CfWI produces quality intelligence to inform better workforce planning, that improves people’s lives QIPP, The quality and productivity challenge: workforce the key component 21 October 2010

Content of the session Context – White Paper, Finances, and TCS Where QIPP sits and latest developments – the workforce stream Wins and Challenges Local variation Link to discussion topics

Context and QIPP Public Spending White Paper consultation TCS QIPP and workforce

Discussion topic A A Policy drivers. What are the main factors that will affect workforce in the next 5 years. To what extent have the implications of the Liberating the NHS White Paper and TCS understood and being acted on? What questions arise from these policies?

Wins Workforce working together effectively Linking in to wider QIPP agenda Financially coherent

Challenges Activity information Structural Change Integration Supporting Data Assurance

Discussion topic B B Activity and Workforce Do you have quantified activity measures for your work area? How comprehensive and robust are they? If so, how comprehensive and robust are they? What Demand Management options could be considered How explicit is the relationship between activity and workforce? What factors will affect this relationship in the future

Local Variations QIPP Streams Integration Starting points Structural intentions Approach

Discussion topic C C Changing Workforce. What changes do you expect in workforce in your work area (numbers, changed shape, productivity potential, skill mix change...)? What transfers of activity and funding are planned or likely between Acute and Community and between NHS and independent sector?

The quality & productivity challenge for workforce a regional perspective Rachael Charlton, Associate Director, NHS North West 21 st October 2010

Overview Context and current position QIPP assumptions – NW summit Plans Risks

NHS NW Workforce 216,448 staff (incl. GP/Practice staff) 64 NHS organisations 12 universities Circa 21,000 students or trainees including doctors in training MPET Budget in excess of £680m 50% bigger than Scotland

Workforce growth (FTE, North West) Data source: Information Centre Annual Census (September). Includes NHS medical and non-medical staff. Excludes GPs & their practice staff and bank staff.

Non-medical staff growth (FTE, North West) Data source: Information Centre Annual Census (September). Includes NHS non-medical staff. Excludes medical staff, GPs & their practice staff and bank staff.

Medical staff growth (HC, North West) Data source: Information Centre Annual Census (September). NHS medical staff only. * Excludes non- medical staff, GPs & their practice staff and bank staff.

North West QIPP summit - HR/workforce assumptions and ‘must do’s’ A workforce that is affordable, flexible and fit for purpose : –Plan the size, shape and education of the current & future workforce (manage the downsizing) –Design and implement a deal for staff to ensure pay, pensions and terms and conditions are fit for purpose and affordable, and promote the flexibility and mobility of staff to support service change (national input) –Drive improvements in labour productivity including delivery of planned agency savings, productive care and benchmarking –Improve Health and Well-being of NHS Staff to support delivery of savings from reducing sickness absence and increasing participation levels (Boorman)

MPET cost reductions Reduction by 15% from a £640m baseline Supporting back office rationalisation WTE reductions as result of Payroll, HR, finance & clerical rationalisation Co-ordinating the wf impact of clinical support rationalisation WTE reductions as result of, for example: path lab centralisation Co-ordinating the wf impact of activity changes WTE reductions as a result of TCS changes & a removal of excess capacity in service provision/estates Co-ordinating the workforce impact of PCT management cost reductions Enablers Supporting local employment policy changes Includes pay, pay protection, out of hours Skill mix Identify & accelerate spread of ‘top 12’ workforce productivity skill mix improvements Productivity improvements; time releasing Clinical productivity The wf impact of changes to treatment - best practice medicine in a standardised, reliable & integrated manner NW Workforce & Leadership QIPP Programme Cash Releasing Projects Managerial productivity The wf impact of full deployment of the productive time series of improvement tools and lean methodologies Communications & partnership working Developing a shared vision - staff, TUs, public & patients, politicians & media Leadership Developing Leaders & GP Consortia Leads Leadership Academy HR infrastructure & support Consolidating funding to support, for eg: clearing houses, flexible contracts & outplacement services Projects Workstreams 6 5 Chief Executive Raj Jain Medical Director Chris Mimnagh NHS NW sponsor: Dean Royles AD lead: Rachael Charlton Innovation & Improvement Deployment of tools & benchmarking AQUA, eWIN & Health and Well Being Alliance Health & wellbeing Improving engagement & reducing costs associated with staff sickness absence (productivity & cash releasing) 7

QIPP - cash releasing activities Paybill reductions through: Back office process improvements Rationalisation of clinical support functions* Changes in activity* PCT management cost reductions* Bank & agency costs reductions associated with sickness absence (implementation of Boorman) Ensuring local employment policies are conducive to early achievement of cash revenue realisation MPET reductions * Coordinating the workforce impact; other QIPP work streams leading QIPP work streams leading

QIPP – productivity improvements Releasing staff time by: Deployment of productive time series improvement tools Reducing staff sickness absence and improving staff engagement and well being Skill mix and competency based projects

QIPP – enablers Innovation and Improvement through AQUA, eWIN (benchmarking and regional dashboards) and Health and Well Being Alliance Communications – maximising engagement (staff and public) Leadership – capability and capacity building through the NW Leadership Academy Partnership – staff consultation and ‘rules of engagement’ to maximise cooperation Infrastructure – clearing houses, flexible contracts etc.

eWIN Portal

Regional QIPP Dashboards

Detailed Page: Sickness Absence

Risks Pace & scale of change required underestimated Potential opportunities seen as too expensive short term. For example: use of web 2.0, portable devices skill mix Staff engagement and partnership working diminishes Data integrity (its getting better but….) Seen as a HR/workforce problem only Alignment with activity Interdependencies & un-intended consequences not recognised or ignored (see next slide … )

Any questions?

Discussion options A Policy Drivers B Activity and Workforce C Changing Workforce

CONTACTS John Deagle, Rachael Charlton ,