ITEM 11c, ENC 10 Birmingham Community Healthcare NHS Foundation Trust. Annual Workforce Plan 2017/18

Transcription

1 ITEM 11c, ENC 10 Birmingham Community Healthcare NHS Foundation Trust Annual Workforce Plan 2017/18 Executive Summary The Trust Board receives an Annual Workforce Report in May of each year. The Annual Workforce Report (Forward Look) has previously set out the workforce strategic aims, objectives and key performance indicators for the forthcoming year. The report also outlines workforce planning forecasts for the period and provides longer term horizon scanning. It has been agreed this year that the title Annual Workforce Plan would more accurately describe the content and purpose of the paper. Key points of the report are summarised as follows: The Transforming Care Together Programme will present a significant challenge for the workforce, particularly within the Corporate support services. The key priorities for the organisation will be to continue to develop workforce capacity and capability and to support workforce change. Annual plan delivery objectives for 2017/18 focus on Recruitment, Retention and Reward strategies. Workforce planning and continued commitment to redeployment and retraining will be required to deliver transformation and financial challenges. Workforce risks and challenges to the delivery of workforce KPIs are anticipated to be consistent with previous years and represent historical challenges requiring culture change and organisational wide commitment to resolve. Reducing sickness absence and vacancies will continue to be a high priority. Reducing Agency staffing and maximising opportunities for internal Bank staffing as a more efficient and effective alternative will be an objective and reducing reliance on administrative and management Agency will be an absolute priority. Divisional workforce plans will focus on the delivery of transformation, service change and delivery of CRES. The organisation will need to be flexible to respond to both growth opportunities and efficiency savings. 1. Introduction The Annual Workforce Plan 2017/18 provides an overview of the broad workforce activity and objectives planned for the forthcoming planning period. The plans within this document reflect the key themes of the Workforce Development Strategy. It is recognised that the Trust Board receives further workforce related reports throughout the year, namely the Staff Survey Annual Report, the Organisational Development Strategy reports which incorporate Staff Engagement and the Health and Wellbeing and the Equality, Diversity and Human Rights Strategies. Therefore these elements are not duplicated in detail in this report. A key component of the Equality and Diversity actions is the Workforce Race Equality Scheme (WRES) this will also be separately reported to the Trust Board and is not therefore included in this report. The Trustboard received a copy of the 2017/18 Operational Plan submitted to NHSI and this included a detailed workforce section. This is attached at Appendix 1. Again, it is not intended to duplicate this in the Annual Workforce 1 year plan. 1 P a g e

2 2. Content The content of the report contains: Workforce Strategy Aims People Objectives Workforce Risks Workforce KPI s Workforce Development Strategy Actions Division Workforce Plans Regional and National Context 3. Workforce Strategy and Aims The Trust has in place a 3 year Workforce Development Strategy which set out the key high level workforce objectives to support the delivery of the Trust Vision, Mission and Values. A revised Strategy will be developed post TCT transaction to ensure that the Strategy is reflective of the enlarged TCT organisation. Initial scoping of workforce strategies in the TCT partners highlights the common workforce challenges and aligned workforce objectives. The Strategy recognises that the key priority and central themes for the workforce in the next planning period are Recruitment and Retention. This applies primarily in our largest staff group Nursing services, but also it has equal significance in some of our specialist and smaller staff groups i.e. Medical staff. The growing challenge and opportunity in the Allied Health Professionals and Scientific and Technical workforce is recognised. Whether in staff groups of 2000 wte plus or in stand alone posts, the ability to recruit staff with the required skills and competence and to retain them is key to the delivery of high quality services. Whilst there is no statistical proven correlation, it is acknowledged that effective recruitment, and the consequential reduction in vacancies, will have a positive impact on many other aspects of the workforce and their associated key performance indicators. It is anticipated that a reduction in vacancies will have a positive impact on staff sickness, turnover, health and wellbeing indicators, staff motivation and the capacity to achieve targeted levels and quality of Appraisal / Mandatory Training. Of course, the number of vacancies is the most significant determinant of levels of temporary staffing i.e. Bank and Agency usage. As described above, the national context for Recruiting is immensely challenging and the reality is that the national labour market is unlikely to change substantially during the period of this plan. Although changes in the Commissioning of Nurse education and funding may well have an impact. Whilst the Trust will, as part of its implementation plans, maximise the recruitment opportunities locally, out of region and internationally it has to recognise the limitations of the available labour market and consider alternatives to employing to existing staffing models. Through its Strategic Workforce Planning, consideration will be given to new roles being built upon the needs of the recipients of the services. To achieve this the Trust will engage with health economy partners and through Health Education England to achieve this. The Trust is committed to continuing the development of new roles i.e. Assistant Practitioners and maximising the opportunities for Health Care Apprenticeships through its Widening Participation / Talent for Care Programme. 2 P a g e

