NHS Highland to be an effective and efficient organisation. To develop a shared understanding and ownership, of the Staff Governance Standard, and of current and new workforce polices, strategies and plans and to ensure that they are prioritised and captured in one succinct document; To demonstrate the roles and responsibilities of human resources services, line managers, staff representatives and staff themselves, in supporting the delivery of the Workforce Agenda; and To confirm the governance arrangements and partnership infrastructure to develop and implement and performance manage the Workforce Agenda. 3

4 A formal sub-group of the Highland Partnership Forum has been formed to oversee the development and implementation of the Workforce Strategy and to ensure that the philosophies of partnership and engagement are explicit. The Workforce Strategy is intended to be a dynamic document and will continue to be developed through further engagement with key stakeholders the staff, staff side organisations, line managers, Human Resources Services, the committees and groups that support NHS Highland and key partners in service delivery. 2. STRATEGIC CONTEXT 2.1 National Context The Scottish Government s vision for a healthier Scotland should enable us to live longer, healthier lives, tackle the inequalities in Scottish society, ensure our children have the best start in life and get support when they need it, and ensure public services are high quality, continually improving, efficient and responsive to local people s needs. NHS Scotland makes a major contribution, not just through the delivery of health services that meet the needs of patients and communities, but also through boosting the economy by directly employing around 150,000 people and by improving levels of health and wellbeing for the whole population. As both service provider and significant employer in Scotland, NHS Scotland contributes to the delivery of priorities outlined in the Better Health, Better Care Action Plan. There have been significant achievements over the past year, which stand NHS Scotland in good stead to face new and emerging challenges, such as personalised care, long term conditions, moving towards more local delivery of care in our communities, the 18 week referral to treatment time target, and the demanding task of delivering against each of these challenges within an even tighter financial environment. Core to delivering against the action plan is a committed, well prepared, dedicated workforce that is both fit to practise and fit for purpose, and is proud to work for the NHS and to deliver services to patients. This relies on NHS Scotland using the talents and experience of staff in the best possible way, ensuring they are able to continue to give of their best and meet challenges to improve health and reduce inequalities, in addition to delivering healthcare services. Better workforce planning and employment practices that directly support the safe delivery of services in a way that is both affordable and sustainable will enable NHS Boards to take full advantage of a flexible and responsive workforce. 2.2 Local Context In line with Better Health, Better Care: Action Plan and the NHS Highland Clinical Framework, NHS Highland s primary purpose is to help people to sustain and improve their health, especially in disadvantaged communities, ensuring better, local and faster access to health care, within the context of national policy. Over the next five years, NHS Highland will need to continue to put patients at the heart of the service, tackle health inequalities, especially in remote and rural areas, and demonstrate commitment to continuous quality improvement and sustainable service provision. 4

5 The Board is responsible for assuring delivery on behalf of Ministers and the public and the Scottish Government assesses Board performance, through the implementation of the Local Delivery Plan and performance against the HEAT targets. The Board recognises that its ability to provide local people with high quality health care depends on the knowledge, skills and commitment of its employees and partners. 2.3 Staff Governance Standard Supporting, developing and managing people to provide better health and better care for the people of the Highlands, now and in the future, is underpinned by the Staff Governance Standard introduced in The development of the Staff Governance Standard was a comprehensive response to the cultural change first described in the White Paper Designed to Care. The supporting National Human Resource Strategy Towards a New Way of Working set out a framework that would recognise and realise the untapped potential within the workforce. Partnership for Care outlined the expectation that the NHS would be an exemplar employer for workplace learning and a champion for staff health and wellbeing and further strengthened the commitment to the effective delivery of Staff Governance through Partnership Working. Delivering for Health further demonstrated a commitment to Workforce Planning and and Pay Modernisation. Better Health Better Care: Action Plan and Better Health, Better Care: Planning Tomorrow s Workforce Today, continue to recognise the importance of staff as partners in service change and delivery and the importance of effective support, development and management of the workforce in providing high quality services. Staff Governance is defined as a system of corporate accountability for the fair and effective management of staff. The Staff Governance Standard, states that investment in staff is a direct investment in patient care and sets out what each NHS Scotland Board must achieve in order to improve continuously in relation to the fair and effective management of staff. Implicit in the Standard is that all legal obligations are met and that all polices and agreements are implemented. In addition the standard specifies that staff are entitled to be: Well Informed Appropriately Trained Treated Fairly and Consistently Involved in Decisions that affect them Provided with an Improved and Safe Working Environment. Workforce Planning and Pay Modernisation are also key components of Staff Governance. However, Staff Governance should not be seen as an end in itself, but as an integral part of the overall Governance agenda, the achievement of Board aims and objectives, and as a means to improving health and health care services. The Staff Governance Committee aims to ensure continuous improvement by supporting the creation of a culture, where the delivery of the highest possible standard of staff management and development is understood to be the responsibility of everyone working in NHS Highland. 5

6 The Staff Governance Committee remit is to assure the NHS Board that NHS Highland has systems in place to ensure the fair and effective management and development of all staff, and that staff performance is monitored and evaluated. Each element of Staff Governance is assessed in relation to policy, targets and organisational effectiveness. NHS Highland has a Staff Governance Integrated Action Plan and a Self Assessment Audit Tool that demonstrates progress. In addition, NHS Highland staff participate in the NHS Scotland Staff Survey and the results of this are incorporated into the process. The Staff Governance Committee is supported in its work by the Highland Partnership Forum. The Highland Partnership Forum ensures that all available data from the Self Assessment Audit Tool and staff survey results are used to create the Staff Governance Integrated Action Plan which in turn supports the Local Delivery Plan and the achievement of the HEAT Targets. Staff Governance is key to the effective and efficient delivery of services. Greater staff involvement in decisions that affect their work allows for better quality of decision-making. Research indicates that a culture of openness and involvement, with staff having a real say, has a direct impact on an employer s ability to recruit and retain staff. We also recognise that a workforce that understands the local population in its demographic make-up is better able to develop responsive inclusive services, and is directly related to the delivery of high quality care and patient satisfaction. 3. DRIVERS FOR CHANGE The Workforce and Staff Governance Agenda are now well established. However there are a range of key strategic drivers that will impact on NHS Highland Workforce in the future and the current Workforce agenda needs to be reviewed in light of the following drivers for change: Demographic, epidemiological and social change Advances in medical research and technology Legislative changes that underpin employment Policy changes that underpin service redesign, new ways of working and new roles 3.1 Demographic, Epidemiological and Social Change As the population ages, there is likely to be an increasing need for health care services. Factors that have and will continue to contribute to increasing demand in the health sector are as follows: Increases in life expectancy, Medical Advances that widen the range of conditions that can be treated; and Increasing expectations from the public regarding access to services. 6

