Waltham Forest - Microsoft · Forest overview of employment information of the domiciliary care...
Transcript of Waltham Forest - Microsoft · Forest overview of employment information of the domiciliary care...
Waltham Forest
Training Hub
Annual Report
2018-19
In the Network Everything is connected
The Contents Executive Summary
Introduction: Challenges 2018-19
Population 1
Population Projections 1
Local Workforce - Health & Social Care 1
Waltham Forest Focus 2018-19
Local & Regional Strategic Aims 2
Building A Sustainable Workforce 2
Impacts: WF Hub Collaborative Investments
Reflections: Lessons Learned As a CEPN
Impacts: Network Legacy & Sustainability
Appendices
Investment 2018-19 3
Investment Impacts : Ongoing 3
Notable Impacts: Retention - Professional Forums 4
Notable Impacts: Primary Care Networks 4
Notable Impacts: Nursing Strategy - GPNs 4
Notable Impacts: Rotational Nurse 5
Notable Impacts: Training = Retention 5
Leading By Example 6
Working at Scale: Physicians Associates 6
Working at Scale: One Workforce 6
Innovation 1: Innovation 1: Digital Training Hub 7
Innovation 2: Primary Care Networks Workforce Planning Toolkit 7
Innovation 3: Roles Catalogue Update 7
Integrated Learning Management System for North East London
8
Using Data & Analysis to deliver OD Change 8
Scalable, Sustainable Workforce: Joined up Working & Workforce Pipelines Strategy 8
Future Investment into WF Hub 9
Future Direction 9
Waltham Forest CEPN Annual Report 2018-19
Executive Summary
Waltham Forest Training Hub has continued to work
collaboratively across the local population footprint on workforce
transformation with local stakeholders from Local Authority,
Patients Association, Healthwatch, Primary Care Commissioning,
Local Education Institutions, Integrated Care Commissioning and
many more. Despite local and regional challenges as a result of
new health and social care system arrangements, 2018-19 has
continued to see a strengthening focus on sustainable delivery
reaching into new areas using digital transformation.
The Training Hub has embedded systematic multi-disciplinary
learning for front line staff across and is now leading
transformation using a digital solution – Digital Training Hub, as
its anchor. The platform includes a learning passporting that can
be shared across Primary Care, Social & Secondary Care
readying staff for integrated working. Waltham Forest Training
Hub is formally placed in the planning for the local Managed
Network of Care & Support framework for Waltham Forest’s
integrated care system led by system commissioning leads. Our
digital pivot includes working directly in partnership with Barts to
achieve primary and social care goals working at scale with local
partners where possible. As a result of this work we are to scope
a collaboration with Newham Training Hub to establish a possible
expansion of our skills matrix.
WF Training Hub maintains its strong year round curriculum for
front line staff based on its Skills Matrix system created in 2016-
17. This system already covers most of primary care staff
ensuring 1000+ multi-disciplinary professionals are being
supported locally. We are now working very closely with
integrated care leads to scope and flesh out a system wide offer
that includes blind spots across social care i.e. domiciliary care,
single handed workers and carers. The aim this past year was to
develop a viable digital product version of our skills matrix and
continue to build a PMO system whilst maintaining core
education training quality support for all our linked staff across
the Training Hub network.
Waltham Forest Training Hub is leading the retention support of
Physicians Associate in North East London with the
establishment of their preceptorship. The programme aims to
socialize the new role into Primary Care but also the wider
system.
The Hub continues working with commissioner’s i.e. palliative
care & integrated care to look at how employment models can be
created for these new roles to secure their long-term pipeline.
Various workforce forums continue to be supported and
developed. In the past year the Hub has created the
establishment of a Care Collaborative Group Forum for social
care managers and firmly established North East London
Sessional & Salaried GP Forum. The Hub’s GP Education Lead
is supporting this group which we hope will yield a pipeline of
long-term committed local East London GPs.
On-going investment in late 2018 from Health Education England
(Transformation Fund) expanded the Hub’s reach into Urgent
Care, Social Prescribing, Care Homes and integration. The
collaboration in the Hub means that it is ahead of recent
commissioning collaborative changes in the health and social
care system. Despite many challenges for WF Training Hub,
outputs in Waltham Forest continue to demonstrate the
importance of strategic partnerships in Education, Transformation
and Workforce to build quality front line staff NHS needs
resilience into the health and care system.
Throughout the year the Hub has been looking at its sustainability
with the view to establish a new hosting arrangement. The
development needs of the hub to mature into a faculty ready to
take on bigger delivery pots like GP VTS led to the creation of a
comprehensive options paper looking at various borough based
integrated hosting options. With recent publication of the Long-
term People Plan and the Long Term Implementation Plan, WF
Training & Transformation Hub continues to be an innovator that
is pre-empting national policy. Workforce Planning, recruitment
and retention are a key feature of this hub with digital elements of
set to go live.
Whilst local challenges continues for the Hub as CCGs merge,
the Hub’s presence is felt at the highest level and is seen as a
transformation enabler that needs to be properly positioned to
deliver its mandate. The hard work continues with the aim to
establish a long-term strategy based on supporting Primary Care
Networks and system integration for the out of hospital and at
home agenda. The hub continues to embrace accountability
attending two Patient Reference Groups with very positive
feedback on delivery in Waltham Forest. The Hub will be working
in the coming months to base itself in the best position to support
change and transformation in coming 4-5 years in the community.