3 Whilst Vacancies are rightly described as a cause affecting a range of other workforce indicators, those other aspects of the workforce system, in turn are causal to retention and therefore vacancies. Leadership style, how staff are engaged, supported and developed will have a significant impact on retention and therefore vacancies. The Workforce Development Strategy is based on the vision that to deliver the Trust s overall mission and objectives, now and in the future, it must display 4 principle characteristics. Productivity Flexibility Capacity Capability Secondly, the Strategy proposes that those characteristics will only be evident if there are 4 underpinning and enabling workforce themes. Well Led and Supported Engaged and Motivated Healthy and Well Excelling in Talent Attraction and Retention These characteristics are described in more detail in Appendix 2: 4. Workforce Annual Plan People Objectives Strategic workforce aims have been translated into annual deliverables within the 2017/18 Annual Plan. The objectives have been presented according to their Executive Director Lead within the diagram below. Quarterly milestones and details of timelines and responsibility have been developed in the overall Annual Plan to give clarity on the key actions and interventions for the workforce. Annual Plan People Objectives Executive Lead HRD HRD HRD Objectives Develop a recruitment plan for all services (clinical and corporate) which demonstrates and communicates the 'unique offer' of employment with BCHC Build on and respond to the staff survey results and exit interviews to develop a plan to retain staff. Explore the opportunities to develop a specific reward package to enable us to attract and retain staff in an increasingly competitive employment and constrained health budget. 3 P a g e

4 DN+T DN+T Develop a capacity and capability matrix to ensure staff are trained and developed to meet the ongoing needs of the Trust In line with the Trust plan for Organisational Development, refine and consistently deliver clinical leadership training programmes and ensure clinical leadership remains a key focus for the Trust 5. Workforce Risks The priority objectives described above are reflective of the need to develop good practice and to support the Trusts overall direction, however they are also established to mitigate risks to the organisation. A key priority for the Workforce Team will be to actively monitor and manage workforce risks. The current Workforce Risks appearing on the Board Assurance Framework are summarised below: Workforce Risks Risk Risk Description ID 1965 If we do not recruit, retain and develop the required number of staff with the appropriate knowledge, skills, clinical leadership qualities and attitudes to deliver patient centred care, we will fail to deliver a skilled, adaptable and diverse workforce If we do not ensure that staff health and wellbeing is maintained, then there is a risk that this will impact on the quality and financial/performance goals of the Organisation. Risk Rating High Level Action in 2016/17 12 Continue to undertake focussed recruitment Monitor agency usage and ensure Trust is using only those agreed on the Framework Bank Recruitment Plan Urgent Care Division Professional Fees Payment 12 Deliver Building Resilience programmes to Leaders, Teams and Individuals. Implement targeted action plan of support to Divisions in response to 2016 Staff Survey results and Staff FFT. Targeted delivery of the successful Lighten Up health and wellbeing programme according to need and Trust priorities. Explore and act upon concerns regarding bullying and harassment to introduce a zero tolerance culture Continued investment and awareness rising of Wellbeing Zone. Identify actions to reduce workplace related stress through inclusive leadership Working with Divisions and HR Business Partners to identify specific areas of recorded high levels of sickness and target interventions accordingly. 6. Workforce Metrics and Planned Activity 2017/18 The workforce metrics agreed as part of the 2017/18 Balanced Scorecard are identified below: Trust KPI KPI 4 P a g e Performance March 2017 Target March Target 2017/18 Strategic Delivery

5 Mandatory Training Non Contractual % of staff appraised (cumulative) Turnover 12 month rolling total (target 5-15%) Percentage of Vacancies % Sickness Absence Spend on Temporary Staffing Agency as a percentage of temporary staffing spend Length of time to recruit (Date advertised to Offer) Spend against NHSI Agency Ceiling % 85.00% 85.00% Mandatory Training Plan 85.0% 90.0% 90.0% PDR Planning and Monitoring 8.97% 12.00% 12.00% Retention Plans OD Strategy Staff Engagement Plan 8.90% 9.00% 9.00% Recruitment Plan 4.67% 4.30% 4.33% Health and Wellbeing Plan Stress Management and Resillience Sickness Absence Management Plan 12.35% 9.39% Removed for 2017/18 Temporary Staffing Models Action Plan 6.96% 4.96% 5.43% Temporary Staffing Models Action Plan 46 Days 60 Days 55 Days Recruitment Streamlining +27% 10.5m 10.5m Agency Reduction Action Plan 7. Workforce Development Strategy Actions The Workforce Development Strategy describes the vision and ambitions for the workforce and highlights themes of activity. However to realise tangible benefits it is necessary to translate the strategic themes into measurable actions for the year. These actions will be included in the personal objective of workforce leads. The 2017/18 actions are summarised below: 5 P a g e

