1. NHS North west CHESHIRE AND MERSEYSIDE WORKFORCE UPDATE

2. Mike Burgess Mike.burgess@northwest.nhs.uk
WORKFORCE STRATEGY
Mike Burgess

3. LETB update
1 LETB in the North West with 3 local workforce and education groups as per current geography
Largest in NHS England, strong ability to influence on the national stage
LETB will need to go through authorisation
Focus on progressing the MPET Investment plan, 5 year workforce development plan, and authorisation criteria
Recruitment of the LETB Managing Director
Workforce and Education staff / Deaneries transferring to Health Education England to support the LETB
HEE website
LETB information on eWIN

4. Workforce Plans 2012/13 – 2017/18
Current refresh of workforce plans out in the system with deadline of 21st September 2012
The refresh covers update to multi-faceted narrative across 8 domains and a workforce risks / issues and mitigating actions paper
The coverage is inclusive of all NHS workforce and includes primary and community care, public health and other sectors where information is available.
Utilisation of the three workforce planning and modernisation networks across Greater Manchester, Cumbria and Lancashire and Cheshire and Merseyside

5. Workforce Assurance and Patient Safety
The national drive by the Department of Health and workforce leaders group (WLG) for workforce assurance
Plans need to be signed off CE, Director of Nursing and Medical Director
Workforce and patient safety links report included with packs issued to providers and commissioners
Workforce assurance matrix available to download from eWIN
Plans to be tested against a single assurance process integrating finance, activity, patient safety, clinical safety and performance metrics
The eWIN system allows providers to benchmark their workforce against other providers along QIPP indicators, priority areas and use knowledge management and best practice to implement changes.
Purchasing the National Workforce Assurance Tool for Providers
Plans / training / implementation been drawn together
Officially launched via HRDs and LETB in next quarter (Sept – December 2012)
Submission
Workforce Demand spreadsheet
Workforce Risks / Issues / Actions report
(Optional) Workforce Narrative refresh
Close of Play Friday 21st September 2012

6. Workforce Assurance

7. The WORKFORCE assurance framework
The Workforce Assurance Framework is a method for achieving system assurance that the planned and available workforce can deliver safe and quality services.
Identify current workforce issues and is an early warning system when reviewing projected workforce changes
Reflects the key lines of enquiry agreed by the DH Operations Board1
1 – Key lines of enquiry referenced in DH KLOE on Safety and Quality Assurance of Workforce Changes

8. The need for a robust system to support workforce assurance
Expertise from 10 SHAs and the Department of Health have been drawn upon to support system design and to address the current limitations associated with attempting workforce assurance using static data and manual processes. The key challenges identified by this group in relation to workforce assurance and the related desired benefits of the system are detailed below:
Current Challenges
Solutions from the tool
Much of the data collected is currently retrospective and not forward looking
The tool will use trend data to project how the picture might change over time which can then be compared to actual performance
Process, dashboards and metrics collected are different in different regions
Good practice adopted consistently across Trusts and regions with a collation of all existing metrics
Individual indicators are often looked at in silos
Enables consideration of the importance of interrelationship between indicators and triangulation of workforce, activity and finance
Current processes are not supported by robust statistical analysis
Assurance processes underpinned by detailed information base and statistical analysis including detailed literature review
Current processes are labour intensive as mainly manual processes
Automation reduced manual data manipulation and handling burden
Currently workforce plans go backwards and forwards between Trusts and Assurers, increasing timescales / tensions
Greater visibility of assurance expectations between Trusts and Assurers – a shared tool that can be also be used by individual Providers

9. How we are approaching assurance
Our different approach creates a different conversation about assurance:
What is different?
A systematic approach enabling rigorous, structured evaluation
A statistically robust underpinning for assurance analysis
Analysis of correlation and relationships between triggers
Thresholds for triggering
Escalation routines to enable consideration of escalation in structured
This enables you to
Create and drive top table discussions
Changes the nature of assurance engagement with Trust Boards and Management Teams
Call on robust evidence and analysis as support for key decision making
Take a more integrated approach to assurance activities
Justify decisions