Dr Peter Carter
Training Hub Co Chair & NELFT
Director for Medical Education (MB)
Dr Anwar Khan
Training Hub GP Education Director &
Co Chair / Education
Introduction: The Challenges 2018-19 1
Population If population growth rate would be same as in period 2011-
2014 (+1.05%/year), Waltham Forest population in 2019
would be: 282 407. Officially according to the 2017 mid-year
population estimates by the Office of National Statistics,
Waltham Forest is home to a total of 275,505 people. This is
3,150 residents more than last year and a gain of 20,000
since the 2011 Census and growing.
The median age of residents is 34 years compared to the
UK average of 40 years. Current figures are however
showing that Waltham Forest has a younger than average
population with 22 per cent of residents being aged 0 to 15
compared to 19 per cent nationally. Similar to London,
Waltham Forest also has a high proportion of young
working-age adults aged 25 to 49 (43 per cent compared to
34 per cent nationally). There are proportionately fewer
people aged over 50 living in Waltham Forest (25 per cent)
compared to the UK average (36 per cent). See table 1 for
the latest population estimates by age group. The borough is
one of the most diverse areas in the country. 48 per cent of
residents are from a minority ethnic background.
Population Projections
The Greater London Authority (GLA) 2015 round of
population projections estimate that Waltham Forest
population will increase from 274,800 residents in 2016 to
a total of 291,500 by 2021, an increase of 16,700 (6%).
The fastest growing group is projected to be those aged 50
and over. GLA produced 2013 Round of Demographic
Projections (trend based, central scenario) suggest that
the borough’s population continues to rise over the next
three decades and will reach 343,100 by 2041. This seen
as a conservative figure due to current data. The
projections suggest a distinct aging pattern with largest
increase projected for the older age groups. The number of
residents aged 65 and over is likely to double by 2041 (see
table 2 below). You can find the suite of population and
household projection produced by GLA & ONS. Waltham
Forest population not only has high levels of multiple
deprivations but it is expected to grow by more than
73,000 people over the next 10 years, one of the highest
increases of any local authority in London. Summary of
key findings where Waltham Forest compares poorly or
well against England Compared to England, Waltham
Forest has high numbers of children in poverty (estimated
at 16,800 children); 23.5% of Year 6 children are obese;
there are high numbers of statutory homeless, poorer
GCSE attainment, higher levels of violent crime and high
numbers of long-term unemployed.
Local Workforce - Health & Social Care
Waltham Forest Training Hub Skills Matrix data collection
shows 38 GP Practices in 2018-19 took up the offer of
support. There are at least 800+ staff working in these
Primary Care settings alone. WF Hub Skills Matrix data
shows there are 185 GPs, 379 Administrators, 64 Nurses
(various levels), 6 Pharmacists, 27 Health Care Assistants
working in our local Practices. More work is being done in
WF to support GPN growth.
Skills for Care Summary of Adult Social Care in Waltham
Forest overview of employment information of the
domiciliary care workforce in Waltham Forest CCG area,
2018 shows in Waltham Forest area, there were a total of
4,400 adult social care jobs in 2017/18 across the local
authority and independent sectors. Of these, 41% (1,800
jobs) were within domiciliary care services. All 1,800
domiciliary care jobs were within the independent sector.
Around 87% (1,600) of domiciliary care jobs in Waltham
Forest CCG were direct care roles. This includes senior
care workers, care workers and support and outreach
roles. A further 9% (150) were managerial roles, including
senior managers and registered managers.
See table 1 below for the latest population estimates by age group.
Table 1 – Mid-2015 population estimates by broad age group
Source: Office for National Statistics
Waltham Forest Focus 2018-19 2
Local and Regional Strategic aims
Waltham Forest Training Hub is clear that it must work in
alignment with national Workforce Strategies- Interim People
Plan supporting new roles across Primary Care Networks but
also taking into account local strategic workforce
transformation aims. North East London Training Hub Alliance
has been formed to support this strategy.
Health Education England Priorities North East London
2017 -19 & Alignment with GPFV & LTP Workforce Strategy
The original strategic directives for NEL continues to be very
pertinent:
1. Retention of workforce
- GPs, Nurses, Admin, New roles 2. Clinical skills development
- MDTs, Pharmacists, Nurses, GPs, Medical Assistants 3. Apprenticeships and widening participation
- Health & Social Care Careers Pathways and new roles - New employment models / new models of care
4. Primary and secondary care interactions -Urgent Care, Integration and Social Care etc.
5. Empowering carers and communities 6. New ways of working 7. ‘Recognize, Rethink, Reform’ for Nursing
- 10 Point Plan local Implementation
Clinical Commissioning & Intergraded Care - Borough
Council 2017-19 Local Commissioning Outlook:
Commissioning Strategic Plan (CSP) & Primary
WF Hub/CEPN continues to feature in the borough’s local
CSP. The annual business review of CCG Commissioning
states WF CCG is committed to Education & Training for the
system, “WF CCG will continue building on established links
with HENCEL, the London Education and Training Boards and
the local Community Provider Education Network to ensure
local workforce is trained with skills that meet the needs of the
local health economy”. These local markers include:
1. Improve primary care services to deliver better health outcomes for our local population
2. Improve patient access to and experience of primary care services
3. Ensure effective community engagement to help support the delivery of patient centered care
4. Maximize clinical engagement, ensuring strong leadership across all primary care services
5. Embrace technology and ensure that the primary care infrastructure is fit for purpose and support patients to self- manage
6. Enable practices to work collaboratively to support the delivery of integrated Care.
Building A Sustainable Workforce
With recent regional change, Waltham Forest Hub has in the last
12 months reviewed activities to reaffirm as well as establish its
principles to secure longevity. The local hub has worked hard with
its stakeholders to using a strategy paper to review next steps.