7 As the population ages there may be increases in demand for elective treatment such as cataract and hip replacement surgery. Cancer and coronary heart disease are more common in later life and will necessitate a move to anticipatory care and the continuing provision of unscheduled care. There are several key demographic trends that correlate directly with the workforce: An ageing population and the disproportionate size of the baby boom generation means that large numbers of the current workforce will retire in the next years. A declining birth rate in some areas means there are less young people in the labour market. In addition, a particular challenge in Highland is the out migration of young adults for education to areas in the south of Scotland. However inward migration to the area, particularly from the European Union, will provide opportunity to enhance the workforce with staff from more diverse backgrounds. Overall population trends mask significant differences across Highland with an increasing pattern of concentration of population around the larger settlements of Inverness, across the Moray basin and population loss in more remote areas. This will present particular challenges in delivering health care services in remote and rural areas. 3.2 Advances in Medical Research and Technology Advances in medical technology clearly have an impact on the workforce, in terms of the requirement of new and enhanced skills and new ways of working. It is widely accepted that new medical technologies can increase the demand for healthcare, principally by increasing the number of treatable patients. It also has the potential to make interventions more efficient and to increase productivity in the workforce, either through swifter and more cost effective treatment or by opening up the provision of care to a wider pool of healthcare staff. Likewise advances in non-medical technology and its increased use in the NHS may also impact on the efficiency and effectiveness of the workforce. 3.3 Policy Changes Better Health, Better Care: Action Plan Better Health, Better Care: Action Plan December 2007 has three overarching drivers with actions from each supported by a number of commitments and actions. Towards a Mutual NHS: The concept of mutuality visions a shift from seeing people as patients or service users to seeing people and staff as partners or co-owners. Working towards a mutual NHS will be achieved through strengthening public ownership, by reinforcing rights to participate, through, public partnership for a patient s experience, patient s rights, Board elections, participation standards, annual ownership reports and independent scrutiny. Mutuality will also be strengthened through embedding patient experience information in the performance management of the NHS and strengthening the collaborative and integrated approach to service improvement that is the hallmark of the Scottish NHS. There is no expectation that there will be a change in financial or structural arrangements. 7

8 Helping People to sustain and improve their Health, particularly in disadvantaged Communities: The Action Plan puts this in the context of the need for greater emphasis on joint working in order that NHS Scotland, Local Authorities and partners can deliver what is seen as a shared agenda and sets out actions to increase the healthy life expectancy in Scotland. These actions make the link between early life adversity and adult disease, reduce health inequalities, particularly in the most deprived communities and reduce smoking, excessive alcohol consumption and other risk factors to a healthier life. Ensuring Better, Local and Faster Access to Healthcare: The Action Plan sets this in the context that improvement can only be achieved through shared ambition and effective joint working with the intention to enable and support patients to be partners in their care, make healthcare in Scotland safer still and a world leader in this area. The action plan will make access to primary care more flexible through redesigning services, spreading best practice and care for people with long term conditions, and will bring a more systematic approach to clinical effectiveness for example by reducing variations in practice. It is also the intention to modernise the NHS through better use of technology and delivering the quickest treatment ever available in Scotland s NHS Better Health Better Care Planning Tomorrow s Workforce Today The Scottish Government published Better Health, Better Care: Planning Tomorrow s Workforce Today to support the implementation of the Better Health, Better Care: Action Plan. The document outlines the requirements for Boards and Regions to further develop and integrate workforce planning with service and financial planning as well as developing the workforce function. In relation to Workforce, it highlights the need for NHS Boards to work in partnership with NHS Education for Scotland Delivering for Remote and Rural Healthcare The National Framework for Service Change identified a number of challenges in sustaining healthcare in remote and rural communities, a key challenge for NHS Highland. Delivering for Health subsequently identified a national work stream and established the Remote and Rural Steering Group to develop a policy framework which would address these challenges. The Remote and Rural Project had six objectives which were to: Deliver a strategy for sustainable healthcare in remote and rural Scotland; Define the role and function of the Rural General Hospital (RGH); Develop a framework of generic principles of service delivery for primary care in remote settings; Develop a rural education strategy; Review the role of the Helicopter Emergency Medical Service ; Develop workforce planning arrangements to support the remote and rural agenda. The final Report Delivering for Remote and Rural Healthcare was completed in December 2007 and an implementation plan is being developed. 8

9 3.3.4 NHS Highland Clinical Framework The NHS Highland Clinical Framework was originally developed to support the implementation of the Kerr Principles and Delivering for Health. It is now in the process of being updated to reflect Better Health, Better Care: Action Plan and the Remote and Rural Work stream. The Framework aims to achieve excellence in clinical quality, value for money and patient experience. It is clear from the Clinical Framework that the types of health care services delivered across NHS Highland will need to change and that these changes will impact on the workforce: More care will be delivered in a non-hospital setting; Currently care can be reactive, hospital centred and geared towards acute conditions. The future focus will be on integrated, anticipatory care, embedded in Highland communities and geared towards long term conditions; Priority will be given to care in deprived and remote and rural areas to reduce health inequalities; Emergency care will be provided separately from planned care so that planned care can be progressed more effectively for patients and with fewer cancellations for them because of emergencies; People will be encouraged to take more responsibility for their own health and well being and adopt health promoting preventative measures; More regional planning for hospital based services, with new networks of hospitals and partner agencies sharing the responsibility for providing key elements of acute care. 3.4 Legislative Changes There are a number of legislative changes in the areas of age discrimination; equality and diversity; maternity and support regulations; working time regulations and changes to pensions. In addition, there is a national requirement to improve efficiency and reduce sickness absence. Staff aspirations for work-life balance also require the development of a number of policies to promote attendance and create workforce flexibility. Implementation of Modernising Medical Careers (MMC) and the move towards fewer trained doctors represents a wide-ranging impact on other staff groups. Changes in roles of medical staff will emphasise the importance of exploring opportunities to develop new roles. Specific Legal, Regulatory and Policy influences that impact on the Workforce Better Health, Better Care: Planning Tomorrow s Workforce today, refers to a range of other Legal, Regulatory and Policy influences that impact on the Workforce, as follows; 9

