NW London Primary Care Workforce Strategy Update Hillingdon PCCC Vicki Newport- Workforce Implementation Lead, NW London Health and Care Partnership Mandekh Hussein-Primary Care Workforce Planning Manager NW London Health and Care Partnership 28th November 2018

Content Key messages Activities to deliver the Tiers 1, 2 & 3 of the Strategy NHSE targets- Primary Care Workforce Recruitment and Retention Appendix 1:Training Practices in NW London Appendix 2 London GP ST3 Trainee survey 2018

Key messages Gathered soft intelligence on other roles being deployed address the GP and GPN numbers. This intelligence, on utilising other roles is shared with NHSE when data reporting is submitted.. Four boroughs in NW London have begun to use the workforce modelling toolkit- once data extraction has been completed this will be shared with other areas to implement. The £80,800 awarded to the Transition Academy will accelerate the work and implementation of existing successes and continue to drive local workforce transformation successes across NW London. The London wide ST3 survey (2018) showed most preferred role was to become a salaried GP. Interest expressed for leadership and partnership roles- support need for career structure. Recent discussions with HEE at a National Level to ensure the sustainable funding of CEPNs.

Tiers 1, 2 and 3 executive Summary Tier 1 supports workforce benchmarking, planning, modelling and directed workforce transformation. Supported through NHSE resources; we will support this work by identifying individuals within CCGs and S&T, to go out and support practices via the networking events through the change management process. Tier 1 Tier 2 will help practices to better recruit and retain key primary care roles and significantly drive forward NW London’s aims to achieve our GPFV GP and GPN10 Point Plan recruitment targets. It also focuses on recruitment and better integration of new roles in primary care. There are opportunities through external partners to support the delivery of this work. Available resources will be scoped as part of the project initiation. Tier 2 will also support development of the sessional workforce by driving forward plans for a single point of access for sourcing high quality locum primary care staff for each CCG, and help CCGs and GP Federations to develop these platforms to ensure professional development and quality assurance of this workforce. This tier will also support the development of common induction programmes for the sessional workforce and opportunities for long-term locums and transition to salaried roles. Tier 2 Tier 3 aims will support the implementation of national career frameworks for nurses and HCAs, as well as the development of new career frameworks for the non-clinical workforce. This tier aims to aid retention, improve carer progression and morale by developing and implementing local career pathways, for both clinical and non-clinical staff. This will create a consistent approach to training and development, by ensuring the minimum professional and educational standards are met for specific roles and informs the commissioning of training which meets these standards. It will support staff to develop their careers in NW London. It is anticipated this tier will be supported by investment available through the delivery of the GPN 10 Point Plan and the apprenticeship levy, and build on the extensive work of the CEPNs. Available resources will be scoped as part of the project initiation. Tier 3

NHSE targets- Primary Care Workforce Recruitment and Retention Activity Target Progress General Practitioner National target 5000. London target 964 NW London 218 1. Funding (£42,649.90) has been given to Hillingdon CCG in order support existing/pre-planned local level initiatives within the following parameters: Activities to support GPs who are newly qualified or are in their First 5 years Activities to support GPs who are actively looking to retire or reduce their working hours Activities to support the retention and recruitment of the wider primary care workforce. 2. There is also work being developed centrally for all of NW London on the above themes that Hillingdon Primary Care is able to access once it has been publicized. 3. Hillingdon CCG has also received funding from the Health and Care Partnership to support the continued growth of the Transition Academy. International GP Recruitment 352 new international GP nationally NW London 8 Cohort 2 in London is currently underway, with a total of 6 international GPs to be placed across NW London. Hillingdon have not expressed interest in the scheme currently General Practice Nurses London target to increase GPNs by 5%, 8% and 10% by 2010, NW London share is 110. General Practice – Developing confidence, capability and capacity A ten point action plan for General Practice Nursing NW London STP GPN Delivery Plan 2018-2021 Health Education England (HEE) ‘Come Back’ website to RTP Trainee Nursing Associates National target 1000 London target 549 HEE driven scheme. Continue to support programme 3 known expressions of interest from Hillingdon Other roles Clinical Pharmacists Physician Associates Clinical pharmacists national 1,500 London 252 No targets NHSE scheme ongoing- shared comms and aware of aware of local initiatives and support CCG leads, Networks and Federations. Supporting General Practice at scale 20 practice-based pharmacists and a further 10 deployed to practice via the Confederation, most are IPPs or training to be 13 2nd year PA students on placement, 4 out of 6 PA students qualified last year, none were recruited by practice although some showed an interest in working there

