Our People A People Strategy for Workforce and Organisational Development to support Herefordshire and Worcestershire Sustainability and Transformation Plan 2017-21 In partnership with: 1
Contents Foreword Acknowledgements Introduction Our STP Challenges Our Workforce Identifying Solutions Our Priorities Retention and Recruitment Education Engagement and Communication Our Governance Our Next Steps Further Information Appendix 1: Appendix 2: Appendix 3: Appendix 4: Herefordshire and Worcestershire Sustainability and Transformation Plan (STP) Overview Workforce and Organisational Development (OD) element of Herefordshire and Worcestershire STP Governance Summary Reference (End) Notes 2
Foreword I am delighted to present the first People Strategy for health and social care across Herefordshire and Worcestershire. Our ambition is to work better together; engaging with, supporting and developing our staff, volunteers and members of the public; building on positive relationships and developing great partnerships to ensure a skilled and motivated workforce today and for the future. This Strategy will support the delivery of the Herefordshire and Worcestershire Sustainability and Transformation Plan (STP) in order to ensure quality and sustainable local health and social care services, maximising the chance for everyone living or working locally to lead a healthy life and to receive information, advice, treatment and care from others when they most need it. I am committed to working with people across the two counties to ensure that we successfully deliver against the ambitions that we have set Jo Galloway, STP Executive Lead for Workforce Chief Nursing Officer, Redditch and Bromsgrove and Wyre Forest Clinical Commissioning Groups Acknowledgements Senior Responsible Officer Authors Jo Galloway, STP Executive Lead for Workforce Jo Galloway, NHS Redditch Bromsgrove & Wyre Forest CCGs Rachel Kirkwood, Worcestershire Health and Care NHS Trust Neil Savage, 2gether Foundation NHS Trust Richard Taylor, Worcestershire County Council Jane Thomas, Worcestershire Health and Care NHS Trust Yvonne Clowsley, Taurus Healthcare Catherine Sills, Health Education England Version DRAFT Version 1.5 Date 16 February 2017 Final Version Approved By STP Programme Board 3
Herefordshire & Worcestershire People Strategy 1. Introduction The vision for Herefordshire and Worcestershire Sustainability and Transformation Plan (STP) is that by 2021: Local people will live well in a supportive community with joined up care underpinned by specialist expertise and delivered in the best place by the most appropriate people Further information on the STP and the supporting workstreams can be found in Appendix 1. This People Strategy exists to support the implementation of the local STP. It sets out how local organisations delivering health and social care services plan to work better together to ensure the workforce of today and tomorrow has the right numbers, skills, values and behaviours, at the right time and in the right place to deliver quality and sustainable services to members of the public. The Strategy addresses: Our STP challenges Our workforce challenges, today and for tomorrow Priorities for collective working across 3 key areas: Retention & Recruitment Education Engagement & Communication The Strategy aims to support local, regional and national workforce priorities arising through: NHS Five Year Forward View (2014) Health Education England Annual Mandate and Business Plan Skills for Care (2016) State of the Adult Social Care Sector and Workforce in England NHS England (2016) General Practice Forward View Primary Care Workforce Commission (2015) The Future of Primary Care: Creating Teams for Tomorrow Public Health England (2016) Fit for the Future: A Review of the Public Health Workforce One Herefordshire Future of Acute Services in Worcestershire 4
2. Our STP Challenges We know there are national challenges meeting the demand for health and social care services and these are reflected locally, including: 3. Our Workforce Across Herefordshire and Worcestershire, data suggests that a minimum of 54,057 FTE (Full-Time Equivalent) workers (including staff, volunteers and carers) currently provide health and social care to a population of 758,000 i, working either for an NHS Trust, General Practice, Social Care provider or as part of a caring role within the family or community ii. Additional staff and volunteers work across wider Primary Care (Dentists, Community Pharmacists and High Street Optometrists), Public Health, services within the Private Sector, and services across the Voluntary and Community Sector, for which there is not yet accurate workforce data. Across England, the NHS workforce is the primary driver of future health costs, with around 70% of recurring NHS provider costs relating to staffing iii. Local workforce challenges include: An ageing workforce Different expectations of the younger workforce, for example leading to increased part-time working Recruitment challenges and high vacancy rates, related to factors such as national workforce shortages within particular professions, varying terms and conditions, geographical rurality, levels of morale Cultural challenges within existing organisations and staff groups presenting some resistance to change An uncertain future supply of staff, with difficulty attracting students to some courses, placements and to stay in the area after qualifying 5
4. Identifying Solutions The critical enabler for identifying and developing solutions to our challenges is our people: the people living locally who require the services, and the people working and volunteering across health and social care to deliver those services. We can design innovative new care models, but they simply won t become a reality, unless we have a workforce with the right numbers, skills, values and behaviours to deliver it (NHS Five Year Forward View) We are keen to work better together to further explore ideas for person-centred solutions. (Kings Fund, 2013) We want to work with our people across the system to: Recognise fears, challenges and barriers Identify good practice and develop areas of opportunity Build on relationships to enable people to influence and lead positive change We recognise the inextricable links between workforce and organisational development (OD) and therefore this Strategy purposely encompasses them both through 3 key priority areas: 1. Retention and Recruitment 2. Education 3. Engagement and Communication 6