6 Workforce Development Actions 2017/18 Theme High Level Action Lead Developing Flexibility Identify the need for, and actively support the development of new roles to support future DHR/DN+T service needs Review the opportunities for pay and reward flexibility as a Foundation Trust DHR Actively participate in the development of new models of care and work with partner DHR organisations in system wide workforce development Ensure that principles of flexible working are embedded in the organisation which balance DHR the needs of employee both now and in the future. Consideration should be given to specific demands placed on the various staff groups i.e. both with a younger and older workforce Developing Capability Develop and deliver systems of professional development in line with Shaping to Care DN+T Maintain existing implementation of systems for revalidation, registration and appraisal for DN+T clinical staff Extend the development of innovative methods of training and developments e.g. e-learning DN+T and maximise access for staff to learning Through education and training support new role development i.e. Assistant Practitioner and DN+T Advance Practitioner Develop concept of career development rotations as part of preceptorship for qualified DN+T nursing Ensure that PDR processes are developed to enrich staff s experience of Appraisal DN+T Engage with external Health Education structures and systems and partners to maximise DHR opportunities for education and development Support the development of the future/undergraduate clinical workforce. Design a generic DN+T development programme for clinical leaders at every level and through participatory learning encourage commonality of skills, develop corporate responsibility, ensure leaders feel empowered and understand roles and responsibilities in order to become more effective in front line services Implement a comprehensive programme of action to ensure the skills development and DN+T career development of staff in Bands 1-4 in response to the Talent for Care Strategy Developing Capacity Embed sophisticated systems of integrated workforce planning throughout the organisation DHR Extend existing recruitment strategies to ensure that staff vacancies are minimised DHR Deliver Apprenticeship targets and maximise the opportunity for Apprentices across the DN+T 6 P a g e

7 Developing Staff Health & Wellbeing Developing Supportive & Collective Leadership Developing BCHC as the Employer of Choice 7 P a g e Trust Deliver a Widening Participation programme of action to maximise the opportunities for work experience. Accelerate existing retention strategies to minimise vacancies and retain skills, knowledge and experience by establishing a robust retention plan Complete Ageing Workforce Profile project Ensure systems for workforce deployment and rostering are extended throughout the Trust Develop alternative model of temporary staffing delivery and maximising the use of Bank staff as opposed to Agency staff Develop workforce productivity measures to support local management decisions and make progress against cost per wte KPI s in line with the Carter Review. Accelerate the programme of reviewing corporate workforce systems to minimise delay and support productivity (Case management and Recruitment, Organisational Change) Further develop workforce information and workforce electronic systems including further roll-out of ESR accessability Occupational Health Services will be monitored and developed to ensure efficient and effective delivery Deliver a comprehensive programme to ensure a sustainable reduction in Sickness Absence Provide skills development support to ensure local managers gain in confidence in handling sickness and health and wellbeing conversations with staff Deliver a People Management component to the SLM development programme to ensure managers feel competent and confident in their people management role Provide specific support and development for managers on managing performance and capability Ensure principles of Succession Planning and Talent Management within the Trust are embedded through appropriate systems and processes Win an accredited and recognised award for workforce good practice during the planning period Implement HR actions within the WRES analysis and support actions for the workforce profile to become more representative of the population it serves Maximise the opportunities, through its representatives, to be a key partner in Health Economy System Workforce Development Infrastructure and organisations e.g. Health Education structures and professional workforce networks Contribute to development of STP workforce plans DN+T DHR DHR DHR DHR DHR DHR DHR DHR DHR DHR/DB+OD DHR DHR DN+T DHR/DB+OD/DN+T DHR/DB+OD DHR/DB+OD DHR/DNT

8 Raise profile of BCHC as an Employer through an effective communication plan Establish productive relationships with schools and other partners to promote BCHC as an employer of choice, particularly through the provision of work experience and future career advice DHR/DB+OD DN+T/DHR 8 P a g e

9 8. Workforce Planning Forecasts Workforce Plan 2017/18 The most recent Long Term Financial Model and return to NHSI reflect the trusts Service redesign and CRES plans. The Startpoint for shows an aggregated reduction of 61 FTE compared to the end of This includes the assumed net -37 FTE outcome from the tendering within the Childrens s services. Division FTE end Start point Service Redesign /CRES Service Change Change note Trust Adults Community Services Urgent Care Services Children & Families * *Balance of Tender Outcomes Corporate Dental Services Specialist (LD & Rehab) LD Rehab Safer Staffing adjustment 9. Divisional Workforce Plans A Strategic Workforce Plan has been developed by each Clinical Division to describe the workforce development and transformation that will be needed to enable the service to develop in the next 5 years. The 5 year plans developed in 2016/17 have been refreshed at high level and modified where appropriate. More specific plans for 2017/18 have been developed in the light of service developments, transformation and CRES delivery. The Trust has established a Strategic Workforce Planning template reflecting the 6 step workforce planning process and is assured that this provides Divisional teams with a framework to highlight all the key workforce issues within the plan. The plans should fundamentally describe the Divisions assessment of workforce demand and supply and measures to address any gap. The core element of the workforce plan will continue to be: Recruitment Retention Re-training / Development Re-organisation / Transformation 9 P a g e

