LKS support for workforce modernisation

Tom Roper, Clinical Librarian,

Brighton and Sussex NHS Library and Knowledge Service

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Two Clinical Librarians

Attached to Children’s Services (IB), Women’s Services (IB), Abdominal Surgery and Medicine (TR), Acute Floor (TR) and Musculoskeletal (TR)

But we also support

Clinical Policies Steering Group

Innovation Forum

Read2Lead, IHI Chapter

Product Selection Group

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3Ts hospital redevelopment

Teaching

Trauma

Tertiary care

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3Ts

Replacing ageing buildings

Neurosciences

Major Trauma Centre

Brighton & Sussex Medical School

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3Ts

c. 92,350m2 of new/replacement accommodation

three stages over eight years

Summer 2019

Autumn 2022

Autumn 2023

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3Ts

Significant increase in capacity Move to single inpatient accommodation (from 12% to average of 65%) Includes hardest specialties to recruit

Critical Care Radiotherapy Chemotherapy Imaging Theatres

42% of 3Ts will support specialist/tertiary services for residents of Sussex and wider region

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What is workforce modernisation?

‘Workforce modernisation’ is the rigorous and systematic process to align the healthcare workforce with the work to be undertaken

NHS England (2013). How to Ensure the Right People, with the Right Skills, are in the Right Place at the Right Time: a Guide to Nursing, Midwifery and Care Staffing Capacity and Capability

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Programme Objectives

Sustainable pay cost reduction •Aim is to improve recruitment & retention, educational experience, engagement, development opportunities etc.

•However financial context is a reality

•Carter productivity opportunities

•Within BSUH, workforce pilots have had to deliver CIPs to be approved

•Possible to reduce pay cost overall but improve opportunities for staff individually

Structured career pathways •Clear ‘line of sight’ (per Cavendish)

•Widening participation (cf. HEE ‘Get In, Get on, Go Further’ Strategy)

•Social Value, Equality & Diversity

Interesting and developmental roles for staff •Staff engagement (wide range of patient, staff, organisational benefits)

•Interprofessional working (role delegation, role substitution, interprofessional learning)

Quality & Safety •New/extended roles underpinned by systematic risk assessment/risk mitigation

•Use of research evidence (supported by Clinical Librarian)

•Aligned with/enable new service models (‘right people, right skills, right place, right time’)

•Statutory/regulatory compliance

Programme Innovations

Building capacity bottom-up eg. •Voluntary Services

•Direct-Entry Apprentices

•HCA role extension etc.

Targeted roles eg. •Band 3 Clinical Assistants to reduce

medical trainees’ working hours / improve educational experience

•Band 2/3+ Clinical Technologists to free up HCA and RN time

Structured risk assessment

•Determine new/segmented vs extended/multiskilled roles

•Underpinning task delegation (eg. Ward Band 4 PAs/Nursing Associates)

Team-based / in-situ learning eg. •Beacon Wards pilot

•Apprenticeship Levy specification

Retaining/developing existing staff

•vs treadmill of recruitment

•BSUH role as teaching hospital within STP/KSS

Creative use of Apprenticeship Levy

•£1.3m/year (+10%) for BSUH

•Incorporating STAM, Care Certificate, some Induction

•Human Factors approach, simulation as ‘golden threads’

Advanced Care Practice roles

•Single interdisciplinary framework

•RNs/AHPs moving into space vacated by medical trainees (and locums)

Interprofessional approaches

•Shared teaching

•Role substitution

•Role delegation

Projects in Progress / RAG Band 1 2 3 4 5 6 7 8

Voluntary Services

• Pilot / high-impact roles x

• Student volunteers/FEIs x

Apprenticeships

• Direct-Entry Apprentices x x

• Apprenticeship Levy procurement x x x x

HCA Role Development

• Role redesign (complete) x x

• Cross-sector competencies (B&H CCG, B&H SS, SCFT etc.) x x

Clinical Technologists

• BSUH pilot x x

• KSS Evaluation/rollout x x

Clinical Assistants x

Beacon Wards Pilot x x x

Career Development Pathway (training roles/stages) x x x x

Ward Nursing Associates

• Pilot wards/ED x

• FD secondments x x x

Retention of Newly Qualified Practitioners x

Surgical First Assistants / Theatre staffing x x x x x

Physician Associates

• BSUH pilots x

• BSMS clinical placements x

Imaging

• 3Ts/Innovation Acceleration x x x x x x x

• Ultrasonography review x

Advanced Care Practice Framework x x x

• On plan, no major issues

Green

•Success probable, requires vigilance

Amber/ Green

• Success feasible, but has issues requiring management attention

Amber

• Success in doubt, urgent attention required

Amber/ Red

• Success unachievable, needs re-baselining

Red

Complete

Searches carried out for all but two projects

2012 National policy and reports to support the 3Ts Full Business Case 2014 Does a Major Trauma Centre benefit all patients (not just trauma) admitted at weekends and out of hours? What is the Research & Development activities of UK teaching hospitals with specific focus on revenue generated? Evidence that patients have better outcomes in teaching hospitals Advanced Clinical Practitioners and Physician Associates in the NHS 2015 Workforce change programme-level evaluations Volunteers in UK hospitals and internationally Does the role of surgical first assistant create any efficiency savings or increase productivity?

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2016 Advanced practice care clinical roles Pharmacy Assistants/Support Workers Retention of newly qualified nurses and allied health professionals Band 4 Assistant Practitioners Benefits of interdisciplinary training Benefits of training for nurse/HCA roles in changing skill mix Ward-based technologist/support/stock controllers Ultrasonographers: workforce and education Effectiveness of embedded radiographers in EDs for triage of minor injuries with suspected fractures

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Custom inductions for project leaders

• Orientation

• KnowledgeShare information needs profiling

• Reference interview for any immediate searches required

• Other information management needs

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20 project staff registered on

KnowledgeShare

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Workforce Programme Stakeholder Board

Education managers

Clinical leads

Project leads

Health Education England

Universities

AHSN

And the Clinical Librarian

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What’s new?

Involvement of clinical librarian in organisation-wide projects

Excellent relationship with project team

Evidence-based innovation

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Vote early, vote often

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