HEE Business Plan 2015/16

HEE Business Plan 2015/16

March 2015

Contents

Foreword

Section 1: Our purpose

Section 2: Our priorities

Section 3: Delivering our Business Plan

Section 4: Our resources and efficiency challenges

Annex A: Our top Priorities and related Work Programmes

Annex B: Our 2015/16 Work Programmes

Annex C: Education and Training Commissions 2015/16

Annex D: Key Risks

Annex E: Glossary

2 Ref: HEE BP 2015-16 FINAL DRAFT

Foreword

Health Education England (HEE) exists for one reason alone: to help improve the quality of care by ensuring our workforce has the right numbers, skills, values and behaviours to meet the needs of patients.

On 1st April 2015 Health Education England becomes a Non-Departmental Public Body as a result of the 2014 Care Act which puts HEE on a firm footing as the organisation responsible for educating and training the health workforce in England now and in the future. This change of status is a vote of confidence in the work of HEE since its creation as a Special Health Authority on 1st April 2013.

This, our third annual business plan and our first as an NDPB, builds on HEE’s achievements in its two years as a SpHA; an organisation that sets out what it is going to do, then delivers on what it says.

• We said we would train 100,000 NHS staff in 2013/14 and a further 250,000 in 2014/15 in dementia awareness. We did that.

• We said we would support the needs of the service in managing the problems in emergency care by working closely with the Royal College of Emergency Medicine. We did that.

• We said we would increase the nurse training places. We did that and will do it again.

• We said we would provide a focus like never before on the NHS healthcare support workforce. We did that through Talent for Care, and we will continue to do it.

• We said we would deliver pre-degree nursing experience pilots. We did that and now hundreds of prospective nurses, and the patients they care for, are benefiting and will do so every year from now on.

These are just some examples of HEE delivering and in 2015/16 we will go further in ensuring the NHS has the right workforce with the right skills, behaviours and values in the right place at the right time, first time. In 2014/15 HEE published its 15 Year Strategic Framework which set out our long term vision for the development of our workforce. Building on that work HEE has been a key partner in the creation of the NHS Five Year Forward View which sets out the changes the service needs to make to meet the needs of patients and the public for quality care on a sustainable basis in the future.

This Business Plan sets out how we will continue to work with partners, locally and nationally, to ensure the workforce changes needed to support better services are put in place. This includes improving the development and capability of the healthcare support workforce; ensuring we educate and train the nursing profession so it is fit for the future; delivering a workforce to help improve primary care; increasing the focus on mental health and its workforce and supporting the changes


required to deliver the Bubb Review recommendations into care for those with learning disabilities.

The business plan is based on the priorities of the service. It delivers better care now, through the return to practice campaign for nurses and staff training in dementia, and prepares for the future by helping make the NHS a world leader in genomics and continuing our work on the Future Patient education and training programmes for carers.

HEE cannot and does not deliver alone. We are proud to work with the providers of NHS services and other organisations such as commissioners, local authorities and Higher Education providers who make up our LETBs. And we are proud of our role on the national stage working with the other Health Arms-Length Bodies and the Department of Health to ensure the workforce, which the NHS spends the vast majority of its budget on, is at the centre of creating a better future. This is our Business Plan for 2015/16. With our partners we will continue to deliver for our patients, our staff, our trainees and our students.

Professor Ian Cumming OBE Sir Keith Pearson JP DL


Section 1: Our purpose 1.1 What we do Our job at HEE is to ensure that when a patient turns to the NHS for help, there is a trained person with the right skills and behaviours ready to meet their needs. Two simple actions are required to ensure that the right staff are available to patients when they need them:

1. Enough jobs must be created and funded to deliver the care required by the people of England

2. Enough staff with the rights skills and behaviours must be available to fill the jobs created.

Provider and commissioners are responsible for the first action. HEE is then primarily responsible for the second, using our training and education commissions to ensure balance between supply and employer demand. Sometimes demand is best met by developing the skills of existing staff, which is why HEE is committed to developing the existing workforce as well as creating the future workforce. To this end, each year we invest approximately £5 billion pounds of public money. Overall, we are commissioning more education and training than ever before, with over 50,000 doctors in training and over 37,000 new training opportunities for nurses, scientists, and therapists. These commissions for under graduate and post graduate programmes make up the majority of our investment and ensure a supply of medical and non-medical healthcare workforce. We need to be assured our investments in education and training are getting the very best value for money for tax payers (especially so in this challenging financial environment), improving quality for current and future patients, and ensuring high level satisfaction rates from our trainees and students. Our budget setting principles of equity, stability, transparency, and flexibility, with an overarching principle of quality, guide our decision making, ensuring the five billion we spend on education programmes are meeting the outcomes we are aiming to achieve. 1.2 What we do and why HEE is not the only body concerned with the education and training of healthcare staff. The regulators have an important part to play, as do providers who are ultimately responsible for employing, maintaining and developing their staff and the quality of care they provide. HEE serves the wider healthcare system (including private and third sector providers) but has no remit over social care. HEE has four levers that we use to achieve our shared purpose of improving the quality of patient care:


These are supported by our corporate enablers that that help support the delivery of HEE’s key objectives including: Strategy, Performance and development, HR and OD, Corporate Finance, Estates, Internal and external communication and Corporate services


Section 2: Our priorities A Business Plan represents a formal statement of a set of business goals or ambitions for a defined period of time. Its purpose is to provide a road map for the future; identifying priorities and allocating resources to give us the best chance of getting there. In order to determine our business goals for the next year, we have assessed our Business Plan against four key tests:

• Does our Business Plan align with and help deliver our fifteen-year strategy and Five Year Forward View

• Does it support the delivery of our statutory directions and Mandate requirements?

• Do we have the capacity and resources to deliver our business goals? • Are we clear what our top priorities are?

Each of these questions is addressed in more detail below. Strategy & Planning into action


2.1 Aligning our business goals with our fifteen year strategic framework and the ‘Forward View Into Action’ In June last year we published our Strategic Framework (Framework 15 / F-15), with a minor update in October (see Framework-15)

It can take over a decade to train a medical consultant or senior nurse. Those who get the student places we have commissioned in 2014 will still be working as healthcare professionals until 2060. Therefore, every time we make an investment in a training place, we are making an expensive set of assumptions about future healthcare needs and how best to meet them. If our assumptions and investments are very wrong, then this could contribute to:

• an under-supply in some areas of the workforce, with negative consequences for the care we are able to offer patients and their families, or

• an over-supply, resulting in a highly-skilled unemployed workforce and a wasted opportunity to invest public money elsewhere in the NHS, or

• the wrong set of skills in the wrong place, locking the service into particular models of delivery that may not be appropriate for the needs of future patients.

We recognise that the workforce is integral to the way that healthcare is provided both now and in the future, so we have chosen to set out in one place our planning assumptions, so that others can let us know if they think we have got it wrong and work with us to address longer term challenges and achieve shared goals.


http://hee.nhs.uk/2014/06/03/framework-15-health-education-england-strategic-framework-2014-29/

Better patient care will only be delivered by co-operation and partnership across the system, because workforce strategy is intimately connected with decisions about service configuration, models of care, quality and cost. By sharing our current thinking, we will promote not just more discussion and debate about strategy, but better decisions and thereby better patient care. Our strategic framework:

• Provides the conceptual framework for how HEE approaches problems and identifies solutions, ensuring our focus remains on the patient.

• Guides the decisions we make in the short term, such as the annual workforce planning process and the priorities in our Business Plan.

• Informs our longer-term work programme, including taking forward The Shape of Training Review and piloting life-cycle workforce planning for children and young people.

• Enables our board and the public to assess our actions against our expressed strategic ambitions, and to challenge us if we veer off course.

• Provides the basis for more detailed conversations with our partners and stakeholders about the challenges and opportunities ahead.

HEE made six strategic assumptions that underpin Framework 15:

These assumptions led us to develop our strategic framework based on three key pillars:


These are represented in the following diagram:

The ‘Forward View into Action’ describes the approach for national and local organisations to start fulfilling the vision set out in the Five Year Forward View (5YFV), whilst continuing to deliver the high quality timely care that the people of England expect today. We have worked closely with the other five ALBs (NHSE, TDA, Monitor, CQC and PHE) to produce aligned planning guidance for the system to ensure that we have common planning assumptions and processes to deliver our shared vision. 10 Ref: HEE BP 2015-16 FINAL DRAFT

The Forward View into Action makes clear that: • We will work together to accelerate the design of new models of care, with a

structured programme of support. • The workforce will be central to the development of the new models of care:

the provision of health and care is delivered by people not buildings. • We expect providers and commissioners to engage with their Local Education

and Training Boards (LETBs) to work together to identify their current and future workforce needs. For those economies that wish to put themselves forward to co-create the new care models, we expect to see plans to develop the existing and future workforce plans to develop these models. In challenged health care economies, a plan to deliver workforce needs will also be a key ingredient of success.

• Planning assumptions must be shared between commissions, providers, LETBs and other partners to ensure alignment, with LETBs triangulating their plans with local commissioners and providers before submitting them to HEE.

• We will establish a Workforce Advisory Board, chaired by HEE and with membership across the system to support delivery of a health and care workforce with the skills, values and behaviours to deliver the new models of care.

HEE continues to work with our partners on programmes that will help us to deliver our shared purpose at scale and pace. LETBs have been engaged with partners in discussing the workforce needs of the Five Year Forward View. These discussions have served to inform local plans as required by The Forward View into Action, but also helped to shape the priorities for the Workforce Advisory Board and for this 15/16 Business Plan and workforce planning guidance by identifying priority areas for investment and action to deliver the workforce transformation required by the 5YFV. This Business Plan sets out at a high level the key priorities that Health Education England will deliver to support other organisations to deliver the commitments for tomorrow and today. This will be supported by the new Workforce Advisory Board, chaired by HEE with senior membership from across the system, to develop a health and care workforce with the skills to support the implementation of new models of care. The Workforce Advisory Board (WAB) will initially focus on four areas:

• additional actions to retain existing staff and attract returners in roles experiencing shortages such as Emergency Medicine, nursing and GPs;

• provide support to challenged economies where workforce shortages are impeding improvement;

• identify the flexibilities that will need to be developed in order to deliver new care models as well as opportunities to reskill the existing workforce;

• identify new roles that may need to be commissioned to deliver on the aspirations of the Forward View.


2.2 Do our business priorities for 15/16 help us to deliver our Mandate?

HEE was given a Mandate by the Secretary of State for Health in May 2013 and this has since been the subject of a refresh for 2014/15 and 2015/16. The latest version published on 5th March. The process of refreshing the mandate happened in parallel to the creation of our Business Plan, and we have mapped each deliverable, identifying timelines and milestones and lead Directors. Following this exercise, we are confident that we have captured each of the mandate requirements within our business functions and respective directorates. The priority commitments highlighted in section 2.4 below address the main themes of the 2015/16 mandate. However HEE’s work programmes (Annex B) ensure that all requirements of the Mandate will be appropriately addressed. 2.3 Do we have the resources and capacity and capability to deliver our business goals whilst making our efficiency savings? HEE is working hard to ensure that it truly acts as ‘one HEE’. Staff have already started to work in different ways and are identifying peers across LETB areas, making connections and sharing work. An example of one HEE already beginning to work includes the new intranet across the whole of HEE enabling greater sharing. There are a range of changes for each national directorate and for each of the four national geographies (the North, Midlands & East, London & the South East and the South). Each structure has been costed to ensure it meets running cost requirements and makes provisions for the delivery of our responsibilities by staff in the right place at the right time with the right skills and experience whether that be nationally, locally or nationwide. Whilst we are seeking greater alignment and focus as one HEE, there will be differences in approach locally which is to be encouraged if linked to a greater focus on sharing, learning and adopting across the organisation. Each LETB area will take taking lead roles, working across the geography, and building on lead commissioning arrangements and managing shared programmes. There is a new pan-HEE network of Research and Innovation Leads that will enable the better connection of expertise and further coherence in the delivery of the Research and Innovation Strategy. We are a very information dependent organisation. Everything we do in planning, delivery and monitoring has information at the heart so we are working on how we can better collect, collate and use information and data in the new structures. Assurance is best provided locally so we are aligning information and data assurance with the LETB leadership and developing a resource for Business Information Systems that aligns the local and national. The purpose of this is to streamline and simplify local systems, processes and practices in each LETB, creating the consistency that is vital to effective information systems. 12 Ref: HEE BP 2015-16 FINAL DRAFT

In the core enabling functions of Communications, Human Resources and Governance within the People and Communications Directorate it became clear that resources across the country needed to evolve to reflect the need for each local area to have equal access to staff, skills and broader resources but also greater understanding of what needed to be done where. Risk and business continuity will remain core to the governance strand within People and Communications. The vital importance of information technology in making one HEE work is understood and action is being taken to address these issues. The Finance structures provide for the distributed support to budget managers from designated financial managers. For financial systems work we have developed a core central team working with designated individuals in geography teams to drive greater consistency (a ‘common spine’) and system improvement. There is a requirement for greater resource for workforce analytics. Therefore it was agreed to increase the resource in the workforce planning functions of the Planning and Strategy Directorate and we are working to ensure the best use of our available skills, experience and resources in this area. 2.4. Are we clear what our top priorities are?