CCGs are the fourth attempt at increasing the involvement of
clinicians in the planning and commissioning of local services.
Commissioning was introduced into the NHS in the early 1990s,
when the purchasing of healthcare services was separated from
their delivery. Since then there have been several changes to the
structure of NHS commissioning organisations and their
population coverage, reflecting the tension between balancing
commissioning at scale and remaining responsive to local needs.
Refined Principles WF Training Hub in 2018-19:
1. Putting People/Patients at Centre of Care through
workforce transformation
2. Workforce & OD delivery support for Primary Care
Networks (PCNs)
3. Continuing to value and develop all front staff
4. Acknowledging on-going relationships and
partnerships across normative boundaries i.e. social
care, managed network of care.
5. New models of care collaboration to advance
innovations and improve analysis i.e. Patients Health
watch, Commissioning.
Priority areas for improvement for WF Training Hub: 1. Reporting growth and transformation – visibility
2. Organisational Development – retaining and growing
staffing levels during difficult transitions
3. Establishment of new employment models for new
roles
4. Evaluation – to inform continuous improvement, and
improve our case for funding (QI)
5. New hosting model/ arrangements achieved
6. Taking an Organisational Development perspective
on the outcomes we’re trying to achieve e.g. being
open to challenging traditional roles and hierarchies.
WF CEPN Priorities agreed against 2018-19 Investments (Transformation Fund, Operational Plan, Nursing, Network Development)
1. WF Hub as local enabler for STP & LTP
2. WF Hub as driver of local deliverables
3. WF Hub leading Primary Care Collaboration
4. WF Hub leading Integrated Care Collaboration
5. WF Hub as a Workforce Systems digital innovator
6. Education & Training Champion
7. Increasing/Maintaining GPN numbers
Impacts: WF Hub Collaborative Investments 3
Investment 2018-19 WF Hub total investment from HEE was an income of £437,000.
This combined operational costs. It also includes the pooled
funding income raised by the skills matrix pilot round 3 at £40k –
this is a new fee set in place to get sites to invest in their Training
Hub and pool funds (£50 per head for the FY).
Description Source Income
GPN Placements x8 + new HEE £289,000
Operational Investment HEE £100,000
Nursing Hub Transfer HEE £10,000
Skills Matrix - Pooled Community £38,000
Additional In-year Placements HEE/ STP Variable
Total at end of FY (capture) £437,000
Investment Impacts – ongoing North East London (NEL) and the North Central London (NCL)
Sustainability and Transformation Plans (STPs) have had
significant focus on the care closer to home agenda. In order to
deliver on the visions set out in the STPs, Health Education
England (North Central and East London) made available
£250,000 transformation fund to each hub in 2017-18 to enable
consistent improvements in primary care education and training
and additional operational funding to help maintain this. This
investment continues to impact the local system with
implementation into 2018-19. Where funded projects where unable
to gain traction, with local collaborative engagement this was
reinvested into the wider Training Budget for all skills matrix staff
or for the expansion of projects i.e. support for growing Clinical
Pharmacists or Portfolio GPs.
Various workforce related projects like Care Academy Apprentice
Pipeline, and upskilling projects including service re-design training
support for Pharmacists and Quality Improvement of Staff in
Primary Care. However the Training Hub also where possible,
continued to add value including the support for digital
enhancements and cross sector working with health watch.
