Health and Social Care Workforce Strategy Item 6... · workforce that delivers ... workforce. Our...
Transcript of Health and Social Care Workforce Strategy Item 6... · workforce that delivers ... workforce. Our...
Health and Social Care Workforce StrategyApril 2019
Hertfordshire and West Essex
Sustainability and Transformation Partnership
Introduction
Our health and care system has
set out an ambitious strategy for
a healthier future of high quality,
person centred and proactive
care; which is better joined up,
improves outcomes, and
increases value.
This strategy set outs the STP’s
approach to ensuring we have a
workforce that delivers care at
the right time; in the right way; in
the right place; by the right
person, with the right skills and
values.
It will act as a guideline for the
STP and the organisations within it
to support and develop their
workforce.
Our health and care system has set out an ambitious strategy for a healthier future of high quality, person centred
and proactive care; which is better joined up, improves outcomes, and increases value. We will also harness new
technologies that offer an opportunity to deliver health and care on a more efficient and tailored basis than ever
before. We can only deliver this this by working together, as a single system, at greater scale and in a more
integrated way.
If we are to achieve this aspiration then our workforce - the single most important factor in the quality of care and
the way in which it is delivered - will be at the heart of this change and integral to realising our Integrated Health
and Care Strategy.
Against this backdrop, this Workforce Strategy set outs our approach to ensuring we have a heath and social care
workforce that delivers care at the right time; in the right way; in the right place; by the right person, with the right
skills and values. It will act as a guiding framework for the STP and the organisations within it to support and develop
their workforce.
The strategy has been developed through discussion with a range of stakeholders across Hertfordshire and West
Essex (HWE), facilitated through discussions with partners at the Local Workforce Action Board and associated
Workstream Leads meetings. In addition, content has been developed with inputs from a range of workforce
groups across Hertfordshire and West Essex and individual discussions, and also takes into consideration other
national and local drivers.
The strategy describes:
The workforce needs
identified from
implementing the
Health and Care
Strategy and other
drivers of change
A vision for the
workforce with a set of
associated core
principles, and how
we will know when we
have achieved it
A clear strategy to
deliver our vision
An evaluation of the
implications of
implementing the
strategy
Strategy Overview
In line with the Long term plan, our
Integrated Health and Care Strategy set
out an ambitious blueprint for a healthier
future of high quality, proactive care;
which is better joined up, improves
outcomes, and increases value.
At its heart is a population health
management approach; delivering
integrated, person centred care
designed around our population,
standardising treatment, and
transforming the key pillars of our system
to ensure their sustainability and
resilience.
Against this backdrop, we will need to
ensure that our health and care
workforce:
� Has the necessary capacity to meet
changing demand across the system
� Has the required skills, capabilities, and
roles to deliver our future model of care
� Works in new ways across professional
and organisational boundaries; and
� Is empowered to deliver change by our
culture and leadership
Our vision is therefore to create:
“One Health and Care Workforce
across Hertfordshire and West Essex;
delivering high quality, seamless, and
person centred care”
We will know we achieved this when:
The right care is delivered at the right
time; in the right way; in the right place;
by the right person,
who has the right skills and values.
Our strategy to deliver this vision is built on 5
key themes:
• Attraction, recruitment, and retention
• Education and Training
• Innovation and Technology
• Leadership and System Wide
Organisational Development
• Enabling a ‘One Workforce’ approach
Making our workforce strategy a reality will require investment, brave leadership, and a different mindset where we put the needs of the system above our
won organisations. Above all, we must commit to working in partnership in all that we do.
Health and Social Care Workforce
Our workforce strategy covers the
broad range of professionals that
contribute towards the health
and wellbeing of our population,
including:
Healthcare
Social Care
Voluntary sector
Private sector
Carers and families also play a
vital role in our workforce.
Schools, universities, and other
academic institutions are key
partners in securing our
workforce.
• Our workforce strategy covers the broad range of
professionals that contribute towards the health
and wellbeing of our population.
• This includes staff working in health and social
care, and also recognises the close links we must
make with voluntary, community, and private
sector organisations - who’s capacity and
capabilities will need to be harnessed to best
meet the needs of our population.
• We recognise the vital contribution that
volunteers, carers and families make as part of
our workforce.
• We will also need to work closely with other
partners, in particular schools, universities, and
other academic institutions to secure and upskill
our workforce.
