All Wales HR Directors Meeting Cardiff 19 th September 2007 Workforce Modernisation in Mental Health Services Barry Foley & Marjorie Kingston “Assisting and supporting you on the road to service improvement and delivery”

What needs to happen in Wales to support you and your staff? NLIAH has commissioned Damascus Services Ltd to support you –with Workforce MH Act (Wales) issues –with wider MH workforce modernisation seeking to build on the real progress being made with New Ways of Working There is a need to share, support and develop further current service modernisation work Also to understand and improve MH Workforce Planning across all Mental Health organisations

New Ways of Working - The Context Wales has had a full role in developing MH NWW with professions and TUs involved At a recent meeting CEs in Wales were keen to see the benefits of NWW not just in MH but for all Care Groups Today we will: Update on New Ways of Working in MH in England Outline progress with MH early implementer sites PRINCIPLES CAN BE APPLIED MORE WIDELY

House of Commons Select Committee on Workforce Planning Key messages from April 2007 Report ‘In sum, there has been a disastrous failure in workforce planning’ ‘Given the pace of change, including technological developments.., we cannot know precisely what future workforce will be needed. This means we will need a more flexible workforce’ ‘DH, SHAs, acute trusts and PCTs have not made workforce planning a priority with the consequences we can now see’ BUT WHAT ABOUT US IN MENTAL HEALTH?

Breaking Down Barriers May 2007 “Breaking down barriers in the way services are delivered: at the heart of these changes will be workforce reform, with the skills of staff more closely aligned to the needs of patients” Professor Louis Appleby

What is NWW? Changing practice of existing staff to make the best use of their expertise and experience, particularly those at senior/consultant level Extending the roles of existing professional staff beyond their original scope of practice Bringing new people to the workforce into new roles at assistant and practitioner roles To deliver services that are person centred, achievable and cost effective IN ESSENCE IT IS WORKFORCE REFORM FOR ALL

“NWW for Psychiatrists” Final Report - but not the end of the story… Work streams for all professional groups Survey of how NWW for Psychiatrists is being implemented Workshops, conferences, communication with people working in the field and with people using services and their carers Field testing of Creating Capable Teams Approach Running 10 pilot sites in CAMHS services CSIP NWW Positive Practice Award Joining up thinking about how NWW is fundamental to service and workforce reform Highlighting how far forward mental health is in comparison with the acute sector to get resources

NWW for everyone - Who is “Everyone”? Applied Psychologists Allied Health Professions, including OT’s Nurses Non professionally affiliated staff Pharmacy clinical and support staff Primary Care Psychiatrists Social Work Service Users and Carers

What was the approach? Project groups, usually with individual work streams Co-chaired by profession involved and NIMHE NWW Team With representation from other professions With service user and carer input With remit across the age groups With requirement for products to be produced on what NWW means for each group

NWW has been discussed with 63% of trust boards; 55% endorsed policy; 60% had current NWW projects; 51% had done analysis of OP clinics; 34% action plan for NWW for everyone There is much innovative practice in different parts of the country, with no single solution and no comprehensive implementation Coroners have been difficult to engage nationally, but draft guidance has been developed for local use Training curriculum does not currently include issues of leadership, multi-disciplinary working and mental health policy Trainees are actively engaging with NWW and its implications for their training Psychiatrists - what’s the latest?

What are the cross cutting themes? Improving workforce planning Developing leadership at all levels How to make the best use of all, based on competences and a career framework, with flexible education and training Using evidence base and developing evidence from practice based work Being clear about complexity

Introducing the Creating Capable Teams Approach (CCTA) Although developed for Mental Health - this is for all professionals and practitioners –Who work in a multi disciplinary team –To meet service user and carer defined need and outcomes –With the relevant values, skills and knowledge [capabilities & competences] –With a flexible and affordable mix of staff –Which they have influenced and can champion

What are the aims of CCTA? –To support the integration of NWW and New Roles, within existing resources –To support teams to review their services based on service user and carer needs –To allow teams the opportunity to be pro-active and directly involved in reviewing their workforce and planning more creatively for the future –To produce a team profile and workforce plan which will feed into the organisations workforce planning process

What are the 5 Steps of the CCTA? POST WORKSHOP S STEP 1 – PREPARATION & OWNERSHIP STEP 2 - TEAM FUNCTION STEP 3 – SERVICE USER & CARER NEEDS STEP 4 – CREATING A NEEDS LED WORKFORCE STEP 5 – IMPLEMENTATION & REVIEW WORKSHOPS PRE WORKSHOPS (3 DAYS)

What are the challenges? NWW, is a rational approach to service and workforce reform BUT It challenges custom and practice, power, competence and professional identity and there is a real fear of the ‘generic worker’ In a context of service reconfiguration, financial challenges and IT failures, e.g. Modernising Medical Careers, it can widen the divide between clinicians and management SO It has to involve those who are affected directly, because they will come up with better solutions if they are on board; they might sabotage it if they are not engaged AND It includes service users and carers, who may have got used to services as they are. It’s all about hearts and minds

Where next for NWW? - 07/08 is the year of implementation Mainstream NWW, with an early priority on mental health trusts and commissioners Support local leaders and change agents, through regional learning sets and CCTA facilitator workshops Collect and share more evidence across our new website:

CCTA and NWW in Wales Following meetings with MH Managers and NHS Trust CEs there are expressions of interest to become early implementer sites –NE Wales –Conway & Denbighshire –Bro Morgannwg 7 Staff have attended CCTA facilitator training Two Trusts have already identified teams

With acknowledgement and thanks to Roslyn Hope Director NIMHE National Workforce Programme PA: National Workforce Programme

“Assisting and supporting you on the road to service improvement and delivery”