CfWI produces quality intelligence to inform better workforce planning, that improves people’s lives QIPP, the quality and productivity challenge: Workforce, the key component Jim Easton National Director for Improvement and Efficiency

CfWI produces quality intelligence to inform better workforce planning, that improves people’s lives QIPP, the quality and productivity challenge: Workforce, the key component Dr Kathy McLean Medical Director, SRO for QIPP, NHS East Midlands

The NHS in the East Midlands The East Midlands has: A population of 4.3 million 23 NHS organisations, including: 8 acute trusts (inc. 4 FTs) 5 mental health trusts (2 FTs) 1 ambulance trust 9 PCTs An NHS budget of over £7 bn NHS Lincolnshire NHS Bassetlaw NHS Nottinghamshire County NHS Nottingham City NHS Northamptonshire NHS Leicester City NHS Leicestershire County and Rutland NHS Derby City NHS Derbyshire County

Growth and expansion The NHS has enjoyed a decade of growth and expansion We have seen real improvements: Many more doctors, nurses and other staff More new hospitals and modern facilities More patients treated than ever before Reduced waiting times Better outcomes for cancer and heart patients, and others

Trend in NHS Funding

The East Midlands workforce The East Midlands has around 80,500 WTE directly employed NHS staff Almost 70% of funding is spent on staff The workforce has grown by 21% since 2001 The big increases have been: Medical and Dental +1,860 (42%) Nursing + 3,500 (18%)

We face increasing pressures Quarter more over 85s by 2015 Diseases of modern lifestyles Rising consumer expectations The cost of new drugs is increasing

The Financial Challenge From April 2011 we expect that funding increases will be negligible. At the same time: Prices will increase by 2.9% per year Demand for activity will increase by 3.1% per year By 2014 the NHS will face a funding gap of around £20 billion (£1.3 bn in the East Midlands) The NHS must respond by becoming much more efficient. We will need to do things differently to get more value from the resources we have

How we are responding Cost reduction measures will not be enough There is much evidence that we can reduce costs by focusing on improving quality: Eliminating waste Avoiding duplication Performing at the levels of the best QIPP is the NHS response to this challenge

National Regional County health system PCT / Provider Organisation Team / Individual Work is progressing at all levels The red thread

33 work streams aiming to: Make urgent care systems work effectively Support people with long term conditions Prevent ill-health (large scale) Improve primary care Deliver high quality planned care Make services safer Streamline non-clinical and cross-cutting services Improve mental health and well-being Our priorities for transformation

We have an East Midlands Delivery Plan: Driven by lead clinicians Sponsored by chief executives leading individual work streams Underpinned by metrics for quality improvement, financial savings and workforce productivity

Workforce Change We now have to focus on using staff as effectively as possible We have workforce planning teams in each of our 5 counties Workforce leads and HR directors are part of our regional workstream leadership teams

Workforce Productivity Programme There are four strands to our programme Service and workforce transformation Pay and benefits – a new deal for staff Workforce utilisation Workforce potential

Modelling Workforce Transformation Over the last two years we have developed a rigorous approach to modelling the workforce implications of service reconfiguration and change. This has already been applied to: Stroke and heart services Long term neurological conditions Maternity services Major Trauma

Pay and Benefits National work on redesigning pay and benefits A common East Midlands HR framework to manage the impact of change Maximising the benefits from contractual levers (inc, AfC, KSF, Consultant job planning)

Workforce Transformation Reshaping the workforce, to meet future needs, with new roles and skill mix will realise savings of £304 million Particular focus on the future medical workforce and developing first level support for healthcare professionals Initial plans for workforce reduction over the next two years amount to 5.1% (3,670 WTE) The estimated total reduction over the next four years is 12.4% (8,900 WTE)

Workforce Utilisation Systematic roll-out of the ‘Productive Care’ series Reducing sickness absence and agency staff use Reducing management costs Supporting other improvements in productivity

Workforce Potential Improving staff health and well-being, Maximising the benefit of training investment Working with staff to improve engagement.

Summary The significant increases we have seen in staff numbers are over Our challenge now is to use staff as effectively as possible Our QIPP workforce programme will support service transformation and improve workforce productivity.

Divider Slide

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?

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

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?