10 The Trust also has access to workforce planning resources which will support the identification of workforce priorities. To support Divisional Workforce Plans a Workforce Planning Guidance document was issued (Appendix 3) Below is a summary of the key components of the Clinical Divisional Plans: 9.1 Adult Community The Adults Community Services Division has a challenging workforce agenda for 2017/18 and this summary identifies the key priorities for the year ahead. 2017/18 Workforce Priorities The key priorities fit mainly into the following groups: Service Review, Redesign & Transformation District Nursing implementation of care in focus methodology & relocation for the Evening Service, review of skill mix within IMTs, implementation of Nursing Associate role, Review of District Nursing provision in line with Service Specification due to over performance on activity, implementation of peripatetic team Clinical Case Management review of model and potential pilot hub model, as well as review of skill mix; considering implementation of the Clinical Care Coordinator role Therapy Review - implementation of care in focus methodology, review of skill mix Adult Complex Care assessment of viability of service Specialist Nursing Services - implementation of care in focus methodology prior to any transformation Community mobilisation IT equipment Delivery of CRES New services ability to tender & flexibility to deliver new services Trust and National Initiatives/Change s Service Line Management Implementation to ensure full accountability of Team Managers to lead with all operational matters including workforce issues Workforce Race Equality Standard Nurse Revalidation Trust processes - Pay Progression, DBS Rolling Scheme Relocation and redeployment of staff to align with service changes and the Estates Strategy Widening Participation Apprentices, Students etc Maintaining High Standards Ensuring effective management of operational workforce matters sickness, Employee Relations Casework etc Succession planning to address potential loss in key staff Availability of temporary staffing for District Nurses, Therapies Training and development of staff PDRs, Band 6 DN Development Programme, Apprenticeships (links above) 9.2 Urgent Care Service Division The Annual Workforce Plan recognises that there are significant decisions yet to be made by Commissioners regarding the future of some of the Urgent Care Services (CCDU introduction of the crisis and recovery modesl). Workforce priorities for 2017/18 based on key service services: 10 P a g e

11 Support 7 day working across health and social care through enhancing our management of patients through the inpatient bedded areas, preventing unnecessary admissions to acute care and facilitating early supported discharge Matching our care provision to demand across the City and safely reducing the average length of stay Implementing the frequent callers review model in conjunction with west Midlands Ambulance Service across the BSoI footprint. Increase the substantive medical workforce to enhance patient care and reduce expenditure on Bank and agency costs. Implement and review the combined access point service to assess its impact on patient services. To assess its suitability for possible extension to include other services across the Trust. Continuing to provide high quality services Development of the Team Leader, Band 7 level in leadership and people management Succession planning for those staff eligible to retire within the next 5 years, focussing on talent management Delivery of workforce related CRES schemes ensuring quality is unaffected Development of a Retention Strategy and Action plan Continued support in training/secondment opportunities for pre and post registration training. Implementation of a Lead Matron and Clinical Development Nurse role to support the nurse led service at West Heath moving forward. Development of services to adapt to Commissioners requirements Increase in Advanced Nurse Practitioners (ANP s) at front door of Acute Hospitals (HEFT,GHH and UHB) supporting Recovery plan of Service Transformation Programme (STP) across the region. Flexibility in workforce to adapt to the requirement to deliver patient services across inpatient and intermediate care units across the City. Discussions with BSMHFT and NHS England in relation to the continuation of the contract to provide Primary Healthcare at HMP Birmingham. Service Redesign to improve productivity and achieve CRES targets Delivery of CRES and its associated workforce schemes: o Review of Administrative services o Design and implement Combined Access Point for specialist services o Ward Skill Mix review (consideration for impact of safer staffing requirements) o Sheldon Unit and re-allocation of respite services o Therapy Services Review Re-allocation of Wards to support patient bed-flow model/strategy Medical Workforce Review Implementation of Trust and National initiatives / changes Merger of BCHC, BCPFT and DWMHT Implementation of Service Line Management Workforce Race Equality Standard Nurse Revalidation Relocation and redeployment of staff to align with service changes and the Estates Strategy Divisional action to respond to 2016 Staff Survey results 11 P a g e

12 Widening Participation incorporating the Apprenticeship Levy Removal of Bursary/Grant status for Nurse Training, Physiotherapy, Podiatry, Dietetics and Occupational Therapy with effect from 1 August 2017 The Urgent Care priority actions are underpinned by the following Divisional Strategies: Recruitment (routine and hard to fill) Succession Planning Temporary Staffing Developments (Apprenticeship, New Roles, Competency Framework) Retention Management, Organisational and Clinical Skills Development Redeployment and Service Change 9.3 Children and Families Division The Workforce Plan has been developed in the light of the Division Clinical Strategy service changes, CRES plans and staff profile analysis. The key workforce priorities are identified as follows: Continuing to provide high quality services To address the staffing difficulties experienced in Specialist Nursing Services through the implementation of increased Headroom establishment and increased flexibility in staffing; Availability of temporary staffing for Therapies, Specialist Nursing and Traded Services Recruitment for SCPHN Qualified Nursing in Special School and School Nursing, Children Community Nursing and B6 Therapists in Inclusion Role and Skill Development (Nurse prescribing, Mental Health module for Special School Nurse, Specialist Health Visitor roles, Complete Care) Compliance with all Trust workforce-related KPIs; especially Sickness Absence and Appraisal as the Division has failed to meet these trajectories through 2016/17; Integration and implementation of services following contract start Either: implementation of the Early Years contract Or: transfer staff from the Early Years Service to the new service provider; Development of services to adapt to Commissioning requirements Change to 10 x District-based structure for Early Years Service. Implementation of the Rapid Response Service Service redesign to improve productivity and achieve CRES targets Delivery of CRES Implementation of Trust and National initiatives/changes Implementation of Service Line Management Participation in the Trust s Workforce Race Equality Standard Action Plan Working within national Agency Staffing restrictions Divisional action to respond to 2016 Staff Survey results Implementation of the new Apprenticeship model Respond to AHPs into Action framework Nurse Revalidation Relocation and redeployment of staff to align with service changes and the Estates Strategy Etc. 12 P a g e