• Our workforce strategy therefore sits alongside,
and is aligned to, a number of local workforce
strategies including Local Authority Social Care
workforce strategies and those of individual NHS
organisations
14% staff turnover rate across the STP, rising to 30% within social care, where
recruitment and retention is particularly challenged.
14% of staff leaving Social Care go to the NHS
Adult nurse recruitment was down 27% in 2018. Learning disabilities nurse recruitment was down 63%
c. ¼ of our workforce are over 50. This number is higher
still within Primary Care settings
38% of staff surveyed in 2018 are not sure if there is
a system leadership group in place
Over 50% of our healthcare staff work in hospitals.
In 2017/18, c. 85% of workforce growth was in the acute sector.
There was a reduction in community staff
12% vacancy rates average across the STP, and a
reliance on bank and agency staff to fill gaps
Our Current Workforce
70%Of our workforce will still workin the system in 10 years time
51,000 staff commission or
provide health and social care to our
population
7% of Social Careworkforce are
directly employed by our Local Authorities
Context
There are a number of
factors at a national,
system, and local level
which will not only
influence our behaviours
but also shape our
workforce requirements
The health and care system within Herts and West Essex does not operate in isolation, with a
range of connections within and outside of the system at a national, system, and local level.
This strategy must therefore be cognisant of these developments, whether they be national
policy, social and cultural trends, or other drivers so that the strategic direction it sets out will be
effective and deliverable. Key examples are outlined as follows:
Nationally there have been a number of reviews, strategies and policy
documents for the whole of the health are care system which have an
impact on how services will be delivered locally in the future. These
include the recently published long term plan, Topol review, and
upcoming HEE workforce strategy. Additionally, national political
decisions which aren’t directly within the health and care landscape are
likely to have an impact on future workforce requirements.
Our local system of Hertfordshire and West Essex is a key driver in what
our future workforce requirements will be. Our current workforce position
future ambition (as set out in the Health and Care Strategy), changing
demographics, and medium term financial plan all influence this
strategy and have helped to shape what our future workforce needs to
look like.
Our system is a collection of health and social care providers and
commissioners who have their own pressures and opportunities. The
strategies of these organisations, and their implications on the future
workforce, have been considered to ensure that this strategy is aligned
with local needs.
Local places and
neighbourhoods
System
National
The Key Drivers for Change
HWE System
• Our current workforce has high vacancy rates, is
aging, and we are facing difficulty in recruiting new
staff, especially in social care. Workforce growth is
higher in hospitals than in other settings. However,
70% of our current workforce will still be with us in 10
years time.
• Ambition to develop integrated, person-centred
care, designed to meet the needs of our
population, delivered in local neighbourhoods
wherever possible.
• Population health management approach.
• Effective and efficient health and care delivered in
the right place, by the right person, at the right time.
Shift care from reactive to proactive when possible,
and standardise our approach to treatments.
• Transform the key pillars of our health and care
system, to ensure they are sustainable and resilient.
• Put in place the staff, culture and systems we need
to support transformation.
Local
• West Hertfordshire - Future model of care based on
prevention, joined up care, the centralisation of
specialist care, and a locality based community
model. Reconfiguration of acute services is planned
to meet this model - for example through the
development of hot and cold sites and capital
investment to improve facilities and infrastructure.
• East and North Hertfordshire – Improved prevention
and Primary Care services, and enhanced
community model and improved acute services.
Investment in the hospital estate to make it more
suitable for the delivery of modern healthcare.
• West Essex – Primary and community service
integration through the development of
neighbourhood model and Primary Care Networks;
supporting the system to manage demand away
from hospitals. Improving the quality of acute
services and developing new hospital facilities.
• Development of Primary Care Networks built on
populations of 30-50k.
National
The NHS Long Term Plan (LTP) - continued focus on
Primary, Community and Mental Health care and a shift
away from silo working towards a more integrated
services delivered closer to people’s homes. Investment
in the development of Primary Care Networks.
The Topol Review - genomics, digital medicine and
artificial intelligence to improve care. The workforce will
need to develop the skills, attitudes and behaviours
required to become digitally competent and confident.
Leadership vital in planning and delivering these
changes.
Nationally, many staffing groups have significant gaps
where demand is outstripping supply – high vacancy
rates in nursing, midwifery and medical professions in
particular. Furthermore, the impact of Brexit still
unknown
A 2019 funding settlement will also be reached with
Social Care, although the publication date of the Social
Care Green Paper is still to be confirmed. A funding
settlement will also be reached with Health Education
England (HEE).
