1. HEE in the South West Derek Sprague Local Director – South West
1 March 2017

2. Contents: Context HEE’s place in the system The challenge
What HEE is doing
STPs/ LWABs

3. Patient demography

4. Context of the current healthcare budget

5. The workforce is evolving and changing

6. Mind the (generation) gap
‘Baby Boomers’
‘Generation X’
‘Generation Y’
‘Generation Z’
Motivated and hard working; define self-worth by work and accomplishments
Practical self-starters, but work-life balance important
Ambitious, with high career expectations; need mentorship and reassurance
Highly innovative, but will expect to be informed. Personal freedom is essential
25% of the NHS workforce
40% of the NHS workforce
35% of the NHS workforce
<5% of the NHS workforce
Jones K, Warren A, Davies A Mind the Gap: Exploring the needs of early career nurses and midwives in the workplace. Summary report from Birmingham and Solihull Local Education and Training Council.

7. Our purpose
"Health Education England exists for one reason only: to support the delivery of high quality healthcare and health improvement to the patients and public of England by ensuring that the workforce of today and tomorrow has the right numbers, skills, values and behaviours, at the right time and in the right place."

8. Workforce Advisory Board
Our place in the system
ALBs
FYFV Board
Executive Team
Board
Workforce Advisory Board
Regional Directors
ALB Oversight
(HEE RDs)
Key
LETBs
Partners/
Advisory
Executive
Support
Accountable
Local Teams
HEE
co-chairs
LWABs
STPs
Advisory

9. We make a difference Nursing Associates Record GP Numbers
Come Back to Nursing
Paramedic Education Project
Emergency Medicine fill rates
The Care Certificate
Widening Participation
Proud to Care
Healthcare Support Workers
The Quality Framework
Physicians Associates
Genomics
CEPNs
Dementia Awareness Training
Shape of Training

10. Mental Health Training
We make a difference
Nursing Associates
One pilot site (Devon) – 69 trainees
Three fast follower sites (BNSSG and Bath, Glos and Somerset) – further 118 trainees
Funding south west wide P2C campaign to encourage careers in care and health as an integrated system
45% of medical trainees now undertake a placement in a MH setting at some stage
85% of SW workforce received dementia training
commissioned places for nursing and AHP staff to attend Tier 2 dementia training
Proud to Care
CEPNs
Six CEPNs in the SW, coterminous with LWABs
Mental Health Training

11. So what’s next? The challenge
HEE to remain fit for purpose, organised at a regional and local office level
Encourage and foster collaborative working between local providers, LWABs and national NHS organisations and ALBs
Co-ordinate activity in order to not duplicate effort, and agree focus of resource for greater impact

12. So what’s next? An opportunity
More joint ALB work in order to align current work programmes on outcomes that matter based on best understanding of local needs.
Target support to accelerate and embed change by offering practical solutions to support employers to deliver the local workforce transition and transformation through LWABs.
Target leadership capability and conditions for success, effective staff engagement and partnership working in conjunction with STPs and the NHS Leadership Academy.

13. What are we doing?
Supporting STPs on workforce transformation and redesign
No longer commissioning undergraduate, non-medical healthcare education programmes
Piloting trainee Nursing Associate roles
Support on Apprenticeship Levy
Working with Royal Colleges to inform development of DH consultation on regulation of Physician Associates
Mental Health Workforce Strategy due very soon
Monitoring Brexit negotiations in relation to the impact on the NHS workforce
There is anecdotal evidence that the vote to leave the EU is increasing difficulties in recruiting staff from the EU.
At present HEE does not have evidence to suggest this is impacting recruitment to training
EU doctors continue to make up 1 in 6 applicants
It will be difficult to quantify the potential impact of any changes to training and recruitment of overseas professionals until a negotiation settlement has been agreed
We may not even see any impact until after these changes come in to force

14. What are we doing? GP expansion:
training GPs – more numbers than ever before, but not finished
expanding professions such as physician associates and clinical pharmacists
Raising the profile of the GP in medical schools
There’s nothing general about general practice
Increase in domestic medical students training in England
Review of medical workforce numbers across specialties
Highly successful GMC regional review visit