13 Similar to Urgent Care plans above detailed plans are highlighted in relation to the above Divisional Workforce Strategies i.e. Recruitment, Retention, Temporary Staffing etc. 9.4 Specialist Services Division The Division has developed a distinct Workforce Plan for both Learning Disabilities and Rehabilitation Services and has highlighted key priority actions under plan headings of Recruitment, Retention, Development and Redeployment. Learning Disabilities Promotion of Trust via universities, careers events and partnership working. Promote career pathways within community services for both clinical and non-clinical staff. Advanced practitioner qualifications. Up-skilling of Community staff. Promotion of apprenticeships with Birmingham schools and job centres through partnership working. Promotion of opportunity to complete additional qualifications. Work experience and job shadowing opportunity. Numeracy and literacy testing for support workers who may require this support. Local and corporate induction, preceptorship, PDRs and clinical supervision. Maintaining mandatory training to support patient safety through training needs development (TNA). Rotational schemes Leadership, accredited and non-accredited from ILM level 2 up to Master Degree level I INSPIRE Leadership Programme), leadership competency framework 360 feedback tool IT skills. Communication skills and personal development e.g. NLP, Enhanced communication skills, assertiveness Customer service/icare Succession planning talent management/ Mentoring and Coaching Skills local and through the Coaching Collaborative Foundation Degrees/ Diplomas/ vocational qualifications for both clinical and non-clinical, CPD short courses, Internal and external Apprenticeships clinical and non-clinical. Development of staff grades with the support of SAS funding for revalidation. Development of qualified nursing and AHPs through LBR funding stream Skills match/personal development plan to incorporate some of the above. Redeployment skills for staff CV writing, interviewing skills, successful application form writing, emotional resilience skills, study skills, individual SWOTs, job trialling and job shadowing Rehabilitation Service Recruitment drives to include attracting qualified and non-qualified individuals to support Inpatient Units. Emphasis upon retention via training and development. Local & corporate induction, preceptorship, PDRs and clinical supervision. Maintaining mandatory training to support patient safety through fingerprint development (TNAs). Work experience and job shadowing opportunity. Rotational schemes. Development of: Band 4 roles 13 P a g e

14 AHP Consultant roles Leadership, accredited and non accredited from ILM level 2 up to Masters Degree level I Inspire leadership programme), leadership competency framework 360 feedback tool IT skills. Communication skills and personal development e.g. NLP, enhanced communication skills, assertiveness. Customer service/icare. Succession planning talent management/mpc tools. Mentoring and coaching skills local and through the Coaching Collaborative Foundation Degrees / Diplomas / vocational qualifications for both clinical and non-clinical, CPD short courses, internal and external. Apprenticeships clinical and non-clinical. Development of staff grades with the support of SAS funding for revalidation. Development of qualified nursing and AHPs through LBR funding stream. Structure and strategy to be agreed and workforce to be matched accordingly. Skills match/personal development plan to incorporate proposed changes. Redeployment skills for staff CV writing, interviewing skills, successful application form writing, emotional resilience skills, study skills, individual SWOTs, job trialling and job shadowing. 9.5 Dental Services The Divisional Workforce Plan highlights key priority actions under plan headings of Recruitment, Retention, Development and Redeployment. Skills audit to be undertaken across the Medical & Dental workforce to inform a training & development plan. Negotiate reduction in activity levels whilst training is being provided. Maintenance of existing staff skills by regular professional development reviews and clinical supervision. Leadership, accredited and non accredited from ILM level 2 up to Masters Degree level I Inspire leadership programme), leadership competency framework 360 feedback tool IT skills. Communication skills and personal development e.g. NLP, enhanced communication skills, assertiveness. Customer service/icare. Preceptorship. Work experience and job shadowing opportunities. Rotational schemes. Apprenticeships. 10. Trustwide Implications Throughout the Divisional Workforce Plans there are a number of emerging themes for the Trusts Workforce Plan. These needs are summarised below: 14 P a g e To review Recruitment Strategies related to both Bank and substantive appointments. There is a need to build on the work done and lessons learnt from Urgent Care Inpatient Services and this to other priorities i.e. Adult Community Teams, Rehabilitation and Allied Healthcare Workforce. To have corporately supported plans in place to tackle more specialist recruitment i.e. Specialist children s Nurses for RCN/Palliative Care, SCPHN Qualified School Nursing and Therapists (Band 6 in Inclusion Service)