2014/15 2015/16 2016/17 2017/18 2018/19
Total population 265,800 269 000 274,800 275,505 275,505
Total number of trained nurse mentors in general practice N/A 26 33 36 35
Total number of sign off mentors (inclusive of GPNs) N/A 26 33 36 35
Number of pre-registration nurse placements in the geographic area now covered by the Hub (how many nurses have been trained)
N/A 2 2 2 4
Number of postgraduate nursing placements in the geographic area now covered by the CEPN (inclusive of GPN and Advance Nurse Practitioners)
N/A
6 5 8 10
Total number of Physician Associates in primary care (only fill if applicable to your area)
N/A
N/A
11
TBC(4-7)
4
Number of apprenticeships in the geographic area now covered by the CEPN (health providers only – excluding Trusts who report separately)
N/A
N/A
0 (197
Potential Placements identified)
2
10
Number of school pupils undertaking work experience in primary care
N/A
N/A
N/A
15
19
Total number of medical student placements filled in primary care N/A
N/A
N/A
N/A
N/A
Total number of placements for medical assistants (General Practice Assistants/Super Administrators) filled in primary care
N/A
N/A
N/A
87
N/A
Total number of pharmacy students in primary care N/A
N/A
4
4
TBC
Total number of pre-registration pharmacists N/A
N/A
N/A
-
3
Total number of Clinical Pharmacists in primary care (post graduate learners: new category 17/18, only fill if applicable to your area)
N/A
N/A
N/A
6
8
Total number of placements for Paramedic Practitioners filled in primary care (post graduate learners: new category 17/18, only fill if applicable to your area)
N/A
N/A
1
N/A
N/A
Number of multi-professional learning opportunities as a proportion of all training running in the area (target minimum 50%)
N/A
400+
800+
2000
2000+
Number of multi-professional training places offered in the geographic area organized and/or facilitated by the CEPN
N/A
300+
1200+
2000+
2675
How many new roles have been created e.g. Nurse Associate, Physician Associates, Care Navigator, Medical Assistant, Other (for those where appropriate). It would be extremely helpful for you to specify numbers for each new role created if not referenced above
N/A
N/A
110 (NAs)
2 (CN) 11 (PA) 87 (MA trained)
110 (NA)
4 (NAs) 2 (PA)
4 (MAs)
Notable Impacts: Retention - Professional Forums
WF Training Hub now supports 7 Core professional workforce
forums/hubs for learning – GPs, NEL Salaried GPs, Nurses,
Pharmacists, Practice Managers, Care Managers, NEL
Physicians Associates and there is work buildup 1 more – for
Health and Social Care Support Workers. The Hub has
continued to support where possible the growth of these very
strong hubs that have 30-50 strong attendance rates of
sharing helping staff to see themselves as sustainability
enablers. These Hubs are strengthen by having on the Ground
Clinical Leadership from Dr Munir-Ali-Zubair and Ruth
Amartey.
These hubs are a well-recognized with the additional central
training opportunities that comes with them for peer learning
and collaboration. Through the GP Portal and the use of
online tools like Eventbrite and soon The Digital Training Hub
WF Training Hub has been able to offer a suite of multi-
disciplinary and specialist clinical leaning for our staff. An
external consultant commented, “This is one of the biggest
CEPN Events I have ever seen”. The quality improvement
has become more and more personal as peers and teaching
staff meet regularly to discuss clinical & workforce challenges.
Continued support for Training Hubs will secure a framework
in which this work can be expanded to support the wider
system in an integrated framework.
The Training is driving up the quality of care closer to home
across the health and social care system. The arrival of
Primary Care Networks It will also mean that workforce
transformation can happen at scale in larger numbers with our
local community providers. Waltham Forest has extended it
reach with the support for Sessional GPs and will be doing
work this FY to support some of these GPs to take on
permanent contracts and partnerships in North East London.
Notable Impacts: Primary Care Networks
Primary care networks build on the core of current primary care
services and enable greater provision of proactive,
personalized, coordinated and more integrated health and social
care. Primary care networks will be based on GP registered
lists, typically serving natural communities of around 30,000 to
50,000.
WF Training Hub was able to feed into the PCN narrative very
quickly. The Skills Matrix helped the local system demonstrate
that in WF, The Hubs was already established. The response to
NHSE included that the coverage of Training support to Primary
Care was such that the gap was only in the recruitment and
retention of new roles, something that would be supported by
GP Federation in collaboration with the Training Hubs. There
are now discussions taking place regarding Commissioning
Hubs in NEL to take forward the work to support PCN
development. The Training Hubs in partnership with its local
networks will be pivotal to the establishment and success of
roles being retained and recruited locally.
Notable Impacts: Nursing Strategy - GPNs 4
To date Waltham Forest has used transformation funds and
additional GPN funding to support the recruitment of 24 New to
General Practice Nurses, 4 Associate Nurse Apprentices and
another 4 support on ANPs. This has been done with 0 attrition
whilst the Nurses learn which an amazing achievement is. The Hub
has worked with system partners via its Nursing Super hub Sub-
group to continue realize additional system nursing goals identified
in HEE’s Nursing Workforce 10 Point plan an:
1. Raising profile of general practice nursing
2. Extending leadership roles to interested local ANPs
3. Increasing number of pre-registration nurse placements
4. Establishing and supporting preceptorships
5. Improving access to return to practice nursing in primary
care (we have the only one in NEL London)
6. Embedding prevention strategy via new models of care
7. Improving retention
8. Developing a career pathway for New to General Practice
Nurses (GPNs) and Health & Social Care Workers
(HSCWs).
9. Supporting return to work schemes for practice nurses
10. Supporting access to Educational Training
Waltham Forest is participating in a number of schemes across
all these areas. We have two Nurses on the NEL Leadership
Course, over 25 education specific opportunities for Nurses per
year including a thriving Nurse Forum often talked about in other
boroughs. We continue to deliver system support including the
placement of Associate Nurses in Primary Care where we
currently have 4 students enrolled. The hub continues to support
Advanced Nurses and Independent Prescribers to develop and
become strong local advocates and Practitioners.