10 Working Time Regulations (WTR) legislation: Reduction in junior doctors working hours to 48 hours per week by August Trust, Assurance and Safety legislation: The Regulation of Health professionals in the 21 st Century, confirms changes to be made to current regulatory systems through the UK Health and Social Care Bill; a number of orders under section 60 of the Health Act 1999 and associated guidance. Public Health legislation: Clarification of the roles and responsibilities of organisations involved in protecting public health; assigns the lead responsibility for the public health protection of people to NHS Boards. Mental Health (Care and Treatment) (Scotland) Act 2003 and Adults with Incapacity legislation: This framework helps to promote best care and treatment options for those who are mentally ill and unable to make informed choices. Clinical practice under continuous and rapid change policy: of academically talented individuals, who are likely to be highly influential in the future development and delivery of clinical services within Scotland. 18 week referral to treatment target: A whole journey waiting time target of 18 weeks from general practitioner referral to treatment, by December Pay and reward systems: Assumptions about workforce are changing or need to change to make best use of these opportunities, including improvements to efficiency, effectiveness and quality through implementation of the Knowledge and Skills Framework and making best use of the opportunities that the Career Framework can offer. New ways of working and using the workforce: Scottish and UK drivers are influencing new and hybrid role developments to meet the needs of service provision, often across traditional sector boundaries. 3.5 Efficiency and Productivity In a more challenging financial environment a range of initiatives and programmes around measuring and improving efficiency and productivity have emerged. These include national improvement programmes, benchmarking, measurement of output and quality, unit costing/tariffs, programme budgeting and work towards achieving greater integration of service, financial and workforce planning in Local Delivery Plans. In addition workforce planning needs to be both sustainable and affordable. The National NHS Scotland Efficiency and Productivity Programme has been established to assist bring Boards in identifying local improvements and efficiency savings. Achieving sickness absence targets is a key element for achieving improved workforce productivity. Sustained reductions in sickness absence levels will allow NHS Highland to adjust staffing levels and achieve efficiencies through reduction in overtime, use of bank and agency staff, etc. The staff sickness absence HEAT target is a challenging one for all Health Boards to achieve. Ongoing communication, leadership and ownership of this issue across the whole organisation are important for success. 10

11 4. RESPONDING TO DRIVERS FOR CHANGE IMPLICATIONS FOR THE WORKFORCE In response to some of the drivers for change and to ensure that staff are able to perform at their full potential, over the last few years, the Board has supported, developed and managed its workforce, with the introduction of a number of strategic human resources policies, initiatives and plans in the areas of partnership working, staff governance, employment practice, workforce planning and development and pay modernisation. In order to continually improve performance, now and in the future, the Board needs to take full cognisance of the strategic drivers for change. This Workforce Strategy aims to recognise and respond to the impact these strategic changes will have on the current and future workforce and identify priorities for the future. Implications for the workforce in responding positively to these drivers for change can be summarised by the need to; PARTNERSHIP WORKING Continue to embed partnership working and infrastructures and staff governance, as key underlying principles and ways of working. Further develop partnership working to embrace the concept of mutuality as identified in the Better Health: Better Care Action Plan. RECRUITMENT Promote NHS Highland as an employer of choice, by creating and maintaining a positive organisational reputation Improve joint working, in relation to recruitment and the design of services, with Independent Contractors, Local Authorities, Voluntary Organisations and NHS Volunteers and other NHS Boards e.g. SAS, NES and North of Scotland NHS Boards Develop a broader approach to Recruitment of the Future Workforce, by targeting populations who have not traditionally worked in the NHS Ensure effective recruitment and induction takes place and that staff are appropriately registered and fit to practice RETENTION AND WORKFORCE PRODUCTIVITY Improve and maintain the health and well being of staff Reduce stress, accidents at work and sickness absence rates Ensure appropriate establishments through the use of workload measurement tools and reduce the use of overtime, agency and bank staff Retain the current workforce by fully embedding the staff governance standard and by meeting legislative requirements and promoting best employment practice 11

12 Fully implement the Working Time Regulations Promote Work-Life Balance and flexible working Integrate Equality and Diversity into all that we do Promote Dignity at Work Fully implement Pay Modernisation Contracts LEARNING AND DEVELOPMENT Develop and implement an Organisational Plan to support NHS Highland in achieving its corporate objectives. Support staff to be competent and confident leaders and managers through the implementation of the Leadership and Management Framework Ensure all staff have Personal Plans and access to Review, through the Knowledge and Skills Framework or other Appraisal Systems Develop innovative ways of providing and sharing information and knowledge for individual and organisational learning Develop and provide a wider range of learning and development opportunities and modes of delivery, in line with the Knowledge and Skills Framework and other Continuing Professional /Continuing Medical Education Requirements and the Learning Strategy Implement agreed Career Frameworks, in partnership with NES. Contribute to the development of a Rural Education Strategy Facilitate benefits realisation from the implementation of the Pay Modernisation Contracts Support the development of innovative and creative solutions for new models of care and service redesign and improvement and ensure staff are able to support and lead effective change Develop enhanced roles to support service redesign and improvement the shift in the balance of care and sustainable services in remote and rural areas Develop new roles to support service redesign and improvement, the shift in the balance of care and sustainable services in remote and rural areas Support the development of Multisciplinary Teams 12

13 Support the development of Multi-Agency Teams WORKFORCE INFORMATION AND WORKFORCE PLANNING AND DEVELOPMENT Improve the quality and appropriateness of workforce information and the utilisation of ehr Systems Develop and integrate Workforce Planning and, with service and financial planning at local and Board level Contribute to workforce planning arrangements to support the Remote and Rural agenda Contribute to Regional and National Workforce Planning. 13

14 THE WORKFORCE STRATEGY FRAMEWORK AND ACTION PLAN KEY STRATEGIC THEMES The development of this Workforce Strategy builds on a wide range of existing current Strategic Workforce Initiatives and Workforce Policies, Strategies and Plans. To help provide a framework for the Workforce Strategy, the PEOPLE acronym (Partnership, Enabling, Opportunities, Performance, Learning, Equality) first developed by the Personnel and Team, has been developed further to illustrate the workforce related initiatives and projects that have been prioritised for implementation. The following section describes the context of each Strategic PEOPLE Theme and illustrates current workforce initiatives and how they are evidenced through existing policies, strategies and plans. The workforce priorities arising from the drivers for change are then listed and Actions required to address these future priorities, in 2008/09 are identified. Finally how the Workforce Agenda supports the delivery of improved outcomes for patients, staff themselves and the organisation is identified along side performance indicators. 14