15 To be flexible in workforce practices, structures and skill mix to respond to Commissioning intentions, particularly retendering and the future development of traded services To have plans in place to address the efficiency, effectiveness and overall costs of support staff, non clinical administration and management support costs To support the development of new and advances roles to support clinical pathways, for example, Community Paediatricians ASD diagnosis for school age children To have sustainable solutions for addressing CRES targets To maximise the opportunities for Apprenticeships and developing the un-registered workforce To develop Strategies for responding to developments and the reform of Education and Training Commissioning To develop a more formal approach to retention and to embed a culture and system for succession planning within the organisation to address retirements and leavers To consider flexibility in terms and conditions and back office functions to support competitiveness and tendering exercises To consider the temporary staffing issues for non-nursing staff groups with no history and culture of Bank working i.e. Therapists To address the under-representation of Black and Minority Ethinic staff in higher bands and levels of the organisational structure 11. Regional and National Context The Annual Workforce Report is set within the context of a changing external environment. The key national policy drivers and external influences are: Sustainability Transformation Planning Changes in Nurse Education and Training Commissioning Revalidation Junior Doctor/Dentist Contract Implementation Shape of Caring and Talent for Care Programmes Agency Controls and Targets Carter Report: Workforce Implications 7 Day Services Implementation Apprenticeship Levy Reshaping the workforce to deliver the care patients need Report Implications of Brexit The Trustwide issues which will feature as key components of the 2017/18 plan are identified as follows: Transforming Care Together Programme - The programme will require a comprehensive and robust response for organisations and Workforce Development. To manage the transactional and transformational element of the change culture, communication and staff engagement will be key determinants of the realisation of the long term benefits frop TCT. However, 2017/18 will also be a period when the transfer of staff, the management of organisational change and maintaining the essential Hygenience factors will be key. Health Education England - Whilst recognising the fundamental changes to education Commissioners and HEE roles and structure the Trust will continue to play a key role in the local arrangements for workforce development and workforce planning across the Health Economy. Through its representatives the Trust will be an active partner in the regional wide integration agenda. 15 P a g e

16 Safe Staffing - Support to the Safe Staffing Project will continue. New Roles of Care Sustaining Transformation Plan - The Trust will continue to engage with health economy partners in the development of workforce plans for STP. Aligned with the Trusts ambition to become a Trusted Partner the Trust will work in partnership at a number of levels on various workforce programmes across the Health system. The Trust will be actively participating in new care model developments opportunities in Dudley and Birmingham through Multi-Speciality Community Provider (MCP) not Vanguards and workforce development will be key to feature of these developments. 12. Five Year Forward View Delivery Plan In March 2017 NHS Employers published the Five Year Forward View Delivery Plan document which sets out the next steps for the 5 years to make health and care more sustainable for the future. It focussed primarily on the delivery of the previously outlined service priorities. Chapter 8 of the document Strengthening our Workforce recognises the enormous pressure that staff are under, acknowledges the improvements made but sets out key priorities for the future. NHS Employers summarised the Key points for the NHS workforce as follows: Continue to improve productivity and grow the frontline workforce, in particular in nursing, mental health, urgent and primary care. A clear message is given that there will be more registered nurses in 2020 than today, for health and social care. A Nurse First programme, similar to the Teach First scheme, will encourage people to enter careers in nursing and will in a very welcome move prioritise access to roles in mental health and learning disability. New professional roles will continue to develop, including doubling the number of nursing associates to 2,000 this year and a commitment to invest in physicians associates. There is also a welcome emphasis on investment in advancing clinical practice, though this seems focused only on nursing at present. Undergraduate medical school places will grow by 25 per cent adding an extra 1,500 places, starting with 500 extra places in Specific staff shortages will be addressed, including: o emergency medicine o endoscopy o ultrasonography o radiology Action on NHS staff health and wellbeing will be extended, and the report proposes that all in 2017/18 trusts will have a plan in place to improve the health and wellbeing of their workforce. NHS England will introduce a new NHS GP health service, to support doctors suffering from mental ill-health and addiction. Over the next two years, trusts will need to show year-on-year improvements in closing the gap between white and BME staff being appointed from shortlisting, and reduce the level of BME staff being bullied by colleague. Leading STPs and accountable care systems will work with staff and trade unions to encourage flexible working, and find ways to de-risk service change and support a proposed staff passport to facilitate collaboration between primary and hospital care. An NHS staff passport will enable and support team-based working, for example, by enabling nurses to work in both primary care and in hospital. 16 P a g e

