NHS HIGHLAND WORKFORCE PLAN 2008/09 EXECUTIVE SUMMARY

NHS HIGHLAND WORKFORCE PLAN 2008/09 EXECUTIVE SUMMARY The implementation of Better Health, Better Care: Action Plan requires a committed, well prepared, dedicated workforce that is both trained to practise and ready for purpose. NHS Highland Workforce Plan 2008/09 illustrates how the Board will use 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 safe, high quality healthcare services for the people of Highland. ENQUIRIES TO: PAMELA CREMIN WORKFORCE PLANNING & DEVELOPMENT MANAGER Pamela.Cremin@hpct.scot.nhs.uk

FOREWORD NHS Highland Board is committed to improve the health of the Highland population and develop services to deliver quality patient care to the people of Highland - whilst recognising the total dependence of these aspirations on its workforce. This third Workforce Plan on behalf of NHS Highland is part of an iterative process, building further on the workforce planning function and the achievement of the 10 recommendations identified by NHS Highland Workforce Plan 2007. The Plan is published at a time of transition and the alignment of the workforce, service and financial planning functions within the Board. In order to deliver against Better Health, Better Care: Action Plan 1 and the NHS Highland Clinical Framework 2, the Board must ensure it has a committed, well prepared, dedicated workforce that is both trained to practise and ready for purpose. During 2007/08 the Board developed its Workforce Strategy 3 to support the implementation of its Clinical Framework. The Workforce Strategy outlines how the Board will support, develop and manage its staff and identifies a number of drivers for change, for example, demographic, technological, policy, and legislative. These present a number of challenges that will impact on NHS Highland s workforce and the key challenges are around remote and rural healthcare delivery, modernising clinical careers, compliance with Working Time Regulations and the achievement of the Health, Efficiency, Access and Treatment (HEAT) targets set by the Scottish Government. In addition there are three strategic issues which continue to impact upon service delivery across NHS Highland: The sustainability of the workforce and the specific challenge of providing services in a remote and rural environment; Tighter financial settlements and reduced reliance on non-recurring resources; and The requirement for greater efficiency and productivity; The strategic issues outlined above are already impacting on the workforce, therefore the key focus of this year s Workforce Plan will be to further develop the Board s capacity and capability of its workforce planning function to ensure that the 1 (2007) Better Health, better Care: Action Plan. Edinburgh: Scottish Government Health Department 2 (2006) NHS Highland Clinical Framework. Inverness: NHS Highland Board. 3 (2008) Developing, Supporting and Managing People. The Workforce Strategy for NHS Highland. Inverness: NHS Highland Board Working with you to make Highland the healthy place to be 2

workforce can better anticipate the changes it can expect in the way NHS Highland services are developed. This will require the re-examination and re-alignment of a number of Board functions to ensure that the NHS Highland workforce meets current and future healthcare demands, and these are discussed in detail throughout the Workforce Plan. Dr Roger Gibbins Chief Executive NHS Highland Ray Stewart Employee Director NHS Highland Working with you to make Highland the healthy place to be 3

EXECUTIVE SUMMARY NHS Highland Workforce Plan 2008 is intended to consolidate previous workforce planning achievements and set the high level strategic direction for workforce planning and the integration of workforce, service and financial planning over the next year. The plan is set, therefore in a context of transition, in that it will support the on-going function of workforce planning and take cognisance of the workforce modernisation agenda, responding to a number of key changes that affect the delivery of health services to the people of Highland. The plan aims to describe a vision to meet future healthcare demands, and seeks to build on existing good work and relationships both within internal NHSH functions and with external partner agencies. In line with Better Health, Better Care: Action Plan and the NHS Highland Clinical Framework, NHS Highland s primary purpose is to help people in Highland 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. The Board has responsibility for assuring delivery of behalf of Ministers and the public. The Scottish Government assesses Board performance through the implementation of the Local Delivery Plan (LDP) and performance against the HEAT targets and the Board recognises that its ability to provide local people with high quality health care depends on the knowledge, talents and commitment of its employees and partners. A key challenge for NHS Highland is the delivery and sustainability of services in remote and rural areas. NHS Scotland Remote and Rural Steering Group have led the development of Delivering for Remote and Rural Healthcare, 4 which addresses a number of challenges in sustaining healthcare in remote and rural communities and identifies a number of approaches to be taken forward through an Implementation Plan. NHS Highland will be involved in taking this work forward and workforce planning and development requirements that will support NHS Highland to deliver and sustain services in remote and rural areas will be progressed as part of the implementation plan. A key achievement in 2007/08 has been the development of a Workforce Strategy for NHS Highland, that will enable the Board to use the talents and experience of staff in the best possible way, ensuring they are able to continue to give of their 4 Delivering for Remote and Rural Healthcare. The Final Report of the Remote and Rural Workstream. Edinburgh: Scottish Government Health Department. 2008 Working with you to make Highland the healthy place to be 4

