1. WELCOME The ‘Once for Scotland’ Approach – Improving Employment Experiences
Shirley Rogers,
Director of Health Workforce and Strategic Change, Scottish Government

2. Purpose of Session
To raise awareness of how the Once for Scotland approach can help to transform services.
To show the approach in action through two case studies:
How the Turas digital platform can be used in a Once for Scotland context for learning, training and professional development
How the Once for Scotland approach will enhance the employment experiences of junior doctors.
To give you a chance to discuss how the Once for Scotland approach can benefit your work.
Theme of the 2017 Event is “Working Differently Across Boundaries: Transforming Health and Social Care.” The Once for Scotland approach will help us to do exactly that. This slide outlines the purpose of the session.
I’m keen that this session achieves a good balance between presentation and discussion.
Delighted to welcome David McColl from NHS Education for Scotland, Kenny Small, Chair of the HR Directors Group and Linda Donaldson, Associate Director of HR in NHS Forth Valley who will be providing some case studies relating to Once for Scotland.
Pleased to welcome you to this session. It’s important for us to hear your views of Once for Scotland and how it can benefit your work.

3. Making Change Happen Vision without action is merely a dream.
Action without Vision is merely passing time.
Vision with Action can change the world.
  Nelson Mandela
This quote from Nelson Mandela is a helpful reminder of how Once for Scotland – or any transformative change - needs to be taken forward.

4. Why are we taking this approach?
Better outcomes for patients.
Improved services and working environment for staff.
Better value for all.
Here is our vision of Once for Scotland.

5. How will this be done ?
Health and Social Care Delivery Plan has the following actions:
Undertake a review in 2017.
Put new arrangements in place in 2019.
And this is the action that we will be taking.
The definition of Once for Scotland that we are adopting for the review is:
Those services that can best be provided through a single function delivered on a national basis – for example, some of the HR processes for junior doctors.)
Those services that can best be provided by adopting a more consistent approach across Scotland – for example, work taking place through the Scottish Patient Safety Programme.
Examples of other services which could benefit from a Once for Scotland approach would be procurement and transport.
I’m keen to hear your views and there will be an opportunity to do this later in the session. To help the discussion, here’s a short film providing some views from colleagues on Once for Scotland
As mentioned earlier, we will be presenting a couple of case studies during the session. I would like to introduce David McColl from NHS Education for Scotland to provide the first of these – how the Turas digital platform can be used in a Once for Scotland context for the professional development of staff .

6. Turas Presentation
Turas presentation available separately.

7. The ‘Once for Scotland’ Approach – Improving Employment Experiences for Junior Doctors and Dentists in Scotland
Kenny Small, Chair of the NHS Scotland Directors Group
Linda Donaldson, Associate Director of HR Forth Valley

8. Why a Once for Scotland approach is needed
Case for Change
Additional cost and time inefficiencies within NHS Scotland due to duplication in processes (personal background checks, Occupational Health checks, repeated induction, duplication on contracts, payroll processes, duplication of on-boarding & off-boarding)
Poor experience for trainees due to duplication in processes arising from having no single employer
Doctors in Difficulty, performance management and conduct issues not monitored effectively due to lack of continuity of support and consistency across the multiple employers (remain undetected for longer)
Variation and inconsistent application of policies across NHSScotland
No end-to-end staff record for trainees

9. Workstream Objectives
Provide DDiT with optimum continuity of employment and positive employment experience across NHSS.
Ensure consistent application of employment policies for DiT across NHSS.
Minimise duplication or unnecessary processes in “onboarding” throughout rotations for clinical placements.
Promote continuity and consistency in Payroll arrangements.
Ensure access to appropriate and high quality training experiences.
Effective information sharing and engagement between NHS Boards and NES in the management of performance and training of DDiT.

10. Employment Model

11. Delivering the Model - Governance

12. Benefits and how we’ll measure them
Evidence financial efficiency savings (reduced PVG costs, OH, administration)
Evidence improved consistency and information sharing via metrics and employee relations reporting through system.
Once for Scotland On Boarding
Monitor maternity and sickness absence for reduced complexity and therefore less administration time.
Improved monitoring of employee relations issues demonstrated through tracking on system (TURAS).
Reduction in tax code issues - monitor feedback from trainees.
Sharing Information (maternity, absence, performance, payroll)
Monitor recruitment and retention data.
Attraction
Monitor feedback through existing questionnaires (trainee surveys, exit questionnaires, iMatter).
Improved trainee employment experience

13. Enabling Workstreams PVG & Disclosure
Single PVG check and agreed sharing of information between Boards and
DDiT. NES now obtaining all PVG checks for Doctors in Training
Protection & Contracts
Working with support of the SJDC to revise T&Cs to remove protection of pay
for banding & develop single contract letter to support new model
Immigration (Tier 2)
NES as single sponsor of Tier 2 visas for all Doctors in Training
Occupational Health Passport
Agree a single dataset and process, and share information between Boards
and DDiT
Single Payroll Number
One employer means one payroll number throughout training programme
Policies & Procedures
Single processes and terminology, single policies and equity of
access/treatment
IT Solutions
Underpinning data sharing to enable new model working with eESS team
National Medical Job Application Form
Single form for application to any Board allowing online
applications

14. Delivering the Model Once for Scotland Regional Model: THE ‘HOW’ and ‘WHERE
NHS Scotland Doctors and Dentists in Training
will be employed within 3 Regions and by NES.
Major specialties will be managed within each Region.
NES will be lead employer and manage all GP’s
Decisions will be made regarding the management of the smaller specialties on a Scotland wide basis
Work ongoing within all Regional Medical Workforce Groups to determine options for Employment Board(s)

15. Delivering the Model: Workstreams
Contracts & Terms & Conditions Manage relationships with BMAScotland and Scottish Government on agreeing terms and conditions, including clarity on data sharing and safeguards
Policies & Procedures Develop and refine single templates, glossaries, processes and policies
Digital Solutions
Plan, design and deliver required digital solutions to underpin and support the new model, and increase ease of use for all users including DDiTs.
Communications
Develop understanding of stakeholders and develop communications strategy including communications of progress to Steering Group and to wider stakeholders
Risks Identify and manage project risks, report on risk reduction and review risk register
Benefits Realisation / Project Delivery
Define and set milestone and indicators to show delivery of benefits, ensure impacts are measured and controlled including EIAs of required processes
Early Adopter Project
review of progress of early adopter project and recommendations
for amendment to policies, agreements and key learning points

16. Employer Board DDiTs employed by programme not location
Single employer for duration of programme
Regions will agree employer model for regional programmes and host a share of national programmes
All Boards are placement Boards
NES oversees training and placements - as now
Single contracts, policies and processes
Agreed information sharing
NES Scotland Deanery
Employer Board
Placement Board

17. Conclusion: Benefits of the Once for Scotland Approach
Simplified, standardised and shared medical staffing recruitment/ employment service/ employee relations practice improving the quality and efficiency of services to managers and other “customers” of Human Resources
Enhances the employment experience of trainees during their employment
Improves governance of medical staffing related services and activities
Enhances local efficiencies and levels of productivity and efficiency
Maximises opportunities which are available through other systems
Improves resilience and sustainability of medical staffing services
Delivers consistency of Policy application with a Once for Scotland focus focus