HEE it is due to release a national workforce strategy to
compliment the LTP
These drivers will require our workforce to evolve in response to a changing landscape, and continue to provide the highest possible quality of care to our population
What happens if we don’t change*?
Our workforce makes up c.70% of the costs of
delivering care to our population
It is the single most important factor in the quality of
care and the way it is delivered
If we do nothing, we know that activity will increase
by 29% over the next 10 years across all parts of the
system*
It therefore follows that our workforce will also need
to increase – estimated as some 22% within the NHS
alone*, and a 3% increase per annuum in social
care+
This increase will also contribute towards a funding
gap of some £1bn across health and social care by
28/29*
Give our current levels vacancy rates and difficulties in recruiting staff, this position is neither viable, sustainable, or affordable
*Figures aligned to HWE MTFP / +Hertfordshire Social Care Workforce Strategy
Impact on workforce numbers
We recognise the need to do further modelling work in order to determine the size and shape of our future
workforce, if we a)do nothing; and b) implement the changes proposed in the Health and Care Strategy
and this workforce strategy.
This will include taking account of factors such as:
Current staffing
numbers Vacancy rates
Recruitment and
retention rates
Changes in
demographics and
demand
New models of care
New ways of working,
innovation, and
technology
Increased productivity New roles
• A more flexible generalist skills base
working across a wider range of health
and care support needs
• Better understand each others roles
and the value we add
• Make best use of specialist skills, doing what
only they can do
• We will need new roles such as care planning
and care navigation
• Increased use of alternatives to GPs in primary
care as part of Primary Care Networks
• Improved digital competence and confidence
• Ability to use new tools and better interpret
data
Our
Workforce
Needs
Against this backdrop, we will need
to ensure that our health and care
workforce:
Has the necessary capacity, in
the right places, to meet
changing demand across the
system
Works in new ways across
professional and organisational
boundaries;
Has the required skills,
capabilities, and roles to deliver
our future model of care ; and
Is empowered to deliver change
by our culture and leadership
• There will be collective leadership
at all levels of the system, which is
inclusive and compassionate
• More diversity in our leadership
• Our leaders will put the needs of the
population first; before that of
their individual organisations
• A collaborative and trusting culture that
enables staff to work in different ways
• Empower staff to put change in to action and
do the right thing by people
• Our leaders will champion the adoption and
spread of new technology
• Talent will be shared across the system
• Our workforce will need to be person centred
rather than organisationally focussed
• Staff will be able to work anywhere, in any
way across the system to deliver integrated
care and improved outcomes for our
population
• Multidisciplinary working across traditional
organisational and professional boundaries
neighbourhoods and primary care networks
will be common place
• Digital technology will mean less face to
face and more virtual interaction
• Our healthcare workforce will need to remain
around the same overall size as is budgeted
for now, yet mitigate against rising demand for
services. The social care workforce will
increase in line with changing demographics.
• Workforce capacity will shift towards planned
and preventative care, with a relative
increase in workforce numbers across primary,
community and mental health services
• There will be more growth in generalist roles
relative to those with highly specialist skills
• There will be a reduced reliance on
temporary staff, in particular external
agencies, to fill gaps in capacity
Our vision and principles
We therefore have a vision to
create “One Health and Care
Workforce” across Hertfordshire
and West Essex; delivering high
quality, seamless, and person
centred care”
We will know we have achieved
this when the right care is
delivered at the right time; in the
right way; in the right place; by
the right person; with the right
skills and values.