17 2bn of surplus NHS assets will create investment to free-up land sufficient for 26,000 affordable homes for NHS staff. Other key workforce priorities include improved e-rostering, job planning and reduced Agency staffing. 13. STP and Local Workforce Action Board (LWAB) The Birmingham and Solihull STP is supported in the development of the workforce elements of local delivery plan by LWAB. The LWAB also has responsibility for delivery of the Health Education England objectives and for meeting the local workforce needs within the Health Economy. Discussions are ongoing with LWAB members and stakeholders in agreeing system level workforce risks, objectives and 2017/18 actions. Local workforce risks have been identified as follows: 1. Recruitment & Retention We have high vacancy rates across several staff groups driven by the demography of the workforce, high turnover, skills shortage and low conversion rates into employment from formal training programmes within some professions. In particular these include nursing (all branches), radiography, doctors (emergency, acute medicine, radiology and oncology, GPs), junior doctors, laboratory staff and cardiac physiologists. 2. Capacity We have some areas of the system that are significantly under resourced, driven by the factors above but also factors relating to funding and service demand. Specifically these include primary care, social care and urgent and emergency care. 3. Workforce demographics We have an ageing workforce with c.7,000 staff aged 55 or over and therefore potentially retiring from the system in the next five years. This compounds issues of capacity, recruitment and retention. 4. Structural Reforms Education Funding Reform/Apprenticeship Levy Changes to the way education and training is funded and structured will impact on all organisations in the system and will require the system to adapt the way it currently plans, trains, recruits and retains its workforce. Addressing the risk underpins the ability of the system to address all workforce risks. Local workforce priorities will be structured around five thematic areas: Supply Upskilling New ways of working New rules Leadership 17 P a g e

18 Three project workstreams have been initially identified as part of the 2017/18 LWAB plan. Workstream/STP Programme Maternity Children & Mental Health Community Care First Secondary and Tertiary Care Primary Care Workforce Strategy Young Children New workforce elements of GP Forward View local delivery plan including international recruitment, new roles and new ways of working Psychological skills development of the primary care workforce Upskilling Paediatric knowledge and competence in primary/community care OD input to support MDT working long-term condition management /urgent care Leadership development IAPT expansion New ways of working to support community models for urgent care pathway Education Reform Apprenticeship Partnership Development of a collaborative approach to education and training the future workforce. Understanding a workforce need and available talent Joint approach to recruitment to training programmes values based recruitment Retention on training programmes delivering the perfect placement /implementing the findings of Narrowing the Gap, single mentorship model Recruitment to new organisations clear career pathways and single development offer Retention in employment Single approach to OD, CPD and talent pipeline Developing a business case to deliver a collaborative apprenticeship offer across BSoI to include: Collaboration on all recruitment and marketing activity Shared training specialist pathway in urgent care, end of life and mental health Agreed career frameworks across all organisations Single procurement of external training provision Rotational apprenticeship placements/hosting Once approach to functional skills development Collective input and coordination of apprenticeship standard development One approach to work experience/schools and college engagement 14. Conclusion The Annual Workforce Plan for 2017/18 sets out a challenging People agenda for leaders and managers at all levels of the organisation. However, it is recognised that implementation of these key actions is vital to the continual delivery of high quality and safe services. Progress against the plan will be reviewed as part of the Annual Plan Objectives Quarterly Reports, QPR Reports to the Trust Board and specific reports to Trust Board Sub Committees. 18 P a g e

19 D.Holmes HR Director May 2017 Appendix 1 Extract from 2017/18 Operational Plan Submitted to NHSI The People Strategic Objective is recognised throughout the organisation as a key enabler for the delivery of the Trust s mission, vision and values. In this respect the Trust has put in place workforce interventions at Strategic, programme/policy and tactical level. These are referred to below. Articulation of a workforce planning methodology linked to the strategic aims of the provider, informed by financial and service objectives and contributing to the integrated operational plan The Trust has developed a Strategic Workforce Annual Planning Cycle and a workforce planning template based on the Skills for Health Six Step Model. This results in each Division and Sub Divisions having a Five Year Strategic Workforce Plan and a 1 year Operation Plan based on service, commissioning and financial plans. Integrated workforce plans are consistent with the long term financial model. Five year and 1 year operational plans are reviewed on an annual basis. An underpinning workforce strategy developed with staff involvement (also linked to clinical and wider STP strategies) The elements of the People agenda are bought together under the Trusts Workforce Development Strategy and associated Action Plan. This Strategy was developed through engagement with the Divisions and employee representatives. It sets out the aspirations for the future workforce and the key themes of the strategy are Capacity, Capability, Productivity and Flexibility. The Workforce Strategy is also supported through a comprehensive Organisational Development plan covering health and wellbeing, staff engagement and equality and diversity. Trust Board approved strategies are reviewed on an annual basis; Workforce and OD Strategies subject to review in Quarter 4. A robust governance process to offer assurance and approval and act as a means of assessing performance against plan in year The Workforce Development Strategy deliverables are monitored through Trust Board and its Sub Committees through quarterly reports on progress towards annual plan objectives and monthly reports of progress related to the Board Assurance Framework. A range of workforce KPIs have been developed and are reported through the Quality and Performance Report to the Trust Board and its Sub Committees on a monthly basis. A Strategic Workforce Committee provides oversight of the workforce agenda and provides regular reports to Quality, Governance and Risk Committee. 19 P a g e