10. Underlying principles of the tool
Fundamental Tenets
Effective workforce assurance is a critical component of helping ensure the ongoing efficient and effective delivery of services across the NHS system.
Organisations should be supported to be rigorous in their self assurance processes, to improve outcomes and reduce the need for external assurance.
By using data appropriately, users can be supported to make better assurance decisions. This is a decision support tool, not a decision making tool.
Consistent high levels of assurance across regions.
Considers a cross section of demand, activity, quality, finance and service information rather than considering workforce alone.
Balances forward looking assessments with previous performance: i.e. Historic dashboards are a useful input but do not tell the whole story.
To minimise effort, Nationally available data will be used wherever possible to reduce the administrative burden.
Differences in data quality and availability need to be allowed for and highlighted within the system.
Throughout the life of the tool, the system will be actively managed so that as new national datasets become available each period they are uploaded into the tool.
Workforce
Assurance in Practice
Data usage

11. What is the Tool intended for?
The Tool IS intended to provide:
The workforce element that will link with wider system level assurance
Triangulation between workforce, activity and finance data
A national platform to workforce assurance that can be adapted as appropriate for each SHA
Best practice approach that is built on existing published literature
An approach that recognises that assurance criteria will change and be refined over time
The Tool IS NOT intended to be:
A tool to publish information
A performance management tool
A data collection tool; existing data is used
A directorate, divisional and professional assurance tool as other resources are available for this

12. The Workforce Assurance Portal
The key components that people use within the portal are illustrated in the table below:
Workforce Assurance Portal
My Actions
My Analysis
My Resources
My Threads
Help
Organisation
Dashboard
My Notes
Supporting Materials
My Assurance Logs
Community
My Flags
Data Sources
These are the 3 sections that were looked at in the pre-reading, in terms of what they do, and what's included. In the next module, we will be looking at how to use each section. For trust users, will only see the organisation and metric dashboards, regional managers can see the regional dashboard. This diagram gives a nice overview of the tool, and the areas within it, so we will refer back to this.
My Qualitative
Indicators
Metric
Dashboard
FAQ
My Plans
Workforce Dictionary

13. Metric e.g. Midwife: birth ratio
Indicators, Metrics and Thresholds
Indicator
The base level of data used to make metrics
This data comes from various source data sets
Metric
Metrics display information about an aspect related to workforce
Metrics can also be direct (taken directly from one indicator) or compound (calculated by combining more than one indicator)
Threshold
The threshold is the level at which metrics turn green, amber or red, indicating the risk associated with each metric
The threshold is different for each metric and based on the value needed for them to be considered high risk, and turn red, or low risk, and turn green
The threshold can take the form of a scale or range
Example: Indicators, Metrics and Thresholds
An indicator could be the number of midwives, or the number of births. The data from these indicators is used to create different metrics.
Metric e.g. Midwife: birth ratio
The metric will be assigned a risk level depending on the threshold. Some thresholds are scales where one extreme is good and the other is bad. Other thresholds are ranges where there is an ideal level and anything either side increases risk. In our example a threshold would be a scale, and less than e.g. 3 midwives per birth is ‘high risk’.
Target Value
Intervals from Target Value

14. The Assurance Map
There are 4 assurance groups, 3 are based on data and are shown below, the 4th is based on qualitative data. Each of the 3 groups below contains trigger groups, triggers, and below each of these are the metrics.

15. Health Visitors update
Monday 17th September 2012

16. NORTH WEST PERFORMANCE – 2011/12
The North West target for Mar-13 health visitors is FTE ( is the absolute minimum required)
The Jul-12 ESR downloads show the current North West performance.
Totals by PCT Cluster
Mar-12
Apr-12
May-12
Jun-12
Jul-12
Gap
(ESR)
to Mar-13
at Jul-12
Lancashire
318.61
315.59
314.89
311.73
312.92
-25.04
Gtr Manchester
533.79
539.49
541.70
516.30
515.39
-61.50
Cheshire
214.10
214.92
216.07
216.84
215.72
-15.32
Cumbria
74.73
76.91
78.43
76.21
76.74
-1.90
Merseyside
255.79
256.74
249.63
244.79
244.98
-19.79
TOTAL
TOTAL (inc Other Providers)
NOTE: ESR cluster figures for Jul ESR have been calculated using proxy figures for the four divisions in Bridgewater, based on the July manual returns.