This will involve working closely
with our partners in the voluntary,
community, and private sectors;
as well as universities and other
academic institutions
“One workforce across Hertfordshire and West Essex; delivering high
quality, seamless, and person centred care”
PRINCIPLES
Embrace innovation,
technology, new roles,
and new ways of
working
Value staff as integral to
delivering care now and
in the future
Promote the health and
wellbeing of our workforce
and empower staff to deliver
change
Recognise the contribution
of, and develop close links
with, the voluntary, private,
and education sectors
Adopt a consistent and
collaborative approach to
managing the workforce
Become the employer of
choice – retaining our
current staff and
attracting new talent
where needed
Right
Care
Right
Time
Right
Place
Right
Person
Right
Skills
Right
Values
Right
Way
Our workforce strategy on a page
Our strategy to deliver this vision is
built on 5 key themes:
Attraction, recruitment, and
retention
Education and Training
Innovation and Technology
Leadership and OD
Enabling a ‘One Workforce’
approach
Capacity Capability Ways of working Culture and leadership
Attraction,
Recruitment, and
Retention
Education and
Training
Innovation and
Technology
Leadership and
OD
Enabling a ‘One Workforce’ approach
HWE Talent
Academy
Affordable
Housing
New curriculums
and pathways
Growing our own
supply of staff
Digitally enabled
working
New ways of
working HWE Leadership
Academy
System Wide OD
Single
HWE Bank
Integrated
Empl’t Approach
Workforce
Passports
Shared Support
Services
Close Links with
Voluntary Sector
Multi-professional working
Attraction, recruitment, and retention
Hertfordshire and West Essex
Talent Academy – supporting
the system to attract, recruit,
and retain staff
Affordable Housing and Transport
- influence the creation of
affordable housing and
improved transport for our
workforce to help us attract and
retain staff
Single apprenticeship scheme
and pooled levy - focussing on
core workforce requirements
across the system
In order to ensure our workforce
has the necessary capacity to
meet changing demand across
the system, we will focus on
attracting, engaging, recruiting,
and retaining staff – by making
HWE a place to fulfil people’s
career ambitions.
We will target four groups of
young, apprentices and students,
our current workforce, and our
alumni.
Core areas of work will include
the development of our own
talent academy, a single
appreciates scheme, and
ensuring there is affordable
housing for staff.
Targeted attraction and
retention strategies - best
practice learning and
adoption so that we do all we
can to make staff want to join
and stay within the system.
Focus on young, students,
current workforce, alumni. Influence private and
independent sectors–
recognise our roles as market
makers and our ability to
influence the private sector
through commissioning
Education and Training
Improved education and
training - new curriculums,
training portfolios & pathways
to develop the right skills and
capabilities for our workforce
Ownership and influence over
our supply chain – growing staff
within HWE through our own
training programmes
Harmonised approaches to
training – standardising
capability and delivering
greater consistency of practice
across the system
System wide funding for CPD –
using local funding to maintain
skills and centralised funding to
transform and develop new
skills Improving education and training
will be vital in developing a more
flexible and generalist skills base
that supports a wider range of
health and care needs.
Greater influence over the supply
of our future workforce will allow
us to grow staff within HWE
through our own training
programmes, and enable us to
develop new curriculums and
training pathways which support
new roles and job descriptions.
Developing our staff to work
differently – supporting, training
and developing our existing
workforce to work in new ways
or perform new roles within the
system
Career development pathways
– looking after our workforce
and supporting them develop
their careers within the HWE
system, across health and
social care
Innovation and Technology
Digital and technology
enabled working – increasing
productivity and driving
additional capacity from our
current establishment by
adopting technology
Innovation and technology will
mean our workforce is able to
work in smarter and more flexible
ways across the system – making
it more productive and enabling
a more collaborative and
integrated approach.
Supporting staff to implement
new technology – so that we
can harness the potential of
areas such as genomics, digital
medicine, and artificial
intelligence
Enable staff to make better use
of data – so that we can adopt
an evidence based approach
and embrace the principles of
population health
management
New ways of working –Multi
professional working across
organisational and professional
boundaries to deliver
integrated care
Development of new roles and
job descriptions – for example
community navigators to
deliver our new models of care
An agile workforce – enabled
by technology to work
anywhere within the system
Leadership and OD
Shared executive
responsibilities and roles across
the ICS / ICAs – promoting a
‘one workforce’ approach and
delivering efficiencies
Leadership Academy – to
develop greater system
leadership capacity and
capability at all levels within the
system
Develop system leadership
networks – bringing leaders
across professional groups and
organisations together to
promote ‘one workforce’
approach
Proactive succession planning
– to increase and sustain
leadership capacity
Developing collective leadership
at all levels of the system, which
puts the needs of the population
before that of their individual
organisations and empowers staff
to deliver change, is a core part
of our strategy.
This will be achieved through the
development of a system wide
leadership academy and a
system wide approach to
organisational development.