The extent of our statutory duties and the scale of our ambition, requires HEE to be very clear about what our core priorities are so that our resources at both local and national level are allocated appropriately. Our top priorities are divided into two categories:

(1) Priority commitments: HEE is committed to delivering our entire mandate, but below we have pulled out those deliverables where we expect to come under greater public scrutiny or where a specific numeric measure has been applied.

The table below details priorities in respect of;

• The Primary and Community care workforce • Mental Health, Learning Disabilities, and Dementia • Birth, Children and Young People • Public Health and Prevention

In addition HEE will continue to increase its focus on supporting partners to address areas of current workforce shortage, including;

• Emergency and Urgent care – including paramedics • Nursing • Specific Geographic Shortages


(2) Transformational changes: These are the actions or programmes of work that may not deliver in-year results, but represent a fundamental change in the nature of the health workforce, that will take HEE closer towards achieving our fifteen year strategic ambitions

The table below describes how HEE, in line with our 15 year strategic framework is seeking to actively shape an increasingly flexible workforce including;

• Patients, the public, and carers as part of the health workforce • Flexible training and careers for doctors • Flexible training and careers for registered nurses and care assistants and the

wider support workforce • A workforce representative of the communities it serves • A workforce planned with the needs of patients as it primary driver not

profession or service

HEE is also seeking to ensure the workforce is able to responds to the key drivers of the future patient and in particular developments in technology;

• Developing a workforce capable of maximising the impact in care of developments in Genome mapping

• A workforce aligned to the strategy of the National Information Board,

The two groups of priorities are not mutually exclusive, for instance the mandate priorities on integrated care include elements with more immediate deliverables and impact, as well as indicating the need for the transformation of future care models and the workforce that delivers them.

We also need to be clear that these work streams represent the key workforce input to implementation of new care models and the radical ambition set out in the five year forward view. As implementation of the Five Year Forward View programme develops, and not least through the work of the Workforce Advisory Board, HEE will be able to become more explicit about how this work directly enables delivery of the NHS of the future.

In addition to these high level priorities we need to recognise that a significant proportion of HEE’s activity can be typified as being core operational business. In particular the commissioning of, and contracting for, at least 129 programmes of structured education. This activity, including nationwide Post Graduate medical recruitment, represents the majority of both our financial and human resource, and it is therefore important to our staff that their contribution to our mission is explicitly recognised within this plan. HEE will also be undertaking a number of enabler / process improvements, designed to ensure that delivery of both our top priorities and core operational business can be undertaken with the highest degree of efficiency and impact. These include:


• HEE beginning in its role as a Non-Departmental Public Body (NDPB) and implementing changes following the Beyond Transition (BT) review

• Establishing the Workforce Advisory Board (WAB) to develop a healthcare workforce with the skills to support the implementation of new models of care

• Refining our process for a medium term Financial Strategy with a longer term perspective that links current investment decisions to the Strategic Framework 15, HEE’s mandate and Five Year Forward View

• Improved workforce data from all sectors, and the streamlining and standardisation of workforce planning processes and products

• An extensive programme of work with DEQ exploring education commissioning for patient safety and quality.

• An extensive programme of informatics delivery in support of ‘one HEE’ operations.

2.5 Flexibility for Emergent Five Year Forward View and New Government Priorities

The HEE Business Plan 2015/16 enables the organisation to progress with pace and intent to ensure the current and future needs of people are met. However, we do need to recognise that the implementation of the Five Year Forward View is in its early stages and that the general election on May 7th will result in a new government of whatever political complexion that may have its own views on the relative priorities for the NHS. Our assessment is that the priority areas identified in this plan are all likely to form part of any emergent priorities and that any re-planning will mainly be a matter of scale and emphasis rather than any fundamental change.


No. PRIORITY COMMITMENTS(what) PURPOSE (why) Indicative dates

PC1 Identify the need for and act to deliver a multi-professional primary and community care workforce (including dentistry) able to meet the needs of current and future service requirements - 3,250 doctors completing Foundation training enter GP training programmes by 2016. - Implementation of the 10-point GP Plan - Progress recommendations of the Primary Care Commission

Resolving the workforce challenges in the provision of out of hospital care is pivotal for both current service delivery, across the system and as the critical component of new integrated care models. Failure to address these challenges presents significant risks to both the successful implementation of the Five Year Forward View and delivery of high quality services to current patients

March 2016

PC2 Implement actions to support end of life care from “One Chance to get it Right” To support patients at all times in their lives, including supporting their choice of where to die.

June 2015

PC3 Ensure a greater focus on mental health workforce, including - support delivery of the IAPT workforce to meet access and recovery targets. - increase number of psychiatrists, - focus on perinatal mental health, - Early intervention and, liaison psychiatry services

As service commissioning responds to the need to ensure parity of esteem between physical and mental health, HEE needs to ensure the mental health workforce is able to grow and develop to meet new service demand and requirements

December 2015

PC4 Dementia – Working to ensure that the tools and training opportunities are available to all staff by the end of 2018.

To improve the experience of people with dementia when they are in NHS and care settings by increasing staff awareness

March 2016

PC5 Support for NHSE on Bubb report: Winterbourne View – Time for Change – Developing the Learning Disabilities workforce to deliver new care models in new settings

To ensure the Learning Disabilities workforce is of the right size with appropriate development and values to deliver the quality care this vulnerable group deserves

July 2015

PC6 Deliver the increased midwifery commissions planned for by HEE in 2015/16 and working through our annual planning process assess the demand required to ensure sufficient midwives and other maternity staff are available to provide personalised care and ensure sufficient staff are trained to meet this demand.

To ensure there are sufficient midwives to provide every woman with personalised one to one care

September 2015

PC7 Commission sufficient Health Visitor (HV) training places to ensure a sustainable workforce to reflect Local Authority (LA) commissioning of HV services

Good, well-resourced health visiting services help ensure that children have the critical positive start to life

October 2015

PC8 Work with PHE, NHS England, DH and other system leaders to deliver the action plan for public health

To support the prevention and public health agenda across the healthcare system

March 2016

PC9 To address the current supply of staff in current shortage areas, including; - Nursing: increasing commissions, Return To Practice initiatives - Urgent and Emergency Care - Emergency Cabinet, Paramedics, new roles for physician associates and pharmacists within EC

To meet the expressed need of employers/patients and to address the significant financial burden of excess agency usage.

September 2015

PC10 Reduce avoidable attrition from training programmes by a third Maximise future supply and return from the investment we make March 2016

PC11 Supporting veterans’ health To target support on veterans with complex needs December 2015


No. TRANSFORMATIONAL CHANGES (what) PURPOSE (why) Indicative dates TF1 Lead work on the Future Patient, to pilot and evaluate approaches

for education and training programmes for people & carers in areas of self-care, self-management, and prevention

Framework 15 and Five Year Forward View both highlight the critical role that the public need and want to take in management of their own health.

October 2015

TF2 Take the lead in England to develop a detailed feasibility assessment of proposals within the Shape of Training review, including proposals to move the point of registration.

To educate and train doctors who are able to provide general care in broad specialty areas across a range of different settings, and to ensure sustainable and flexible careers to meet the changing needs of the pubic

September 2015

TF3 Following consultation take forward agreed proposals within the Shape of Caring review, including increasing flexibility across training pathways, an increased focus on care assistant roles, and the need to ensure nurses are supported in their development over the whole of their careers

To deliver patient focussed education and training for registered nurses and care assistants linked to appropriate careers structures. The potential for the delivery of more practice, district, and community nurses, to support integrated service provision across health and social care.

July 2015

TF4 Play a leadership role in continuing to implement the relevant recommendations of the Cavendish Review

Improving the capability of the care assistant workforce in support of integrated care models and flexible care teams.

March 2016

TF5 Implement the Talent for Care strategic framework and the take up of the employer partnership pledge

Drive the development of the healthcare support workforce and provide opportunities for effective career progression and maximisation of individuals capabilities and potential

November 2015

TF6 Implement the widening participation strategy, including developing evidence about effective approaches to widening participation through research and evaluation.

To ensure diversity of the workforce to represent the communities it serves, raise aspirations and support flexible methods for entering training

December 2015

TF7 Continuing to develop and implement the approach to demand led/ service based workforce planning by piloting a life cycle approach starting with children and young people

So that we can embed a method for planning the future workforce based upon the needs of future patients, so that care is more person centred

March 2016

TF8 Lead on the workforce implications of, and develop a training strategy for genomics and Bio-informatics

To actively develop the current workforce to equip them with the skills to utilise in the near term, developments in genetics within the management of populations and their health conditions.

March 2016

TF9 Supporting the National Information Board (NIB) strategy for the health and care workforce to embrace information/data/technology

To ensure the workforce is willing and able to embrace innovation and takes full advantage of new technology and the use of information to enhance patient care.

April 2016


3. Delivering our Business Plan

3.1 Our 2015/16 Work Programme The top priorities outlined above are a summary of a number of specific work streams allocated to HEE directorates who in turn will work coherently with equivalent LETB colleagues to ensure consistent and comprehensive delivery. Other work streams represent the fuller mandate deliverables, core operational work, and our system and process improvement goals for the year. Annex A describes which individual work programmes contribute to which priority areas Annex B sets out these key work programmes for 15/16, and includes:

• Core business activities required to deliver our key objectives and business goals

• Strategic priorities to ensure that we deliver our fifteen year ambition • Mandate deliverables and statutory requirements • Enabler activities such as HR and Finance that will deliver our efficiency

savings through new operating model and ways of working


3.2 Delivering through our staff We will measure how well we are doing in meeting the deliverables in this business plan by using a robust programme management system and integrated performance framework. The framework details all our activities as described in this business plan and we will monitor our progress to provide assurance to our board we are meeting our objectives.