best and meet challenges to improve health and reduce inequalities, in addition to delivering healthcare services. NHS Highland Workforce Plan 2008/09 should be considered in line with the Workforce Strategy, which demonstrates significant investment in workforce retention policies and approaches. Improved 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 Highland to take full advantage of a flexible and responsive workforce. The workforce planning and development function also contributes to NHS Scotland supply and demand imperatives, and identifies the education, training, development and accreditation options that will enable the Board and partner agencies to maximise the effective use of staff in both existing and new and extended roles. Key processes Local Delivery Plan: In line with the Scottish Government s move to develop and fully integrate workforce plans with service delivery and financial plans, this year the NHS Highland Local Delivery Plan 2008/09 risk narrative section made a first attempt at identifying workforce requirements against each HEAT Target 5. What was required was clear and explicit workforce narrative that takes consideration of workforce affordability, availability and adaptability along with specific workforce requirements (projections) for each HEAT Target. This was achieved for some, but not all of the HEAT Targets in the 2008/09 LDP. For 2009/10, this will be improved upon through a better understanding of what is required and a more robust relationship between workforce, finance and service planning systems in the lead up to the development of NHS Highland Local Delivery Plan 2009/10. Workforce Projections: Scottish Government Health Department issued an NHS Board Workforce Projections Template to Chief Executives in November 2007, which was populated with NHSH Board workforce data as at the NHS Scotland workforce census at 20 th September 2007. The development of SWISS 6 information systems and the communication between ISD 7 and Board workforce planning and workforce information staff underpinned the publication of more accurate and usable data, than had been collated for this purpose in the past. The template was required to be completed by all NHS Boards and be tested against the 3 feasibility factors; affordability, availability and adaptability previously identified by HDL(2005)52 8. Through the agreement of Board financial plans and business cases linked to service needs and local delivery plan requirements, specific affordable workforce 5 HEAT Target(s): Health, Efficiency, Access and Treatment targets set by the Scottish Government 6 SWISS: Scottish Workforce Information Standard System for NHS Scotland 7 ISD: The NHS Scotland Information and Statistics Division 8 NHS HDL (2005) 52 National Workforce Planning Framework Guidance. Scottish Executive Health Department. 2005 Working with you to make Highland the healthy place to be 5

projections were identified, which were imported into the Workforce Projections Template. The completed template was returned to Scottish Government Health Workforce Directorate, where the data will assist the Scottish Government in determining overall demand for staff and inform decisions about training supply for relevant staff groups. Developing Board Workforce Plans: This year, Board Workforce Plans are intended to fully integrate with service and financial plans. The workforce projections template summary page will become part of the Local Delivery Plan, for future submissions. However, as this is a transitional year and timetables are not yet fully aligned (the deadline for Boards to complete the workforce projections template was set at 30 April 2008, later than the deadline for all other LDP templates which was 18 February 2008). Therefore, NHS Boards are not required to submit their 2008 Board Workforce Plan separately to Health Workforce Directorate this year. However, this remains an important NHS Board function and Boards should continue to move towards better integrated workforce planning, and should develop and publish local workforce plans each year. CHP and Raigmore Hospital Workforce Plans: Building on the initial workforce plans developed for each CHP and Raigmore Hospital in 2007, these plans have been updated to take cognisance of Better Health, Better Care: Action Plan and issues identified by the CHP and Raigmore workforce plans have been underpinned the development of NHS Highland Workforce Plan 2008//09 and the Actions identified by the Plan. The development of local Partnership Forums has supported the development of CHP and Raigmore Hospital Workforce Plans and are actively involved in their implementation and further development to underpin NHS Highland s workforce planning and development function. Working with you to make Highland the healthy place to be 6