Reporting: Activity Narrative and Expected Outcomes in Hillingdon Narrative and Expected Outcomes Across NW London The Transition Academy Hillingdon CCG has been awarded £80,800 to be used towards the enhancement of the recruitment and career pathways for nurses and ST3 GPs into general practice in Hillingdon. NW London Health and Care Partnership acknowledges the existing successes of the Transition Academy and the potential of this to continue to drive local workforce transformation successes. Expected impact of this funding includes: Quality and consistency of general practice offer Functions and competencies of staff across the patch Transfer of skills from experienced to new staff Potential to redress the north / south borough divide Influencing the pipeline working with HEIs and VTS / Trainer Improved Quality Improvement Processes Activities include: ST3 and VTS engagement and support HYP peer support and learning Masterclass training in clinical, business and resilience skills Portfolio careers within practice, Confederation, CCG and beyond Pathways to Partnership with current GP partner mentoring Hillingdon’s Transition Academy is grounded on harnessing expertise and a business model that fundamentally transform the way in which primary care workforce retention and recruitment is approached. Through their expertise and successes, Hillingdon Transition Academy, via Hillingdon CEPN will share best practice to local CEPNs through workshops. Some workshops (e.g. Bid Writing 13/11/18) have occurred and future workshops will be developed based on CEPN demands from January 2019. We expect that this support will accelerate the capacity of CEPNs in developing and implementing activity plans going forward and increase the success and uptake of existing similar interventions. This funding will continue to support the spreading of best practice across CEPNs and NW London with regards to retention and recruitment and effectively utilizing workforce schemes offered nationally and via HEE. NW London Workforce team will continue to support the NW London level interventions in a coordination capacity · Reporting: NW London Primary Care Workforce Planning manager will collate qualitative impact of funding through reporting aligned with Primary Care Workforce Retention and Recruitment funding.

Change Management Facilitator Training in Hillingdon CCG Activity Progress Change Management Facilitator Training in Hillingdon CCG Marie Franklin is one of 15 (initially 16) delegates attending the Change Management Facilitator Training for NW London. This 5 day training session, plus 2 Action Learning sets and 3 hour of individual consulting sessions is an opportunity to up-skill system leaders to deliver transformative initiatives that align with the development of new ways of working in general practice. Of the many outcomes, delegates expect to Learn a structured change management approach to ensure the robust management of change Advise others - leaders, managers, staff – about the specific role(s) involved in delivering change and be able to build/advise on how to build a suitable change team/network Support and coach inter-disciplinary teams/stakeholders involved in transforming services with a greater understanding of change dynamics, thereby enabling them to remain focused and effective despite ambiguity and operating in a complex system Workforce Modelling Toolkit There are four boroughs in NW London who have begun to use the workforce modelling toolkit, or expect to use it in order to support their local workforce re-design initiatives. These same initiatives have sent delegates to the Change Management Facilitator course.

Appendix 1:Training Practices in NW London (91 Practices) Harrow (12 Practices) Peer Group 1: 3 Peer Group 2: 1 Peer Group 3: 3 Peer Group 4: 2 Peer Group 5: 1 Peer Group 6: 2 Hillingdon (12 Practices) Hayes & Harlington: 2 North Hillingdon: 8 Uxbridge & West Drayton: 2 Brent (16 Practices) Harness: 5 K&W: 8 Kilburn: 3 Ealing (16 Practices) Action: 3 Central Ealing: 4 North North: 3 South Central Ealing: 2 South North: 2 North Southall: 0 South Southall: 2 Central London (7 Practices) Regents Canal And Paddington: 3 SWPCH: 2 West End and Marylebone: 2 Maida Vale and St. Johns Wood: 0 Hammersmith & Fulham (9 Practices) Central: 5 Northern: 1 Southern: 3 West London (11 Practices) North: 2 North Central: 1 South East: 4 South West: 4 Hounslow (8 Practices) B&I: 2 Chiswick: 3 Feltham: 1 GWR: 1 HOH: 1

Appendix 2: London GP ST3 Trainee survey 2018 (n. 163) Louise Devlin1, Vhenekayi Nyambayo2, Colette Roach2 and Jonathan Sampson2)  1Health Education England 2Healthy London Partnership