SCOTTISH AMBULANCE SERVICE Interim Strategic Workforce Plan Towards 2020 Workforce Plan update 2013/14 Coralie Colburn Version 1-1 -
Introduction The Scottish Ambulance Service Strategic workforce plan will cover period from 2014 as we move towards 2020. It is expected to deliver a significant shift in the service delivery and workforce model. The landscape in which the Scottish Ambulance Service operates is changing and the need for SAS to become a modern, flexible and responsive organisation has never been more acute. The Service must be able to support the wider integration of health and social care and the delivery of the Scottish Government s 2020 Vision where care is increasingly delivered locally, often at home, with pathways for patients being person-centred and appropriate. Our current workforce will be the basis of our future workforce. Our future workforce will have to be affordable, available and, above all, adaptable. Our aim is to develop the right clinical skills and roles to enhance the treatment we offer and make better decisions for patients every day. Scottish Ambulance Service Current Position We are currently in the process of consultation on the Strategic Workforce Plan. The development and implementation of the Scottish Ambulance Service strategic workforce plan will be aligned to its strategy refresh which is working towards the 2020 Vision. This work is being developed in partnership with staff through our Developing our Future Workforce Group and, additionally, supported by Skills for Health who have worked with the Service in 2013/14 to strengthen workforce planning capacity and skills and explore key roles requiring development across the Service. Whilst the specific number of staff for the purposes of the Projections is not yet fully modelled, there are a number of key assumptions set out, which will be progressed in this transition year 2014/15; Review the role of frontline paramedics and support staff to ensure that those dealing with patients are able to operate effectively in an integrated model with access to alternative pathways, remote diagnostic capability and increased treatment at home and in the community; Develop the role of specialist paramedic to support both health and social care services as they integrate further and provide additional critical care capability; Review the education and training model for frontline staff to ensure that staff continue to be appropriately trained for the roles they are performing; Strengthen leadership and management capability implementing SAS Developing Frontline Leaders and Managers programme and creating capacity for managers; Enhance clinical supervision in the Ambulance Control Centres to ensure more effective triage and dispatch of appropriate response to patients; Development of a one ambulance service model reviewing and developing the role of the scheduled care service particularly to better support a more clinically focussed non-emergency service and management of flows across the wider NHS system.
The Strategic Workforce Plan SAS, in its development, takes forward implementation of the 5 key priorities set out in the 2020 Workforce Implementation Framework which will be monitored by the Staff Governance Committee. Key actions include; Embedding the NHS Scotland values as part of ongoing organisational development programme; Developing Frontline Leadership and Management capacity and capability across the Service; Developing talent management and effective succession planning; Ensuring the Service has the right mix of skills and resources to effectively contribute in an integrated health and social care system; Robust staff governance and Partnership arrangements SAS are also undertaking staff governance audits; developing and delivering a staff governance action plan; and taking forward actions and recommendations arising from the NHS Staff Survey at a national and local level. We will continue with our programme of workforce modernisation and will continue to implement our action programme to improve attendance. Skills for Health update - Workforce Planning Capacity and Capability Skills within the Scottish Ambulance Service Following on from the programme of work we have undertaken with the support of Skills for Health, the Scottish Ambulance Service will further develop workforce capabilities and move towards more dynamic workforce planning, including more effective horizon scanning, scenario planning based on projected patient needs and improved use of evidence, data and available tools and techniques to provide better-planned and delivered services for patients. We will continue to review the delivery of the national workforce plan annually to ensure it achieves what it set out to do. The Divisional and Departmental Plans will be reviewed on a regular basis (bi-monthly) via the local and national partnership forums. This will ensure that any planned outcomes and unintended consequences are continually measured and problems addressed. In 2013, over a hundred managers across the Service, from the Executive and Senior management teams to staff on the road and Support staff, have been trained in the Six Steps Methodology. The 6 Steps approach has been developed by the Workforce Projects Team at Skills for Health 1. By providing this training for specific managers on what workforce planning is and how it underpins the delivery of divisional and departmental delivery plans we will ensure that managers understand their responsibility to develop and monitor the delivery of this plan as part of their objectives By reviewing this process we will ensure that the Service has the right people with the right skills and abilities available at the 1 http://www.healthcareworkforce.nhs.uk/resources/latest_resources/six_steps_refresh.html and http://www.skillsforhealth.org.uk