OVERVIEW OF NHS HIGHLAND WORKFORCE PLAN 2008/09 The Workforce Plan begins by describing NHS Highland Workforce Planning function and illustrates the Board s Workforce Planning Framework. Progress made against the 10 Recommendations in NHS Highland Workforce Plan 2007 are illustrated and actions to be taken forward in 2008/09 are identified. AVAILABILITY: Workforce Supply and Demand: The factors influencing workforce demand are analysed against key documents such as NHS Highland Clinical Framework; Better Health, Better Care: Action Plan Better Health, Better Care: Planning Tomorrow s Workforce Today; and Delivering for Remote and Rural Health Workforce supply aspects are illustrated by a Political, Economic, Social, Technological, Environmental and Legal (PESTEL) Framework, taking into account the challenges and the opportunities required to address demographic issues specific to Highland: An ageing population and ageing workforce; Falling birth rate; Less people of working age in the labour market; Out migration of young adults to central and south Scotland; In-migration of Eastern European workers but competition from retail and tourism industry in Highland; Population migration to Inverness and across Moray basin creating service sustainability and workforce recruitment difficulties in remote and rural areas where population is reducing; In addition there are separate workforce demand sections specific to Delivering for Remote and Rural Healthcare and workforce requirements in relation to delivery of the HEAT Targets. AFFORDABILITY: NHS Highland s funded business cases and workforce projections are illustrated in this section. Whilst there has been significant investment in recent years to increase staffing establishments, future workforce growth is expected to slow and the focus will move to role development, skills development and workforce deployment to meet changes in healthcare demand. Where additional staffing is required, these are explicit within the funded business cases agreed by the Board Working with you to make Highland the healthy place to be 7

and the integration of the finance planning, workforce planning and service planning systems within the Board will ensure that workforce growth does not overtake affordability in the future. The Workforce Plan then goes on to discuss the Workforce Planning requirements for each workforce group, taking cognisance of the workforce supply and demand issues that have been considered: Nursing and Midwifery Workforce Planning Medical Workforce Planning Dental Workforce Planning Allied Health Professional Workforce Planning Healthcare Science Workforce Planning Pharmacy Workforce Planning Psychology Workforce Planning Facilities Workforce Planning Administrative, Clerical and Management Workforce Planning Within each workforce group, workforce planning approaches are outlined and specific Actions are identified, which are summarised below. ADAPTABILITY: The Workforce Plan describes Workforce Development systems at NHS Highland and describes National strategies such as Knowledge and Skills Framework and other Performance Management arrangements which 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. Current workforce development approaches are described and future workforce development and educational solutions are outlined that will enable the Board to respond to workforce challenges. Strategic engagement with NES will enable Boards and Regions to develop specific workforce educational solutions to address workforce challenges. A Workforce Development Sub Group of Highland Partnership Forum has been developed to oversee this work. 29 Actions have been identified by the development of NHS Highland Workforce Plan 2008/09 and these are summarised in the next section of this Executive Summary with the identified page of where the Action can be accessed within NHS Highland Workforce Plan 2008/09. Working with you to make Highland the healthy place to be 8

SUMMARY OF ACTIONS The following Actions 29 have been identified by NHS Highland Workforce Plan 2008. An Action Plan will be developed by the end of October 2008 to take these Actions forward. Ensure detailed analysis of workforce supply informs NHS Highland Board in terms of capacity to attract future workforce to deliver requirements (page 24). Align and integrate NHS Highland Workforce Planning function with partner agencies to maximise employee potential. Consider joint workforce planning arrangements for local authority staff working across Highland and Argyll and Bute (page 25). Work with neighbouring boards and Regional Planning Groups to identify solutions to recruitment of specialist practitioners. The implementation of Delivering for Remote and Rural Healthcare will specifically support the remote and rural needs, through the Workforce and Education Workstream (page 25). Engage at a strategic level with NES and a range of higher and further education providers to ensure that the needs of the NHS workforce of the future are met and that programs are developed that are specific and ready for purpose (page 26). Analyse the age profile of NHS Highland workforce and ensure the policies and practices on recruitment, selection, promotion and training are fair to all ages (page 26). NHS Highland will develop an Organisational Development Plan which will identify and support the strategic relationships that the Board will develop and maintain with partner public sector, voluntary and private organisations in Highland and Argyll and Bute to jointly approach environmental workforce challenges and seek solutions (page 27). NHS Highland will work with the Remote and Rural Steering Group and North of Scotland Planning Group to contribute to the development and delivery of the (Remote and Rural) Project Plan in partnership with Boards, Regions, NHS Education for Scotland and other parties (page 35). Working with you to make Highland the healthy place to be 9