15 5.1 Partnership Working NHS Highland has benefited greatly from its approach to partnership working between staff and their representative organisations and managers. Partnership is not merely about good employee relations, it is invaluable in shaping and supporting service redesign, developing roles and ways of working and increasing skills, across all our activities. It ensures that our values of co-operation and collaboration are realised in both our strategic direction and in the practical issues that affect people s working lives. The Staff Governance Standard The principle of Partnership Working underlies the achievement of all the elements of the Staff Governance Standard; well informed, appropriately trained, treated fairly and consistently, provided with an improved and safe working environment, but is particularly relevant to involved in decisions CURRENT WORKFORCE INITIATIVES Revised NHS Highland Partnership Working Arrangements and Infrastructure in place and Review of PIN policies Supporting Organisational Change Defined responsibilities of Human Resources Managers and Trade Unions in respect of staff management and Employee Relations Strategic and proactive engagement with NHS Education for Scotland (NES) and a range of learning and development provider organisations EXISTING WORKFORCE POLICES, STRATEGIES AND PLANS Continuing to develop a culture of cooperation and partnership: NHS Highland Board Partnership Forum, associated sub-groups and CHP & Raigmore Local Partnership Forums. Staff Governance Integrated Action Plan & Self Assessment Audit Tool NHS Scotland Staff Survey Implementation and monitoring of workforce polices as detailed in the Opportunities for Retention section, below Engagement and joint working with public sector partners and those partners in the independent sector 15

16 RESPONDING TO DRIVERS FOR CHANGE - FUTURE PRIORITIES Continue to embed partnership working and infrastructures and staff governance, as key underlying principles and ways of working. Further develop partnership working to embrace the concept of mutuality as identified in Better Health: Better Care Action Plan. ACTION PLAN 2008/09 Continue to support and facilitate the attendance of Staff Representatives at CHP and Raigmore Management Team and Committee Meetings Ensure all CHP s and Raigmore Hospital have fully functioning Partnership Forums and review the Partnership Arrangements in other operational units Ensure that Staff Representatives are proactively involved in service redesign/improvement programmes. Develop and implement the Staff Governance Integrated Action Plan Promote the 2008 Staff Survey and identify key issues to be addressed. Review the Communication Strategy Contribute to the national work on the development of the concept of mutuality and ensure that local debate takes place on how this concept can be developed locally. LEAD Director of HR and Employee Director with CHP and Raigmore General Managers Public Engagement Director of HR and Employee Director with HPF BENEFITS FOR PATIENTS Front line staff will have the opportunity to shape services to suit identified patient needs and continue to provide high quality care by skilled, motivated staff. Service will be improved from seeking and implementing ideas from a much wider pool of those involved directly in service delivery. BENEFITS FOR STAFF Staff will be involved, engaged and able to contribute, as individuals and though their Trade Unions/Professional Organisations to the development of Strategy, Policies and Organisational Change. Staff will be aware of the organisation s objectives and involved in setting them, strategically and/or locally to their own department/service. 16

17 BENEFITS FOR THE ORGANISATION NHS Highland will have a culture that values partnership working, staff engagement and positive employee relations and the benefits this will have on motivation, commitment and organisational performance as well as quality of decision-making and service delivery. Research shows a strong link between the quality of communication and engagement and improved organisation performance. Staff involvement, partnership working and good employee relations are particularly important during times of change. Research evidence suggests that higher rates of staff involvement lead to lower absence rates, better organisational results, higher commitment and trust; ultimately good outcomes for better patient care. Our staff are the agents of change. We cannot hope to bring about improvements envisaged by this plan unless the people who will deliver these improvements are protected in their places of work, recognised and rewarded fro their contribution to our success and given the opportunities to develop the skills and experiences they require. Better Health, Better Care: Action Plan Staff Partnerships PERFORMANCE INDICATORS Staff Survey Staff Governance Self Assessment Audit and Mandatory Statistical Information Staff Governance Integrated Action Plan. 17

18 5.2 Enabling Recruitment - Now and in the Future As the population and the workforce ages and the demands for health and healthcare services change, particularly in a remote and rural environment, NHS Highland will be required to ensure that effective workforce and recruitment plans are developed. These plans will need to reach sections of the population that may not have traditionally worked in the NHS. In addition partnership working with other agencies and with the voluntary sector and volunteers will need to be encouraged to ensure that the future workforce is secured. The Staff Governance Standard Enabling Recruitment - Now and in the Future is particularly relevant to the achievement of the elements of the Staff Governance Standard well informed, and treated fairly and consistently. CURRENT WORKFORCE INITIATIVES Seeking to become an exemplar employer by meeting legislative requirements and promoting best employment practice. Promoting Healthcare Careers Implementing Pay Modernisation Contracts Effective Recruitment and induction Occupational Health Services Pre Employment Screening Integrated, service, financial and workforce planning processes EXISTING WORKFORCE POLICES, STRATEGIES AND PLANS Local Delivery Plan Workforce Plan Recruitment Plan Agenda for Change Implementation Plan Consultant Contract Action Plan Modernising Medical Careers Action Plan Occupational Health Service Strategies and Plans 18

19 RESPONDING TO DRIVERS FOR CHANGE - FUTURE PRIORITIES Promote NHS Highland as an employer of choice, by creating and maintaining a positive organisational reputation. Improve joint working, in relation to recruitment and the design of services, with Independent Contractors, Local Authorities, Voluntary organisations and NHS Volunteers and other NHS Boards e.g. SAS, NES and North of Scotland NHS Boards. Develop a broader approach to Recruitment of the Future Workforce, by targeting populations who have not traditionally worked in the NHS. Ensure effective recruitment and induction takes place and that staff are appropriately registered and fit to practice. ACTION PLAN 2008/09 Identify the key issues that impact on organisational reputation and identify ways of promoting a positive reputation and addressing the issues that have a more negative impact. Continue to participate in local careers fairs, facilitate work experience and promote health care careers. Review current working arrangements with partner organisations and identity opportunities for joint working in relation to recruitment and redesign of services. Develop a plan to implement the refreshed NHS Highland Volunteering Strategy. Work with Job Centre Plus, and the Condition Management Programme (and other partners as appropriate) to encourage people from disadvantaged communities to again NHS employment. Continue to improve the recruitment and induction process in line with best practice guidance and ensure that performance against the QIS Standard on Fitness to Practice is maintained and improved. LEAD Senior HR Team and Public Engagement Recruitment and Employment Services/ Workforce Planning and Manager Workforce Planning and Manager Director of Human Resources Recruitment and Employment Services/ Workforce Planning and Manager Recruitment and Employment Services/ Learning and Manager 19

