NHS North west CHESHIRE AND MERSEYSIDE WORKFORCE UPDATE liz.thomas@northwest.nhs.uk

Mike Burgess Mike.burgess@northwest.nhs.uk WORKFORCE STRATEGY Mike Burgess Mike.burgess@northwest.nhs.uk

LETB update 1 LETB in the North West with 3 local workforce and education groups as per current geography Largest in NHS England, strong ability to influence on the national stage LETB will need to go through authorisation Focus on progressing the MPET Investment plan, 5 year workforce development plan, and authorisation criteria Recruitment of the LETB Managing Director Workforce and Education staff / Deaneries transferring to Health Education England to support the LETB HEE website http://healtheducationengland.dh.gov.uk/ LETB information on eWIN https://northwest.ewin.nhs.uk/

Workforce Plans 2012/13 – 2017/18 Current refresh of workforce plans out in the system with deadline of 21st September 2012 The refresh covers update to multi-faceted narrative across 8 domains and a workforce risks / issues and mitigating actions paper The coverage is inclusive of all NHS workforce and includes primary and community care, public health and other sectors where information is available. Utilisation of the three workforce planning and modernisation networks across Greater Manchester, Cumbria and Lancashire and Cheshire and Merseyside

Workforce Assurance and Patient Safety The national drive by the Department of Health and workforce leaders group (WLG) for workforce assurance Plans need to be signed off CE, Director of Nursing and Medical Director Workforce and patient safety links report included with packs issued to providers and commissioners Workforce assurance matrix available to download from eWIN Plans to be tested against a single assurance process integrating finance, activity, patient safety, clinical safety and performance metrics The eWIN system allows providers to benchmark their workforce against other providers along QIPP indicators, priority areas and use knowledge management and best practice to implement changes. Purchasing the National Workforce Assurance Tool for Providers Plans / training / implementation been drawn together Officially launched via HRDs and LETB in next quarter (Sept – December 2012) Submission Workforce Demand spreadsheet Workforce Risks / Issues / Actions report (Optional) Workforce Narrative refresh Close of Play Friday 21st September 2012

Workforce Assurance

The WORKFORCE assurance framework The Workforce Assurance Framework is a method for achieving system assurance that the planned and available workforce can deliver safe and quality services. Identify current workforce issues and is an early warning system when reviewing projected workforce changes Reflects the key lines of enquiry agreed by the DH Operations Board1 1 – Key lines of enquiry referenced in DH KLOE on Safety and Quality Assurance of Workforce Changes

The need for a robust system to support workforce assurance Expertise from 10 SHAs and the Department of Health have been drawn upon to support system design and to address the current limitations associated with attempting workforce assurance using static data and manual processes. The key challenges identified by this group in relation to workforce assurance and the related desired benefits of the system are detailed below: Current Challenges Solutions from the tool Much of the data collected is currently retrospective and not forward looking The tool will use trend data to project how the picture might change over time which can then be compared to actual performance Process, dashboards and metrics collected are different in different regions Good practice adopted consistently across Trusts and regions with a collation of all existing metrics Individual indicators are often looked at in silos Enables consideration of the importance of interrelationship between indicators and triangulation of workforce, activity and finance Current processes are not supported by robust statistical analysis Assurance processes underpinned by detailed information base and statistical analysis including detailed literature review Current processes are labour intensive as mainly manual processes Automation reduced manual data manipulation and handling burden Currently workforce plans go backwards and forwards between Trusts and Assurers, increasing timescales / tensions Greater visibility of assurance expectations between Trusts and Assurers – a shared tool that can be also be used by individual Providers

How we are approaching assurance Our different approach creates a different conversation about assurance: What is different? A systematic approach enabling rigorous, structured evaluation A statistically robust underpinning for assurance analysis Analysis of correlation and relationships between triggers Thresholds for triggering Escalation routines to enable consideration of escalation in structured This enables you to Create and drive top table discussions Changes the nature of assurance engagement with Trust Boards and Management Teams Call on robust evidence and analysis as support for key decision making Take a more integrated approach to assurance activities Justify decisions