We will ensure all our activities are aligned to achieving the vision of HEE by using the process shown in the diagram below. By taking this approach we can be assured all our staff have individual objectives contributing to achieving our vision for patients:

Framework 15

Strategic Priorities

Business Priorities

GD/LD and Directorate Objectives and Deliverables

Individual Objectives and Deliverables

Strategic Framework

Business Plan 2015/16

Performance Appraisal Process 2015/16

Team Objectives and Deliverables

Delivery Framework (AspireView system) 2015/16

Patient needs


3.3 Delivering with our partners

There is increasing recognition of the importance of our workforce; the Five Year Forward View makes it clear that the new models of care simply won’t become a reality without the people to deliver them. We now need to work with our partners through the Workforce Advisory Board to encourage: • Employers to provide robust workforce forecasts to LETBs. These form the basic

building blocks of our national plan, so the higher quality they are the better the overall plan. Every CEO needs to be engaged in this process, ensuring alignment with commissioning and provision plans and plans to implement the new care models, with workforce forecasts signed off by their medical and nursing director

• Employers and commissioners to create jobs in the right settings so that the staff we train are able to realise and deliver the policy intent of Five Year Forward View, rather than perpetuate an imbalance between community and acute sectors

• Employer and professional bodies to work with HEE and our LETBs on data sharing so that patients receive care from staff employed by a range of different sectors and bodies: the NHS, social care, the independent and charitable sectors. Currently, we only have access to data on staff employed in the NHS, which means we have an incomplete picture of supply

• Greater employer focus on retaining and investing in their current staff. It is our responsibility to commission education and training places to secure the supply of the future workforce, but it is becoming apparent that in some areas, requests for more commissions are due to a ‘leaky bucket’ effect, whereby employers are failing to retain and develop their skilled staff. Commissioning more trainees is the most time consuming and expensive way to address shortages in supply. Attracting people back to the profession is more cost-effective, but the most effective approach of all would be to retain and develop their employees. We will work with NHS Employers and other partners to develop a more strategic and cost-effective approach to staff retention

• Patient groups, Royal Colleges and other stakeholders to work with us on reshaping the workforce. We know that more of the same simply won’t deliver the transformed services that patients need. As set out in our Framework 15, we need a more flexible, adaptable workforce, able to work across professional boundaries and settings, so that they can provide high quality care wherever and whenever the patient needs help. This will require the creation and/or expansion of new roles, and active decommissioning of others, if we are to develop a workforce planning process shaped by patients’ needs rather than supply

• Continued support for a shared vision and aligned planning and action. The most important development this year has been the development of a shared NHS view of the future. The Five Year Forward View provides a clear service vision, and it is now our responsibility to develop an appropriate workforce to make that vision a reality.


Section 4: Our resources and efficiency challenges Ensuring that we deliver quality education and training from initial supply to further development of the workforce within the financial resources provided to us is of utmost importance. HEE is responsible for £5 billion of NHS funding in order to deliver its objectives and we recognise that ensuring it is spent effectively and efficiently is essential.

The following assessment is of income and expenditure anticipated for our ‘business as usual’ activities and to deliver the mandate. In addition to this HEE will receive additional non-recurrent funding to support work on genomics in line with the recently approved business case.

Income

HEE receives most of its funding directly from the Department of Health, with other substantial funding from a few key sources as shown in the table below. We received an indicative allocation in December 2014. This indicated a £30 million reduction in our programme allocation and a £5.1m reduction in administration allocation. Whilst we were anticipating a reduction in our administration allocation, and this is being dealt with through the ‘Beyond Transition’ change programme, the reduction in programme expenditure was unexpected. This has resulted in some late stage revisions to the Investment Plans. However, HEE remains committed to delivery of the Workforce Plan and Mandate within the resources available.


NIHR and Leadership Academy are categorised as other income as this activity does not relate to our main programmes. In both cases the income is available for specific purposes and expenditure budgets are matched with the level of income. The Leadership Academy is considering a substantial reduction in funding to local leadership teams which are commissioned and/or managed by HEE. Last year’s values have been used whilst we await confirmation of final values and expenditure budgets will be reset as necessary when income is known. There still remains some uncertainty regarding the size and timing of income relating to international students.

Expenditure

Detailed spending plans have been put together from local level to ensure that budgets provide for the implementation of the Workforce Plan agreed by the Board in December. (see: http://hee.nhs.uk/2015/02/05/workforce-plan-for-england-201516/ ). The 2014-15 budget has been revised and expanded from that approved by the Board last March to reflect reclassification of expenditure to more appropriate headings and allow better comparison between years.

2014-15 Budget

2015-16 Budget Change

£ million £ million £ million % ChangeDH Grant in AidDH Programme - Recurrent 4,846.0 4,816.0 -30.0 -0.6%DH Admin - non-ring-fenced 81.9 76.8 -5.1 -6.2%DH Admin - ring-fenced DEL 1.0 1.0 0.0 0.0%Subtotal Recurrent funding 4,928.9 4,893.8 -35.1 -0.7%DH Programme - Non-recurrent* 1.0 6.4 5.4 537.4%Subtotal Grant in Aid 4,929.9 4,900.2 -29.7 -0.6%

Contributions to programmesDevolved administrations 1.2 1.2 0.0 0.0%Clinical excellence 0.7 0.7 0.0 0.0%International Office ** 0.0 0.0 0.0 - Subtotal Contributions 1.9 1.9 0.0 0.0%

Other incomeNIHR 57.0 57.0 0.0 0.0%Leadership academy 12.1 12.1 0.0 0.0%Subtotal Other 69.1 69.1 0.0 0.0%

Total Income 5,000.9 4,971.2 -29.7 -0.6%

* Genomics Programme approved business case** Subject to contract being agreed and trainee recruitment in line with business case


http://hee.nhs.uk/2015/02/05/workforce-plan-for-england-201516/

The following table shows the main categories of expenditure:

Future workforce is the largest category of expenditure and covers funding of clinical placements for both medical and non-medical undergraduate students and post-graduate medical and non-medical trainees. There are also some post-graduate 2nd registration courses covered by future workforce.

The expenditure for future workforce is closely linked with activity levels. Once student places are commissioned expenditure is committed for the subsequent period until professional qualification is achieved. Therefore, there is a lead in time for changing expenditure patterns that can be anything up to 7 years. It was also noted that there were various stakeholders such as Royal Colleges who influence training numbers.

The majority of the expenditure is subject to either benchmark prices for higher education institutes or transitional tariffs that are being introduced (with a transition path to smooth large changes in income) for placements with providers. Some clinical roles and professionals such as training in primary care, pharmacy and healthcare scientists are outside the scope of tariffs.

2014-15 Revised Budget

2015-16 Budget Change

£ million £ million £ million % ChangeProgramme ExpenditureFuture workforce - post graduate M&D 1,825.7 1,819.8 -5.9 -0.3% - undergraduate medical and dental 890.0 858.6 -31.4 -3.5% - non medical 1,668.7 1,706.8 38.2 2.3% - other 20.3 9.9 -10.4 -51.4%Subtotal future workforce 4,404.7 4,395.1 -9.5 -0.2%

Workforce development 205.0 205.0 0.0 0.0%Education support 130.5 126.5 -4.0 -3.1%National activities 77.8 67.3 -10.5 -13.5%Transformation fund 30.0 24.0 -6.0 -20.0%

Genomics project 1.0 6.4 5.4 540.0%

Subtotal Programme Expenditure 4,849.0 4,824.3 -24.6 -0.5%

Admin Expenditure 82.9 77.8 -5.1 -6.2%

Other Expenditure 69.1 69.1 0.0 0.0%

Total Expenditure 5,001.0 4,971.2 -29.7 -0.6%


Budgets for undergraduate medical reflect the tariff reduction for undergraduate placement fees paid to placement providers. DH undertook to reduce this tariff as part of our allocation settlement, which makes it possible for our workforce plan to be affordable. The budgets also assumes a second year of ‘zero uplift’ to the Benchmark Prices paid to HEIs in relation to undergraduate course fees for nursing and allied health profession courses. However, the effect of the increase in commissions for these professional groups in the workforce plan results in an aggregate increase in the budget.

The budget for Workforce Development has been held at the 2014-15 budgeted level of £205m. This is an important resource to support the improvement, and changes to the skill base of the existing NHS Workforce which are essential to the transformational changes needed to deliver the recently published vision for the future in the “Five Year Forward View”.

In 2014-15 we set a Transformation Fund at £30m to provide for contingency and to support delivery of the Mandate. The budget for 2015-16 separates this into two items – a contingency fund to cover residual inflationary effects and other minor variations on programme budgets of £9m and a central Transformation Fund of £15m to supplement locally held budgets.

Our restructuring programme – Beyond Transition, reduced our admin costs by c20% to provide for the anticipated allocation reductions over the three years 2013-14 to 2016-17 and to cover the impact of inflation. We have a small degree of non-recurrent flexibility in 2015-16 that will cover slippage on estate changes and infrastructure improvement, particularly to enhance productivity through better use of technology.


Projection of Statement of Financial Position as at March 2016:

Capital Expenditure It is anticipated that there will be minimal capital requirement for HEE and LETBs. Approximately £3 million is required for IM&T improvements, due to slippage of expenditure plans from 2014-15. These are initial estimates; options are still being considered which could impact on the exact amount required.

Estimated Mar-15

Projected Mar-16

£ million £ millionNon Current AssetsProperty Plant and Equipment 1.9 2.0Trade and Other Receivables 1.9 1.9Land and Buildings 0.0 0.0Total Non Current Assets 3.8 3.9

Current AssetsTrade and Other Receivables 36.0 36.0Other Current Assets 0.0 0.0Cash and Cash Equivalents 10.0 10.0Total Current Assets 46.0 46.0

Total Assets 49.8 49.9

Current LiabilitiesTrade and Other Payables -200.0 -190.0Provisions -0.2 -0.2Other Current Liabilities 0.0 0.0Net Current Assets/Liabilities -200.2 -190.2

Total Assets less Liabilities -150.4 -140.3

Taxpayers EquityGeneral Fund -150.4 -140.3ReservesTotal Taxpayers Equity -150.4 -140.3


Procurement Landscape Health Education England has expected expenditure of nearly £5 billion. The majority of expenditure is committed through costs of staff in training e.g. salary costs of junior doctors, facilities and supervision. This supervision is usually from qualified NHS staff and using NHS premises. For both undergraduate and postgraduate levels training is provided in University and Further Education settings. The vast majority of the procurement HEE will manage over the next few years will relate to these existing education and infrastructure activities. A number of contracts have been mandated by DH through their efficiency review. These contracts have either been implemented or have a time line to be implemented. The contracts’ database has identified a number of key areas that need reviewing, here collaboration will give efficiency benefits; these include IT, Agency Staff and procurement provision. Procurement governance The Finance function within HEE has the lead responsibility for procurement and maintenance of all appropriate contractual records. The Director of Finance will therefore ensure the HEE Board has oversight of all relevant procurement decisions. A scheme of delegation and procurement manual has been issued to LETBs and will be reviewed and updated regularly to ensure guidance is current and best practice. HEE are developing a new national standard framework contract for use from 1st April 2014 for business with further and higher education providers, and a new learning and development agreement (LDA) for NHS and associated placement providers. The new national standard framework contract with higher educational institutions and LDA agreements with NHS trusts, represent the organisations core contracting activity. These education and training contracts will be the main focus of the Procurement and Contracts function based on their strategic importance to HEE. Appropriate resource will be designated to these strategic contracts, to ensure contracted performance levels and outcomes are delivered and maximum value achieved. A robust contract management framework will be developed and embedded within the organisation to ensure our commercial relationships are managed and developed to extract maximum value for money. HEE will ensure organisational compliance with EU and UK procurement regulations and will evaluate and implement any necessary changes to processes and policy resulting from the changes to EU directives due for implementation in 2015 and 2016. Procurement and contract management guidance is available to all colleagues within HEE which provides rules and processes to be followed in line with both the organisation’s standing financial instructions and EU procurement rules. The guidance is also updated to incorporate current governmental policy and Cabinet Office controls in a number of business activities.


The procurement committee will oversee organisational compliance to overarching procurement strategy and policy and will where necessary make recommendations to the board on any identified, strategic procurement decisions. Procurement Service Procurement is provided through inherited arrangements with three Procurement Partners for 2015/16. They are:

• South of England Procurement • Leicestershire and Rutland Procurement Partnership • Leeds and York NHS Foundation Partnership Trust.