17. NHS Operating plans: NORTH WEST

18. PRECEPTORSHIP REPORTING
Trust will be paid a preceptorship fee for all newly employed Health Visitors who are new to the profession and joined the trust from September 2012.
Payments will be quarterly and based on numbers collected directly from trusts on a quarterly basis. The collection will form a ’bolt-on’ to the health visitor manual collection
Numbers for September (Q2) will be collected in October and payments will be made to trust in December (Q3)

19. HEALTH VISITOR WORKING GROUP
Inaugural meeting on the 25th September at Piccadilly Place
Group will look at improving Health Visitor workforce information and sharing of Health Visitor strategies and modelling tools
Target audience: Workforce Analysts, HR Managers, HV Service Leads
To register or for more information:

20. SCHOOL NURSING WORKFORCE AUDIT
Manual collection coordinated by Macaila Finch (SHA)
Deadline for completion was 24th August (snapshot as at 1st August 2012)
Work is underway to complete an analysis of the current school nursing service in the North West.

21. Saba Razaq
Senior Workforce Analyst

22. data quality update: AUGUST 2012 DATA

23. DATA QUALITY UPDATE
Acute and mental health trust in England data quality results published in Health and Social Care Information Centre report:
Available on HSCIC here or eWIN
Woven report ex-employees validation limited to leavers since 1st July 2012
Woven report GMC/GDC registration validation been corrected. Scores might have changed but are now correct
Emphasis on putting in place strong data collection & validation processes remains
Would a data quality summary page in eWIN be useful?
Updated June-12

24. Data Quality update – north west score
SHA
Aug-11
Sep-11
Oct-11
Nov-11
Dec-11
Jan-12
Mar-12
Apr-12
May-12
Jun-12
Jul-12
Aug-12
Rank
Position from previous month
NHS East Midlands
6,230
6,360
6,640
6,710
6,725
6,750
6,950
6,970
7,180
7,320
7,825
7,175 10 ↓
NHS East of England
6,220
6,410
6,430
6,660
6,790
6,880
7,030
7,055
7,105
7,140
7,480 9 ↑
NHS London
6,445
6,510
6,735
6,845
6,935
7,130
7,200
7,230
7,265
7,885
7,290 8 →
NHS North East
7,425
7,585
7,650
7,945
7,990
8,135
8,210
8,430
8,545
8,555
8,850
8,460 4
NHS North West
7,375
7,795
8,195
8,540
8,785
9,095
9,160
9,240
9,415
9,490
9,190 1
NHS South Central
7,390
7,580
7,660
7,960
8,060
8,005
8,160
8,115
8,145
8,415
8,250 6
NHS South East Coast
6,695
6,835
7,485
8,185
8,440
8,465
8,455
8,710
8,370 5
NHS South West
7,595
7,835
8,055
8,320
8,515
8,580
8,740
8,800
8,905
8,960
9,255
8,900 2
NHS West Midlands
6,920
6,875
7,185
7,395
7,510
7,715
7,625
7,685
8,205 7
NHS Yorkshire and Humber
7,360
7,505
7,745
8,000
8,045
8,175
8,345
8,445
8,495
8,750
8,560 3
NW retained first place Dec ‘11 to Aug’12
Error count increased by 3,060 (24.0%) errors Jul-Aug
Error count reduced by 28,462 (64.3%) errors Sep11-Aug12
Trafford Healthcare NHS Trust missing from report