Underlying principles of the tool Fundamental Tenets Effective workforce assurance is a critical component of helping ensure the ongoing efficient and effective delivery of services across the NHS system. Organisations should be supported to be rigorous in their self assurance processes, to improve outcomes and reduce the need for external assurance. By using data appropriately, users can be supported to make better assurance decisions. This is a decision support tool, not a decision making tool. Consistent high levels of assurance across regions. Considers a cross section of demand, activity, quality, finance and service information rather than considering workforce alone. Balances forward looking assessments with previous performance: i.e. Historic dashboards are a useful input but do not tell the whole story. To minimise effort, Nationally available data will be used wherever possible to reduce the administrative burden. Differences in data quality and availability need to be allowed for and highlighted within the system. Throughout the life of the tool, the system will be actively managed so that as new national datasets become available each period they are uploaded into the tool. Workforce Assurance in Practice Data usage

What is the Tool intended for? The Tool IS intended to provide: The workforce element that will link with wider system level assurance Triangulation between workforce, activity and finance data A national platform to workforce assurance that can be adapted as appropriate for each SHA Best practice approach that is built on existing published literature An approach that recognises that assurance criteria will change and be refined over time The Tool IS NOT intended to be: A tool to publish information A performance management tool A data collection tool; existing data is used A directorate, divisional and professional assurance tool as other resources are available for this

The Workforce Assurance Portal The key components that people use within the portal are illustrated in the table below: Workforce Assurance Portal My Actions My Analysis My Resources My Threads Help Organisation Dashboard My Notes Supporting Materials My Assurance Logs Community My Flags Data Sources These are the 3 sections that were looked at in the pre-reading, in terms of what they do, and what's included. In the next module, we will be looking at how to use each section. For trust users, will only see the organisation and metric dashboards, regional managers can see the regional dashboard. This diagram gives a nice overview of the tool, and the areas within it, so we will refer back to this. My Qualitative Indicators Metric Dashboard FAQ My Plans Workforce Dictionary

Metric e.g. Midwife: birth ratio Indicators, Metrics and Thresholds Indicator The base level of data used to make metrics This data comes from various source data sets Metric Metrics display information about an aspect related to workforce Metrics can also be direct (taken directly from one indicator) or compound (calculated by combining more than one indicator) Threshold The threshold is the level at which metrics turn green, amber or red, indicating the risk associated with each metric The threshold is different for each metric and based on the value needed for them to be considered high risk, and turn red, or low risk, and turn green The threshold can take the form of a scale or range Example: Indicators, Metrics and Thresholds An indicator could be the number of midwives, or the number of births. The data from these indicators is used to create different metrics. Metric e.g. Midwife: birth ratio The metric will be assigned a risk level depending on the threshold. Some thresholds are scales where one extreme is good and the other is bad. Other thresholds are ranges where there is an ideal level and anything either side increases risk. In our example a threshold would be a scale, and less than e.g. 3 midwives per birth is ‘high risk’. Target Value Intervals from Target Value

The Assurance Map There are 4 assurance groups, 3 are based on data and are shown below, the 4th is based on qualitative data. Each of the 3 groups below contains trigger groups, triggers, and below each of these are the metrics.

Health Visitors update saba.razaq@northwest.nhs.uk Monday 17th September 2012

NORTH WEST PERFORMANCE – 2011/12 The North West target for Mar-13 health visitors is 1489.0 FTE (1463.0 is the absolute minimum required) The Jul-12 ESR downloads show the current North West performance. Totals by PCT Cluster Mar-12 Apr-12 May-12 Jun-12 Jul-12   Gap (ESR) to Mar-13 at Jul-12 Lancashire 318.61 315.59 314.89 311.73 312.92 -25.04 Gtr Manchester 533.79 539.49 541.70 516.30 515.39 -61.50 Cheshire 214.10 214.92 216.07 216.84 215.72 -15.32 Cumbria 74.73 76.91 78.43 76.21 76.74 -1.90 Merseyside 255.79 256.74 249.63 244.79 244.98 -19.79 TOTAL 1397.02 1403.64 1400.72 1365.87 1365.76 -123.56 TOTAL (inc Other Providers) 1410.63 1419.06 1415.10 1380.26 1381.17 -108.67 NOTE: ESR cluster figures for Jul ESR have been calculated using proxy figures for the four divisions in Bridgewater, based on the July manual returns.