20 Improve the quality and appropriateness of workforce information and the utilisation of ehr Systems. Develop and integrate Workforce Planning and, with service and financial planning at local and Board level. Contribute to workforce planning arrangements to support the Remote and Rural agenda. Contribute to Regional and National Workforce Planning. Continue to improve the comprehensiveness and timeliness of Workforce Information for corporate and operational utilisation, for recruitment. Continue to contribute to the development and implementation of SWISS and the national ehr system to improve workforce planning Continue the process of integrating service, financial and workforce planning and confirm the availability, adaptability and the affordability of the workforce in the Local Plan. Contribute to the development of workforce planning arrangements to support the Remote and Rural Agenda as part of the implementation of the Remote and Rural Framework. Continue to contribute to the North of Scotland Integrated Workforce Planning Group. Recruitment and Employment Services Personnel and Workforce Planning and Manager with Workforce Sub Group Workforce Planning and Manager Director of HR/Workforce Planning and Manager BENEFITS FOR PATIENTS The right staff, with the right skills, will be in the right place at the right time to provide health improvement and healthcare services. BENEFITS FOR STAFF Staff will feel welcomed, supported and valued by the organisation and equipped to undertake their role effectively and will have the confidence of, and confidence in, their colleagues to do the same. BENEFITS FOR THE ORGANISATION NHS Highland will have effective and efficient Workforce Plans and Recruitment Strategies which meet legislative requirements and reduce organisational risk. 20

21 PERFORMANCE INDICATORS Workforce Plans identify numbers and types of staff required now and in the future, to be employed by NHS Highland and other relevant organisations. Workforce planning is embedded with service and financial planning in the Local Delivery Plan. Vacancy Rates are monitored Recruitment processes are efficient and effective. All staff receive appropriate and timely Induction Training. The Workforce reflects the diversity of the Highland population. 21

22 5.3 Opportunities for Improving Retention, Efficiency and Productivity NHS Highland will need to ensure that it retains as many staff as possible as the potential future workforce declines and demands for healthcare increase A key outcome of successful recruitment, retention and reward approaches is the minimising of staff turnover through the more effective matching of people to posts, and the management of expectations of those joining the organisation. To develop a positive employee experience, NHS Highland is working towards full achievement of the Staff Governance Standard, as part of a process of continual improvement robust recruitment, retention and reward approaches are important to ensure that NHS Highland develops the right workforce to achieve its aims and objectives. In the context of a challenging financial environment, NHS Highland must also support staff to work efficiently and ensure that productivity is improved. Staff Governance Standard Opportunities for Improving Retention, Efficiency and Productivity is relevant to the achievement of all the elements of the Staff Governance Standard: well informed, appropriately trained, involved in decisions, treated fairly and consistently, and provided with an improved and safe working environment CURRENT WORKFORCE INITIATIVES Minimising corporate risk in respect of effective staff management and Employee Relations Flexible working patterns to meet service needs and individual work-life balance Developing effective teams and positive working relationships Promoting Healthy Working Lives initiatives Promoting Attendance and Managing Absence Reducing Stress and Accidents at work EXISTING WORKFORCE POLICES, STRATEGIES AND PLANS Equal Pay and conditions of service Promoting Attendance and Managing Absence Action Plan Staff Award Scheme PIN Policy Review and Implementation Plan Dignity at Work Action Plan Staff Governance Integrated Action Plan Organisational Change Policy Redeployment Policy 22

23 Redeployment for staff affected by e.g. organisational change Achievement of legislative requirements in relation to workforce management of Occupational Health Services Health and Safety policies and procedures, advice and management Health and Safety Policy, Strategies and Plans Occupational Health Policy, Strategies and Plans of local workforce information systems, SWISS and e- HR Pay Modernisation Implementation and Benefits Realisation Plans RESPONDING TO DRIVERS FOR CHANGE FUTURE PRIORITIES Maintain and improve the health and wellbeing of staff. Reduce stress, accidents at work and sickness absence rates. ACTION PLAN 2008/09 Achieve Healthy Working Lives (HWL) Registration for all departments/localities in NHS Highland and a % increase in the number of awards at Bronze, Silver and Gold. Develop and implement the Stress Prevention and Management Action Plan. Continue to risk assess working environments and working practices to reduce accidents and incidents at work. Review the Health and Safety Policy and Strategy and develop a plan for implementation Implement the revised approach to develop and maintain Health and Safety Competence in the workplace. LEAD Director of Human Resources/ Health Improvement with Healthy Working Lives Sub Group Director of Occupational Health General Managers, supported by Health & Safety Team and Occupational Health Team Professional Service - Health and Safety 23

24 Ensure appropriate establishments through the use of workload measurement tools and reduce the use of overtime, agency and bank staff. Retain the current workforce by fully embedding the staff governance standard by meeting legislative requirements and promoting best employment practice. Fully implement the Working Time Regulations. Promote work-life balance and flexible working. Promote Equality and Diversity. Review the Promoting Attendance and Managing Absence Action Plan to ensure that good practice is further developed and new ways of addressing sickness absence are identified. Further develop OHSXtra Services to ensure equity of access Continue to implement the national project to measure nursing workloads and establishments, with the intention of using the flexible workforce appropriately, safely and efficiently. Develop and implement the Staff Governance Integrated Action Plan for NHS Highland and local plans for the CHP s and Raigmore Hospital. Continue to monitor compliance with the Working Time Regulations. Develop and implement an Action Plan to ensure compliance for Junior Doctors, by August Continue to promote Employee Friendly PIN Polices and Flexible Working practices. Implement the Action Plan to promote Equality and Diversity and ensure legal requirements are met. Director of Human Resources/ Employee Director with Promoting Attendance and Managing Absence Sub Group Director of Occupational Health Associate Director (Clinical Workforce ) Director of Human Resources/ Employee Director and General Managers with HPF Personnel and Recruitment & Employment Services Personnel and Pay and Equality Manager with Equality and Diversity Sub Group 24

