The Benson Model: School

Nursing

A new methodology for caseload and workforce assessment

Q1 2014

This presentation• Introduction / about the service planners• Who is using the Benson Model• Examine the methodologies• Case study: Liverpool Community Health• Planning, implementation and support• Discussion

The Benson Models: Children’s Health

• Clients have own folder and secure access

• Tools are updated quarterly with new features

Health Visiting Service Planner

School Nursing Service Planner

About the service plannersOwned locally with ongoing remote supportObjectiveTransparentLive - reflecting and developing strategyBenchmarking and discussion groups

Current providers

North Somerset

Ealing

Cornwall & IoS

Liverpool & Sefton

Birmingham

Cumbria

Derby CityDerbyshire

SalfordStockport

Bury

Leic & Rutland

BedfordshireHertfordshire

Coventry

Bridgewater

BSBC x 5

Settings

Live folder

System architecture

School Nursing

Database

Benson Model

Benchmarking and external

validation

Download/upload and use offline

Local intelligence

National policy

Local strategies

Service and workforce level

data from providers

Model overview

HCP 0 - 5

Profiling local complexity

Schools

Model overview

Developinglocal

serviceprofiles

GPs

Developinglocal

serviceprofiles

Model overview

Developinglocal

serviceprofiles

GPs

LOCAL POLICY

NATIONAL POLICY

Aligning service profiles with policy, best practice

and drivers of improvement

BEST PRACTICE

NEW TECH

SNSP DATABASE – IDEAS FROM OTHER AREAS

Model overview

HCP 5-19

Workforce structure

Model overview

HCP 5-19

Workforce profiling

and capacity

Model overview

HCP 5-19

Aligning our workforce profiles with policy, best practice and drivers of

improvement

LOCAL POLICY

NEW TECH

SNSP DATABASE – IDEAS FROM

OTHER AREAS

Model overview

Identifying workforce potential

GPs

Model overview

Example: the SNSP indicates we have a workforce shortfall in Area 1

GPs

SHORTFALL

Model overview

GPs

SHORTFALL CHANGE?

Can we address this by increasing our workforce?

Model overview

GPs

SHORTFALL

CHANGE?

Or revising our workforce assumptions around role profiles to allow more delivery time?

Model overview

GPs

SHORTFALL

CHANGE?

Or by revising the service programme? - but this will apply to all areas

Model overview

GPs

SHORTFALLCHANGE?

Or do we need to rebalance the caseload? Can we rezone some of the school’s into Area 2?

Targeting services by complexity

By Deprivation

•Deprivation is captured by locality and used as a basis to profile services that are targeted at or sensitive to deprivation

•Child deprivation data is captured and profiled by locality using deprivation quartiles

By Special population

•Alternatively, groups who receive targeted or more intensive support may be defined and populated by locality

•These provide an alternative to profiling service delivery by deprivation•e.g.:

•Safeguarding (CP, CIN, LAC)•Additional health needs•Special needs•Ethnic groups / English as a 2nd language

Case study : Liverpool Community Health School Nursing

• Project began in late 2012• Reconfiguration of 3 services into one

– North Liverpool– South Liverpool– Sefton

• Each service had its own – service programme – workforce roles– beliefs on how the service should look

Outcomes - Liverpool

Workforce allocation

Service programme

Policy

Risk, opportunity and improvement

LCH outcomes: Workforce allocation

• Assessed the effectiveness of the existing workforce to deliver the future programme and identified skill shortages

• Revised caseloads to reflect complexity of needs across each locality

• Provided an objective basis for new team structure and deploying new practitioners

• Review the balance and contribution of skill mix

1 2

3

4

LCH outcomes: Service programme• Developed a clear, transparent, local and

harmonised service programme

• Identified Additional Needs Groups who we target services to

• Explore future delivery strategies, workforce roles and opportunities to incorporate new technology

• Profiled travel time and administration duties to reflect service requirements moreaccurately

1

2

3

4

LCH outcomes: Policy

1

2

3

4

• Facilitated the rebalancing of the new team structure and caseloads

• Ongoing development of a single set of local service profiles and alignment with outcomes

• Currently documenting the service profiles to link to local policy & demonstrate compliance with the HCP etc

• Develop local workforce profiles based on a collective understanding of requirements

LCH outcomes: Risk, opportunity and improvement

• Identified and quantify risk of workforce shortfall

• Helped identify and incorporate best practice for both the service programme and workforce strategy

• The new workforce and service profiles prompted discussion and pointed to potential variances in the current service

Service plan

Performance data

Benchmark vs. other services

Targeted improve-

ments

National policy

1

2

3

4

Implementation plan - overview

Ongoing support

Use, improve and refine Access to updates & benchmarking

Implementation

Workshops Planner developmentPlanning

Scoping and configuration Data development

Implementation plan - exampleMilestone Activities involved Time

Project initiation, scoping and planning

•Agreed objectives with steering group•Establish working group•Develop the data specification

1-2 weeks

Data development •Working with analysts and access national datasets to develop comprehensive local school dataset•Configure tool in accordance with local requirements

2-3 weeks

Workshops Run 2 half day workshops to introduce the tool and develop local area and workforce profiles, and a service specification

2 weeks

Post workshop support Co-ordinate collection of outstanding dataComplete development of the tool and assist rollout to ensure the tool is supportedSetup the live client folder and logins

2-3 weeks

Rollout / Ongoing support Provide ongoing assistance as required

Linking with other initiatives

Service planning - caseload sensitisation

- workforce deployment- -demographics

Service forecasting - identifying future demand and workforce requirements

- Predict levels of productivity

Service scheduling - Workflow and scheduling

- Phasing of staff / demand- - Recording outcomes

Local policy - local and national

initiatives

Comparison to actuals - Compare with actuals from

PM system- Identify variation from plan- Target areas of efficiency- -Validate assumptions

Service forecasting - identifying future demand and workforce requirements

- Predict levels of productivity

Service scheduling - Workflow and scheduling

- Phasing of staff / demand- - Recording outcomes

Local policy - Local / national initiatives

- Link to Outcomes- Joint working

Contact details

Michael McGechieDirector – health services[T]  0207 617 7134[M] 0796 919 9920michael@bensonwintere.comwww.bensonwintere.com/healthcare

EALING CASE STUDY

SELECTED SCREENSHOTS

Developing a service spec

•Each child protection case in this area takes an estimated 63 hours each year, when including administration and travel

Defining the service offer

•What services do we want to offer in the future?•In this example we have switched off a few services but may explore these as potential services later•This allows us to link each service to the HCP and local policy by clicking on the INFO button next to each service

Workforce planning

•This currently commissioned workforce for this area is unable to deliver the service plan, with 69% service potential•We can create a custom profile to explore workforce required to deliver 100%•Why does the skill mix not have enough work?

Dashboard – how does the service look? (1)

•It appears our commissioned workforce levels in three of the main teams are not adequate to deliver the desired programme

Dashboard – how does the service look? (2)

•However by switching to a customised workforce we have developed, we can show the additional workforce (and cost) requirements to deliver the desired programme

Service plan