NHS Operating plans: NORTH WEST

PRECEPTORSHIP REPORTING Trust will be paid a preceptorship fee for all newly employed Health Visitors who are new to the profession and joined the trust from September 2012. Payments will be quarterly and based on numbers collected directly from trusts on a quarterly basis. The collection will form a ’bolt-on’ to the health visitor manual collection Numbers for September (Q2) will be collected in October and payments will be made to trust in December (Q3)

HEALTH VISITOR WORKING GROUP Inaugural meeting on the 25th September at Piccadilly Place Group will look at improving Health Visitor workforce information and sharing of Health Visitor strategies and modelling tools Target audience: Workforce Analysts, HR Managers, HV Service Leads To register or for more information: https://northwest.ewin.nhs.uk/knowledge/resource/650/Health-Visiting-Working-Group-Call-for-participants

SCHOOL NURSING WORKFORCE AUDIT Manual collection coordinated by Macaila Finch (SHA) Deadline for completion was 24th August (snapshot as at 1st August 2012) Work is underway to complete an analysis of the current school nursing service in the North West.

Saba Razaq Senior Workforce Analyst saba.razaq@northwest.nhs.uk 0161 625 7774

data quality update: AUGUST 2012 DATA liz.thomas@northwest.nhs.uk

DATA QUALITY UPDATE Acute and mental health trust in England data quality results published in Health and Social Care Information Centre report: Available on HSCIC here or eWIN Woven report ex-employees validation limited to leavers since 1st July 2012 Woven report GMC/GDC registration validation been corrected. Scores might have changed but are now correct Emphasis on putting in place strong data collection & validation processes remains Would a data quality summary page in eWIN be useful? Updated June-12

Data Quality update – north west score SHA Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12   Rank Position from previous month NHS East Midlands 6,230 6,360 6,640 6,710 6,725 6,750 6,950 6,970 7,180 7,320 7,825 7,175 10 ↓ NHS East of England 6,220 6,410 6,430 6,660 6,790 6,880 7,030 7,055 7,105 7,140 7,480 9 ↑ NHS London 6,445 6,510 6,735 6,845 6,935 7,130 7,200 7,230 7,265 7,885 7,290 8 → NHS North East 7,425 7,585 7,650 7,945 7,990 8,135 8,210 8,430 8,545 8,555 8,850 8,460 4 NHS North West 7,375 7,795 8,195 8,540 8,785 9,095 9,160 9,240 9,415 9,490 9,190 1 NHS South Central 7,390 7,580 7,660 7,960 8,060 8,005 8,160 8,115 8,145 8,415 8,250 6 NHS South East Coast 6,695 6,835 7,485 8,185 8,440 8,465 8,455 8,710 8,370 5 NHS South West 7,595 7,835 8,055 8,320 8,515 8,580 8,740 8,800 8,905 8,960 9,255 8,900 2 NHS West Midlands 6,920 6,875 7,185 7,395 7,510 7,715 7,625 7,685 8,205 7 NHS Yorkshire and Humber 7,360 7,505 7,745 8,000 8,045 8,175 8,345 8,445 8,495 8,750 8,560 3 NW retained first place Dec ‘11 to Aug’12 Error count increased by 3,060 (24.0%) errors Jul-Aug Error count reduced by 28,462 (64.3%) errors Sep11-Aug12 Trafford Healthcare NHS Trust missing from report

Data Quality update – priority areas Significant increases this month: Ex-employees 30.1 (Destination on Leaving is blank) up by 573 errors from 10 to 583 33.1 (Destination on Leaving is NHS Organisation but NHS organisation is blank) up by 117 errors from 6 to 123 Significant decreases this month: 9.5 (Staff Group Medical & Dental but Grade code doesn't start K, L, M, Y or Z ) down by 54 errors from 105 to 51 9.6 (Occ. code Medical & Dental but Grade code doesn't start K, L, M, Y or Z ) down by 60 from 112 to 52

