London Workforce Strategic Framework

01 Transforming London’s health and care together About the programme 2

Healthy London Partnership Workforce Programme “Everything comes down to the people, both right now and in the future: so we must pay attention now if we are to expect results in 10, 15, 20 years. People are long term.” Source: Better leadership for tomorrow: NHS leadership review (Lord Rose) (2015) 3 To enable the delivery of this modern NHS workforce in London for Londoners, a collaborative workforce transformation programme has been established on behalf of London’s clinical commissioning groups (CCGs) and NHS England (London) (Healthy London Partnership) together with Health Education England (HEE). Our vision is to “To support the development a modern health and care workforce in London that is trained, focused and supported to deliver the best care for patients now, and in the future.” Workforce Programme vision statement – HLP Programme Prospectus To deliver this vision we have taken a collaborative approach establishing a coherent voice around the most pressing existing and future workforce challenges. This is especially important at a time of significant transformation of the health service across London. The primary objective for the Workforce Programme this financial year is to deliver an agreed pan- London Workforce Strategic Framework. By gaining consensus with stakeholders across London on the key workforce priorities for London, clarity will be achieved on what actions need to be taken in the short-term (1 – 2 years) and beyond (3 – 5+ years).

Different perspectives on workforce priorities 4 The programme has considered a number of different perspectives in developing the Framework. Workforce Priorities Local Health Economy Transformation Programmes Strategic Drivers, Barriers & Enablers FYFV – New London Models of Care International Models (e.g. ChenMed) Current vs Future Modelling National & London Priorities ( e.g. the Lord Carter Review) Embedding Consistent Delivery Workforce Perspectives A B C H E D G F DRAFT FOR DISCUSSION

The following model has been used to provide a framework to determine the workforce implications of future models of care, and identify where actions to support implementation can be most effectively taken This has been used to identify and prioritise groupings of workforce activities across the programmes to inform the strategic framework, on a 1 to 2 year timeframe and on a 3 to 5+ year timeframe Governance New ways of working Education and training Workforce numbers Developing skills and roles Enablers Workforce segments Spheres of influence The assessment wheel has six segments to structure and group the workforce implications of a new model of care, for example, governance includes contract management and recruitment. There are four spheres across which the components are assessed, from national commissioning groups, for example, regulators and HEE, to regional and local groups, and finally employers. Workforce spheres of influence structure 5 National Regional Local Employers A shared language across London DRAFT FOR DISCUSSION

02 Transforming London’s health and care together Workforce Strategic Framework 6

7 Workforce Strategic Framework outline By gaining consensus with stakeholders across London on the key workforce priorities for the capital, clarity will be achieved on what actions need to be taken in the short-term (1 – 2 years) and beyond (3 – 5+ years). The London Workforce Strategic Framework establishes a coherent voice around the most pressing workforce priorities in London. It is made up of six chapters and outlines eight workforce findings.. Chapter 1: London’s workforce landscape Chapter 2: The national workforce agenda and priorities Chapter 3: London’s workforce agenda and priorities Chapter 4: Local workforce agenda and priorities Chapter 5: Key workforce findings Chapter 6: A framework for action

Engaged stakeholder groups to date 8 To raise awareness of the London Workforce Strategic Framework, and gather feedback on the eight key workforce findings, a series of key system influencers have been engaged within this pre-engagement & co-development phase. Commissioners (CCGs) & NHS England Health Education Institutes (HEIs) Health Education England & LETBs Local Government & Social Care London AHSNs London Providers Regulatory & National Bodies HLP Programme Governance Groups Strategic Clinical Networks Unions & PPI Royal Colleges & professional associations Strategic Planning Groups (SPGs) In this phase of work, we have: Engaged over 1,000 senior NHS stakeholders across a range of system stakeholder groups Presented the London Workforce Strategic Framework at key system governance forums and events (e.g. The London Clinical Senate) Confirmed the eight key workforce findings, and captured recommended actions against each.