5. Our Priorities Priority 1: Retention and Recruitment In order to achieve a sustainable, affordable and flexible workforce, we will work together to: Improve Workforce Information and Planning Capabilities Ensure an information sharing agreement across the STP so that workforce intelligence can be shared across organisations for the benefit of the wider system Further develop our ability to project future workforce requirements, anticipating the roles and skills mixes we need in the future Better share case studies of good practice of different workforce models, ways of working, new roles, roles working in different settings and within different teams Better utilise business case models and financial modelling to explore different affordable workforce options and to support workforce investment decisions at a system level Identify the workforce required to provide people with appropriate access to services across 7 days of the week and a proposed delivery plan to provide this workforce Identify methods of better benchmarking with other STPs and organisations to inform, for example, local targets and Retention and Recruitment Strategies Retain Existing Workforce Agree system-wide STP retention priorities to be reflected in associated individual organisation strategies, including actions to build staff resilience, increase morale and health and well-being Maximise system-wide opportunities for offering staff benefits, career progression and career portfolios, flexible contracts and rotational posts, career breaks and flexible working, flexible retirement options, and succession planning Maximise system-wide opportunities for personal and professional development (for example, work shadowing, leading improvement projects, rotational working), shared learning and development programmes, secondment and gateway opportunities linking to the Education section Adopt and sponsor a Workplace Health and Wellbeing Charter in the local economy Explore opportunities for shared Occupational Health services or joint purchasing arrangements Recruit Future Workforce Agree system-wide STP recruitment priorities to be reflected in associated individual organisation strategies, including recruitment incentives, packages and contracts to attract people Identify priority areas for exploring and agreeing new models of workforce for example, in areas of high long-term vacancies or projected workforce shortages Identify education priorities to support recruitment and widening participation, including opportunities to grow your own local workforce; development of routes into shortage areas (for example through work experience, bespoke training or bridging programmes); joint promotion of jobs within health and social care to schools, colleges, universities and the local labour market; increased joint working with the Local Enterprise Partnerships (LEPs) link to the Education section Maximise opportunities for system-wide rotational training and post-qualification career roles which are innovative and attractive Build on existing work to increase efficiencies through shared recruitment processes, including those used to employ temporary staffing; to advertise vacancies online; to induct staff and undertake 7
mandatory checks; to train staff, with transferable evidence of achievement such as an STP staff training passport Maximise the Apprenticeship Levy Ensure system-wide opportunities to maximise the apprenticeship levy as both a retention and recruitment tool link to the Education section Ensure the area is marketed as an attractive come here / stay here place to work Develop a single Herefordshire and Worcestershire branding for health and social care recruitment so that we can attract people to live and work within our STP area link to the Engagement and Communication section Priority 2: Education In order to ensure we have an appropriate workforce both today and for tomorrow, we will work together to: Appropriately Upskill the Current Workforce Develop a plan for the upskilling of the support workforce to maximise the impact of one of the largest sections of the workforce, learning from good practice, the development of apprenticeship standards and of new roles Develop a process for identifying, retaining, further developing and systematically managing talented staff within the system Explore innovative ways of ensuring the sustainability and growth of appropriate educational and care development activities Develop an agreed systems-wide approach to coaching people to support the prevention agenda ( health coaching or similar) Train a Workforce Fit for the Future Identify priority new roles in line with workforce models required for the STP models of care Explore the development of appropriate STP Communities of Practice to agree consistent principles and ways of working for new roles and to support embedding them (for example, Leads across the STP for Support Workers delivering healthcare, or Leads for Advanced Clinical Practice), ensuring links with regional and national programmes Establish a process for service providers to continue to influence and shape education and training curriculum for training the future health and social care workforce Develop system-wide good practice principles for a good learning environment regardless of setting, employer and type of learning Identify how to maximise the use in health and social care of trained individuals currently in oversupply, for example Pharmacists, Psychology graduates Increase the Knowledge and Skills of Local People Develop actions to support an increase in the knowledge and skills of local people to better prepare them to make the right decisions around which services are appropriate to access at which times for what need Increase the Knowledge and Skills of Volunteers Develop a system-wide plan for the development of volunteers supporting health and social care services, in order to maximise any opportunities to share, for example, induction and training opportunities 8