Data Quality update – HIGH IMPACT priority areas Destination on Leaving is blank – no longer a high impact error New % baselines established for five high impact errors 40.1 Recruitment Source is Blank: 31.4% of total errors 19.1 Sexual Orientation is Blank: 13.7% of total errors 31.1 Disability is Blank: 16.4% of total errors 16.1 Religious Belief is Blank: 13.5% of total errors 2.1 Area of Work is Blank: 10.1% of total errors Five high impact areas account for 85% of total errors 30.1 Destination on Leaving is Blank: no longer a high impact error

Data Quality update Two organisations in the North West in August 2012 had maximum scores of 10,000 Halton And St Helens PCT Calderstones Partnership NHS Foundation Trust Updated June-12

Data Quality update: FINAL SCORE C&M Current month August 2012

Data Quality update: ERROR COUNT C&M Current month August 2012

ACCESSING EWIN REPORTS https://northwest.ewin.nhs.uk/benchmarking Select QIPP Dashboard

ACCESSING EWIN REPORTS https://northwest.ewin.nhs.uk/benchmarking Navigate to the Woven Data Quality Reporting “speed-o-meter” and select graph

ACCESSING EWIN REPORTS https://northwest.ewin.nhs.uk/benchmarking 4 data reports are available and a data guidance page All reports can be exported to PDF Demo WebExes can be set up on request liz.thomas@northwest.nhs.uk

Liz Thomas Senior Programme Manager, Workforce Strategy Liz.thomas@northwest.nhs.uk 0161 625 7793

EWIN update C&M PLANNERS liz.thomas@northwest.nhs.uk Monday 17th September 2012

EwIN current and pending projects QIPP Dashboard Review Health Visitor Working Group / Priority Dashboard Review Knowledge Exchange Redesign Equality and Diversity Proposal Health and Well-Being Homepage & Dashboard eWIN Research Project Updated June-12

EWIN: QIPP DASHBOARD REVIEW QIPP Dashboards developed to assist NHS organisations identify efficiencies and savings Twelve metrics for review Functionality and design for review Meeting 2nd October, 11am-1pm at NHS North West Contact liz.thomas@northwest.nhs.uk / 0161 625 7793 Updated June-12

EWIN: HEALTH VISITOR WORKING GROUP To facilitate collaborative working between Health Visiting workforce leads and service leads Motivate competition and challenge complacent operations To define reporting methods on eWIN in respect of Health Visitors To share Health Visitor workforce planning tools/strategies To produce the redesigned Health Visitor workforce dashboards Meeting 25th September, 12-1.30pm at NHS North West Contact saba.razaq@northwest.nhs.uk / 0161 625 7774 Updated June-12

EWIN: KNOWLEDGE EXCHANGE REDESIGN To make the Knowledge Exchange search clearer and easier to use Stage 1 produced a single search bar which displays results Results can be filtered as required Stage 2 discusses the requirements of an Advanced Search function Contact christine.stewart7@nhs.net / 0161 625 7285 Updated June-12

EWIN EQUALITY AND DIVERSITY PROPOSAL Produce automated reports to support EDS requirements and CQC equality prompts Support production of annual equality data publication Provide organisational data and benchmarking data Assist in developing analysis skills within the E&D community Meeting 19th September, 12-1.30pm at NHS North West Contact liz.thomas@northwest.nhs.uk / 0161 625 7793 Updated June-12

EWIN HEALTH AND WELL-BEING PAGE AND DASHBOARD Health and well-being homepage coming soon Potential to develop data dashboard based on ESR Data Warehouse sickness reasons data Days Lost by Sickness Absence Reason Days Lost Per Quarter Average FTE Average Length of Absence Incidence by Long/Short Term Call for participants will be released in October Contact liz.thomas@northwest.nhs.uk / 0161 625 7793 Updated June-12

EWIN research project Conducting interviews with eWIN users Inform eWIN team’s strategic planning Contacting primary care representatives Developing links with HEIs and academic research hubs Updated June-12

Liz Thomas Senior Programme Manager Workforce Strategy Liz.thomas@northwest.nhs.uk 0161 625 7793