25 Promote Dignity at Work. Fully implement Pay Modernisation contracts. Improve the quality and appropriateness of workforce information and the use of ehr Systems. BENEFITS FOR PATIENTS Implement the Action Plan to promote Dignity at Work. Complete the implementation of Agenda for Change. Implement the New Contract for Non Consultant Career Grade Doctors. Continue to improve the comprehensiveness and timeliness of Workforce Information for corporate and operational utilisation, for retention and continue to contribute to the development and implementation of SWISS and the national ehr system. Continue to implement eksf and the All-Time Learning System Personnel and with Dignity at Work Sub Group Pay and Equality Manager Recruitment and Employment Services Personnel and Learning and Manager Recruitment strategies, Staff Governance interventions and robust workforce development approaches support NHS Highland to recruit and develop its workforce to support choice and better experience of care delivery. With stronger emphasis on high quality patient care, waiting times become shorter with fewer patient complaints resulting in higher staff satisfaction and greater improvements in service. For example, by providing allied health professionals with development opportunities the Board has been able to increase the number and the remit of Extended Scope Practitioners in areas such as musculoskeletal physiotherapists and the treatment of minor injuries. BENEFITS FOR STAFF Staff will feel that they are supported, developed, motivated to reach their full potential and managed positively and that they are committed to providing high quality care for patients. 25

26 BENEFITS FOR THE ORGANISATION NHS Highland will be able to retain its current workforce and enhance performance. This will reduce costs associated with recruitment and sickness absence and improve efficiency and effectiveness and reduce organisational risk PERFORMANCE INDICATORS Sickness absence rates are reduced to 4% by 31 st March 2009 Reduce the use of overtime, bank and agency staff Appropriate targets are identified and achieved for Workforce Stability/Turnover PIN Policy Utilisation and monitoring of Legal Cases Staff report higher degrees of wellbeing and organisational commitment in the staff survey. 26

27 5.4 Managing Individual and Organisational Workforce Performance Supporting and managing individual performance takes place through the Personal Planning and Review Process, as part of the Knowledge and Skills Framework and through other Formal Appraisal Systems e.g. for Consultants and Senior Managers. Performance on the Workforce Agenda takes place directly through the HEAT Targets on sickness absence and on the implementation of the Knowledge and Skills Framework and Personal Plans and Review. In addition Performance is monitored at National level through the submission of the Staff Governance Integrated Action Plan, Mandatory Statistical Information and the Self Assessment Audit Tool, the Pay Modernisation Benefits Realisation Plan and the Workforce Plan. NHS Highland monitors performance on the Workforce Agenda through the Local Delivery Plan and through the Board Performance Meetings, the Staff Governance Committee, the Highland Partnership Forum, CHP and Raigmore Governance Committees and through Workforce Reports and the Staff Governance and Health and Safety Annual Reports. In addition High Level Risks are recorded on the Corporate Risk Register and Action Plans developed to mitigate them. Staff Governance Standard Managing Individual and Organisational Workforce Performance is relevant to the achievement of all the elements of the Staff Governance Standard: well informed, appropriately trained, involved in decisions, treated fairly and consistently, and provided with an improved and safe working environment CURRENT WORKFORCE INITIATIVES EXISTING WORKFORCE POLICES, STRATEGIES AND PLANS Aligning the workforce to meet the needs of Highland Clinical Framework Workforce information systems, SWISS and the emergence of e-hr Continue improvement of Workforce Reports Workforce Planning and strategies and Plans Staff Governance Integrated Action Plan Agenda for Change Implementation Plan KSF Implementation Plan Performance Management Systems for Senior Managers 27

28 Performance Management framework to ensure staff have appropriate skills to carry out their roles HEAT Target Sickness Absence Pay Modernisation Benefits Realisation Plan Workforce Reports and Annual Reports Corporate Risk Register HEAT Target KSF PDPs RESPONDING TO DRIVERS FOR CHANGE FUTURE PRIORITIES Improve the quality and appropriateness of workforce information and the use of ehr Systems. Reduce stress, accidents at work and sickness absence rates in line with the HEAT Target. Reduce the use of overtime, agency and bank staff. Ensure all staff have Personal Plans and access to Review, through the Knowledge and Skills Framework or through other Formal Appraisal Systems, in line with the HEAT Target. ACTION PLAN 2008/09 Continue to improve the comprehensiveness and timeliness of Workforce Information for corporate and operational utilization for workforce planning, recruitment, induction, retention, PIN Policy utilisation, learning and development and Equality and Diversity monitoring, in line with the development and implementation of SWISS and the national ehr system. Continue to report and monitor accidents and incidents at work. Continue to report and monitor sickness absence and other absence from work, on a monthly basis at corporate and operational level, in line with national targets. Continue to report and monitor the use of overtime, agency and bank staff. Continue to report and monitor the implementation KSF and PDP s and eksf in line with national timescales and the NHS Highland Implementation Plan. LEAD Personnel and Health & Safety Team and OH Team and Clinical Governance Teams Personnel & with Promoting Attendance and Managing Absence Sub Group Personnel and Learning and Manager with Learning and Sub Group 28

29 Retain the current workforce by fully embedding the staff governance standard, by meeting legislative requirements and promoting best employment practice. BENEFITS FOR PATIENTS Ensure that all members of the Executive and Senior Managers Cohort have PDP s and that national performance management arrangements are implemented. Ensure all Consultants and salaried GPs and Dentists have PDP's and participate in Appraisal arrangements as appropriate. Develop and implement the Staff Governance Integrated Action Plan for NHS Highland and local plans for the CHP s and Raigmore Hospital and monitor its implementation. Promote the 2008 Staff Survey and identify key issues to be addressed. Produce Annual Staff Governance and Health and Safety Reports. Director of Human Resources Medical Director Director of Human Resources/ Employee Director and General Managers with HPF Director of Human Resources Better Care, Better Health: Action Plan focuses on the development of a culture of continuous improvement and the pursuit of quality. One aspect of this will be a continuing focus on cutting waiting times for patients and the introduction of an 18 week whole journey time. Modernising working practices, benchmarking, efficiency and improving productivity in the workforce and in services will demonstrate NHS Highland s commitment to continuous improvement across the six dimensions of quality: safety, effectiveness, patient centeredness, timelines, efficiency and equity. BENEFITS FOR STAFF Staff will have an explicit system to support performance, which will set clear objectives and provide support for development. Feedback on performance will facilitate development and motivate staff to perform, to their full potential. BENEFITS FOR THE ORGANISATION NHS Highland will have explicit performance management and governance arrangements in place to ensure that local and national workforce targets are monitored and achieved and organisational risk is reduced. 29

30 PERFORMANCE INDICATORS Percentage of staff participating in PDP&R and other Appraisal Systems is monitored Improved performance against Workforce HEAT targets. Improved workforce reporting as SWISS is developed further and the National ehr System is implemented. Clear and effective governance arrangements and Staff Governance and Health and Safety Annual Reports. 30

