The Benson Model: School Nursing A new methodology for caseload and workforce assessment Q1 2014

This presentation Introduction / about the service planners Who is using the Benson Model Examine the methodologies Case study: Liverpool Community Health Planning, implementation and support Discussion

The Benson Models: Children’s Health Clients have own folder and secure access Tools are updated quarterly with new features Health Visiting Service Planner School Nursing Service Planner

About the service planners Owned locally with ongoing remote support Objective Transparent Live - reflecting and developing strategy Benchmarking and discussion groups

Current providers Bedfordshire Hertfordshire Ealing North Somerset Cumbria Bury Liverpool & Sefton Salford Stockport Bridgewater Derbyshire Derby City Leic & Rutland Coventry Birmingham Bedfordshire BSBC x 5 Hertfordshire Ealing North Somerset Cornwall & IoS

School Nursing Database System architecture Settings Local intelligence Benchmarking and external validation Live folder School Nursing Database Local strategies Benson Model National policy Service and workforce level data from providers Download/upload and use offline

Model overview Profiling local complexity Schools HCP 0 - 5

Model overview Developing local Developing service profiles local GPs Developing local service profiles

SNSP DATABASE – IDEAS FROM OTHER AREAS Model overview Developing local service profiles GPs Aligning service profiles with policy, best practice and drivers of improvement BEST PRACTICE LOCAL POLICY NATIONAL POLICY NEW TECH SNSP DATABASE – IDEAS FROM OTHER AREAS

Model overview Workforce structure HCP 5-19

Model overview Workforce profiling and capacity HCP 5-19

SNSP DATABASE – IDEAS FROM OTHER AREAS Model overview Aligning our workforce profiles with policy, best practice and drivers of improvement HCP 5-19 LOCAL POLICY NEW TECH SNSP DATABASE – IDEAS FROM OTHER AREAS

Identifying workforce potential Model overview GPs Identifying workforce potential

Example: the SNSP indicates we have a workforce shortfall in Area 1 Model overview GPs SHORTFALL Example: the SNSP indicates we have a workforce shortfall in Area 1

Can we address this by increasing our workforce? Model overview GPs SHORTFALL CHANGE? Can we address this by increasing our workforce?

Model overview GPs SHORTFALL CHANGE? Or revising our workforce assumptions around role profiles to allow more delivery time?

Model overview Or by revising the service programme? GPs SHORTFALL CHANGE? Or by revising the service programme? - but this will apply to all areas

Model overview GPs SHORTFALL CHANGE? Or do we need to rebalance the caseload? Can we rezone some of the school’s into Area 2?

Targeting services by complexity By Deprivation Deprivation is captured by locality and used as a basis to profile services that are targeted at or sensitive to deprivation Child deprivation data is captured and profiled by locality using deprivation quartiles By Special population Alternatively, groups who receive targeted or more intensive support may be defined and populated by locality These provide an alternative to profiling service delivery by deprivation e.g.: Safeguarding (CP, CIN, LAC) Additional health needs Special needs Ethnic groups / English as a 2nd language

Case study : Liverpool Community Health School Nursing Project began in late 2012 Reconfiguration of 3 services into one North Liverpool South Liverpool Sefton Each service had its own service programme workforce roles beliefs on how the service should look

Outcomes - Liverpool Service programme Workforce allocation Policy Risk, opportunity and improvement This is what our clients are using the tools for

LCH outcomes: Workforce allocation 1 2 3 4 Assessed the effectiveness of the existing workforce to deliver the future programme and identified skill shortages Revised caseloads to reflect complexity of needs across each locality Provided an objective basis for new team structure and deploying new practitioners Review the balance and contribution of skill mix

LCH outcomes: Service programme 1 2 3 4 Developed a clear, transparent, local and harmonised service programme Identified Additional Needs Groups who we target services to Explore future delivery strategies, workforce roles and opportunities to incorporate new technology Profiled travel time and administration duties to reflect service requirements more accurately

LCH outcomes: Policy 1 2 3 4 Facilitated the rebalancing of the new team structure and caseloads Ongoing development of a single set of local service profiles and alignment with outcomes Currently documenting the service profiles to link to local policy & demonstrate compliance with the HCP etc Develop local workforce profiles based on a collective understanding of requirements

LCH outcomes: Risk, opportunity and improvement 1 2 3 4 Identified and quantify risk of workforce shortfall Helped identify and incorporate best practice for both the service programme and workforce strategy The new workforce and service profiles prompted discussion and pointed to potential variances in the current service Service plan Performance data Benchmark vs. other services Targeted improve-ments National policy

Implementation plan - overview Ongoing support Use, improve and refine Access to updates & benchmarking Implementation Workshops Planner development Planning Scoping and configuration Data development

Implementation plan - example Milestone Activities involved Time Project initiation, scoping and planning Agreed objectives with steering group Establish working group Develop the data specification 1-2 weeks Data development Working with analysts and access national datasets to develop comprehensive local school dataset Configure tool in accordance with local requirements 2-3 weeks Workshops Run 2 half day workshops to introduce the tool and develop local area and workforce profiles, and a service specification 2 weeks Post workshop support Co-ordinate collection of outstanding data Complete development of the tool and assist rollout to ensure the tool is supported Setup the live client folder and logins Rollout / Ongoing support Provide ongoing assistance as required

Linking with other initiatives Service scheduling - Workflow and scheduling Phasing of staff / demand - Recording outcomes Service scheduling - Workflow and scheduling Phasing of staff / demand - Recording outcomes Comparison to actuals - Compare with actuals from PM system - Identify variation from plan Target areas of efficiency -Validate assumptions Service planning - caseload sensitisation workforce deployment -demographics Local policy - local and national initiatives Local policy - Local / national initiatives - Link to Outcomes - Joint working This is what our clients are using the tools for Service forecasting - identifying future demand and workforce requirements - Predict levels of productivity Service forecasting - identifying future demand and workforce requirements - Predict levels of productivity

Contact details Michael McGechie Director – health services michael@bensonwintere.com www.bensonwintere.com/healthcare

Ealing case study SELECTED SCREENSHOTS

Developing a service spec Each child protection case in this area takes an estimated 63 hours each year, when including administration and travel

Defining the service offer What services do we want to offer in the future? In this example we have switched off a few services but may explore these as potential services later This allows us to link each service to the HCP and local policy by clicking on the INFO button next to each service

Workforce planning This currently commissioned workforce for this area is unable to deliver the service plan, with 69% service potential We can create a custom profile to explore workforce required to deliver 100% Why does the skill mix not have enough work?

Dashboard – how does the service look? (1) It appears our commissioned workforce levels in three of the main teams are not adequate to deliver the desired programme

Dashboard – how does the service look? (2) However by switching to a customised workforce we have developed, we can show the additional workforce (and cost) requirements to deliver the desired programme

Service plan