right time to play their part in delivering the highest possible standard of patient care and provide us with a sustainable workforce for 2020 and beyond. As we consult on and finalise the Strategic Workforce Plan, Skills for Health will complete the final part of their programme of work with us. This involves a detailed audit of our workforce planning processes, use of data and aims to measure the success of the training programme in the methodology described above. Some of the outputs which have helped support and guide our thinking around role based skill requirements, future recruitment and education needs as well as inform our planning around skills mix at an operational level have come out of this work with Skills for Health. This work has been overseen by the Developing our Future Workforce Group. Remit for Developing Our Future Workforce Group The role and remit of the above mentioned group is to oversee the critical review of the skills our staff need to carry out the roles they are being asked to fulfill in order to meet the 2020 Vision. Supported by Skills for Health and the Scottish Government the group will also monitor progress of the above mentioned programme of work. The main focus of this group is to ensure that the Workforce Plan is aligned to our Corporate and Strategic objectives. The Delivering Our Future Workforce Group has completed a draft strategic workforce plan which is subject to widespread consultation and discussion over the summer months. It also agrees the annual projections and design of the Board WFP. Workforce Steering Group It was previously agreed in partnership that there are a number of workforce issues which we need to address as we progress the Workforce Modernisation agenda. Whilst there are a number of groups working on these issues, it was agreed that there is a need to have an overarching steering group to oversee this work. Individual workstreams report into this group. This group has operational responsibility to ensure that we have the right people, in the right place and at the right time. They make recommendations to the Developing Our Future Workforce Group regarding establishment, recruitment needs, developments and working practices. They take into account demand profiles, supply needs and HEAT targets to ensure the most flexible and integrated approach to workforce planning across the Service. Progress reports are fed in to the Staff Governance Committee and National Partnership Forum. Key Workforce Implications and actions for 2014-15 This interim plan and action plan (appendix i) sets out what we need to do over the next twelve months and beyond to bring about the future workforce which we require to develop an efficient high-quality service. The action plan will be updated annually in line with this Strategic Workforce Plan which will be published in full later this year.
The role of partnership remains vital in ensuring the successful delivery of SAS strategic programmes and the Service will continue to build on this as we move through this transitional year of our strategy in 2014/15. Staff engagement is critical to the success of this transformational change programme and staff will continue to have the opportunity to influence and inform the improvement programme in another challenging year for SAS. For the year 2013/14 we have seen a rise in our annual turnover, largely due to increased numbers of staff retiring. Our projections reflect our expectation of a potential 5.0% Service turnover, which we anticipate to come mainly through retirals and natural turnover and should allow us to achieve our efficiency savings for this year. In addition, with the reality of the financial environment becoming even tighter and with potential changes to taxation and pension policies, it is possible we may see an increase in turnover of staff of a pensionable age Any service redesign will need to ensure that it reflects the key drivers indicated above alongside the decisions around the Working Time Directive and On Call, the pension situation, the 25% target reduction in management posts and the implications of our ageing working population profile, in order to build a sustainable workforce for the future. Other Key considerations and actions The impact of the Elgin Tribunal around On Call working may have a significant effect on any future models of working within remote and rural areas and is currently being considered as a matter of priority. Workforce profiles have an impact on future planning and the annual equality monitoring report will be included with all workforce plans. The Equality Monitoring Report for 2012-13 (attached) will be published with this interim plan and will form appendix ii) in the Strategic Workforce Plan A Workforce Data group will be developed and coordinated to take into account all relevant data and ensure its quality and relevance to the workforce planning process. 9. Summary and Conclusion The programme of work to consult on and finalise the Strategic Workforce Plan, outlined in this paper, will be taken forward over the next few months and we have an expected output by Autumn 2014. As stated earlier in this paper, as we move forward to implement this and in terms of supporting the governments 20:20 vision for healthcare delivery in Scotland, our aim is to optimise our unique position as a 24/7 provider of emergency, urgent and planned healthcare to work across boundaries in primary, secondary, tertiary and social care through a range of clinical networks to support delivery of the national healthcare quality outcomes. We will do this by developing our workforce capabilities as outlined and move towards more dynamic workforce planning, including more effective horizon scanning, scenario planning based on projected patient needs, improved use of evidence, data, available tools and techniques to provide better-planned and delivered services for patients.