31 5.5 Learning and, for Individuals, Teams, Services and the Organisation NHS Highland is committed to becoming a learning organisation, recognising that staff require access to opportunities to learn, maintain and develop skills and knowledge. Staff need to be able to apply these within their work situation and have opportunities to regularly review their development. This will ensure that staff are competent and confident to deliver safe clinical and support services. As learning needs are wide ranging and resources to meet identified needs are finite, NHS Highland will continue to focus on meeting its learning and development needs on a prioritised basis using information from eksf. Embedding the Knowledge and Skills Framework (KSF), Personal Planning and Review (PDP&R), and other formal Performance Management arrangements, are important in maximising the contribution and potential of staff to the achievement of NHS Highland Corporate Objectives, especially Clinical and Staff Governance, and wider organisational aims. Staff Governance Standard Learning and, for Individuals, Teams, Services and the Organisation is particularly relevant to the, appropriately trained element of the Staff Governance Standard, but well informed, involved in decisions, and treated fairly and consistently are also important. CURRENT WORKFORCE INITIATIVES Leadership and Management development programmes to ensure managers are appropriately skilled Developing a range of competence based learning and development opportunities for staff at all levels through various processes, for example, access to SVQs and blended learning methods of course delivery Implementation of the KSF and Personal Planning and Review EXISTING WORKFORCE POLICES, STRATEGIES AND PLANS Learning Strategy Leadership and Management Framework Learning Plan Knowledge and Skills Framework and Personal Planning and Review Implementation Plan Learning Partnership Agreement Learning and strategies, opportunities and partnerships 31

32 Union Learning Representatives Network Developing effective teams and positive working relationships Alignment of existing Learning and Programmes to the Knowledge and Skills Framework Organisational Change, and Service Redesign RESPONDING TO DRIVERS FOR CHANGE FUTURE PRIORITIES Develop and implement an Organisational Plan to support NHS Highland in achieving its corporate objectives. Support staff to be competent and confident leaders and managers through the implementation of the Leadership and Management Framework. Ensure all staff have Personal Plans and access to Review, through the Knowledge and Skills Framework or other Appraisal Systems. Develop innovative ways of providing and sharing information and knowledge, for individual and organisational learning. Develop a wider range of learning and development opportunities and modes of delivery, in line with the Knowledge and Skills Framework and other Continuing Professional /Continuing Medical Education and the Learning Strategy. Implement agreed Career Frameworks, in partnership with NES. ACTION PLAN 2009/09 Develop and implement an overall Organisational Plan to support NHS Highland in achieving its corporate objectives and delivering the Local Delivery Plan Develop a plan to prioritise the programmes to be implemented in the Leadership and Management Framework Continue to implement KSF and PDP s, in line with national timescales and the NHS Highland Implementation Plan. Develop and implement the NHS Highland Action Plan for Sharing Information and Knowledge, in partnership with NES. Develop a Learning Plan for 2008/09 to be agreed by the HPF and Staff Governance Committee and implement the Learning Agreement. Confirm the national priorities for implementation of Career Frameworks and agree how they should be implemented in NHS Highland. LEAD Director of Human Resources/ Learning and Manager Learning and Manager Learning and Manager Director of Human Resources Learning and Manager with Learning and Sub Group Workforce Planning and Manager with Workforce Sub Group 32

33 Contribute to the development of a Rural Education Strategy. Identify how NHS Highland can best contribute to the development of a Rural Education Strategy, with NES and RRHEAL. Learning and Manager with RRHEAL Facilitate benefits realisation from the implementation of the Pay Modernisation Contracts. Support the development of innovative and creative solutions for new models of care and service redesign and improvement and ensure staff are able to support and lead effective change. Develop enhanced roles to support service redesign and improvement, the shift in the balance of care and sustainable services in remote and rural areas. Develop new roles to support service redesign and improvement, the shift in the balance of care and sustainable services in remote and rural areas. Support the development of multidisciplinary Teams. Support the development of multi-agency Teams. Continue to facilitate and identify benefits realisation from the implementation of the Pay Modernisation Contracts. Provide OD and HR support to the Service Improvement Group in support of Service Redesign and National Improvement Programmes Identify and prioritise the opportunities for developing enhanced roles to support service redesign and improvement, the shift in the balance of care and sustainable services in remote and rural areas. Identify and prioritise the opportunities for developing new roles to support service redesign and improvement, the shift in the balance of care and sustainable services in remote and rural areas. Identify and provide opportunities for Team Building interventions to multi-disciplinary Teams. Identify opportunities for providing Team Building interventions to multiagency Teams Pay and Equality Manager/ Workforce Planning and Manager Director of Human Resources/ Workforce Planning and Manager Workforce Planning and Manager Workforce Planning and Manager Personnel and Workforce Planning and Manager 33

34 BENEFITS FOR PATIENTS Investment in, and modernisation of, learning and development will ensure care is provided and supported by competent and skilled professionals and support staff working effectively together, placing patients at the centre of all they do. Public and patient safety and protection will be enhanced through staff whose skills are updated, maintained and extended in line with changes and advances in knowledge. BENEFITS FOR STAFF Staff will be capable and confident in delivering services and feel supported and valued by the organisation. In addition they will be able to develop their potential and careers and obtain rewarding employment opportunities. BENEFITS FOR THE ORGANISATION NHS Highland will see investment in learning and development as an investment in staff, which enhances the quality of health and healthcare services and reduces organisational risk. PERFORMANCE INDICATORS KSF PDPs HEAT Target. Improved access to wider range of learning opportunities. Evidence of Career development, in line with the NHS Career Framework. Increased number of Enhanced and New roles. 34

35 5.6 Promoting Equality and Diversity Equality is about creating a fairer society that everyone can participate in and has the opportunity to fulfil their potential. Diversity is about recognising and valuing difference in its broader sense. It is about creating a culture and priorities that recognise, respect, value and harness difference for the benefit of patients, carers, members of the public and members of staff. All NHS staff have a responsibility to respond sensitively to the needs of patients and those we work with and to be aware of the key equality and diversity issues. The quality of care and range of services that we are able to provide is dependant on our ability to recruit, develop and retain a diverse group of staff, who reflect the diversity of the population we serve. Over the years we have learned that some people who we work with and provide care for have not been treated sensitively by the NHS and other public bodies. To try to change this we have been given legal duties to guide what we do and to make sure our work is fair for all and sensitive to each. These are: Improve the health of all our communities Support all staff and encourage diversity in our workforce Plan and deliver services that consider everyone s needs and go out of the way to reduce inequalities Promote good relations between everyone Specifically for the NHS workforce, this will mean delivering best practice in terms of recruitment and employment; and ensuring data is collected to allow NHS Highland to evidence its commitment to equality and diversity. The Workforce Equality and Diversity HPF sub group has been set up to oversee workforce actions on equality and diversity Staff Governance Standard Promoting Equality and Diversity underlies the achievement of all the elements of the Staff Governance Standard: well informed, appropriately trained, involved in decisions, treated fairly and consistently, provided with an improved and safe working environment CURRENT WORKFORCE INITIATIVES Promoting equity for staff in terms of Equal Pay and Agenda for Change EXISTING WORKFORCE POLICES, STRATEGIES AND PLANS Workforce Equality and Diversity Action plan 35