HEE has reviewed the procurement service and will be working to commission a revised service during 2015/16 to ensure alignment with central government direction relating to the efficiency challenges which will be met in part, through the adoption of the Crown Commercial Service. HEE will be looking to rationalise the procurement service to ensure a common approach to procurement delivery and efficiency and will be evaluating options based on value for money and the expertise required to deliver future projects which have been identified through the HEE procurement pipeline. Procurement Strategy and policy HEE are committed to ensuring that procurement development and delivery aligns with the National standards of procurement and will be building its strategy on the “NHS standards of procurement” including plans relating to Leadership, People Partnerships and process. HEE will also incorporate any recommendations or policy resulting from the “Better Procurement, Better Value, Better Care review. HEE will be supporting SMEs through greater transparency of contract opportunities and the promotion of contracts finder for tenders and contracts. HEE guidelines have been drafted on providing procuring officers a toolkit on practical steps that can be incorporated into tender processes. The guidance has been circulated throughout the organisation and tests will be carried out at regular intervals to ensure guidance is being incorporated into delivery. Linked to support of small medium enterprises HEE will be ensuring that all contracting opportunities will be made available through contracts finder as mandated by the cabinet office. We will also be publishing all spend of a value of over £25k on our website. LEAN Sourcing principles have been evaluated and will be incorporated into procurement manuals and guidance documents. HEE have identified procurement activity through projects that HEE and its LETBs will be delivering over the next 12-24 months. Pipeline information will be provided to DH and the supply market through the use of Contracts Finder. Contracts finder will ensure openness and transparency of opportunities to all potential suppliers. 27 Ref: HEE BP 2015-16 FINAL DRAFT

Estates Efficiencies Health Education England currently occupies a varied number of properties throughout England which are provided by the DH, NHS Property Services, a number of Universities and other NHS Organisations. The occupation agreements for these premises fall under four main headings full lease, under lease, Memorandum of Occupation and Licence and are in the main dependent upon the arrangements previously put in place by the Strategic Health Authorities. The core objectives for 2015/16 will be to: • Ensure the management of our estate delivers efficiencies against the developed

KPI’s • Ensure our estate rationalisation plans contribute to HEE’s financial saving

targets • That the efficiency plans and rationalisation plans are in harmony to the service

delivery requirements of our LETB’s and national offices, whilst maintaining a ‘fit for purpose’ estate

Working in collaboration with our sponsors and stakeholders we will seek to ensure that we deliver the following.

Estates Strategy

Using the approved estates strategy action plans we will be able to provide a clear statement to our sponsors, staff and stakeholders as to how Health Education England plans to optimise estate management and support the efficient management of facilities through the next 5 years. It will detail an alignment of the Health Education England estates’ strategies and policies with government and sponsors guidelines. It will underline our commitment to sustainable development throughout the estate helping to reduce our environmental impact. We will be able to introduce clear controls and targets (KPI’s) with particular interest in working towards the achievement of the workplace standard of flexible working and an 8m2/FTE average for the occupied office estate by the end of 2016 and then seeking to reduce this in line with targets when and where appropriate. Regular review of the estate policies and procedures will ensure that challenges are being met and performance is in line with providing an effective, efficient and value for money estate.

Estates Data Information gathered from a number of sources in 2014/15, as part of our review now provides HEE with a clear understanding of the condition and management of the current estate and how it currently impacts upon the health and wellbeing of staff and the wider environmental impact through sustainable development. This base level data will now be utilised to develop and embed a set of workable key performance indicators, which will be a focus on which efficiencies and improvements can be measured.


HEE enabling services: Following the Beyond Transition review, implemented in February 2015, HEE is creating single teams for its enabling services such as HR, Communications, Governance and Finance to work across HEE, nationally and locally, creating a resource for the whole organisation. This will, in 2015/16 and beyond, enabled these teams to work on HEE wide projects supporting local and national activities, developing their skills with peers, sharing good practice with colleagues and benefiting from profession-based line management structured. These high performing teams will foster personal, professional and career development and well as developing good practice models and uniform approaches and processes where it makes sense to apply these.

HEE getting better connected

As an arm’s length body to the DH, HEE’s digital approach, expenditure and strategy is governed by the Government’s Digital Strategy, the current Cabinet Office zero spend controls and more broadly the European Digital Capability Framework (EDCF

HEE digital priorities

From 1 April 2015, HEE will have a dedicated new digital team of four reporting into the Head of Corporate Communications. Their priorities will be driven by a clear need to streamline HEE’s digital presence to increase user satisfaction. To achieve this for year two the objectives are as follows:

• launch and develop a new single HEE website that encompasses all 13 LETB sites by April 2015, migrating content from the 14 interim sites by May 2015

• map out HEE’s digital capability and skills across communication and IT teams by September 2015

• write a development plan for HEE’s Intranet to encourage wider engagement and interaction but also enhanced user satisfaction

• create HEE’s digital roadmap for internal and external use including an audit of inherited digital material by March 2016

• decrease the number of websites, URLs and digital activities within HEE’s remit by integrating content, reducing duplication, managing hosting more effectively and focusing on user needs

• to work with HEE colleagues locally and key stakeholders to agree a new solution for web presence for the former Deanery websites by December 2015.

In 2014/15, HEE established two internal groups; the HEE Digital Assurance Group which approves internal digital spend prior to DH submission under the spend controls and the HEE Digital Leaders Network. The latter was established to start the process of bringing together the communication and IT teams to share best 29 Ref: HEE BP 2015-16 FINAL DRAFT

practice, talk about local challenges and work together to meet common goals. These two groups will strengthen during 2015/16 with the appointment of the new digital team and their dedication and support for administrating them.

There are a number of websites within HEE’s remit that are managed by project teams; e-Learning for Health and NHS Careers are two examples of these. The two teams work closely with the communications team to deliver integrated communications using all channels and this will continue.

With the implementation of these priorities, HEE hopes to achieve the following outcomes:

• Increased engagement from our various audience groups • Improved user journey and increased levels of user satisfaction • An increase in the amount of people across the organisation using digital to

communicate information effectively • Digital projects commissioned based on user need and value for money • A decrease in the number of websites, URLs and digital activities within

HEE’s remit by integrating content, with the aim to decrease expenditure.

Getting social

In 2014/15, HEE launched its Social Media Policy and Guidelines to staff. HEE has 14 Twitter accounts; one corporate site and one each for our 13 LETBs. We have experienced over 100% growth in followers since 2014 from 10,000 to just over 23,000 in January 2015.

HEE has a dedicated page on Facebook with 993 followers and on LinkedIn there are 774 followers which range from HEE staff to media contacts and staff from partner organisations. We use these channels to push more detailed messages and engage with stakeholders where relevant.

For 2015/16, HEE will continue to develop its social media presence by expanding growth and engagement in established networks and groups to meet the needs of specific high profile niche projects like for example the ‘Come back’ to nursing campaign which targets the general public – and the general public are not as a rule following corporate national organisations.

Human Resources HEE has a simple strategy for the HR&OD services delivered to staff and managers. This is: To know our core business, and what managers and staff want, and provide

systems, support and advice to deliver this


To engage with staff and with our trade union partners To take a positive and proactive approach at all times To find solutions To set a standard that others aspire to

We recognise that supporting staff and managers through our current organisational changes, and beyond, remains a priority. We will ensure an appropriate emphasis on supporting business as usual as well as working closely with managers to ensure appropriate staffing and skills are in place – and in development – to meet service needs. Enabling our staff to deliver HEE’s strategy is our key driver and we are taking the opportunity of the Beyond Transition changes to: Be explicit about the behaviours, skills and approach that is required from our

staff to engage with a changing Health System Value the diverse cultures that exist within HEE as a result of the way we

were created, but emphasise the importance of ensuring that HR&OD services are delivered in a consistent and equitable manner, to a high standard

Create a healthy and effective organisation, and to consciously and deliberately stimulate the conditions in which people can give their best so that the organisation can thrive

Use and develop our HR metrics and systems to benchmark ourselves and identify areas for attention and investment

Become an excellent employer and to be recognised as such. Remuneration HEE continues to work closely with colleagues at DH, NHS Employers and with the other NHS ALBs in matters relating to national pay policy. We are clear about the need for continued pay restraint in the NHS. HEE uses the nationally determined NHS Terms and Conditions of Service (Agenda for Change) and the national contracts and terms for medical and dental and very senior manager (VSM staff). We will continue to work with DH, ALB and staff-side colleagues in all matters regarding our pay policy. HEE’s Remuneration Committee has formal responsibility, on behalf of the Board, for the oversight and agreement of senior staff salaries in accordance with the agreed terms of reference. All of our appointments and arrangements for determining the salaries of our senior staff are carried out in accordance with the processes set by our colleagues in the DH and, where required, with the approval of the Department’s Remuneration Committee. The Remuneration Committee is chaired by Mary Elford, non-executive director. Equality & Diversity HEE remains committed to conducting and planning its business so that equality is at the heart of everything we do. We have robust objectives in place, to promote and further improve engagement with our staff and stakeholders. An established Equality and Diversity Group (‘AHEAD’) meets on a regular basis to ensure that HEE is both meeting all legal requirements and obligations under the Equality Act and the Public Sector Equality Duty and working towards establishing best practice in this 31 Ref: HEE BP 2015-16 FINAL DRAFT

area in due course. The AHEAD group is chaired by Kate Nealon, non-executive director. HEE is striving to ensure that all employees are empowered and engaged in development activity across the organisation. We are committed to all staff taking part in the annual appraisal cycle, with an agreed personal development plan and a formal half yearly review. Our workforce profile is regularly reviewed across all protected characteristics to ensure that action plans are drawn up to address under representation as appropriate. In addition, to enable HEE to develop against its mandate, we continue to develop and promote a flexible and dynamic workforce through: Ensuring flexible working options are accessible and promoted to all HEE staff Assessing and benchmarking our performance through external accreditation

processes in order to enhance our ability to develop a diverse organisation as follows - Working Families, Tommy’s, Stonewall, SABRE (Defence Employer Recognition Scheme) and Two Ticks.

Our commitment to Health and Wellbeing through the NHS Pledge We continue to work in partnership with our Trade Union colleagues, and we are committed to good formal and informal partnership working relations on emerging issues in an open, honest and transparent way. This in turns contributes to helping HEE to deliver its services and obligations effectively, and in partnership, supporting the delivery of high quality patient care and a supportive and developmental working environment for all of our staff. Informatics & ICT HEE’s business is critically dependent upon good quality information. We use data and information in everything we do; from establishing future workforce plans, to assessing the quality and outcomes from education and training, through to the effectiveness of those on the patient-facing workforce and health services. As a national public body we are held to account by Parliament, and we must therefore ensure that our decisions and actions are evidence based, transparent and clear to patients, public and professionals alike.

We are also a very distributed organisation, with representation at local / geographic levels, as most of work depends upon a detailed understanding of the local context of service providers and their workforce needs, and higher educational institutions and their capabilities in delivering the training we require. The distributed nature of our business has led to many local arrangements for information systems, data collection/use and technology infrastructure. Our core task in 2015/16 is to build upon the work we did in 2014/15 and extend this to develop a coherent informatics plan, and associated programme of work which enables us to:


• work more effectively and productively as a single logical organisation( “oneHEE”), ensuring that the basic things our staff need on a daily basis (e.g. email, diaries, directories, and document collaboration) are readily available, easily accessible, work consistently and reliably, irrespective of location or place of work;

• reduce the number of different ways we conduct our core business operations, especially where there is no logical reason for difference, by standardising common operating processes and reducing the number of different computer systems we use to help us run those processes;

• exploit information more effectively by using the information we already collect in better ways, reducing duplication and gathering a wider range of appropriate new information which collectively enables us to form a much more holistic picture of our workforce, the needs of the sector, the quality and effectiveness of our delivery, and the views of trainees, staff, patients and the public; and establish clear national / local operating arrangements for HEE’s informatics workforce, so that we can use the capabilities of our technical, information and systems professionals more collaboratively and effectively across geographies, in concert with the national team.


Annex A – Top Priorities and related Work Programmes

No. High Level Priority Work Programme Mapping

PC1

Identify the need for and act to deliver a multi-professional primary and community care workforce (including dentistry) able to meet the needs of current and future service requirements - 3,250 doctors completing Foundation training enter GP training programmes by 2016. - Implementation of the 10-point GP Plan - Progress recommendations of the Primary Care Commission

A3; D6; F1

PC2 Implement actions to support end of life care from “One Chance to get it Right” F12

PC3

Ensure a greater focus on mental health workforce, including - support delivery of the IAPT workforce to meet access and recovery targets. - increase number of psychiatrists, - focus on perinatal mental health, - Early intervention and, liaison psychiatry services

C3; C5; D9; D10; F6

PC4 Dementia – Working to ensure that the tools and training opportunities are available to all staff by the end of 2018. D11

PC5 Support for NHSE on Bubb report: Winterbourne View – Time for Change – Developing the Learning Disabilities workforce to deliver new care models in new settings

D10

PC6

Deliver the increased midwifery commissions planned for by HEE in 2015/16 and working through our annual planning process assess the demand required to ensure sufficient midwives and other maternity staff are available to provide personalised care and ensure sufficient staff are trained to meet this demand.