Appendix (i) Table of Key Workforce Actions 2014-15 Objective Key Actions Executive Lead/Manager Continue to implement the Developing Frontline Develop transition plans Director of Leaders and Managers Programme working towards Strategic 20% protected management time and 100% e-ksf Training & development Planning & completion for the cohort by April 2015 Finalise transition plans Director of HR Training & development Implement transition plans Timescales Quarter (Q) Q1 (April-June 2014) Q2 (July-Sept 2014) Q3 (Oct-Dec 2014) Q4 (Jan-Mar 2015) Status Implement transitions plans Within the context of strategic workforce planning, review and consider the scope of practice and Education and Training of paramedics and specialist paramedics with the aim of meeting the NHS 2020 Workforce Vision Define scope of paramedic, advanced practitioner and support roles Determine clinical model and capacity required for ACC Define and develop education and training model Director of Health Professions and Nursing Q1 (April-June 2014) Q2 (July-Sept 2014) Q3 (Oct-Dec 2014) Q4 (Jan-Mar 2015) Implement the new occupational health phase 1 Implement phase two of occ health Director of HR Apr June 2014 Jan Mar 2015 Develop and implement a wellbeing programme to contract support staff to stay at work and progress the Gold Review existing welfare / wellbeing May Sept 14 HWL status by end of 2015 offerings and propose enhancements as required Achieve HWL Silver award in all regions Achieve HWL Gold Award in all regions Mar 2015 Dec 2015 Continue to implement the 4 point plan to improve Implement the new occupational health Director of HR Apr June 2014
sickness and absence phase 1 Implement phase two of occ health contract Develop the 2020 strategic workforce plan and associated transition plans by summer 2014 Develop a person-centred programme and continue to develop the SAER process Involve patients in the Recruitment and Induction process with the longer term aim of improving services and standards of care of our staff in delivering person-centred care Complete workforce modelling (SP May) Complete Annual Board WFP and Projections and submit to SG Complete Delivering Our Future Workforce strategic workforce plan. Consult widely across and beyond the Service. 2020 Transition plan developed (DWG Dec) Project Plan developed focussing on 3 strands patients, staff and co-production (see LDP and Person-centred project plan) Implement 38 key actions from above plan Publish anonymous SAERs for learning by summer 2014 Build on initiatives developed via the Quality Improvement Hub. Review current Service recruitment process and discuss the implications of patients and their families participating in the recruitment process Develop a plan for a pilot project for patient involvement in recruitment process and ensure clear objectives, briefing and support for patients participants involved with the recruitment process. Review current National Induction Programme with regards personcentredness content and ensure that Director of HR/Director of Health Professions and Nursing Director of Health Professions and Nursing Director of HR/National Recruitment Manager Jan Mar 2015 Q1 (April-June 2014) Q2 (July-Sept 2014) Q3 (Oct-Dec 2014) Q4 (Jan-Mar 2015) Q1 (Apr-June) Q1- Q4 Q2 All actions to be reviewed and auctioned during Q1 and Q2, (Apr-June and July-Sep).