WF CEPN Nurse Clinical Lead Ruth Amartey and Nurse
Facilitator Catherine Edmonds have been is instrumental in the
sustainability of this Programme. The have both ensured there is
a hub and spoke learning and support model in WF. They ensure
placement settings are adequate for new learners and support
Nurse Supervision where there are gaps. This framework means
when new nurses come into Waltham Forest they are greeted
with a Lead Nurse, training, consistent access to opportunities
including the chance to become leaders. We have built up the
space so that there is a clear pathway for Nurses who come into
Primary Care. The lessons applied has meant that WF Training
Hub has built a reputation for well managed recruitment
frameworks, process and tools that minimizes the risk of a Nurse
leaving not only the various programmes but the borough itself.
As a result WF is retaining 70% of Trainee Nurses to work locally
with some of them taking up positions where older Nurses have
retired.
Key Retention elements in Waltham Forest
- The development of a formal Induction Process for
various roles
- Successful Supplementary training year round (e.g.
Ear care, sexual health and contraception and travel
health)
- Newly designed systems and toolkits (e.g. tailored
welcome packs for both trainee and practice)
- Set / recommended salaries candidates.
- Having a clear post-qualification employment route
Notable Impacts: Rotational Nurse
Since April 2017, we have been working with Barts & NELFT to test
out various rotations to look at how pipelines for roles in the
community setting can be improved so that sites get more rounded
professionals. These roles sit across health and social care settings
with a number of strategic and systematic initiatives including
personalised Workforce Planning Toolkit and a New Roles Catalogue
introducing a new type of workforce and competencies to
community/primary care providers.
Task & Purpose of Rotations (Retention & Attrition)
We continue to design both observational and working rotational
placements across both Health and Social Care sites to secure
strategic direction and successes of Nursing Associate role for East
London, by exposing trainees to “open door opportunities” to them
post qualification. Nursing Super hub for BHR & WF led by NELFT
NHS Foundation Trust bravely considered rotations mini-rotations
across Primary and Social Care settings in partnership with local
stakeholders.
Rotations elements being looked at for scale
• Induction for every cohort – taking trainees through range of
teams that work across primary and community services.
• Associates are encouraged at induction to take part fully when
in their settings
• Cohorts of 8-15 placements per cohort are being looked at for
hub and spokes in 2019-20
How to recruit settings / get local involvement:
Settings were contacted to become official hosts and signed up.
Settings engaged with the scheme do so by
• Returning a signed agreement
• Signing an Honorary contract on conduct during participation
• Being open to a visit from Nurse Leads to look at the setting
suitability
• Supervisors being open to improving their support skills
• In total about 22 sites continue to work with us Health and
Social care to host 6 Practices, Medicines Optimisation Team, 6
Care homes, 6 Social Care teams
Some of the Lessons being learned
• Rotations are a great way to help staff see and experience
whole systems
• It is likely for Waltham Forest to use the rotations hub and
spoke from HEIs as a way of bringing in at all times in the year
new staff where GPN placements are deemed not viable
• Social care welcomes engagement and wants to be part of
wider pipeline initiatives so we need to build on this willingness
5
Notable Impacts: Training = Retention
WF training regime is systematic. The Hub uses data it
collects regularly to ensure that the quality of the offer for staff
for their CPD is that this is enhanced. WF Hub continues to
collaborate widely and is preparing to go more digital in the
coming months with the initial introduction of The Digital
Training Hub and then video, webinars etc. Altogether, 2292
registered and 2490 attended in total. Individually, amongst
the 96 sessions, registrations were greater than attendance for
47% of the sessions, 46% sessions had lower registrations
than attendance, and registered equalled attendees for a
small proportion of 7%.
Feedbacks have now been used to look at future training
quality and improvements including brining more modern tools
like digital registrations and automated attendance to
sessions for delegates. A majority of the Thursday Education
sessions are targeted towards GPs, Nurse and HCA training
are focused, while Skills Matrix 2018/19 covers a range of
both targeted and multi-disciplinary programmes.
We are now working hard to get the Digital Hub up and
running so that processes we once did manually to record
uptake is done electronically. The Skills Matrix has continued
to result in a Curriculum learning circuit for a range of local
health and social care professionals. Using evaluation is key
to future improvement of the learning quality which we know if
kept at a high level will help local retention of staff.
Full Deep Dive Education Report 2018-2019 Available
Reflections: Lessons Learned 6 Leading By Example
Dr Munir Ali-Zubair (GP) and Ruth Amartey (Nursing) have
continued to be a great strength for WF Training Hub. As
the day to day Clinicians on the ground challenging
education content, championing analysis of sessions, hub
development and investment into skills across the
workforce, their work is impacting leadership. Their Educator
skills is growing and they are now highly south after to take
forward strategic work from Physicians Assistants,
International GP Recruitment, Commissioning advise.
Commissioners have been tagging WF Hub Operational
Meetings as the place to come if they wish to sound off
workforce models of care. Education Leads, have now
stepped into more strategic and sustainability leadership
roles regionally. Being a Training Hub Clinical Lead is
potentially a development track for aspiring young clinicians
who want to have an Education portfolio career locally.
Having both CCG and NELFT Clinical Education Leads
steering the Hub’s overall direction but also having the
Nurse Clinical Lead sitting at the Nursing Super-hub level
has meant that we were already working in Alliance in
Integrated formation before STPs or Health & Care alliances
for integrated care came into play formally. Their experience
in the last four years means they can be called on to support
the development of future workforce strategies building on
lessons learned.