C4

PC7 Commission sufficient Health Visitor (HV) training places to ensure a sustainable workforce to reflect Local Authority (LA) commissioning of HV services

C4

PC8 Work with PHE, NHS England, DH and other system leaders to deliver the action plan for public health C4; F2

PC9

To address the current supply of staff in current shortage areas, including; - Nursing: increasing commissions, Return To Practice initiatives - Urgent and Emergency Care - Emergency Cabinet, Paramedics, new roles for physician associates and pharmacists within EC

A3; C1; C4; D5; F17

PC10 Reduce avoidable attrition from training programmes by a third F16 PC11 Supporting veterans’ health D10; F6; F7; F8

TF1 Lead work on the Future Patient, to pilot and evaluate approaches for education and training programmes for people & carers in areas of self-care, self-management, and prevention

B1; B2

TF2 Take the lead in England to develop a detailed feasibility assessment of proposals within the Shape of Training review, including proposals to move the point of registration.

D1

TF3

Following consultation take forward agreed proposals within the Shape of Caring review, including increasing flexibility across training pathways, an increased focus on care assistant roles, and the need to ensure nurses are supported in their development over the whole of their careers

D4

TF4 Play a leadership role in continuing to implement the relevant recommendations of the Cavendish Review D3

TF5 Implement the Talent for Care strategic framework and the take up of the employer partnership pledge D13


No. High Level Priority Work Programme Mapping

TF6 Implement the widening participation strategy, including developing evidence about effective approaches to widening participation through research and evaluation.

D14

TF7 Continuing to develop and implement the approach to demand led/ service based workforce planning by piloting a life cycle approach starting with children and young people

B4

TF8 Lead on the workforce implications of, and develop a training strategy for Genomics and Bio-informatics G1

TF9 Supporting the National Information Board (NIB) strategy for the health and care workforce to embrace information/data/technology H6


Annex B – Our 2015/16 Work Programmes Key Work Area Business Priorities / Work Programmes What we are going to do by when…

A. Careers

1. Support the career decisions of the current and potential health workforce through robust, accessible careers information and labour market intelligence

Undertake research activity with users to support ongoing development of Health Careers website - ongoing to March 2016 Develop a marketing communications plan to raise awareness of the Health Careers website by June 2015 Measure and take action to improve search engine optimisation (SEO) of the new Health Careers website by June 2015. Redevelopment of online Health Careers career management and self-exploration tools by December 2015 to meet the needs of all users, not just doctors. Develop the Health Careers course finder tool so that the academic entry requirements for specific undergraduate medical courses are available to potential applicants by September 2015. Ensure high-quality delivery of Health Careers helpline that supports career decisions by March 2016 Scope future arrangements of Health Careers helpline by December 2015.

2. Develop and implement a nationwide careers strategy connecting implementation at local and national levels

Produce and publish a Health Careers strategy by 30 September 2015 Establish a careers network to bring together activity from across LETBs and agree priorities by June 2015 Perform a scoping exercise across HEE and the LETBs to map current careers activity and run four geographically based best-practice sessions by September 2015 Ongoing support of LETB and service provider engagement through the delivery of national careers resources and materials by March 2016 Review of current NHS Careers literature and other materials to meet local delivery needs by September 2015 Explore the feasibility of developing a health careers week with a series of coordinated events for young people and primary, secondary and further education providers in each of the thirteen LETB regions by


Key Work Area Business Priorities / Work Programmes What we are going to do by when…

March 2016. 3. Contribute to achieving a health workforce with the

right number of people with the right skills, values and behaviours based on the needs of patients and the public.

Ongoing development of video, audio and written real-life stories that illustrate career pathways, reflect widening participation and priority areas of national workforce plan for England by March 2016. Develop and implement communications activities to support priorities of workforce plan by March 2016, including:

• GPs and wider primary and community care workforce • core psychiatry training • geriatrics • learning disability and community based nursing • high intensity therapists.

Evaluate and relaunch schools competition by September 2015 Attendance at national careers and skills events to engage young people and careers advisers on careers in health by March 2016

B. Strategy 1. Supporting people and carers as part of the wider health workforce in line with priorities in Framework 15 (F-15) and Five Year Forward View (5YFV)

• Evaluate education and training approaches to self-care to agree a set of design principles to guide our investment decisions for 2015 - October 2015

• Ensure links and synergies with Shape of Training and Shape of Caring – with regular reviews to March 2016.

• Identify opportunities to support a joined up approach with other ALBs to get a greater return from our investments - March 2016

2. Driving workforce transformation to deliver Five Year Forward View and Framework 15

• Develop a 3 year delivery plan aligned to deliver our 5 year, 10 year and 15 year strategic priorities - December 2015

• Establish a network of peers enabling the spread, application and adoption of innovative practice - June 2015



• Identify key areas of workforce transformation required to support transformation across the system e.g. new care models – September 2015

3. Engaging with partners on delivering the Five Year Forward View

• Engaging with partners to shape and agree shared assumptions for strategies. Various presentations throughout the year and presence at national conferences – Review in Sept 2015

4. Implementing our Framework 15 starting with the life cycle approach

• Continuing the develop and implement the approach to demand led/ service based workforce planning by piloting a life cycle approach starting with children and young people – March 2016

5. Keeping strategy relevant, aligned and connected • Refresh our Framework 15 to align with 5YFV, other national policy; and international best practice - September 2015

• Ensure a strong evidence base and horizon scanning process to inform the refresh – Monthly updates, with review in September 2015

6. Getting the best advice • Develop the role of our advisory structure including WAB, PAF and HEEAGs to ensure all advice and information is connected and relevant to our investment decisions based on value for money and patient needs – June 2015

• Contribute section on the work of the Patient Advisory Forum (PAF) to the HEE Annual report - April 2015

C. Workforce Planning

1. Operate the annual workforce and investment planning process and produce the Workforce Plan for England 2016/17

• implement / disseminate new planning guidance and associated process changes - April 2015

• nationwide assessment of main PG medical specialties - comprehensive coverage of all 13 LETB areas to a standard process



using a common national dataset analysed at a local geographic level - January 2016

• assessment of small medical specialties and non-medical professions with lead LETB arrangements within standardised analytical process - January 2016

• create 'shortage alerts' - HEE to use its collection of aggregate trust positions and forecast to provide system wide alerts to potential immediate supply shortages - June 2015

• Operate main elements of planning cycle including - call for evidence - aggregation of LETB supply and demand forecasts - triangulation, challenge, and moderation with advisory

structures and partners - aggregation of initial investment plans - finalisation of investment plan and publication of WP4E

2016/17 - December 2016 • develop planning guidance for 2016 planning round for 2017/18

commissions - March 2016 • instruction on the implementation of the outcomes of PG medical

reviews - February 2016 2. Priority workforce planning exercises • undertake specific workforce planning analysis to understand the

drivers and routes of supply and demand for all staff working in primary and community care settings, to include GPs, Nursing, and all other professional and support staff - August 2015

• support the NHSE and HEE chief nurses in their nursing capacity review by undertaking a comprehensive assessment of current shortage, any residual level of unrealised demand (from 'safe staffing') and consensus on supply variables in the near and medium term. The output will support both current supply activity in concert with initiatives to reduce agency spend and become a key input to HEEs mainstream future supply planning for this year. - July 2015



• with partners undertake a review of the level of undergraduate medical training in English medical schools.

3. Planning system and process improvements • implement a process of standardised demand forecast collection through a web interface, to minimise collection burden and improve consistency and reliability. Increase consistency of planning approach with Monitor and TDA to minimise duplication. - April 2015

• lead a programme of standardisation in respect of core supply and demand analysis and associated products and reporting. To generate greater transparency and peer comparability and signal a true 'one HEE' approach to stakeholders and colleagues - December 2015

• continue to work with various partners to improve data quality, coverage, and reliability - independent and primary care HSCIC collections - August 2015 - national PG medical data set - August 2015 - IAPT census 2015 - December 2015

• capacity and capability building - ongoing - team recruitment - ongoing work with CfWI and the workforce collaborative - trust focussed development through the 'workforce planning

recipe' product and eWin tools and resources - close links to BI developments and in particular TIS

4. Specific commissions

Through the operation of the annual workforce planning process ensure that specific education commissioning requirements of the mandate are met, namely; • Ensure delivery of the 2015/16 increase in commissions and ensure

sufficient midwifery and other maternity staff commissions in future plans to enable personalised one to one care

• continue to commission sufficient health visitor training places to ensure the right number of qualified staff are available at the right



time and in the right place • continue to work with PHE to commission the appropriate number

of public health specialists to meet demand and improve the public health capability of all professional healthcare staff undertaking training

• additional nursing numbers HEE will also support partners in identifying the level of need for staff in diagnostic areas and where it is our responsibility to do so, ensure sufficient commissions. Development of the current workforce post-registration currently remains an employer responsibility and thereby ensure that the NHS has available the right number of trained staff to deliver current and future demand for diagnostic tests, including working with colleagues on approaches to quantification of current supply to assess demand.

5. IAPT and Priority Mental Health Services

Through the mainstream planning process supplemented by support for a specific IAPT workforce census ensure appropriate commissioning volumes for core IAPT groups in line with new access, recovery and treatment standards

• support delivery of the IAPT programme, working with NHS England to ensure that there are sufficient therapists and other staff with the right skills to achieve future service expansion in support of the Government’s commitment to meet the 15% access and 50% recovery target and the targets of 75% of people treated within 6 weeks and 95% within 18 weeks of referral.

Support partners in assessing the skills and development gap for delivery of early intervention and liaison psychiatry services, such that appropriate development plans can be developed and commissioned by the appropriate partner. • work with partners to support an appropriate skills mix so that early

intervention in psychosis, liaison psychiatry and IAPT services



enables access to the full range of evidence based therapies recommended by NICE.

6. 7-day services

Within the mainstream annual planning process undertake work to assess the impact of 7 day working on the demand for and consequent supply of staff. Work with NHS England and partners to support the safe delivery of 7 day Services



D. Transformational

work programmes 1. SHAPE of Training Lead Shape of Training in England, in consultation with stakeholders, to develop

a more detailed feasibility assessment of elements of the Shape recommendations by September 2015. This will support the aim to ensure all doctors acquire generalist skills to enable flexibility of the workforce and to meet the needs of patients and the service both now and in the future. This will include:-

• considering the needs of particularly vulnerable patient groups, such as children, acute surgical patients and the frail elderly population and supporting the academic medicine agenda

• coordinating with new service models such as those described in the Five Year Forward View

• maintaining a workforce that can deliver high quality patient care in the right way, at the right time, in the right setting.

2. Securing registration for suitable graduates of UK medical schools

HEE will, in the short-term, ensure all suitable graduates in 2015 secure places on the Foundation Programme, successful completion of the first year of which leads to full registration with the GMC - and will work with stakeholders to find a sustainable long-term solution. To this end, HEE will undertake a stakeholder engagement exercise on moving the Point of Registration and report to DH in May 2015.

3. Nursing and Caring

Work with partners to ensure preceptorship programmes are designed to provide newly qualified nurses with the support and guidance to grow in competence and confidence, and effectively make the transition from being a student to a professional, practising registered nurse


Key Work Area Business Priorities / Work Programmes What we are going to do by when… Continue to ensure that there is an increased focus on delivering safe, dignified and compassionate care in the education and training of health care professionals

Play a leadership role in improving the capability of the care assistant workforce by continuing to implement the relevant recommendations of the Cavendish Review

4. Shape of Caring The Shape of Caring Review has set out proposals to improve future education and training of care assistants and nursing, aligned with the Five Year Forward View. These proposals support the need for:- • greater flexibility across all training particularly the need to deliver staff who can

provide whole person care • a focus on increasing the numbers of those working in the community • greater standardisation of post registration on-going learning and the need to

develop a flexible life long career. • a review of commissioning and funding mechanisms across the system to ensure

HEE delivers a workforce with the appropriate skill mix. The review team will report to HEE Board with consultation response from stakeholders on Shape of Caring recommendations by 31st July 2015.