36 Taking positive action in employing/ retaining staff who have a disability Ensuring staff are treated equitably Ensuring that NHS Highland workforce profile reflects changing demographic trends and the diversity of the communities we serve Advocating Equality and Diversity principles and practice Pay Modernisation Contracts to promote equality and facilitate new ways of working PIN Policy Review and Implementation Plan Actions arising from the Equal Pay statement Equality schemes for gender, race and disability RESPONDING TO DRIVERS FOR CHANGE FUTURE PRIORITIES Retain the current workforce by fully embedding the staff governance standard, by meeting legislative requirements and promoting best employment practice. Promote work-life balance and flexible working. Integrate Equality and Diversity into all that we do. Fully implement Agenda for Change ACTION PLAN 2008/09 Develop and implement the Staff Governance Integrated Action Plan. Ensure all PIN Policies are subject to Equality and Diversity Impact Assessment as they are reviewed. Continue to promote Employee Friendly PIN Polices and Flexible Working practices. Contribute to the overall Strategy for Equality and Diversity and the Action Plan to promote Equality and Diversity in the Workforce. Continue to provide opportunities for awareness raising and training for Equality and Diversity Complete the implementation of Agenda for Change. LEAD Personnel and with HPF Personnel and Pay and Equality Manager with Equality and Diversity Sub Group Learning and Manager Pay and Equality Manager 36

37 Improve the quality and appropriateness of workforce information and the utilisation of ehr Systems, to reflect Equality and Diversity monitoring. Produce Equality and Diversity Monitoring Reports as required by legislation and to demonstrate how the NHS Highland Workforce reflects the diversity of the population Personnel and BENEFITS FOR PATIENTS The Board has a well trained and well-informed work force that reflects at all levels, the diversity in the population that it serves, who understand and respect the needs for a diverse range of services. BENEFITS FOR STAFF All staff will be treated fairly and consistently and their diversity valued. BENEFITS FOR THE ORGANISATION NHS Highland will have a rich and diverse workforce, which reflects the local population. NHS Highland will be able to meet its legislative requirements and reduce organisational risk. PERFORMANCE INDICATORS Equality & Diversity monitoring in line with legislative requirements. NHS Highland workforce reflects the diversity of the population. 37

38 6. ROLES AND RESPONSIBILITIES The complementary roles and responsibilities of Human Resources Services, Managers, Staff-side Representatives and Staff themselves are being key to the effective implementation of the Workforce Strategy and achievement of the Staff Governance Standard. Full engagement and ownership of the Workforce Agenda and Staff Governance at both corporate and operational level will be essential in making a difference for patients, staff themselves and the organisation. Further engagement with the CHP s and Raigmore Hospital and other operational units will enable the development of local Workforce and Staff Governance Actions, that can be integrated into Local Delivery/ Plans and formally monitored on an annual basis. 7. GOVERNANCE AND PARTNERSHIP WORKING ARRANGEMENTS The development of a Workforce Strategy for NHS Highland underpins a strategic framework against which the organisation develops its aims, objectives and strategies. This strategic framework is essential to support the implementation of the NHS Highland Clinical Framework and the achievements of performance related targets outlined in the Local Delivery Plan. The publication of Better Health, Better Care; Action Plan outlines NHS Scotland s objectives and describes how these could best be achieved in the future. NHS Highland Organisational Plan integrates and aligns the service delivery and development agenda across the Board, ensuring that effective interventions are put in place which can be measured and add value. NHS Highland Board has overall governance of the Workforce Strategy. The Board s governance framework to support the Workforce Strategy is provided through the Staff Governance Committee and CHP and Raigmore Governance Committees. The Highland Partnership Forum with its associated sub-groups and the Operational Unit Partnership Forums/Arrangements in the CHPs and Raigmore will be key to affecting the workforce, staff governance and service redesign challenges across NHS Highland. STRATEGIC FRAMEWORK: Better Health, Better Care (2007); Delivering for Remote and Rural Healthcare (2007); NHSH Clinical Framework (2006) NHSH Local Delivery Plan; NHSH Organisational GOVERNANCE FRAMEWORK: NHS Highland Board; Staff Governance Committee; CHP/Raigmore Governance Committees Highland Partnership Forum and associated sub-groups Operational Unit Partnership Forums/Arrangements 38

39 8. NEXT STEPS Progress with implementation of the Workforce Strategy at Corporate level, will be monitored six monthly in October 2008 and March The development of local operational Workforce and Staff Governance Actions will be taken forward through local engagement sessions and progress against Actions identified will be reviewed in March

40 Table 3: Current Strategic Workforce Strategies & Plans APPENDIX I NHS HIGHLAND WORKFORCE STRATEGY Workforce Plans ORGANISATIONAL DEVELOPMENT PLAN ** Accessing Future Workforce Plan (to be reviewed) ** Recruitment Plan (to be reviewed) * Plan required by Health Workforce Directorate ** NHS Highland Workforce Plan *** CHP/ Raigmore Workforce Plans ** Modernising Medical Careers Action Plan * Junior Doctors Working Time Compliance Plan Pay Modernisation Plans ** Agenda for Change Implementation Plan ** Consultant Contract Plan ** ngms Contract Plan Non Consultant Career Grade Contract (to be developed) Pharmacy Contract Plan Well Informed ** Communication Strategy Implementation Plan (to be reviewed) * Staff Governance Integrated Action Plan Appropriately Trained ** Learning Strategy ** Leadership and Management Framework ** Learning Plan * KSF Implementation Plan Treated Fairly and Consistently ** PIN Policy Review and Implementation Plan ** Dignity at Work Action Plan ** Equality & Diversity Action Plan Involved in Decisions ** Partnership Infrastructure and Working Arrangements Provided with an improved and safe working environment ** Promoting Attendance and Managing Absence Action Plan (to be reviewed) Health and Safety and Occupational Health Strategies and Plans (to be reviewed) ** NHS Highland Corporate Plan *** NHS Highland Operational Plan * Pay Modernisation Benefits Realisation Plan 40

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