25. Data Quality update – priority areas
Significant increases this month:
Ex-employees
30.1 (Destination on Leaving is blank) up by 573 errors from 10 to 583
33.1 (Destination on Leaving is NHS Organisation but NHS organisation is blank) up by 117 errors from 6 to 123
Significant decreases this month:
9.5 (Staff Group Medical & Dental but Grade code doesn't start K, L, M, Y or Z ) down by 54 errors from 105 to 51
9.6 (Occ. code Medical & Dental but Grade code doesn't start K, L, M, Y or Z ) down by 60 from 112 to 52

26. Data Quality update – HIGH IMPACT priority areas
Destination on Leaving is blank – no longer a high impact error
New % baselines established for five high impact errors
40.1 Recruitment Source is Blank: 31.4% of total errors
19.1 Sexual Orientation is Blank: 13.7% of total errors
31.1 Disability is Blank: 16.4% of total errors
16.1 Religious Belief is Blank: 13.5% of total errors
2.1 Area of Work is Blank: 10.1% of total errors
Five high impact areas account for 85% of total errors
30.1 Destination on Leaving is Blank: no longer a high impact error

27. Data Quality update
Two organisations in the North West in August 2012 had maximum scores of 10,000
Halton And St Helens PCT
Calderstones Partnership NHS Foundation Trust
Updated June-12

28. Data Quality update: FINAL SCORE C&M Current month August 2012

29. Data Quality update: ERROR COUNT C&M Current month August 2012

30. ACCESSING EWIN REPORTS
Select QIPP Dashboard

31. ACCESSING EWIN REPORTS
Navigate to the Woven Data Quality Reporting “speed-o-meter” and select graph

32. ACCESSING EWIN REPORTS
4 data reports are available and a data guidance page
All reports can be exported to PDF
Demo WebExes can be set up on request

33. Liz Thomas
Senior Programme Manager, Workforce Strategy

34. EWIN update C&M PLANNERS
Monday 17th September 2012

35. EwIN current and pending projects
QIPP Dashboard Review
Health Visitor Working Group / Priority Dashboard Review
Knowledge Exchange Redesign
Equality and Diversity Proposal
Health and Well-Being Homepage & Dashboard
eWIN Research Project
Updated June-12

36. EWIN: QIPP DASHBOARD REVIEW
QIPP Dashboards developed to assist NHS organisations identify efficiencies and savings
Twelve metrics for review
Functionality and design for review
Meeting 2nd October, 11am-1pm at NHS North West
Contact /
Updated June-12

37. EWIN: HEALTH VISITOR WORKING GROUP
To facilitate collaborative working between Health Visiting workforce leads and service leads
Motivate competition and challenge complacent operations
To define reporting methods on eWIN in respect of Health Visitors
To share Health Visitor workforce planning tools/strategies
To produce the redesigned Health Visitor workforce dashboards
Meeting 25th September, pm at NHS North West
Contact /
Updated June-12

38. EWIN: KNOWLEDGE EXCHANGE REDESIGN
To make the Knowledge Exchange search clearer and easier to use
Stage 1 produced a single search bar which displays results
Results can be filtered as required
Stage 2 discusses the requirements of an Advanced Search function
Contact /
Updated June-12

39. EWIN EQUALITY AND DIVERSITY PROPOSAL
Produce automated reports to support EDS requirements and CQC equality prompts
Support production of annual equality data publication
Provide organisational data and benchmarking data
Assist in developing analysis skills within the E&D community
Meeting 19th September, pm at NHS North West
Contact /
Updated June-12

40. EWIN HEALTH AND WELL-BEING PAGE AND DASHBOARD
Health and well-being homepage coming soon
Potential to develop data dashboard based on ESR Data Warehouse sickness reasons data
Days Lost by Sickness Absence Reason
Days Lost Per Quarter Average FTE
Average Length of Absence
Incidence by Long/Short Term
Call for participants will be released in October
Contact /
Updated June-12

41. EWIN research project Conducting interviews with eWIN users
Inform eWIN team’s strategic planning
Contacting primary care representatives
Developing links with HEIs and academic research hubs
Updated June-12

42. Liz Thomas
Senior Programme Manager Workforce Strategy