5. Urgent and Emergency Care Programme • Emergency workforce • Paramedics

Continue to deliver multi-professional workforce interventions to support the emergency department including the use of physicians associates, advanced clinical practitioners and pharmacists. Continue to explore the potential benefits of up-skilling and training paramedics to allow them to deliver more treatment in the community, as well as better deliver on-site triage and treatments in emergencies, where clinically appropriate, in line with PEEP recommendations for HEE.



6. Primary and Community Care • Primary Care Commission • Community placements for Nursing

Students

Deliver the workforce development commitments required of it in Transforming Primary Care, working with the appropriate health and care organisations. To establish an independent Primary Care Workforce Commission to identify models of primary care to meet the needs of the future NHS. This will inform priorities for investment in education and training to deliver a primary care workforce that is fit for purpose, flexible and able to adapt to new models of primary care. The report and recommendation will published in July 2015. In conjunction, HEE have developed a 10-point action plan to increase recruitment to GP specialty training. Work with partners to ensure nurses have the most up to date knowledge and skills required to provide high quality care for people with complex needs

7. Development of Community Nursing Continue to ensure that all pre-registration nursing students in training experience an assessed and dedicated period of time in a community placement setting. HEE will ensure that nurses currently working in the acute sector and wishing to work in the community, have ready and easy access to courses to enable them to do so and are supported in making this switch. Will support staff who wish to train on a part time basis in order to meet family needs or working patterns, continuing work with education providers to establish a course to support staff to enter the nursing workforce through this route. HEE, following evaluation, will look to roll this programme out across the NHS

8. Pharmacy Reform Programme Lead work to develop the knowledge skills, values and behaviours of the pharmacy workforce to support a range of workforce transformation programmes including Urgent and Emergency Care, Out of Hospital Care and to support the wider government objectives relating to optimising the use of medicines, including addressing Antimicrobial Resistance. Working with key implementation partners to take forward:

• Further development and roll out of the Consultation Skills Training Programme and clinical research capacity building to support workforce transformation across the system, with a new focus on out of hospital care



- by 31st December 2015 • Scoping of work needed on professional and clinical leadership to support

the patient safety agenda and developing approaches to planning and developing small and specialist workforces, particularly but not exclusively, in scientific and technical services - by 31st March 2016

• Reform of pharmacist E&T, taking into account findings from the consultation on implementation models and the joint consultation with HEFCE on student numbers

9. Supporting Children & Young People • Maternity workforce • Child immunisation

Continue to deliver the education & training and workforce requirements for the vision for personalised maternity care by 2022 with partners with the aim of helping to reduce variation across England and improve skills and knowledge for supporting women with substance misuse.

Continue to work with partners to develop pre-registration and post-registration training in perinatal mental health, and ensure delivery of the continuing professional education framework developed in 2014/15 for the maternity and early years’ workforce. HEE and the RCM and have agreed learning objectives on perinatal mental health for student midwives, in addition eLearning modules are being reviewed for their suitability for midwives - 31st March 2016

Also, ensure training in cultural sensitivities is available for those involved in early years care.

Continue to ensure the supply of the workforce for school aged children and young people, including school nurses, considering how services could be strengthened to support the extension of the flu vaccination programme to all healthy children aged 2 to less than 17 over the coming years.



10. Supporting people with mental health issues - Mental Health Programme

Work with stakeholders and system partners to deliver a structured programme of work meeting the priorities and key deliverables for the development of the mental health and learning disability workforce, (including access targets), and a wider workforce that is psychologically minded and aware of the links between mental and physical health. The programme will include taking a life course approach and focus on:- • Public mental health • Perinatal mental health • Children and young people • Early Intervention Psychosis, Eating Disorders and CAMHs • Liaison and Diversion services • Veterans • Autism This whole systems approach has been agreed and will be led by our Mental Health Steering Group with ongoing review.

The Learning Disability work will focus on Transforming care: A national response to Winterbourne View Hospital, the Winterbourne View Concordat and Positive and Proactive Care.

11. Supporting services for people with Dementia

Continue to work with partners to develop and deliver the required training for the workforce to ensure:-

provision of leadership through LETBs in the development of training programmes setting out the required training needs to support staff to diagnose, where clinically possible, early symptoms of dementia

• Tier 1 tools and training opportunities are available to all staff by the end of 2018. Expand this work to support Tier 2 developments in dementia training to ensure



that NHS staff continue to receive the most advanced support available

• newly qualified staff who look after patients with dementia receive Tier 1 dementia training

• all new nurses and doctors have the right skills to work with older people and ensure that, by September 2015, all undergraduate courses include training in dementia

12. Better Training Better Care HEE will continue to promote the spread and adoption of the BTBC pilot projects on

a national basis by working with a collaborative network of experts to share the outcomes of the projects, mobilising doctors in training and supporting organisations to implement these concepts. Completion date 31st March 2016. The outcome of this work will also support the learning to be safer programme, primarily the Commission’s report on patient safety.

13. Talent for Care Implement the Talent for Care strategic framework and the take up of the employer partnership pledge, with the strategic intentions to: o Broaden the ways into training and employment in the NHS, especially to

attract more young people and improve diversity within the workforce. o Increase the chances for people to try new experiences of working in the

NHS. o Engage more staff to act as NHS Ambassadors who can promote NHS careers

to schools, colleges and local communities. o Challenge and support every NHS employer and contractor to implement a

development programme for all support staff o that is over and above annual appraisals and mandatory training. o All new Healthcare Support Workers and Adult Social Care Workers to

achieve the new Care Certificate, which will be introduced in March 2015; and, for those that want it, a universally recognised Higher Care Certificate.

o Double the number of HEE funded or supported apprenticeships by March



2016 and establish an NHS Apprenticeship offer to rival the best in the country.

o Simplify career progression for those who want it, with innovative new roles and pathways to promotion, including more part-time higher education as a route into nursing and other registered professions.

o Agree with employers and education providers a universal acceptance of prior learning, vocational training and qualifications.

o Support talent development that identifies and nurtures people with the potential to go further, especially for those wanting to move into professional and registered roles.

14. Widening Participation Implement the widening participation strategy, increasing the capacity of organisations in supporting health ambassador and work experience opportunities with the strategic goals to: o Improve monitoring and reporting of widening participation activities o Enhance further the visibility and targeting of Health Careers Information and

Advice o Increase, through research and evaluation, the understanding and evidence

of what and what does not work in relation to widening participation developments in healthcare education and workforce development

o Increase collaborative approaches in supporting widening participation initiatives, including outreach activity

o Stimulate and increase the capacity of healthcare organisations in being able to expand and support work or work related experience opportunities

E. Commissioning &

Quality Priorities 1. Ensuring the highest quality

Commissioning of Education and Training

Continue to lead the commissioning of education and training for the future workforce, working with partners in higher education to keep medical, dental and other healthcare numbers under review, and where number controls are determined nationally, agree any changes with DH in discussion with relevant Government Departments, such as BIS.


Key Work Area Business Priorities / Work Programmes What we are going to do by when… Build an effective partnership with DfE to ensure the planning and commissioning of training for educational and clinical psychologists reflects the need for more integrated service delivery, including reviewing the scope for jointly delivered training.

2. Quality Framework

With our LETBs, HEE will develop a national Quality Framework for all HEE commissioned education & training. This will include the development of clear quality indicators and education outcomes measures to track improvement to support robust commissioning

3. Learning to be safer:

a. Patient Safety Commission

b. Human Factors

The Commission on education and training for patient safety (CETPS) will make recommendations about the education and training interventions needed to improve patient safety. This work will also include practical information and guidance for students on how to feedback on education & training and the Better Training Better Care pilot projects. The Commission will report by 30 November 2015.

HEE will work with partner organisations to support embedding the practices and principles of human factors in education and training. During 2015/16 HEE will gather evidence to identify and measure good practice and share these findings with the Commission by 31st October 2015.

Following the Commission’s report, the Programme team will develop a strategy outlining how HEE plans to take these recommendations forward. This will be delivered in the 2016/17 financial year.

4. Mandatory Training & CPD

Help support a culture of safety by reviewing provision of mandatory training and ensuring minimum standards are set for training across different aspects of health


Key Work Area Business Priorities / Work Programmes What we are going to do by when… and care to ensure it is delivered across the NHS.

Continue to explore with stakeholders the incentives, accountabilities and transparency for employers in supporting the ongoing development of the existing workforce, taking forward the recommendations made in 14/15 report for CPD. Providing leadership to ensure CPD continues beyond the end of formal training to enable staff to deliver safe and high quality healthcare and public health services both now and in the future.

5. The Role of the Educator HEE will work with the LETBs and healthcare providers to ensure that trainers and educators have access to the necessary support and professional development to allow them to provide excellent education and training.

6. Using patient experience measures

Continue to work with NHS England to support the systematic development of clinical audit and patient-report outcome and experience measures.

7. Safeguarding Work with partners to review its ‘safeguarding children’ e-learning resource by August 2015 and ensure that the principles of safeguarding are integral to education and training curricula for health professionals.

8. Quality Assurance

To enable the drive for improvement, HEE will develop a Quality Assurance Education and Training Framework for Health that describes the learning and outcomes at each job related academic level across the domains of knowledge, skills and attitudes/behaviours/ values.



F. Development & Support

1. Supporting the development of Medical Recruitment

• National Recruitment

• Increasing GP recruitment

• Foundation programme

Continue the delivery and assurance of national recruitment into post graduate medical, dental and healthcare science training programmes. To include;

• Leading ongoing development and implementation of the Oriel recruitment system and expanding its use where appropriate

• Delivering an ongoing evaluation of selection processes and promote best practice

• Development of specialty recruitment test • Implementing national Tier 2 visa sponsor for England

Work in partnership with devolved nations and Royal Colleges to improve the data collection and analysis of applicant behaviour to support training programmes or regions with poor fill rates.

Work closely with NHS England, RCGP, BMA to promote recruitment into general practice supporting the “Building the workforce: New Deal for General Practice” action plan and the HEE mandate requirement of 3,250 starters by 2016 and work to increase the numbers of doctors in foundation training undertaking placements in psychiatry, linking with HEE’s primary care 10-point plan project

Work with the 3 health departments to agree and set objectives for the foundation programme for 15/16

2. Support the focus on improving Public Health

Work with PHE, NHS England, DH and other system leaders to deliver the action plan for public health to include.

• Commissioning the appropriate number of public health specialists and improving the public health capability of all professional healthcare staff undertaking training by 30th November 2015

• Supporting staff to deliver improvements in public health in England in line



with priorities in the 5YFV by 31st March 2016

• Supporting the Secretary of State in meeting his duty to reduce health inequalities in England by 31st March 2016

3. Anti-microbial resistance & sepsis Continue to work with PHE and partners to embed in curricula the competence and principles of prescribing medicines, including antimicrobials. Working with stakeholders to ensure workforce capability, capacity and planning mitigates the risk of antimicrobial resistance as set out in the UK Antimicrobial Resistance strategy

Continue to take steps to ensure that training is available so that healthcare staff are competent in the recognition of, and response to, acute illness such as sepsis as a key factor in preventable mortality.

4. Non – surgical cosmetics review Continue to work with regulators and royal colleges to finalise the review of the qualifications required for non-surgical cosmetic procedures and make recommendations on accreditation and course delivery by autumn 2015.

5. Developing Technology Enhanced Learning • TEL Hub and associated projects

Continue work with partners to create an integrated online hub and professional network that can fast track the sharing of good practice and knowledge amongst clinicians, including trainees and students by December 2015.

