Kim Sales Associate Director for Workforce, Education & OD Birmingham Women’s NHS Foundation Trust

Current Health & Social Care Workforce 50 million + Service Users 5 million + Informal Carers

Rising Numbers of Older People

Growing numbers of people with long term conditions and multiple conditions

The home is becoming the locus of care

Workforce to support integrated care The creation of new roles working across professional boundaries supports integrated delivery. Good evidence No one “right” staffing model. Teamworking more important than individual roles. A focus on the service user/patient helps overcome professional boundaries. Understanding of different roles and responsibilities is important to successful integration within a team. Some evidence

Framing the options for workforce redesign increasing the numbers of nurses, doctors, and other health professionals changing the job descriptions of existing workers handing off existing tasks to other workers creating new jobs for work previously not done by anyone REDISTRIBUTION CREATION CAPACITY EXPANSION RETRAINING New alternative worker Old worker Source: Bohmer and Imison, Health Affairs, November 2013 Old workNew work

Messages from ‘Time to Think Differently’ The staff we will have are the staff we already have – don’t rely on the pipeline Align the workforce to the work – not the other way round Develop teams not just individual professional groups Support and “activate” patients Support the informal workforce Reverse the inverse training and investment law Challenged current terms and conditions National facilitation but local action

Are We Part of the Relay? Integration as part of the solution is echoed by National Voices (2011): “Patients and service users want services that are organised around, and responsive to, our human needs. We are sick of falling through gaps. We are tired of organisational barriers and boundaries that delay or prevent our access to care. We do not accept being discharged from a service into a void. We want services to be seamless and care to be continuous. That means primary and community health services, social care services, and services from voluntary organisations should all mesh together to help us succeed in managing our lives and conditions.”

What is the Race for the Future? A future in which the health needs of populations will be very different to that of today. A future in which a large elderly population, with multiple long term conditions and co-morbidities, will challenge our traditional models of healthcare delivery A future in which people will want more control over their own health. A future where care will be delivered closer to home, embedded within local communities A challenging economic backdrop Who are the Racers and What are the Batons? THE RACERS The informal workforce The ever increasing number of valuable volunteers, and carers that contribute Patients themselves to take the reins in managing their own conditions THE BATONS Collaboration with Public Health Empowering local communities to play a greater part Asset based approaches Radical & innovative workforce solutions

The Shining Batons – the System Leader I SEE AN OPPORTUNITY I LEAD LEARNING I MODEL MORAL ACTION I BUILD CAPACITY & COLLABORATE I GROW INDEPENDENCE

The Space Between the Batons Approaches to workforce planning need to change - align the workforce around the work; not the other way around The location of care will change so must the locus of training and education to support and develop education and training in, and for, community settings New services will require new roles to innovate and challenge traditional roles Prepare the workforce for multi-professional team-working and seamless integrated care Inter professional education and training is key as is a well-developed understanding of healthcare systems and how to work within them Healthcare is increasingly distributed and complex but must also become less anonymous Navigation and coordination are important future components of effective care Self-management will become a central component of care Healthcare professionals need the interactive skills to help patients take on responsibility for their health including the use of technology as a powerful intermediary and aid to self-care We all want whole person-centred care Embed ‘the lived experience’ in all curricula System & Distributed Leadership development are paramount for collaborative working and co- design The NHS workforce is becoming predominantly female Training and education pathways must accommodate to the demography of the workforce The voluntary sector will play an increasingly important role in care - this sector has training needs too, identify these, support and develop Succession planning is vital for a healthy health service Encourage talent management and developmental human resource practices Health care professionals should take wider community responsibility for improving health We should encourage raising awareness about health and healthcare professionals within the local community i.e. schools

From Start to Finish ? It’s not just the Destination, it’s the Journey…

So…what’s the first Lap? INTEGRATED WORKFORCE ASSESSMENT MODELLING PROGRAMME Come together as a collaborative multi disciplinary network Transparently know what our public health, demographics, workforce establishments and care pathways are Work together to develop integrated workforce plans, training needs analysis & new roles/ways of working

Now The How…. DATE GATHERING PRESENT THE DATA WORKFORCE DEVELOPMENT PLANNING TRAINING NEEDS ANALYSIS NEW ROLE DEVELOPMENT – Care Navigator & Lead Practitioner roles Multi-Disciplinary Team Working modelling REPORTS PRODUCED, RECOMMEND, ACTION ENERGY INDEXING Data gathering: #1 Islington Public Health data #2 Demographics #3 Workforce statistics re: roles within h&SC economy #4 Care pathways within themes #1 & #2 opposite Weaving in 6 Step Workforce Planning model – building joint capabilities in workforce planning across locality #1 TOP 2% of population with complex needs (Older People (inc dementia), Long Term Conditions, Mental Health, Children & Families) # 2 Next 10% of population with complex needs (this will incorporate the groups above) Mid August - September OctoberNovemberDecemberJanuaryFebruaryMarch Skills for Health gathers data across health & social care locality 22 nd & 23 rd October – Collective Data Seminars (160 reps across health & social care) Thematic Group #1 Older People Thematic Group #2 LTC Thematic Group #3 Mental Health Thematic Group #4 Children & Families Evaluation Report and Recommendations for Next Steps for 2015 roll out model Partnership between service users, h&sc providers, commissioners, training & education providers, local community, workforce EVALUATION RUNNING FROM START – FINISH

Other OD linked Integrated Care ventures! COMMUNITY SIMULATION ‘MY HOME’ TRAINING HUB The 1 st UK integrated care training centre, with simulated ‘home’ & ‘community’ clinic observation: using real people & centred around holistic, person centred care INTEGRATED DEVELOPMENT PROGRAMME for new Integrated Health & Social care Rehabilitation & Reablement Locality Teams in Islington

THANKYOU..Any Questions?