“ Eastern Cheshire Integrated Workforce project” HENW Integrated Care Showcase, 03.11.15 1 1 1

Caring Together programme: context 2 2 2

Who we are In Eastern Cheshire we are working together to drive forward the development of integrated care across our health & social care system through our “Caring Together Transformation Programme”. Local partners include; Eastern Cheshire Clinical Commissioning Group, Cheshire East Council, Cheshire & Wirral Partnership NHS FT, East Cheshire NHS Trust, Vernova CIC (primary care), Healthwatch, our patients/service users & carers….. And lots of others. Since 2013, partner in the Cheshire Pioneer health & social care integration programme. In terms of community based co-ordinated care (care coordination) this means: -   support from the most appropriate care professional to work with each person to assess their needs, plan and oversee their care and assist in organising care when required e.g. planning appointments and follow ups, reviewing the care plan and assisting in management whilst in hospital and planning discharge home (care professionals have an increasingly important role in educating service user’s and carers) In terms of rapid assessment and short term plans this means:- providing an alternative to unnecessary admissions to hospital and care homes by responding to the persons need in situations of crises. (requiring speedy and appropriate access to specialist opinion and diagnostics). Establishing a single point of contact (including early assessment), that provides people with direct access to information, appropriate health or social care need, will require reorganising work flows, working methods, roles and responsibilities. Early assessment by a senior professional will be key to ensuring that people receive an appropriate response as soon as possible – determining the competencies and requirements of (and for) these new roles will therefore be a key element of the project This project will enable partners to explore potential workforce options and solutions, share innovative ideas for how roles can be re-designed to meet different service demands, and implement new roles to meet the changing care model. 3 3 3 3

Case for change summary 4 4

Our Vision For local people success will mean… I am supported to live well and stay well because I can access effective and helpful joined up care and support when I need it and can readily find accurate information in order to remain mentally and physically well and healthy. For care staff working within Eastern Cheshire success will mean…. Supporting people to live well. By providing adequate mental and physical wellness information and supporting people to access effective and helpful joined up care when it’s needed, we support them to stay well. 5 5 5

Transformation Programme Aims To transform the provision of care from a traditional episodic one that addresses people’s needs at times of crisis to a more coordinated, person centred care within an integrated system by 2019. Our Integrated Care System will support the whole population covered by the Eastern Cheshire Clinical Commissioning Group (204,000 people), with an early focus on the 20% (40,000) who are most at risk due to their complex needs and / or long term conditions. 6 6 6

Our New Integrated Care Model 7 7

Our New Integrated Care Model 8 8

Caring Together programme: Position at Autumn, 2014 9 9 9

Partners had ….: Been 'forming & norming' since 2012; Established joint workforce group since 2013 (incl staff side); Experienced some large scale change realities; Agreed workforce map was key priority (but…); Just captured engagement from primary care; 10 10 10

Achievements by late 2014: Extensive service user & carer engagement; Agreed quality standards; Agreed 5 years service integration strategy & associated costings; Agreed workforce cultural transformation strategy; 2 x partners shared wfp priorities; Primary care completing wf mapping; Agreed ‘making changes happen’ next steps; 11 11 11

Immediate next aim was to ….   Deliver proactive community based co-ordinated care , reactive or responsive short term assessment intervention, rehabilitation and recovery, enabled by having a single point of contact with health and social care that is easy and convenient and available to those who need it 24/7. 12 12 12

‘Changing workforce’ targets of … Launch large scale ‘integrating service’ workforce communications programme; Develop shared ‘new starter’ induction pack; Progress development of a footprint wide workforce plan (hence the bid!); Include ‘evidencing cultural transformation’ measures into 2015/16 provider contracts; 13 13 13

So, the Integrated Workforce Plan Project 14 14 14

Our Project Aim ‘Utilising the Workforce Repository and Planning Tool (WRaPT), to deliver a 5 years integrated workforce strategy and system wide integrated workforce plan with agreed priorities and work programme’ (‘demonstrator’ bid submission) 15 15 15

Key Planned Project Priorties (a) Increase the level of understanding and awareness of the integrated workforce challenge among partners; Engage partners in developing an integrated system workforce strategy Secure utilization of the WRaPT by all main partner organisations & create ‘starting point’ workforce map; Start to align workforce data to service activity/plans and volumes, enabling us to model workforce requirements against different integrated care scenarios; And …. 16 16 16

Key Planned Project Priorties (b) 5. Develop at least a draft work programme; 6. Recruit WFP resource to lead the work; 7. Secure support from external expert ‘mentor’; 8. Fulfill the funding reporting requirements, including Nov, 2015 workshop presentation. 17 17 17

Our Next Steps? 19 19 19 19

Actions underway Complete the roll out of WRaPT; Understand the shared ‘key challenges’ emerging from completed workforce plans; Incorporate learning from initial integrated community based care teams / STAIRRS (including ‘culture tracker’ results); Develop / keep under review action plans; There is a shared understanding of the workforce challenge and a commitment to work together to deliver solutions 20 20 20 20

Lessons & Learning 21 21 21 21

Increase the level of understanding and awareness of the integrated workforce challenge among partners and key stakeholders …“One boat” 22 22 22

Our Learning Summarised (a) We thought the “product” from our project would be an integrated workforce plan – we have learned it’s much bigger than a plan! Not to underestimate the time and effort required to get the right people in the room (and keep them engaged) in making system wide working a reality; The importance of being clear about the nature of the challenge – complicated vs complex; Accepting “good enough” forecasting and planning in the interests of making a start; And ... Approach to workforce planning at very different stages of maturity Necessary to re-visit assumptions about the size, scale and complexity of the project and change our plan accordingly Importance of language 23 23 23 23

Our Learning Summarised (b) 5. Workforce Planning in a complex adaptive system isn’t an exact science and requires checking and rechecking of workforce assumptions; 6. Collective leadership and leadership “buy-in” is key to successful collaboration: but not sufficient on its own; 7. When you are trying to deliver ambitious system wide solutions - things don’t happen at pace unless available resources match the ambition. Approach to workforce planning at very different stages of maturity Necessary to re-visit assumptions about the size, scale and complexity of the project and change our plan accordingly Importance of language 24 24 24 24

Discussion Session 25 25 25

Next steps for developing an Integrated Care Workforce Toolkit How does cultural change need to be managed to support the successful implementation of such an initiative? 26 26 26

Discussion Question 1 What are the cultural characteristics of a successful Integrated Care System? 27 27 27

What behaviors do staff exhibit in a successful Integrated Workforce? Discussion Question 2 What behaviors do staff exhibit in a successful Integrated Workforce? 28 28 28

Why does workforce planning still feel like an extreme sport? Discussion Question 3 Why does workforce planning still feel like an extreme sport? 29 29 29

Any Questions? 30 30 30

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