Through effective promotion, launch and development of the TEL hub by 31st December 2015 HEE will achieve a significant increase in the use of technology in the education, training and development of staff including through e-learning. The hub will show and share successful examples of TEL in action, making accessible in clinical and educational settings resources being used in high quality education, training and development. It will initially focus on simulation, e-Learning and m-Learning (mobile learning) and enable individuals to lodge, find, sample, access, co-


Key Work Area Business Priorities / Work Programmes What we are going to do by when… create, experience and comment on a wide range of technologies and techniques in healthcare education.

The TEL hub will also be a new professional healthcare network. As well as already commissioned materials, crowd-sourced resources will be uploaded by students, healthcare professionals and organisations and by Higher Education Institutions. The Hub will also offer opportunities to build positive cultural attitudes and behaviours towards digital technologies by demonstrating ‘effective’ technological approaches to healthcare education - specifically designed to support and nurture an individual’s clinical, practical and personal competencies, ultimately promoting improved patient care, self-development, productivity and return on investment. In addition to the hub, the TEL programme is delivering a range of associated projects looking at continued user needs research and how to effectively involve all our stakeholders in the programme of work to address key issues around digital literacy and the barriers to IT in the NHS.

6. E-Learning In terms of e-learning development and delivery, HEE will, through its e-learning arm, e-Learning for Healthcare:

o maintain, review, and promote the e-Portal for children and young people’s mental health by 31st March 2016

o continue to work with the RCGP to explore how the existing e-learning package and uptake amongst GPs can be improved by 31st March 2016

o design an e-learning module for Veteran’s Health Champions and seek to ensure that this training is available for the whole healthcare workforce before spring 2016.



o work with partners to seek to develop a bespoke multi-disciplinary e-learning package for introduction in September 2015, focusing on mental health awareness and the skills required across the A&E team

o Work with relevant partners to design, develop and provide e-learning addressing mandate and service priorities by 31st March 2016

7. Working with the Ministry of Defence (MOD)

Continue to work with key stakeholders to develop close links with the MoD to support the aims and objectives of the Future Reserves 2020 White Paper (ongoing) and enhance the capability of the defence medical services through upskilling the existing workforce and training new entrants (ongoing).

8. Armed Forces and Veterans Health Explore how the revised e-learning package and its uptake by GPs can be improved

9. Working time directive (WTD)

Work with DH to explore the recommendations resulting from the RCS led review of the impact of the Working Time Directive, taking forward work with stakeholders to explore the detail and options open to the NHS. Two projects are in development:

• Explore options for new ways of working which will minimise impact of WTD

• Analysis of tasks undertaken by surgical trainees to attempt to understand why the WTD has an impact on them in particular

10. Evaluating the nurse post graduate programme

• commencing in September 2015, undertake a one year evaluation of the older persons’ nurse postgraduate qualification training programme developed by HEE, DH and PHE.



11. Tackling the Shortage Occupation List • ensure that where roles are recommended for inclusion on the Home Office 2015

Shortage Occupation List a clear action plan is produced for each role outlining how HEE will work with stakeholders to remove these roles from the list.

12. End of life care • continue to support End of Life Care by taking forward its actions detailed in ‘One

chance to get it right’ and contribute to the one-year on report by June 2015.

13. Improving recruitment & retention

• work with NHS Employers and the trades unions to support efforts to improve recruitment and retention of staff, providing broad recommendations by winter 2015/16.

14. Supporting developments in Diagnostic Testing

HEE will ensure the NHS has available the right number of trained staff, with the right skills to deliver the future workforce in both endoscopic and sonography testing

15. Dentistry Postgraduate Dental Training

To develop a consistent national approach to the requirements of education and training in Dental Core Training. This will include standardisation of recruitment processes and development of a national curriculum and framework by March 2016.

• Establishment of systems for satisfactory completion for Dental Foundation training.

• Establish curriculum for Dental Core training. • Develop further national recruitment to Dental Specialty training posts. • Work towards national recruitment to Dental Core training posts in 2017. • Implementation of General Dental Council (GDC) Specialty Education

standards. • Develop quality assurance systems that build on COPDEND standards for



quality assurance of dental continuing professional development and meet GDC Standards

16. Reduce Attrition • Agree and adopt a single definition of “unnecessary attrition” – by March 2016

• Undertake a baseline measurement of unnecessary attrition across all commissioned pre-qualifying nursing and programmes – March 2016

• Identify best practice initiatives for reducing attrition across England and share – March 2016

• Reduce avoidable attrition from training programmes by a third 17. Return to Practice (RTP) • National steering group will continue to work with key partners and LETBs to

deliver opportunities for nurses to return to practice and support/explore alternative supply options.

• We will continue to monitor interest in programmes, number of students on courses and first destination data. Reporting is undertaken on a monthly basis.

• An evaluation has been commissioned which consists of a survey to establish student views of the overall RTP experience and a comparative study between two LETB sites, one using a provider driven model, the other a HEI approach to determine if one out performs the other. Due to report July 2015.

Key Work Area Business Priorities / Work Programmes What we are going to do by when… G. Performance and

Development 1. Embed the deliverables in the HEE

Research and Innovation Strategy

To create an annual report summarising progress against the objectives in the R&I Strategy - March 16 Delivery of training strategy for Genomics and Bio-informatics - March 16

2. Work with the NHS Leadership Academy Following scoping work completed in 2014/15, we will work with NHS Leadership Academy to take forward agreed actions regarding inclusion of leadership content in curricula. To present in March 2016 as an annual report.

3. Values Based Recruitment (VBR) To undertake an annual review of the longitudinal study being commissioned by DH to evaluate impact of VBR implementation - March 2016. (Note completion of


Key Work Area Business Priorities / Work Programmes What we are going to do by when… study due in 2018)

4. Proton Beam Therapy

To continue involvement with the DH PBT Special Interest Group and work through any necessary deliverables in year – March 2016

H. Information Technology and Informatics

1. Informatics Delivery: Coherent Plan for ‘one HEE’ operation

Develop an integrated Systems, Information and Technology strategy, building on the work in 2014/15

Produce a single integrated “Systems, Information and Technology” strategy by June 2015, and ensure that this is well understood by informatics colleagues across the country, and is embedded into local delivery plans by September 2015.

2. Informatics Delivery: Reducing variation, and aligning systems and processes

For each functional component of HEE’s core business, we will establish a clear roadmap for the systems, data and technology necessary to deliver that component more effectively

Following the System Audit conducted in early 2015, we will produce a clear high-level roadmap, identifying the principal functional systems and their relative priorities and timelines, by June 2015.

Beyond June, the informatics team will identify the detailed options and issues associated with each of the key components and by September 2015 we will have established and agreed the detailed plans for each functional area.

A key priority in 2015/16 is the delivery of a single national Trainee Management System (TIS), and work is presently underway to develop the business case and procurement approach for that system, with the aim of launching the procurement during the summer 2015.

3. Informatics Delivery: Exploiting information more effectively

Our aims here are threefold:

i.) to exploit the information we already

Following the review of the data and information flows which underpin HEE business, conducted in early 2015, we will produce a clear plan for addressing the shortcomings of current collections, and for expanding collections where needed, to create a much more consistent and reliable body of data to underpin HEE analyses.


Key Work Area Business Priorities / Work Programmes What we are going to do by when… collect much more effectively;

ii.) to gather new data, to fill gaps in our understanding / portfolio ; and

iii.) to use gathered data to support more complex analyses, stronger evidence for our decisions and greater transparency.

We will produce this plan by June 2015, and anticipate that we will complete that programme of improvements by March 2016.

In terms of increasing our analytical uses of the data we collect, we will, by August 2015 have put in place the mechanisms to marshal our ‘information assets’ into much more useable forms, and by December 2015, to be routinely using those assets to respond to more than 50% of the queries we receive. We anticipate that this will increase cumulatively during 2015/16, such that by the end of the year a larger proportion of data requests / information queries can be answered readily from the assembled ‘information asset’ pool.

Around the same time, December 2015, we will produce a wider range of standard facts / information about HEE’s commissions, quality and outcomes, performance, and start the process of routinely publishing this information via a suitable web channel.

During the latter part of 2015/16 we will further increase our analytical capabilities, by introducing a HEE ‘information platform’, to house our ‘information assets’ and better support those analysis at a national and local level.

4. Informatics Delivery: Operating arrangements to maximise our capacity and capability

Our priorities for 2015/16 are to make sure that HEE is using our collective informatics skills, knowledge and capacity to deliver significant improvements against our strategy and roadmaps.

Working with the geographic Informatics Leads, the CIO will, by June 2015, establish a clear ‘operational plan’ aligned to the overall strategy for systems, information and technology, and the specific systems roadmaps. The plan will describe how we expect local informatics teams to be configured, their key roles and responsibilities, and the ways in which they will interact with HEE’s national informatics team and peers. We anticipate that we will start executing the plan in September 2015.



5. Informatics Delivery: Enabling greater collaborative working (‘oneHEE’)

Implement ICT improvements in line with HEE’s agreed IT Information Strategy; the priority being to improve ways of working across the whole of HEE to improve efficiency and flexibility.

HEE has inherited a variety of VC arrangements which do not integrate with desktop or mobile VC reducing their usefulness. It is expected that implementing this solution will reduce staff travel and its associated costs, so HEE will implement a common VC service combining fixed unit and desktop-based VC by June 2015

HEE has in place 10 distinct email services and there is no common file-sharing solution in place. This inhibits working across LETB boundaries and reduces efficiency, so HEE will implement a common email and file-sharing solution by October 2015

6. Supporting National Information Board

strategy Working collaboratively with the NIB and HSCIC colleagues, supporting the NIB strategy for the health and care workforce in embracing information/data/technology by: i.) reviewing existing KSFs and introducing new/modified KSFs levels, where

needed, by April 2016, ii.) by embedding relevant information/data/technology knowledge, skills and

characteristics into core curricula by April 2017.

I. Finance Developing corporate and strategic finance to maximise our efficiency and effectiveness

1. Financial Strategy Develop a Financial Strategy that takes a longer term perspective and links to the Strategic Framework 15, HEE’s mandate and Five Year Forward View by June 2015 Engage with the finance community to align their operational issues and implications for workforce education and training using local finance networks to catalyse conversations - ongoing

2. Financial control, capacity and capability Achieving financial balance at Year End and meeting admin and programme funding limits by 31st March 2016.


Key Work Area Business Priorities / Work Programmes What we are going to do by when… Ensuring effective financial control with no contracting, outcomes, accounting or audit issues (incorporating activity information that has financial implications) – ongoing.

3. Supporting procurement Compliance to procurement process and governance ensuring transparency, openness and auditability – ongoing Use appropriate procurement activities to seek value for money, including updated contract model for the HEI sector and associated funding arrangements (including Benchmark Pricing) by December 2015

4. Value for money Through a robust and comprehensive financial planning process integrated into operational and commissioning decision making deliver excellent value for money with strategic reinvestment of savings in priority areas with planning aligned to workforce planning by December 2015.

5. Tariff Review of education and training reference costs to develop currencies (education resource groups) and work with DH on recommendations for tariff implementation in 16/17 by December 2015. Engage with the finance and education community to support placement providers to improve education and training reference costs in time for Summer 2015 cost collection.

