WELCOME The ‘Once for Scotland’ Approach – Improving Employment Experiences Shirley Rogers, Director of Health Workforce and Strategic Change, Scottish Government

Purpose of Session To raise awareness of how the Once for Scotland approach can help to transform services. To show the approach in action through two case studies: How the Turas digital platform can be used in a Once for Scotland context for learning, training and professional development How the Once for Scotland approach will enhance the employment experiences of junior doctors. To give you a chance to discuss how the Once for Scotland approach can benefit your work. Theme of the 2017 Event is “Working Differently Across Boundaries: Transforming Health and Social Care.” The Once for Scotland approach will help us to do exactly that. This slide outlines the purpose of the session. I’m keen that this session achieves a good balance between presentation and discussion. Delighted to welcome David McColl from NHS Education for Scotland, Kenny Small, Chair of the HR Directors Group and Linda Donaldson, Associate Director of HR in NHS Forth Valley who will be providing some case studies relating to Once for Scotland. Pleased to welcome you to this session. It’s important for us to hear your views of Once for Scotland and how it can benefit your work.

Making Change Happen Vision without action is merely a dream. Action without Vision is merely passing time. Vision with Action can change the world.   Nelson Mandela This quote from Nelson Mandela is a helpful reminder of how Once for Scotland – or any transformative change - needs to be taken forward.

Why are we taking this approach? Better outcomes for patients. Improved services and working environment for staff. Better value for all. Here is our vision of Once for Scotland.

How will this be done ? Health and Social Care Delivery Plan has the following actions: Undertake a review in 2017. Put new arrangements in place in 2019. And this is the action that we will be taking. The definition of Once for Scotland that we are adopting for the review is: Those services that can best be provided through a single function delivered on a national basis – for example, some of the HR processes for junior doctors.) Those services that can best be provided by adopting a more consistent approach across Scotland – for example, work taking place through the Scottish Patient Safety Programme. Examples of other services which could benefit from a Once for Scotland approach would be procurement and transport. I’m keen to hear your views and there will be an opportunity to do this later in the session. To help the discussion, here’s a short film providing some views from colleagues on Once for Scotland As mentioned earlier, we will be presenting a couple of case studies during the session. I would like to introduce David McColl from NHS Education for Scotland to provide the first of these – how the Turas digital platform can be used in a Once for Scotland context for the professional development of staff .

Turas Presentation Turas presentation available separately.

The ‘Once for Scotland’ Approach – Improving Employment Experiences for Junior Doctors and Dentists in Scotland Kenny Small, Chair of the NHS Scotland Directors Group Linda Donaldson, Associate Director of HR Forth Valley

Why a Once for Scotland approach is needed Case for Change Additional cost and time inefficiencies within NHS Scotland due to duplication in processes (personal background checks, Occupational Health checks, repeated induction, duplication on contracts, payroll processes, duplication of on-boarding & off-boarding) Poor experience for trainees due to duplication in processes arising from having no single employer Doctors in Difficulty, performance management and conduct issues not monitored effectively due to lack of continuity of support and consistency across the multiple employers (remain undetected for longer) Variation and inconsistent application of policies across NHSScotland No end-to-end staff record for trainees

Workstream Objectives Provide DDiT with optimum continuity of employment and positive employment experience across NHSS. Ensure consistent application of employment policies for DiT across NHSS. Minimise duplication or unnecessary processes in “onboarding” throughout rotations for clinical placements. Promote continuity and consistency in Payroll arrangements. Ensure access to appropriate and high quality training experiences. Effective information sharing and engagement between NHS Boards and NES in the management of performance and training of DDiT.

Employment Model

Delivering the Model - Governance

Benefits and how we’ll measure them Evidence financial efficiency savings (reduced PVG costs, OH, administration) Evidence improved consistency and information sharing via metrics and employee relations reporting through system. Once for Scotland On Boarding Monitor maternity and sickness absence for reduced complexity and therefore less administration time. Improved monitoring of employee relations issues demonstrated through tracking on system (TURAS). Reduction in tax code issues - monitor feedback from trainees. Sharing Information (maternity, absence, performance, payroll) Monitor recruitment and retention data. Attraction Monitor feedback through existing questionnaires (trainee surveys, exit questionnaires, iMatter). Improved trainee employment experience

Enabling Workstreams PVG & Disclosure Single PVG check and agreed sharing of information between Boards and DDiT. NES now obtaining all PVG checks for Doctors in Training Protection & Contracts Working with support of the SJDC to revise T&Cs to remove protection of pay for banding & develop single contract letter to support new model Immigration (Tier 2) NES as single sponsor of Tier 2 visas for all Doctors in Training Occupational Health Passport Agree a single dataset and process, and share information between Boards and DDiT Single Payroll Number One employer means one payroll number throughout training programme Policies & Procedures Single processes and terminology, single policies and equity of access/treatment IT Solutions Underpinning data sharing to enable new model working with eESS team National Medical Job Application Form Single form for application to any Board allowing online applications

Delivering the Model Once for Scotland Regional Model: THE ‘HOW’ and ‘WHERE NHS Scotland Doctors and Dentists in Training will be employed within 3 Regions and by NES. Major specialties will be managed within each Region. NES will be lead employer and manage all GP’s Decisions will be made regarding the management of the smaller specialties on a Scotland wide basis ......... Work ongoing within all Regional Medical Workforce Groups to determine options for Employment Board(s)

Delivering the Model: Workstreams Contracts & Terms & Conditions Manage relationships with BMAScotland and Scottish Government on agreeing terms and conditions, including clarity on data sharing and safeguards Policies & Procedures Develop and refine single templates, glossaries, processes and policies Digital Solutions Plan, design and deliver required digital solutions to underpin and support the new model, and increase ease of use for all users including DDiTs. Communications Develop understanding of stakeholders and develop communications strategy including communications of progress to Steering Group and to wider stakeholders Risks Identify and manage project risks, report on risk reduction and review risk register Benefits Realisation / Project Delivery Define and set milestone and indicators to show delivery of benefits, ensure impacts are measured and controlled including EIAs of required processes Early Adopter Project review of progress of early adopter project and recommendations for amendment to policies, agreements and key learning points

Employer Board DDiTs employed by programme not location Single employer for duration of programme Regions will agree employer model for regional programmes and host a share of national programmes All Boards are placement Boards NES oversees training and placements - as now Single contracts, policies and processes Agreed information sharing NES Scotland Deanery Employer Board Placement Board

Conclusion: Benefits of the Once for Scotland Approach Simplified, standardised and shared medical staffing recruitment/ employment service/ employee relations practice improving the quality and efficiency of services to managers and other “customers” of Human Resources Enhances the employment experience of trainees during their employment Improves governance of medical staffing related services and activities Enhances local efficiencies and levels of productivity and efficiency Maximises opportunities which are available through other systems Improves resilience and sustainability of medical staffing services Delivers consistency of Policy application with a Once for Scotland focus focus