Working at Scale: Physicians Associates
WF Hub took is the Preceptorship programme lead for North
east London. We have designed a programme to support
this new role. Recently reporting the role into NHSE Leads,
it is deemed as a progressive and forward thinking Hub that
is seeing then future of the role’s need to be socialized into
the primary care and wider workforce. NEL STP asked WF
to lead. The Preceptorship presently takes recent graduates
into a space where they are learning with their peers and
senior clinicians on how to navigate and embed their role.
This project shows how dynamic Training Hubs can be
across the system to retain new roles in the local area. WF
is also working very closely with Barts and NELFT to support
Nurse Preceptorship as well. One feedback is as follows,
“The second preceptorship programme was the first one I
attended and it was very helpful, particularly discussing
cases. I will be looking forward to attending the future ones.
Especially, the case based discussions was helpful.” We are
hoping this model will help national programmes.
Working at Scale: One Workforce
Then Digital Training Hub is here and will be launched in
November to first the Primary Care Workforce then wider
joined-up sustainable Learning Management System (LMS).
Based on the Skills Matrix, WF is lead the way in NEL with
its use of Bluestream Academy to enhance learning and
compliance for primary care but also social care. All NEL
Hubs apart from Newham. WF CEPN envisaged in its 2016
Sustainable CEPNs Options Paper two scenarios that would
involve future systems mergers and possible at scale
working future Workforce via HR systems and programmes
that cross natural provider boundaries. Our Skills Matrix has
demonstrated that a sustainable federated buy –in LMS
model from primary care and social care providers into one
LMS system is possible.
The Hub has 95% buy in from WF Practices and wider
primary care like the GP Federation and Community
Enhanced Services adopting our Skills Matrix Learning
Management system (LMS). The Pilot has yielded returns of
40k in the last year alone just from primary care subscribers.
Board CEPN members have been steering workforce
transformation discussions around sustainability through a
tabled paper by the WF Hub Lead and this model is showing
that if working at scale, more can be done to pool funds for
delivery. The Digital Training Hub will be launched in
November formally. This will be an online-based integrated
portal which will streamline all your training, education and
eventually workforce processes. It will eventually be rolled
out to Social Care Providers Features will include:
Booking training
Webinars/Live video lessons
Automating processes like e-certificates
Instant registrations
Workforce planning dashboard for Site Managers to
help you keep track of staff learning and appraisals in
real-time.
Automatic electronic certificates for online and face-to-
face learning
Training passport/ID transferable across other
NHS/social care sites i.e. Barts, Care Homes, etc.
Mobile app where you can do training anytime
anywhere
WF digitization will usher in a transformation of the past
moving into new ways of working. It however needs more
support across the STP to enhance the offer.
Impacts: Network Legacy & Sustainability 7 Innovation 1: Digital Training Hub Launched April 2016 as a pilot, WF CEPN partnered with End of
Life Care Lead, Practice Managers & Care Homes Manager
Lead at the CCG to extend the Education & Training offer to
Front Line GP Practices & Care / Domiciliary Care Staff. The
Skills Matrix is now an established sustainable training hub for
staff in Waltham Forest. Practices & Care Homes pay a nominal
fee and in return gain access to Bluestream (Online Training)
and Face to Face Training commissioned by CEPN. 2017-2018:
37 Practices & 7 Care Homes signed up to the Skills Matrix.In
order to ensure WF CEPN commission training that is both
essential and requested, a Training Needs Analysis was carried
out for the following staff groups:
Nurses
HCA’s
Practice Managers
Care Home Staff
Pharmacists
Additional to the TNA, a Training Return Form was sent to all
sites on the Skills Matrix Agreement to fill out. This was to find
out what Training is needed by each member of staff (i.e.
Receptionists). So far we have had 36/37 practices return their
completed document. These Training Return forms have been
collated to create a Master Tracker which lists all the Staff
Members & Details in Practices in WF. This tool however is
currently managed manually. This is now transformed into a
digital processes we are launching in November. Testing has
begun. The Hub is finally here and has been tested on
transferring learning passport across Barts and Primary Care
settings.
The Digital Training Hub was presented as a concept at HEE’s
2019 Education Conference. It gained a lot of interest from
regional Training Hubs. Once live hubs like Barnet, Newham
and BHR are open to exploring potential partnership. WF Hub
has agreed to share and show what it is doing as
implementation progresses into 2020 and has agreed with
Newham to potentially work on the iterative build. However as a
digital platform, WF Hub will also seek more support for the
build at an STP and national level.
Innovation 2: Primary Care Networks Workforce Planning Toolkit WF has enhanced this with an analytics tool and has continued
to invest in the development of a Workforce Planning toolkit for
primary care which it is hoping will be later used for content for
an automated LMS system. The view of this toolkit now shows
Practice Network Workforce Data as well as highest top 5
spend areas including LTCs across PCNs and Practices will be
getting a Toolkit in the summer to support their workforce
planning needs including a learning session on the ongoing
benefits for having workforce planning as a core human
resources skill as a Practice Manager. In 2016, WF CEPN
wanted to have an “audit in action” and decided to build into a
new audit a profiling tool which combines workforce data from
the Matrix & Primary Care with live and current workforce data
for Practices. In order to have an “audit in action”, NHS Digital
and Practice by Practice data was used in combination with the
Matrix training data to present the Practice with their own
numbers for reflection. This is a tool and method that can easily
be scaled to support and secure Training Hubs to PCNs.
