1. Workforce Assurance Tool - Overview & Application John Parker Workforce Planner / Analyst East Cheshire NHS Trust June 2013

2. Workforce Assurance Tool - Overview & Application John Parker Freelance Workforce Planner / Analyst June 2013

3. … provide an overview of the key functional areas of the Workforce Assurance Tool …give the opportunity to see navigation through the WAT and look at how metrics can be analysed …establish how the Workforce Assurance Tool can assist in providing oversight of the workforce (data) Aims for Today

4. Assurance Process & Navigating the WAT in practice Tool developed for West Midlands SHA in response to Francis Enquiry

5. WAT – Assurance Framework Trigger Groups – Groups of similar assurance triggers e.g. workforce or finance Triggers– Collections of similar metrics e.g. Staff turnover or CIPs Metrics: Individual metrics in relation to specific triggers (311) Weighted aggregation: to allow Chalk + Cheese = Green Up to date? 137 47 127

6. Navigating the WAT 1. My analysis - Organisation and metric dashboard 2. My actions – Reporting and uploading of Trust plans 3. My resources – Supporting material and FAQs

7. WAT – Core Functions Triangulation between workforce, activity and finance data A national platform to workforce assurance that can be adapted as appropriate Best practice approach that is built on existing published literature An approach that recognises that assurance criteria will change and be refined over time A tool to publish information A performance management tool A data collection tool; existing data is used A directorate and divisional assurance tool The tool is intended to provide: The tool is not intended to provide:

8. TDA Planning Guidance 2013: Requirement for Trusts to… 3. The Trust is either using or has familiarised itself with the National Workforce Assurance Tool application, in anticipation of its rollout later in 2013 Annex F: Workforce TDA Mandate “We will expect Trusts to know that they are red flagged and why”

9. WAT has the potential to assist Trusts with further compliance: 1.The Trust has a Board-approved workforce plan which includes the period 2013/14 2. The workforce plan has been approved by the medical and nurse directors prior to Board ‘sign off’ 4. Workforce metrics, benchmarking, trends and plans, with related quality metrics and intelligence have been used to identify trends, measure performance and inform the workforce plan for 2013/14 6. It is important that activity, financial and workforce plans are changing in a proportionate way over the planning period. Triangulation of the workforce plan for 2013/14 with financial and activity plans for 2013/14 has been undertaken 7. The triangulation demonstrates that the workforce plans are consistent with activity and financial plans 9. A system to deliver the workforce plan is in place which provides assurance to the Board Annex F: Workforce

12. Trigger Group Trigger Metric

16. The Midwife to Births Ratio Review Summary of Findings The WAT correctly identifies that our midwife to birth ratio is greater than RCM recommended but we disagree that the measure is consistent with RCM guideline definitions. The tool has functionality that enables cross referencing to local data sources. The precise definition of measures is critical and may require further work (births or birth related admissions and midwifes or midwifes excluding support roles) on the tool. By the method used in the local maternity network our ratio is even further away from the RCM guidelines. The measure did not inform the Trust. Does the measure/tool help to increase the number of midwifes?

17. (((I0213*1000)+(I0193*1000))/number of months in actual data) / NULLIF((I0443*1000)*I0463)/12)+(((I0213*1000)+(I0193*1000))/number of months in actual data)

18. Summary of Flag Reviews Red Flag Bed occupancy KH03 return from Trust based on usage (> 100% occupancy) Return now amended, will take up to 6 months to work through WAT Red Flag Midwife : Birth Ratio Dispute method used is RCM standard Service and Operational Management aware of Midwifes < RCM guidelines Green Flag Nurse Temporary staff cost Known issue in Trust (if we are green…..) Dispute calculation….

19. Organisational Choices Do Nothing (it will probably go away or be replaced by something different, anyway I already know about my workforce and who are the TDA?……) Carry out an urgent scoping exercise to understand red flags in Organisation Indicators (needs competent widely experienced analyst) ? done by HR ? done by Governance ? done by Operations ? done by Information Carry out detailed analysis and implement recommendations or board to acknowledge risk (? Led by Operational Manager) Complete Plan assurance - requires Workforce, Finance and Activity templates to be completed

20. Summary Utilises existing, established data – latest but not up to date Triangulates Finance, Activity and workforce metrics Generates red flags for statistical anomalies Useful audit of data returns (DQ / misinterpreted will cause many anomalies) Mandated by TDA for non FT’s Gives assurance (after all indicators are investigated and understood) and false assurance until…..… Tool “is a stick to be beaten with” without investigations Resources required - not just an HR issue Provides workforce plan Assurance