Develop Systems Leadership Agree system-wide priority actions in order to maximise the opportunities of developing Systems Leadership across the STP, ie Leadership across organisational and geopolitical boundaries, beyond individual disciplines within a range of organisational and stakeholder cultures, often without direct managerial control Deliver New Ways of Learning Explore ways to optimise innovative and technology enhanced learning Develop and embed comprehensive supervision practice across organisations Identify specific opportunities to increase interdisciplinary learning and shared training for staff from across the whole system Priority 3: Engagement and Communication Good staff engagement is central to the success of the STP. In order to maximise the opportunities for staff to engage in the STP process and help to identify and develop solutions, we will work together to: Develop an Informed and Engaged Workforce Provide staff with honest, easily accessible information on a regular basis through an online portal Offer staff a range of meaningful engagement processes, including face-to-face, where they can ask questions, engage in discussion, offer feedback and share ideas Involve staff in key decisions that affect them and the services they provide Invite staff to co-produce service re-designs along with patients, carers, managers and the voluntary and community sector. This may be through existing groups, informal networks, relevant Communities of Practice (for example, Human Resources, Advanced Clinical Practice, Support Workforce) or specific Task and Finish Groups Invite staff to influence the direction of their work, changes made to working practices and other decisions that affect patient care Offer staff the opportunity to discuss how proposed service changes will affect them as individuals Measure and monitor the quality of staff engagement and involvement Invite staff to complete local staff survey and the national NHS survey Ensure staff engagement is agreed as a regular item in individual organisation senior management teams 6. Our Governance The People Strategy will be monitored by the Workforce and OD Action Group on behalf of the Herefordshire and Worcestershire Local Workforce Action Board (LWAB). This Action Group will ensure links to any relevant Subgroups, Networks, Communities of Practice or Task and Finish groups deemed necessary to ensure the successful delivery of the work. Governance is summarised in the diagram attached as appendix 3. 7. Our Next Steps The Workforce and OD Action Group will develop a People Strategy Implementation Plan including sections on the 3 key priority areas. The Action Group will ensure progress against the Plan is monitored and reported upon to the Local Workforce Action Board (LWAB) and in turn the STP Programme Board. 9
The People Strategy and its Implementation Plan will remain live documents in order to respond flexibly to requests from the STP Programme Board and the Local Workforce Action Board. 8. Further Information For further information or to become more involved in the implementation of this Strategy, please contact: To agree 10
Appendix 1: Herefordshire and Worcestershire Sustainability and Transformation Plan - Overview Source: Herefordshire and Worcestershire STP Oct 2016 In order to deliver on the above, the STP has identified 4 overarching priorities and 3 enabling themes: 1. Maximise Efficiency and Effectiveness 2. Deliver Prevention and Self Care 3. Develop Out of Hospital Care 4. Establish Clinically & Financially Sustainable Services a) Workforce & OD b) Digital & Technology c) Engaging Communities & Voluntary Sector The aim of the Workforce and Organisational Development (OD) enabling theme is to: Develop the right workforce and Organisational Development within a sustainable service model that is deliverable on the ground within the availability of people and resource constraints we face 11
14 clinical workstreams support the 4 overarching priorities: STP Plan priorities Infrastructure and Back Office Diagnostics and clinical support Medicines optimisation Prevention Prevention - CYPF Self care Developing sustainable primary care The role of community hospitals Integrated primary and community services Improving mental health and learning disability care Improving mental health and learning disability care Improving Urgent Care Improving maternity care Elective Care Work Programmes Procurement; Strategic Estates; Transactional Services (Back Office); Digital Strategy; Transport Pathology; Clinical Supporting including pharmacy and radiology; System demand management strategies Pharmacy; Medicines Optimisation; Prescribing / reducing variation Social Prescribing; Making Every Contact Count; Digital Inclusion; Lifestyle Change Programmes Children Young People and Families Self Care GP Forward View, Primary care at scale Bed based care Non-Bed based care New models of care Frailty pathways; End of Life Mental Health Learning Disabilities Urgent Care; Stroke Maternity, Neonates, Gynaecology. Jointly commissioner service and management structure Non-Life Threatening Commissioning Strategies Life threatening conditions Cancer Services Each clinical workstream was asked to identify workforce and organisational development (OD) priorities for the STP People Strategy. 12
Appendix 2: Workforce and Organisational Development element of Herefordshire and Worcestershire STP (Oct 2016) 13
Appendix 3: Governance Summary 14
Appendix 4: Reference Notes i Mid-2013 Population Estimate, Office of National Statistics ii Primary Care GP Practices (2015 return + estimate for non-submitting Practices); NHS Trusts eworkforce ESR data (HEE Mar 2016) + summary 2gether NHS Trust + assumptions for West Midlands Ambulance Service, bank/agency 5%; Social Care Paid - National Minimum Dataset + estimate for non-submitting employers; Social Care Unpaid assumption from Census 2011 iii The King s Fund (2015) Workforce Planning in the NHS 15