Innovation 3: Roles Catalogue Update The catalogue was created to complement the above Workforce
Mapping Toolkit and has continued to be enhanced and shared
across the STP. There are many new roles and Apprentice
standards being developed for Primary Care. There is also the
impending Apprentice Levy which is proving challenging to
providers in terms of explaining and understanding practicalities
of the benefits. Primary Care staff continue to not have a single
or regional local means of accessing information on national
and regional workforce transformation in layman's terms i.e.
salary, standards, training providers and accessing
Programmes. Looking at the toolkit we created for Workforce
Planning, WF realized it also needed another tool that would
help Practices understand the new roles better but also see how
easily they could be implemented to compliment workforce
needs at Practice Level.
Integrated Learning Management System for North East London
Hubs currently have an awareness of the knowledge, skills and
attitudes needed to meet health needs (or support the health) of
the population within the network area. They are able to do data
collection about the number of primary and community
professional and “lay workers” within the network area and
collaborate to build up a view on future demand for these roles
from employers, to support both local and regional workforce
planning. They are able to analyze what the training needs of
these groups are in partnership with network providers so that
detailed training assessments can systematically address issues
with the workforce as they emerge and change over time.
WF Hub has tabled a paper to counterparts and regional leads to
consider at scale Digital Training Hub. This Hub represents a
grand opportunity to deliver a self-sustained system for the region
integrated with primary care and social care. The conversations
about this continues.
Using Data & Analysis to deliver OD Change
Since 2016 WF Hub has used investments to build up sustainable
workforce support tools for primary and social care partners. The
ongoing development of sustainable tools and their use has also
benefited various stakeholders within and outside the Network.
The tools and methods are user friendly, practical, systematic and
can be easily tailored to suit local or at scale needs.
If integration is going to be a success, WF Hub is determined to
use data analysis to better position its stakeholders in workforce
transformation as it begins to help soften and shift professional
boundaries. In January 2015, the CEPN was invited to work in
partnership with Skills for Health to develop an integrated working
plan in one themed service area; Long Term Conditions. WF GP &
Nurse Education Leads are using this data to improve education
sessions in real time and do deep dives on impact across
commissioning and patient services.
Since 2016 the CEPN has become increasingly relied upon within
the CCG to confirm data for Primary Care but also other teams
wanting to understand what training had taken place to influence
changes in services but also outreach to workforce professionals.
Enhanced data about the local General Practice workforce was
also recently used to shape Waltham Forest's CEPN & Primary
Care joint work in delivering a Workforce Planning Toolkit for
Primary Care. Data is transforming the way we are planning
workforce implementation with stakeholders and showing the
Hubs credibility. It recently delivered for Primary Care a coherent
response to workforce transformation across the system.
WF Hub is focused on identifying and filling “real” Workforce gaps
in Primary Care rather than using a scattergun approach and
continues to work with in house CCG’s in- house Research
8
Consultant to measure impacts training is having across
commissioned services and where these metrics could be better
identified for future commissioning programmes. The partnership
has recently seen the publication of a Patient Record sharing
Benefits Study. The training impact will be has been published
and is available.
Scalable, Sustainable Workforce: Joined up Working & Workforce Pipelines Strategy
The Transformation fund has being instrumental in supporting the
direction for all Providers to reflect on the impact of the
Apprenticeship Levy. The report into the primary care and
provider landscape has shown that scale can be achieved if the
right tools to support this and willingness is there. WF Hub has
partnered with Lifetime health Education Institutions to scale new
roles numbers in health and social care can happen if larger
providers take seriously the challenge to work with smaller
providers in educator transactions to create a real Apprenticeship
economy. If the private sector is using this to its advantage, health
and social care can also do the same. In the same way WF Hub
has been able to work at scale delivering 100 Nurse mini-rotations
in 2017-18 and is about to deliver experience weeks and more
Nurse Rotations into Primary Care. There are major hurdles i.e.
infrastructure/ systems for health and social care, however these
are not insurmountable done in stages.
The Hub and its neighboring Hubs are now also at the table
working with Barts, ELFT and NEFLT to champion rotations from
Acute into Primary Care which will begin to have an impact on the
direction of funding as well.
Future Investment into WF Hub
The CEPN continues to maintain high impact value to support to
continue its Network Impact. However current funding is not
sufficient to continue at pace investment of time.
Future Investment Outlook
1. Digital Transformation enhancement and scale where
match funding is available is key to the future
sustainability of the hub.
2. Local staff is needed to continue to coordinate the Hubs
activities. It often becomes difficult to scale when staff
come and go too frequently. This may mean that the
Hub changes it hosting model.
3. This Hub continues to invest in excellent, committed
Clinical Leads bring to the Network.
4. Professional peer forums is incredibly important to WF.
Multi-disciplinary working and learning especially in the
advent of PCNs and integrated care systems.
5. Social Care & Voluntary Sector as key workforce
transformation partners continue to need more
investigation and investment.
6. Mental Health is an area WF continues to want to
develop and support.
7. Volunteer sector support needs to continue and grow
with system based learning opportunities.
Future Direction
WF Training Hub has spent the last 12 months looking at its
hosting model and sustainability in light of systems changes.
