1. Developing the Future Workforce
An Employer Perspective
Michael Proctor
11th May 2017

2. North Sustainability & Transformation Plan Footprints1
Northumberland, Tyne and Wear
Durham, Darlington and Tees, Hambleton, Richmondshire and Whitby Humber, Coast and Vale South Yorkshire and Bassetlaw West Yorkshire Greater Manchester (Devo Manc) Cheshire and Merseyside Lancashire and South Cumbria West, North and East Cumbria 9 2
North Sustainability & Transformation Plan Footprints 5 3 8 6 4 7

3. Our Footprint Population characteristics Three main acute providers
1.4 million population
23% live in the most deprived areas of England
Diverse rural, urban and coastal communities
Huge variation in health outcomes
Three main acute providers
Hull and East Yorkshire Hospitals NHS Trust
North Lincolnshire and Goole NHS Foundation Trust
York Teaching Hospital NHS Foundation Trust

4. We Serve

5. Almost every problem I deal with (finance, performance quality, safety) have, at their root, a workforce issue.

6. The Policy Context Brexit A need for new ways of delivering care
Five year forward view
HCV STP
Reduction in HEE funding for existing staff
Education reform - from August 2017
Apprenticeship levy
From bursary to fee paying
Opening the education market place

7. The Workforce Context
Supply and demand – RNs, AHP’s, junior doctors, GPs, some Consultant specialities
Medical workforce ‘fixed’ for 10 years
Recruitment
Retention (Social Care staff turnover 27%)
Ageing workforce (47% over 55)
EU recruitment may diminish
Pretty much aware of the challenges we face in HCV but things are becoming more critical with high percentages of RNs for example able to retire in the next 2-3 years albeit many organisations offer flexible retire and return packages to encourage experienced staff to return. New and existing staff need to have greater flexibility to deliver care in different ways, potentially with different or additional sets of competencies. Inconsistencies of care across different sectors in part caused by differences in training, job satisfaction and confidence which in turn can lead to high staff turnover, unnecessary numbers of people presenting at A&E and hospital admissions and ofcourse impact on the quality of care people receive. HEE are like other organisations having to balance their books and this has and will impact on funding available. And we don’t know as yet the outcome of the education reforms though we are actively encouraging and seeking to strengthen partnerships between education and service providers to mitigate against the risks of under recruitment to programmes and create new pathways into the registered professions.

8. The Financial Context Our System Pressures
Existing CCG savings targets £25m
York FT £23m (8th year of 4%)
‘Shortfall’ £14m
Capped Expenditure Programme
York FT Locum/Agency expenditure
13/14 £5m
14/15 £11m
15/16 £25m
16/17 £21m
Apprenticeship Levy - £1.5m

9. Focus of HCV Local Workforce Action Board
Learn from the innovation that takes place where there are the greatest pressures
A focus on supporting Primary Care
To attract, recruit, develop and retain a sufficient supply of health & social care support staff through the establishment of a collaborative framework.
Developing Advanced Clinical Practice to meet existing and future workforce demand across HCV
Workforce issues cut across the whole system and will be present within each workstream. Even in developed a report now it may not include all WF needs as the develop through the emerging workstreams, but we need a benchmark from which to build, not to mention gain assurance from work already in progress. Rationale - In May 2016 HEE led a workforce workshop bringing stakeholders together from across health and social care organisations in our patch to consider workforce challenges and through table top discussions identify some solutions and priority areas. Following on from this event the LWAB was formed with members from key stakeholder organisations (listed in the delivery plan section 8) who identified this vision as an initial priority. Stakeholders at both the May event and from within the LWAB identified that steps need to be taken not only to scale up the recruitment of support staff but to establish a system wide approach to their development in order to enable portability of qualifications and mobility of competent highly skilled flexible staff – that could progress into RN training should they wish to by undertaking a shortened route to becoming a RN. Strengthening our need to create a grow your own workforce framework that is created and owned by HCV. Ideas generated in May are incorporated into the programmes.
Similarly with ACPs – stakeholders were highlighting the need to address gaps in junior doctor numbers in the hospitals and GP gaps in primary care for instance with a need to scale up ACP numbers across HCV. This is happening currently in pockets and there was recognition that as a system we need to not only scale up the numbers but identify ways to attract them to HCV and retain them.
Lots of ideas around and progress being made in pockets – our role is to identify the champions, pull those ideas in and make them happen for HCV

10. A Personal Wish-List
Get the right people into ‘care’ and give them a job for life by offering progression (no matter how low the start point).
Merge Health and Social Care learning and qualifications
Stop pretending nursing is an academic pursuit.
Recruit locally to Pre- Reg programmes
Recruit more medical students but widen the entry gate