20 Well modelled alignment with both financial and service activity plans to ensure the proposed workforce levels are affordable, sufficient and able to deliver efficient and safe care to patients The Trust has robust processes for ensuring that Safe Staffing is maintained across all Inpatient Nursing areas. An electronic Rostering system and a dependency tool ensure that there is shift by shift monitoring and management of Safe Staffing. Establishment reviews taking into account patient safety, acquity and dependency are completed every 6 months. Safe Staffing reports triangulating quality and patient safety are produced for Trust Board and its subcommittees on a monthly basis. Within the community teams the District Nursing service has implemented a powerful demand planning tool to match Patient needs to the nursing care required with subsequent gains in efficiency and timely safe care. Achievement of workforce efficiency, capitalising on collaboration opportunities to increase workforce productivity within STPs and inform subsequent CIP development (taking into account any impact on quality and safety, with ongoing measurement to identify adverse outcomes and ensure effective mitigating actions where necessary) Workforce Transformation has been at the heart of service transformation projects and the delivery for Cash Releasing Saving Schemes. All CRES projects are subject to a Quality Impact Assessment and a Gateway review to provide assurance in relation to the impact on quality and patient safety. The Trust has successfully delivered a range of workforce transformation projects including service redesign, workforce and deployment analysis, process efficiency, technology mobilisation and skill mix. Workforce cash releasing savings have also been delivered through tendering of services, estates rationalisation and working practice efficiency. The Trust has been working in partnership with Black Country Partnership NHS Foundation Trust and Dudley and Walsall Mental Health Partnership NHS Trust as part of the Transforming Care Together Programme. Significant back office savings and efficiencies have been identified. Quality Impact Assessments are undertaken and reported to a Governance Assurance Sub Committee of the Board on all CRES projects. Detail the required workforce transformation and support to the current workforce, underpinned by new care models and redesigned pathways (responding to know supply issues), detailing specific staff group issues Meeting the demand for staff now and in the future is a key priority for the Trust and has therefore developed robust plans for recruitment, temporary staffing and latterly retention. A High Level Recruitment Plan is in place which includes the raising the profile of BCHC as an employer, enhancing relationships with Higher Education Institutes, international recruitment, streamlining processes and the development of career development opportunities. The Trust is actively participating in system wide workforce planning and is a key player in the development of the STP and exploring new models of care through a range of partners in primary and secondary care. Plans for any new workforce initiatives agreed with partners and funded specifically for 2017/18 to 2018/19 of the Five Year Forward View demonstrating the following: A link with the STP approach to workforce resourcing and how this will be supported through the operational plan 20 P a g e

21 As stated above the Trust has a lead role in the STP process and in particular the delivery of the Community Care First Programme. The Trust CEO is the STP Workforce Lead, Chair of LWAB and Lead for the Regional Wide Integrated Care Workforce Transformational Theme Programme. Trust Executives are active participants in STP/HEE Workforce Programmes. In addition to the range of workforce initiatives mentioned above the Trust will be planning the development and use of new roles i.e. Advance Nurse Practitioner and apprentices as part of their widening participation commitment. How a balance in workforce supply and demand will be achieved As stated above the Trust has a robust approach to identifying workforce supply and demand through its integrated workforce planning process and has actively participated in the Education Commissioning process. The Trust has also a range of workforce interventions to maximise retention and recruitment. The right skill mix, maximising the potential of current skills and providing the workforce with development opportunities The Trust has an effective infrastructure to support the development of workforce capability both with clinical and non-clinical staff. The Trust has a track record of delivering Mandatory Training, PDR targets and effective professional development. Secondments, Mentoring, Coaching and Leadership are positively supported. The Trust has received the Investors in People Silver Award. Competence Training Needs Analysis is conducted to inform the development of staff. Underpinning strategies to manage agency and locum use including spend avoidance. (approaches may include, but are not limited to, strengthening bank staffing arrangements and utilisation of the flexible workforce by developing shared banks with other providers in the STP footprint. Providers should also consider the effective use of technology including e-rostering and job planning systems to enable more effective rota management and staff utilisation, focused on flexibility around patient need) The Trust faces considerable challenge to meet ambitious NHS I targets on Agency spend, partly due to a range of difficult to recruit staffing areas, non- recurrent service development funding and a range of transformation projects requiring specialist interim support. The Trust has in place a robust Agency Reduction Plan which includes increasing the functionality and efficiency of the Bank system, rolling out e-rostering and effective deployment systems. Escalation processes are in place as are reporting arrangements. The Agency Plan includes reviewing Bank pay, establishing centralised systems for Medical and Dental staff and reviewing revised models of temporary staffing. The Trust is conscious of the need to work with partners across the system to address the Agency challenge. Activity to support delivery of workforce plans in conjunction with local workforce advisory boards The Trust actively supports the Sustainability and Transformation Plan (STP) process, with the Trust Chief Executive Officer acting as STP Workforce Lead and joint chairing the LWAB. The Chief Executive Officer Chairs a Regional Wide Workforce Integration Transformation Theme 21 P a g e