6. Promoting science and economic growth Work with the DH, the Devolved Administrations and the education sector in making a contribution to the growth agenda – ongoing. Contribute to realising the potential of research and innovation in healthcare and demonstrate commitment to the UK Life Sciences growth agenda – ongoing. Following Cabinet Office Policy HEE will seek to ensure SMEs small and medium enterprises are able to participate in tendering for contracts – ongoing


Key Work Area Business Priorities / Work Programmes What we are going to do by when… J. Communications 1. HEE digital priorities

In 2014/15, HEE established two internal groups; the HEE Digital Assurance Group which approves internal digital spend prior to DH submission under the spend controls and the HEE Digital Leaders Network. The latter was established to start the process of bringing together the communication and IT teams to share best practice, talk about local challenges and work together to meet common goals. These two groups will strengthen during 2015/16 with the appointment of the new digital team and their dedication and support for administrating them. 2. HEE Websites There are a number of websites within HEE’s remit that are managed by project teams; e-Learning for Health and NHS Careers are two examples of these. The two teams work closely with the communications team to deliver integrated communications using all channels and this will continue

From 1 April 2015, HEE will have a dedicated new digital team of four reporting into the Head of Corporate Communications. Their priorities will be driven by a clear need ‘to streamline HEE’s digital presence to increase user satisfaction’. To achieve this for year two of operation the objectives are as follows:

• launch and develop a new single HEE website that encompasses all 13 LETBs by April 2015 migrating content from the 14 interim sites by May 2015

• map out HEE’s digital capability and skills across communication and IT teams by September 2015

• write a development plan for HEE’s Intranet to encourage wider engagement and interaction but also enhanced user satisfaction by September 2015

• create HEE’s digital roadmap for internal and external use including an audit of inherited digital material by March 2016

• decrease the number of websites, URLs and digital activities within HEE’s remit by integrating content, reducing duplication, managing hosting more effectively and focusing on user needs by March 2016

• to work with HEE colleagues locally and key stakeholders to agree a new solution for web presence for the former Deanery websites by December 2015.

. With the implementation of these priorities, HEE intends to achieve the following outcomes by March 2016:

• Increased engagement from our various audience groups • Improved user journey and increased levels of user satisfaction • An increase in the amount of people across the organisation

using digital to communicate information effectively • Digital projects commissioned based on user need and value for


Key Work Area Business Priorities / Work Programmes What we are going to do by when… money

• A decrease in the number of websites, URLs and digital activities within HEE’s remit by integrating content, with the aim to decrease expenditure.

3. Getting social In 2014/15, HEE launched its Social Media Policy and Guidelines to staff. HEE has 14 corporate Twitter accounts; one corporate site and one each for our thirteen LETBs. We have experienced over 100% growth in followers since 2014 from 10,000 to just over 23,000 in January 2015. HEE has a dedicated page on Facebook with 993 followers and on LinkedIn there are 774 followers which range from HEE staff to media contacts and partner organisations. 4. International Health Workforce Collaborative

(IHWC) Conference

For 2015/16, HEE will continue to develop its social media presence by expanding growth and engagement in established networks and groups to meet the needs of specific high profile niche projects like for example the ‘Come back’ to nursing campaign which targets the general public – as the general public are not as a rule following corporate national organisations. Health Education England is hosting the prestigious International Health Workforce Collaborative (IHWC) Conference on Tuesday 12 May until Friday 15 May 2015

K. Corporate 1. Getting the most from our estates and premises.

2. Corporate Governance Framework – step change

enhancement to HEE governance across the

• Develop ‘Key Performance Indicators’ from our estate data, to

measure the delivery of estates efficiencies by June 2015 • Embed the key estate strategy objectives within the organisation, to

focus & identify priorities for 2015/16 - ongoing • Implement the estate strategy key action points and estate priorities

in order to deliver improved utilisation and the estate rationalisation plans for 2015/16 - ongoing

• Invest additional resources in Information Governance and


Key Work Area Business Priorities / Work Programmes What we are going to do by when… organisation

3. HEE Authorisation Framework

implement processes across HEE, achieving satisfactory IG Toolkit rating by December 2015

• Embed Business Continuity processes across HEE by July 2015 • Bring the Corporate Governance into one team providing effective

and efficient support across HEE by June 2015 All LETBs have achieved Maturity Level 2 and satisfied any residual conditions from authorisation. In 2015/16 LETBs will be assessed against a ‘one HEE’ framework to improve efficiency, reduce duplication, ensure compliance and support a sustainable future for HEE. Assessment will focus on:

• A single approach to organisational development; • Standard reporting format; • The application of standard financial processes; • Greater consistency of governance process; • The identification and implementation of good practice.


Annex C: Education and Training Commissions 2015/16 Non-Medical

Clinical Professional Education Programmes: 2014/15 Commissions

Planned 2015/16

CommissionsIncrease / Decrease %

Pre-registration Nursing & MidwiferyAdult Nurses 13,228 13,903 675 5.1%Children's Nurses 2,182 2,343 161 7.4%Learning Disabilities Nurses 653 664 11 1.7%Mental Health Nurses 3,143 3,243 100 3.2%Midwives 2,563 2,605 42 1.6%

Total - Pre-registration Nursing & Midwifery 21769 22758 989 4.5%Allied Health ProfessionsDietetics 336 343 7 2.1%Occupational Therapy 1,523 1,536 13 0.9%Physiotherapy 1,490 1,543 53 3.6%Podiatry 362 362 0 0.0%Speech & Language Therapy 644 668 24 3.7%Diagnostoc Radiography 1,059 1,115 56 5.3%Therapeutic Radiography 371 414 43 11.6%Paramedics 853 1,241 388 45.5%Orthoptics 77 77 0 0.0%Orthotics/Prosthetics 30 30 0 0.0%

Total - Allied Health Professions 6745 7329 584 8.7%Other Scientific, Technical & TherapeuticOperating Dept. Practitioner 842 957 115 13.7%Pharmacist pre-registration year 600 657 57 9.5%Pharmacy Technician 300 360 60 20.0%Clinical Psychologist 532 526 -6 -1.1%IAPT - Psychological Wellbeing Practitioner (Low intensity) 436 579 143 32.8%IAPT - High intensity practitioner 320 367 47 14.7%Child Psychotherapist 41 43 2 4.9%HCS Higher Specialist Scientific Training (HSST) 94 103 9 9.6%HCS Scientist Training Programme (STP) 271 282 11 4.1%HCS Practitioner Training Programme (PTP) 246 473 227 92.3%Physicians Associates 24 205 181 754.2%Dental Nurses 455 442 -13 -2.9%Dental Technicians 69 69 0 0.0%Dental Hygienists 116 128 12 10.3%Dental Therapists 118 134 16 13.6%

Total - Other Scientific, Technical & Therapeutic 4464 5325 861 19.3%Specialist Nurse - Post RegistrationDistrict Nurses 431 502 71 16.5%School Nurses 198 340 142 71.7%Practice Nurses 218 359 141 64.7%Health Visitors 1,041 1,193 152 14.6%

Total - Specialist Nurse - Post Registration 1888 2394 506 26.8%

TOTAL Clinical Professional Education 34866 37806 2940 8.4%

Education & Training Commissions for 2015/16


Medical & Dental

Undergraduate Medical & Dental Education: 2014/15 Commissions

Planned 2015/16

CommissionsIncrease / Decrease %

Undergraduate Medical & DentalUndergraduate Medical 6,071 6,071 0 0.0%Undergraduate Dental 899 809 -90 -10.0%

Total - Undergraduate Medical & Dental 6,970 6,970 -90 -1.3%

Post Graduate Medical & Dental Education: Number of Training Posts

Increase / Decrease %

Foundation TrainingMedical Foundation Programme 12,567 -12 -0.1%Dental Foundation Programme 881 7 0.8%

Total - Medical & Dental Foundation Programmes 13,448 -5 0.0%Core TrainingAcute Care Common Stem - Acute Medicine 212 0Acute Care Common Stem - Anaesthesia 322 35 10.9%Acute Care Common Stem - Emergency Medicine (including RunThrough) 681 96 14.1%Core Anaesthetics Training 901 -17 -1.9%Core Medical Training 2,510 107 4.3%Core Psychiatry Training 1,450 -20 -1.4%Core Surgical Training 1,197 -67 -5.6%Broad Based Training (PILOT) 69 36 52.2%

Total - Core Training 7,342 170 2.3%Run Through TrainingPaediatrics 2,859 0Ophthalmology 547 -3 -0.5%Neurosurgery 229 -5 -2.2%Obstetrics and Gynaecology 1,779 -1 -0.1%Community Sexual and Reproductive Health 25 0Histopathology 492 -1 -0.2%Chemical Pathology - Including Metabolic Medicine 70 -3 -4.3%Diagnostic neuropathology 8 0Paediatric and perinatal pathology 9 0Forensic histopathology 2 0Medical Microbiology 198 0Medical Virology 13 0Clinical Radiology 1,081 18 1.7%General Practice 8,311 209 2.5%Public Health Specialists 421 0

Total - Run Through Training 16,044 214 1.3%Post Graduate Dental TrainingDental Core Training 506 2 0.4%Dental Specialty TrainingDental and Maxillofacial Radiology 4 0Oral and Maxillofacial Pathology 7 0Oral Microbiology 2 0Oral Medicine 14 0 0.0%Orthodontics 175 0Restorative Dentistry 44 0Paediatric Dentistry 39 1Additional Dental Specialties 14 0Oral Surgery 22 0Endodontics 12 0Periodontics 13 0Prosthodontics 9 0Special Care Dentistry 22 0Dental Public Health 22 0

Total - Dental Specialty Training 399 1 0.3%

Education & Training Commissions for 2015/16


Annex D – Key risks There are a number of risks that HEE faces in the delivery of its business plan. External risks include economic, political and environmental. Internally HEE faces risks around access to sufficient resource in terms of finance and to staff with the right skills and capacity to deliver its business objectives.

HEE maintains its Corporate Risk Register risk register which is reviewed, updated and published with Board papers every two months. The HEE Board papers can be found at:

http://hee.nhs.uk/category/our-board/heeboardpapers/


http://hee.nhs.uk/category/our-board/heeboardpapers/

Annex E: Glossary

5YFV Five Year Forward View (see http://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf )

ALB Arm’s Length Body

BTBC Better Training Better Care – aims to improve the quality of training and learning for the benefit of patient care

CfWI Centre for Workforce Intelligence

CPPD Continuing Personal and Professional Development

Dementia Dementia is a syndrome associated with an ongoing decline of the brain and its abilities

DH Department of Health

EOF Education Outcomes Framework – the framework sets the outcomes that the Secretary of State expects to be achieved from the reformed education and training system

Framework 15 HEE’s 15-year Strategic Framework / F15 (see http://hee.nhs.uk/2014/06/03/framework-15-health-education-england-strategic-framework-2014-29/ )

Francis Report Public inquiry into Mid Staffordshire NHS Foundation Trust

GMC General Medical Council

HEE Health Education England

HR Human Resources

HV Health Visitor(s)

IAO Information Asset Owner

IAPT Improving Access to Psychological Therapies (IAPT) is an NHS programme rolling out services across England for treating people with depression and anxiety disorders.

ICT Information Communication Technology

LA

LDA learning and development agreement for NHS and associated placement providers

LEAN sourcing Based on a five stage process that sets out the most efficient path for getting from the required business outcome to the award of a contract

LETBs Local Education and Training Boards

LTC Long Term Condition

MDRS Medical and Dental Recruitment and Selection Mandate


http://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf

http://hee.nhs.uk/2014/06/03/framework-15-health-education-england-strategic-framework-2014-29/

Monitor Monitor is the sector regulator for health services in England. Their role is to make sure foundation hospitals, ambulance trusts and mental health and community care organisations are well led and are run efficiently.

MPET Multi Professional Education and Training

NDPB Non-Departmental Public Body

NHSTDA The NHS Trust Development Authority provides support, oversight and governance for all NHS Trusts.

NIHR The National Institute for Health Research (NIHR) is funded through the Department of Health to improve the health and wealth of the nation through research.

NHSE NHS England (NHSE) is an independent body, at arm’s length to the government. Its main role is to improve health outcomes for people in England.

OD Organisational Development

PHE Public Health England (PHE) provides national leadership and expert services to support public health and works with local government and the NHS to respond to emergencies.

Procurement Acquisition of goods or services from an external source

R&D Research and Development

SHA Strategic Health Authority

SID HEE Strategic Intent Document

SIRO Senior Information Risk Owner

SLA Service Level Agreement

SME Small or medium sized enterprise

Two Ticks This symbol (which appears on job vacancies and organisations’ websites) means the employer is committed to interview all disabled applicants who meet the minimum criteria for a job vacancy and to consider them on their abilities (see https://www.gov.uk/recruitment-disabled-people/encouraging-applications)


https://www.gov.uk/recruitment-disabled-people/encouraging-applications

HEE Business Plan 2015/16

Documents

Transcript of HEE Business Plan 2015/16