Sharing talent – Putting the
workforce needs of the system
above individual organisations
and sharing talent where it is
needed most
A system wide approach to
organisational development
to embed the right culture and
behaviours
Enabling ‘one workforce’
A single bank operating across
all acute trusts - enabling
temporary staff to be deployed
flexibly across the system to
reduce reliance on agency
staff
Adopting a more integrated
approach to employment - e.g.
harmonized job descriptions and
contracts, allowing capacity to
be deployed more flexibly
Workforce passports - enabling
staff to work across
organisational boundaries and
capacity to be deployed more
flexibly across the system
Closer links with the voluntary
and private sectors – supporting
the system to harness the
capacity of local volunteers and
our wider partners
Alignment and co-location of
staff – facilitating staff to come
together to support integrated
/ multidisciplinary working within
local places and
neighbourhoods
Shared support services - Single
support services across the
system, with central functions
and localised delivery. What
can be done once is done
once (small steps)
We will ensure that our workforce
will is person centred rather than
organisationally focussed.
This will mean that staff can work
anywhere, in any-way, across the
system to deliver integrated care
and improved outcomes for our
population
What makes our strategy stands out?
Attraction, Recruitment, and
Retention
Education and Training
Innovation and Technology
Leadership and OD
Enabling a ‘one workforce’
Approach
� The development of a HWE Talent Academy
� Influencing the development of affordable housing
� Greater ownership of nursing, midwifery, and medical
education within HWE
� Digitally competent and confident staff
� Embedding technology and a culture of quality improvement
� A HWE leadership academy, developing collective
leadership at all levels of the system
� System wide OD
� A single temporary staffing bank
� A single and consistent approach to employment
The implications of our strategy
Making our workforce
strategy a reality will
require investment,
brave leadership, and a
different mindset where
we put the needs of the
system above our won
organisations.
Above all, we must
commit to working in
partnership in all that we
A commitment to ‘One workforce’
Realising our vision for ‘one workforce’ will
mean putting the needs of the system
above individual organisations and
thinking of our own staff as part of the
HWE workforce
Bold Leadership
We will need to make bold decisions as
leaders – for example will we commit to
working together to deliver affordable
housing or new education courses within
HWE?
Investment
Delivering our strategy will require
investment in talent; technology;
organisational development; and
education
Consistent Partnership Working
The partnership working required to deliver
our strategy cannot be a pick and mix
approach – we must adopt a consistent
approach to working partnership across all
that we do.
Future Workforce Planning
The diagram below provides an early indication of where workforce planning roles and
responsibilities could sit within the future system architecture:
ICP
(500k)
Primary Care Network (30-50k)
• System-wide workforce strategy as a guiding framework
• System wide organisational development
• Investment and funding
• Single and consistent employment approach
• Development of leadership and talent academies
• Establishing a single staff bank and shared support services
• Greater ownership of education and training and partnerships with Universities
• Developing new roles and ways of working aligned to local models of care
• Detailed workforce planning to establish local capacity requirements
• Influence over private and independent sectors through commissioning
• Implementation of affordable housing and transport with local partners
• Enabling staff to work across organisational boundaries
ICS
(1.5m)
• Implementation of new roles and ways of working
• Alignment and co-location of staff
• Multi professional working
• Closer links with voluntary sector
Manging and assuring the delivery of our strategy
In order to assure the delivery of our strategy, we have put in place a robust governance structure based around key workstreams. Each
workstream is headed by a leader within the system with an appropriate programme and project governance in place. These workstream will
report into the Hertfordshire and West Essex LWAB and subsequently into the STP CEO Steering Group. This will ensure both local and system focus
on our work in line with this strategy.
Next Steps
• Workstream leads to check if current
workstream plans will deliver strategy
• Incorporate any newly identified
areas into existing plans
• Scope and develop plans for newly
identified initiatives
• Agree what will be delivered in the
next 1,3, and 5 years
• Baseline of current workforce
projections under a ‘do nothing’
scenario
• Quantify the impact of STP care area
workstreams on future workforce
requirements
• Quantify impact of workforce
strategy initiatives on recruitment,
retention, etc.
• Model future workforce requirements
• Gap analysis between future
requirements and do nothing
projections
• Adopt a robust portfolio management
approach to manage implementation
and realise benefits
• Evaluation of future investment costs
e.g. Talent Academy, Leadership
Academy etc
• Business case development as
applicable
• Regular reporting against delivery plan
milestones and benefits
• Regular programme reviews to ensure
work continues to be aligned with
objectives and outcomes
Programme
Planning
Workforce
Modelling Implementation01 02 03
Ongoing Programme Management
April – June 2019 May – June 2019 June 2019 onwards