NHS Highland will actively participate in the Workforce and Education Workstream (of the Remote and Rural Project Plan) to ensure that sustainable workforce solutions are understood and addressed in relation to Highland requirements (page 35). In line with the development of the Board s Local Delivery Plan, there needs to be clear and explicit workforce narrative that takes consideration of workforce affordability, availability and adaptability along with specific workforce requirements (projections) for each HEAT Target (page 43). Action: Workforce Productivity and Efficiency measures will require development in line with the integration of workforce planning, service planning and financial planning systems (page 43). NHSH and CHPs and Raigmore Hospital workload measurement reports will be developed and the information will be used to support a review of nursing and midwifery workforce establishments over the next twelve to eighteen months (page 47). Implement the nursing and midwifery bank service and evaluate the service including recommendations on its relevance to other workforce groups (page 47). Further analysis of nursing and midwifery agency staff use to be undertaken in conjunction with information provided by the nursing and midwifery workload measurement tools to inform establishment reviews across the service. New bank and agency targets will be set for 2008/2009 with associated financial plans (page 47). Further developments in nursing and midwifery workforce information approaches will be implemented across all the nursing, midwifery and AHP groups in 2008/09. A project plan is currently under development, which will clarify how this will be done (page 48). Progress the 3 priorities of Review of Nursing in the Community in line with agreed timescales and implementation plans (page 48). Working with you to make Highland the healthy place to be 10

National Nursing and Midwifery Toolkit to be integrated into a range of Charge Nurse / Team Leader development programmes (page 49). Deliver workshops to communicate and Modernising Nursing Careers work streams in partnership with SGHD and NES involving, NHSH managers, staff side representatives, HR / organisational development and workforce planning staff (page 50). Identify a range of solutions to support compliance with WTR such as service redesign and implementing a full Hospital at Night service provision. Detailed plans will be required for each speciality at Raigmore Hospital and for rotas of the Rural General Hospitals (page 54). Ensure workforce planning and development needs of the Dental workforce are progressed by the NHS Highland Dental Clinical Governance and Risk Management Group (page 56) Further develop Allied Health Professional workforce plans and contribute to AHP workforce planning and development on a Board, Regional and National basis (page 60). Ensure that healthcare science educational and role development needs are taken cognisance of by the NHSH Workforce Development Sub-group and are explicit within the NHSH and NES Portfolio (page 62). Establish a local healthcare science area forum to improve service visibility and cohesion, ensure inclusion in Board level decision making that impacts on HCS demand and to develop HCS services to meet the needs of patients and NHS referrers (page 63). Revise and continue to implement the workforce issues identified in the Pharmacy Workforce Section of NHS Highland Workforce Plan 2007 (page 65). Working with you to make Highland the healthy place to be 11

Work with partner agencies such as Highland Employers Coalition to address labour market issues that Highland employers have in common, and seek joint and sustainable solutions to address workforce requirements (page 69). Improve workforce intelligence in relation to administrative, clerical and management workforce groups. Specific workforce profiles and workforce planning and development issues will be identified (page 70). Develop an infrastructure within the Board to take forward the Recommendations identified in the Developing an Education Framework for Staff in Administrative Services and Support Services: Scoping Study and Stakeholder Consultation Report (page 72) Develop and communicate the NHS Highland / NES Portfolio in partnership with staff side and NES representatives (page 76). Link the outcomes of the Nursing and Midwifery and the AHP Workload and Workforce Planning Projects findings and analysis, develop an understanding of the needs of staff in AFC Bands 1-4 and align their development to the NHS Career Framework to enable career development structure and underpin role development and service development (page 79). Take forward Learning and Development policies, strategies and plans in line with NHS Highland Workforce Strategy implementation Plan (page 82). Working with you to make Highland the healthy place to be 12

The full version of NHS Highland Workforce Plan 2008/09 is available from: http://www.nhshighland.scot.nhs.uk/publications/documents/strategy/nhs%20hig hland%20workforce%20plan%202008_09.pdf For further information, please contact: Anne Gent Director of Human Resources NHS Highland Assynt House Beechwood Park INVERNESS IV2 3HG E-mail: anne.gent@hpct.scot.nhs.uk Tel: 01463 704865 Pamela Cremin Workforce Planning & Development Manager NHS Highland John Dewar Building Inverness Business and Retail Park Highlander Way INVERNESS IV2 7GE E-mail: pamela.cremin@hpct.scot.nhs.uk Tel: 01463 706916 Working with you to make Highland the healthy place to be 13