SPF - 20 November 2014 Workforce Planning and Commissioning Update

Strategic Workforce Planning View Develop existing workforce Transferability of skills Build capacity in clinical decision making / risk management Develop new carer structures, particularly for bands 1-4 Develop existing workforce Transferability of skills Build capacity in clinical decision making / risk management Develop new carer structures, particularly for bands 1-4 Stated Aspirations Shift in care from acute to community and primary care Person centred care / empowered patients and carers Integration of care across sector boundaries and extended day/week New workforce supply New roles ‘Grow your own’ programmes New Education programmes New workforce supply New roles ‘Grow your own’ programmes New Education programmes Working in new ways Roles and career paths across health and social care Skills mapped to patient pathways Innovative training across professions Working in new ways Roles and career paths across health and social care Skills mapped to patient pathways Innovative training across professions Sustaining service delivery – quality and supply

Workforce profile headlines The EoE NHS workforce experienced a growth of 36% between 2000 and 2013, greater than the growth in population and hospital activity levels over the same period. After a slowdown between 2011 and 2013, providers’ workforce grew at 2% in 2013/14; There is little evidence of workforce capacity shifting to the community; Compared to other regions, EoE workforce has richer skill mix but is smaller in relation to bed numbers and population; There are fewer medical trainees in EoE relative to beds and population compared to other regions; There are fewer GPs per number of patients in EoE; There are shortages of nurses, AHPs, HCS, GPs.

Commissioning reviews As part of the implementation of the National Standard Education Framework Agreement (NSEFA) a series of commissioning reviews were agreed by HEEoE. The reviews being undertaken are outlined below: A fundamental review of nurse education, due to report in September Commissioning patterns for clinical psychology, reporting in November Commissioning patterns of Midwifery, reporting in November Commissioning patterns for AHPs, reporting in December Outcomes from the commissioning reviews will be implemented as part of the NSEFA; An outcome from the commissioning reviews and feedback from the commissioning process has been the need for more flexible entry in to commissioning programmes. This will be developed in addition to the commissions identified in 2015.

Commissioning decisions for 2015 We recognise that the development of reliable numerical forecasts remains a challenge for providers, as the need to maintain and improve quality of services becomes increasingly challenging within the current service configurations Our understanding of future workforce requirements has been largely informed by the work we did during the strategic planning phase; We have seen a strong link between service commissioners’ intentions and providers’ workforce planning narratives and our investment decisions reflect providers’ proposals; Our investment decisions also take into account the analysis of supply we carried out at the centre; We have taken a multi-professional approach to the review of investment decisions commissions.

Planning in Start the process earlier than last year to ensure continuity of workforce planning and alignment with the service planning process; 2.Continue the “strategic conversation” with commissioners and providers. Capitalise on and further refine what insight and workforce intelligence we have; 3.Allow greater focus on the development of supply forecasts and commissioning plans and on consulting with stakeholders; 4.Target effort to work with “select” providers and systems; 5.Strengthen the multi-professional approach to decision-making, ensuring parit y of medical and non-medical processes and coherence of investment choices.

TIPS 1.How to address the current supply shortfall and support existing services 2.How to support the development of new service models and the different workforce this will require. 3.How to make progress simultaneously on both points and make sure 1 is directional to anticipate 2 and flexible to adapt to the uncertain and changing picture in 2

TIPS Addressing Workforce supply shortfall Increase educational commissions Improve our employment offer Grow your own approaches Develop your staff career & development approaches Develop new roles and new educational programmes Support Longer Term Service and Workforce Development Sustain our transformation approach on the established three service priority areas: Primary care, Emergency care and Dementia Align our Workforce Supply approach specifically to support this Strengthen the fit for the future and patient first focus of Skills Development in all our existing and future programmes Underpin this with continued focus on NHS Constitution Values

Increase the number of apprenticeships and expand the opportunities for bands 1-4 staff Regional / national driver Ensure effective workforce supply, responding to identified deficits Support the reconfiguration of primary care at scale by workforce transformation Improve urgent and emergency care services Improve patient care of frail elderly and people with dementia Transform patient experience through embedding the values of the NHS Constitution in the workforce LETB wide actions EoE wide leadership and performance management WP lead on adoption and spread Establish development pathway for band 4 to band 5 Implementation of national bands 1-4 project deliverables Return to Practice system wide approach and campaign Recruitment of GP training numbers Advance practitioner / physician associates pathway and commissioning plan Lead adoption and spread of N&S dementia approach, dementia alliance and training approach Performance manage tier 1 training uptake Development of recruitment to values benchmark All HEEoE programmes recruit to Values Develop 360 behavioural modelling tool for VBC and roll out to all HEE students Commission VBR core training package Workforce Partnership actions Engagement and local delivery, cross LETB lead on adoption and spread Local provider / system driver Grow your own approach Develop education portfolio for bands 1-4 Generic skill sets / cross sector roles Shared streamlined recruitment processes Shared approach to overseas recruitment Flexible resourcing across organisation boundaries Leadership – talent pipeline Supply pathway and development plan Pre-professional development Expansion of pre- registration placements Develop local opportunities for Advanced Practitioner and physicians associates Establish dementia alliance Mapping, reporting and enhancing tier one training Development of advanced dementia training portfolio Implementation of dementia coach, champion Implementation of VBR benchmark across HEIs VBR core training package rolled out across all EoE clinical learning environments Securing local supply, grow your own approaches and integration of roles across sectors Short to medium term supply, address on-going temporary staffing and increased turnover across nursing Increase GP numbers, supply and retention of practice nurses Address supply shortfall and improve retention Deliver tier 1 training and adoption and spread of N&S dementia alliance model Embed NHS Constitution in local workforce Bands 1-4 Workforce Supply Primary Care Emergency Care Dementia Values Drivers / actions Ensure transferability of skills, cross sector working and focus on patient in skills development Clinical decision making Skills cross sector Common core skills set Patient experts Self care and health coaching Technology Rotations and placement redesign Promote integrated working and patient first Skills Development Transformation – Investment – Planning – Strategy Increase commissions Employment offer Grow your ownNew programmes / new roles Increase pre-registration commissioning Employment offer maximise NQHP return Rotation programme for registered nurses New programmes – 2 year shortened degree; 2 year masters programme Adaptation - system wide approach for adaptation / conversion for registered nurses Recruitment, retention and career support Commissioning pathway for Practice Nurse Develop physicians associate role Commission 400 paramedic trainees Expand recruitment to ACCS EM and DREEM programmes Pre-registration review Roll out of CLIP

Workforce Supply Programme 1.New workstream / HEEoE Board priority 2.Programme Board established with SPF representation 3.Targeted work to ensure future workforce supply across all clinical professions 4.Close working with emergency, primary care and talent for care workstreams 5.Scoping work to be undertaken with a view to sharing good practice and identifying priorities for east of england 6.Task and finish group approach – first group has focussed on nursing Return to Practice 7.Other workstreams include employment offer, preceptorship and new roles 8.Engagement with providers is key.

QUESTIONS AND DISCUSSION