15. Sustainable Transformation Plans
Health and Wellbeing
Improve health outcomes and preventable diseases
Care and Quality
High quality, consistent and equitable standards of care for all
Finance and Efficiency
STP process as a pathway to financial sustainability as a system

17. Six STPs/LWABs in the south west

18. LWABs Bath & North East Somerset, Swindon and Wiltshire
Collaborative approach across the STP footprint
Collaborative approach to workforce planning and modelling – use of WRaPT to support processes – initial focus on Stroke care pathways
Assure that priority workstreams ask the right workforce questions
Collaborative approaches to the BSW employment offer being developed
Shared and aligned approach to education, training and use of apprenticeship levy
Focus on staff Health and Wellbeing as part of prevention priority workstream
Preventive and proactive care; - health & wellbeing advisors; Behavioural change skills for Practice nurses; higher level of MECC training
Urgent & Emergency care – initial focus on understanding care navigator roles; staff flexibility; retraining HCAs
Bristol, North Somerset and South Gloucestershire
Aiming for integration across the STP footprint
Joint approach to workforce planning and modelling – use of WRaPT and Calderdale framework to support processes – initial focus on Stroke care pathways
Assure that priority workstreams ask the right workforce questions
Shared approaches to education and training
Mental Health and Community staff
Nurse associates
Use of apprenticeship levy across the STP
Shared approach to the workforce offer across the STP
Alignment of bank
Shared recruitment processes
Support of MECC in prevention and staff wellbeing

19. LWABs Gloucestershire Somerset
Overall Strategy group with three main thematic groups:
Capacity Group:
using Six Steps and WRaPT to support planning and modelling processes
focus on Primary Care and the 30,000 community model
countywide recruitment model
Capability Group:
understand and advise on workforce implications of redesigned pathways and new models of care
5 year learning & development plan for STP - career pathways; best practice for Apprenticeship levy
Develop local education provision and collective approach to careers
Priority workforce skills
Culture group
One Gloucestershire culture
Quality Improvement Academy to develop co-production/improvement
Shared model of distributed leadership
Somerset
Collaborative approach across the STP footprint to develop and implement a system-wide workforce programme, including:
Workforce profiling, modelling and planning of the current and future workforce across Somerset;
Resourcing Strategy, including achieving a common set of organisation policies;
Developing the existing workforce, up-skilling in leadership capacity and capability;
Focus on attracting, retaining and the well-being of staff;
Review existing roles, re-shape and agree new roles e.g Nursing Associates;
Engaging the workforce and working in partnership to deliver the transformation requirements;
OD Strategy, including learning and development with engagement across Somerset.

20. LWABs
Devon
Collaborative approach working towards “One Devon” workforce across the STP footprint and towards integration by
Identification of changes needed to the workforce which add value, build resilience and a sustainable workforce, supported by workforce modelling, forecasting and planning;
Focus on resourcing requirements to maintain safe effective workforce levels and support operational demands whilst maintaining quality;
Developing a flexible and multi-skilled workforce who are supported to be deployed system wide;
Implement plans to secure high quality learning opportunities in response to changes in commissioning and service models;
Define career pathways, manage talent and support leadership development.
Cornwall
Working together to deliver “Shaping our Future” – Cornwall and Isles of Scilly Health and Social Care Plan
Collaboration to workforce profiling, modelling and planning for current and future workforce;
Agreement on Information Governance and implementation to use WRaPT to support workforce activities, initial focus on Urgent and Emergency care pathways;
Scoping workforce changes in other priority areas, eg prevention and primary care, community care and support;
Social Partnership forum in place to support developments;
Thematic Groups supporting the main Strategy Group including focus on staff recruitment and retention, human resources and employment law, organisation development and education and training.

21. HEE STAR

22. Summary Demand for NHS services is outstripping current resources
STPs/LWABs will continue to be a major focus for transformation in 2017/18 and the foreseeable future
HEE still has a significant budget and Mandate which will help deliver system transformation.

23. Summary
HEE has a central place in the system with a key role to play for the current and future workforce in health.
Your continued engagement with us is crucial to our success in transforming the workforce.

24. Your engagement is really important to us
Thank you!
Your engagement is really important to us
Membership council meetings
Workshops
Surveys
LWABs and STPs