Network development continues to strengthen with work now
taking place to engage with Social Care & Voluntary Sector as
key workforce transformation partners having been involved
with mini-rotations and work experience weeks. Part of WF Hub
strength is its growing credibility to develop lasting systems that
deliver change through enabler innovations it has created.
There are conversations as to what the collaboration scope
should be. A real teamwork culture across different
geographies is emerging with conversations that span beyond
the projects being jointly commissioned as Hubs build their
Alliance to look at work areas.
Hubs are a group of primary and community care organisations
that come together as a group of like-minded providers to collabo-
rate to bring about major workforce, education and training and
create an education shifts. As a precursor in the moving tide to-
wards Accountable Care Organisations & Systems, WF Hub
continues to demonstrate how this can be done through Network
Collaboration and the building up of common tools to establish
systems.
Waltham Forest Training Hub will continue to collaborate with
External & Internal Networks and Groups to meet local workforce
requirements (such as specific skills shortages), including the
9
development of new bespoke programmes to meet specific local
needs (this would include developing educational programmes
based around integrated care pathways and new roles reflecting
care pathways). Going forward, Primary Care Strategic
Commissioning, Digital, Integrated Care, STP Workforce, Barts &
NELFT partnership will be working with Waltham Forest Hub to
undertake local coordination of education and Workforce
programmes.
Hubs need to be positioned as the local
educational voice across PCNs and Intergraded
Care
Develop Education & Workforce against new
Models of Care.
Support the identification and delivery of local
workforce needs.
Through planning, educate workforce as to what
changes may be needed.
Collaborate with various stakeholders from sectors
related to Health & Social Care.
Look at approaches that will foster an environment of
life- long learning across the workforce.
Together, all groups will ensure improved economies of scale,
reduced administration costs, minimize duplication and deliver
trans- formation of front line staff behavioral change in both
primary care and acute services. WF Hub will also aim to ensure
the workforce is fit for purpose for tomorrow’s challenges by
working together to develop local people and their learning giving
them opportunities to live and work locally. We enter new models
of care implementation phases.
Waltham Forest Hub will use current window of opportunity to
embed the work and set options around scalability, sharing where
it can its successes locally at the CCG & wider STP level. On-
going investment in Waltham Forest Hub has led locally to the
emergence growing integrated alliances. The visibility of the WF
has really taken shape as a transformation enabler. This Hub is
advising commissioners on new models of care. Waltham Forest
Hub encourages new relationships between stakeholders
encouraging them to develop a burst of new ideas, methods and
tools to move forward best practice for integrated models.
Training Hubs/ CEPNs continue to emerge as central catalysts
in Workforce Education, Research, Training and Strategic
Development across local health and social care borough
areas. Hubs continue to have the the ability to cross
Organisational boundaries - health, social and voluntary care
leading to the possibility of at scale working and integration
with singular provider organisations.
Appendices
Please note some project delivery can be reviewed from last year’s Annual Report Here
Project Documents Availability
Care Academy: Care Academy Apprentices Pipeline Delivery Report & Presentation
Apprenticeships Report Skills for Health: CEPN & Provider Side 2 Reports – One for Primary Care One for Barts / Providers
Urgent Care : Enhanced Pediatric Skills 2 Interim Reports
Urgent Care : Ambassadors (Health Watch Partnership) 1st Report 2016
Optimum Birth Pilot: Home Birth Pilot Full Reports 2016-17
Sustainable Training Hubs Options Paper Updated Document – 2019
Associate Nurse Mini-Rotations – Health & Social Care Interim Report
Receptionist & Admin Report Full Report – being used by Primary Care (Impact)
Upskilling Domiciliary Care Staff using Significant Seven Programme Available in last year Annual Report
Mental Health First Aid Training Available in last year Annual Report
Better Care Together – Integrated Care Hybrid Roles Managed Network of Care Design
Multi-Disciplinary Training MDTs
Primary Care Leadership Development Programme / Quality Improvement
Pharmacy Training & Development
Workforce– Care Homes Strategy (Planning & Mapping)
Henry
Multi-disciplinary Training (Patient Centered)
Diabetes Care Investment
Physicians Associates Preceptorship
Managed Network of Care Workforce Transformation
Attached in this report – Delegate Analysis
Full Curriculum Plans 2018-2019 can be requested
Martials and report available
Report available
Henry Workforce Development Report
Let’s Learn together
Waltham Forest Nurses, Diabetes Care
Available ( will be shared on microsite in September)
Interim Report Available
Innovations
Digital Training Hub – Skills Matrix Model Go Live November 2019
Primary Care Networks Modelling – Workforce Planning Toolkit
Rotations Toolkit
Roles Catalogue
Availability:
www.ICSTrainingHub.com – access to site on request
Networks view available on request for Hub Managers
Available ( will be shared on microsite in September)
Available ( will be shared on microsite in September)
Projects Pending End FY Reports / Project Update
Social Prescribing Collaboration Pending
Positive Behavior Support (PBS) for people with learning disabilities Pending
Get Fit Stay Fit Pending
Keep In touch...
Waltham Forest Training Hub, Kirkdale
House, 7 Kirkdale Road
London
E11 1HP
0203 688 2624
www.WFTraninghub.com