Ensuring that there are sufficient high quality staff to deliver health and social care services is particularly challenging, given London’s professionally and personally demanding environment. This affects all professions, but particularly lower paid staff. Retaining and recruiting the best staff The increasingly complex needs of the population mean that staff must be supported to work across organisational and professional boundaries to develop and deliver integrate services around the patient. From the ability to put aside organisational loyalties to collaborate in networks, to increasingly developing collaborative working arrangements across different organisational structures, this need exists across the health and social care economy. Supporting staff to collaborate across organisational and professional boundaries There is a need to meet the increasingly complex care needs of patients through encouraging a much greater versatility in the workforce. The ability for individuals and multi-disciplinary teams to adapt to provide care in different settings, at different times and in different organisational and team structures is becoming even more essential. To achieve this there will need to be an improved balance of generalist and specialist skills across the current health and social care workforce. Supporting workforce versatility to adapt to the multiple needs of patients To manage the increased scale and pace of change in such a complex and interdependent operational environment, there is a need to further identify, encourage and develop clinical and non-clinical leaders and managers. This will ensure the scale of transformation is achieved and delivered efficiently and effectively. Developing leaders and managers at all levels Workforce findings (1/2) These eight key findings provide a guide to those areas of focus where action is required to ensure the NHS develops and delivers the health and social care workforce to meet the needs of patients now, and in the future.

A constant in the NHS is that it is always undergoing significant change. There is no reason why this will not continue into the future. There will be a need for greater agility in the current and future workforce to respond and manage repeated change. Creating a workforce which can adapt to change quickly will be crucial. Supporting workforce agility to respond to change Service commissioners and providers are needing to work together more to deliver further integrated approaches of care delivery for their local populations. To balance national and local priorities, alongside new models of care, there is a need to build the capability and capacity within our providers and commissioners to lead transformational change in a complex environment with changing boundaries. Strengthening health systems – providers & commissioners The combined impact of existing local, regional and national transformation programmes on primary health care delivery is profound. Many of the proposed transformation activities across London require primary health care services to operate in a different way to ensure that patients are at the centre of health care. Without fundamental changes to primary health care, with appropriate development and support of the workforce, the planned benefits of shifting care away from secondary care into the community will not be realised. Therefore, a particular focus on the primary health care services workforce is required. All roads lead to greater patient interventions in primary health care & community services The NHS in London is facing a £4.76 billion affordability gap by 2020/21. Delivering the right care in the right setting, improved productivity within existing services, and establishing new ways of delivering care are all recognised as areas of opportunity for the workforce to deliver improvement value for patients. Delivering improved value, quality and productivity through the workforce Workforce findings (2/2)

03 Transforming London’s health and care together What now? 11

Next Steps 12 Pre-Engagement PhaseEngagement Phase Today March Launch Event 23 2 Further development of the London Workforce Strategic Framework includes: Continuing to engage across the system to determine where solutions to identified workforce challenges are best solved once for London Evolving the design of current London Workforce Strategic Framework to make the document shorter and the key findings more accessible. Provide further clarity around the roles of different organisations in the system in the delivery of actions against the framework key findings. Raised awareness Confirmed key workforce findings Captured feedback on actions Our aim is to discuss with stakeholders across the system how these key findings can be used to develop coordinated action to identified workforce challenges. In addition, it will be important to reflect on where solutions to identified workforce challenges can be best solved once for London.

Framework launch Please join us to Celebrate and learn from teams across London who are addressing local workforce challenges Hear from key influencers on the issues affecting London’s workforce, and learn about the actions being taken to support change Find out how the London Workforce Programme can support your priorities Influence how London’s health and education system can best work together to deliver the ambitions of the London Workforce Strategic Framework 23 March 2016 Kia Oval, Kennington 9:30am - 4:30pm

Get in touch Share your feedback on actions to deliver the eight workforce findings Spread the word Identifying and sharing solutions to existing workforce challenges Highlight your achievements Get Involved Support us to deliver Value to you