Implement eees HR system, SSTS and interface with e-payroll in line with nationally agreed implementation plan person-centredness continues to be a key element of future National Induction Programmes (ongoing). Investigate the possibility of patients participating in future National Induction Programmes. Testing / training phase Technical system interfaces developed Complete Roll out Director of HR Q1 (April-June 2014) Q3 (Oct-Dec 2014) Implement GRS workforce planning system from July 2014 Technical system interfaces developed Data configuration Divisional pilot underway?director of Service Delivery Q1 (April-June 2014) Q2 (July-Sept 2014) Complete roll out Q3 (Oct-Dec 2014) The key themes that emerged from those results were: Executive Team Q3 Report on Priority actions Respond to the results of the staff survey with local and national plans developed and those priority actions implemented by December 2014 Develop the Talent Management & Succession Planning approach for the Service Tackling bullying and harassment Protecting our staff from abuse Improving the way we engage and communicate with staff Treating staff fairly and consistently. Agree exclusive approach to Talent Management based upon Critical roles Populate the Service Succession Plan for critical roles Prepare paper for Board approval including funding of Talent Development and release for staff Q1 2015 Annual Report Paul Bowtle Q1 2014 Q1 2014 Q2 2014
Publish the Talent Management & Succession Planning Strategy and tools for the Service Develop the Talent Development proposition Evaluate the approach Q2 2014 Q2 Q4 2014 Build a High Performance Management framework and culture within the Service Learning Governance Widening Access to Learning Agree Service wide definition of Performance Management Describe and agree high performance behaviours and add to all job descriptions and person specifications. Evaluate effectiveness of current Performance management system Develop a new approach to training on performance management that is inclusive of all staff Build multi channel learning and development tools that support and sustain behaviour change Embed High Performance Management metrics in existing and emerging reporting and feedback mechanisms Draft Learning & Development policy Consult on draft policy Agree learning policy and strategy Communicate widely to all staff Arrange learning governance to maximise investments in learning and development Work collaboratively with NHS Education Scotland to develop Learning & Development Framework Map roles to specialist skills and transferable knowledge and to appropriate qualification framework Q1 2015 Paul Bowtle Q2 2014 Karen Wilson/John Burnham, Paul Bowtle Paul Bowtle and John Burnham Q2 Q4 2014 Q2 2014 Q3 Q4 2014 Q2 2014 Q1 2015 Q3 Q4 2014 Q1 2014 Q2 2014 Q2 2014 Q1 Q3 2014 Q1 Q2 2014 Q2 Q4 2014
Implement and monitor equality outcomes action plan and publish annual updates as per agreed national plan. Develop the plan to widen access to learning, particularly to roles in o Clinical healthcare support roles o Administrative services o Estates and facilities services. Ensure learning governance provides clarity of access, time and funding for staff to participate in learning activities Annual update for Staff Governance Committee Publish reports to ensure compliance with the legislation Q3 Q4 2014 Q1 Q3 2014 Director of HR Q1 - May each year Q1-Q4 - As required
References 1. Better Health, Better Care: Planning tomorrow s workforce today Scottish Government, Edinburgh 2007 2. Better Health, Better Care: Action Plan Scottish Government, Edinburgh 2007 3. A Force for Improvement: The Workforce Response to Better Health Better Care, Scottish Government, January 2009. 4. Scottish Ambulance Service Strategic Framework, Working Together for Better Patient Care 2010-2015, launched 2009. 5. Scottish Ambulance Service Corporate Plan 2014-15 6. Scottish Ambulance Service Strategy for Learning, Realising Our Potential 2009-2013. 7. Scottish Ambulance Service Human Resources and Organisational Development Strategy 2010-2015, Doing the Right Thing. 8. Refreshed Strategy for Volunteering in NHS in Scotland (CEL 10 2008) 9. CEL 32 (2011) Revised Workforce Planning Guidance 2011. 10. Scottish Ambulance Service 2014-15 Local Delivery Plan 11. Everyone Matters: 2020 Workforce Vision, Implementation framework and plan 2014-15. 12. Scottish Ambulance Service Staff Governance Action Plan 2014-15.