1. Introducing KSF in a Medical Physics Department Hugh Wilkins Medical Physics Department Royal Devon & Exeter Hospital

2. AfC Project Structure Project Steering Group Terms & Conditions Communication Payroll /IT Monitoring & Evaluation Training/ Knowledge Skills Framework Service Modernisation Finance Job Evaluation Nominated Lead

3. KSF - Main Purpose Provides NHS-wide framework that can be used consistently across the service to support: –Personal development in post –Career development –Service development –Equality and diversity

4. What is the NHS KSF ? Common descriptions of the knowledge and skills that need to be applied in the NHS Applicable and transferable across the NHS Simple, easy to explain and understand Feasible to implement

5. What the NHS KSF is not Does not seek to describe what people are like or their attitudes Does not describe the exact knowledge and skills that people need to develop Does not determine job weight or pay band (JES does this)

6. The NHS KSF in context Links with current and emerging UK or national quality assured standards or competencies Supportive of the NHS Plan and related developments (eg Skills Escalator, Lifelong Learning Framework and the wider HR strategy) Included in development of the Electronic Staff Record (Computerised tool for EI sites)

7. e-KSF Web-based KSF: www.e-ksf.org Library (KSF Outline examples) Links with ESR (electronic staff record) for annual review (PDR – personal development review) Find out more at: www.e-ksfnow.org

8. Structure of the NHS KSF 30 dimensions: –6 core dimensions for all posts –24 specific dimensions Each dimension has 4 levels Level titles further supported by indicators Clear examples of application for different posts References to other standards, competences etc

9. Core Dimensions NHS KSF Equality & Diversity Personal & People Development Quality Service Improvement Communication Health, Safety & Security

10. 24 Specific Dimensions - Promotion of HWB - Assessment & care planning - Protection of HWB - Enablement to address HWB needs - Provision of care to meet HWB needs - Assessment & treatment planning - Interventions & treatments - Biomedical investigation & intervention - Equipment & devices to meet HWB needs - Products to meet HWB needs - Systems, vehicles & equipment - Environments & buildings - Transport & logistics CORE - Info processing - Info collection & analysis - Knowledge & info resources - Learning & development - Development & innovation - Procurement & commissioning - Financial management - Services & project management - People management - Capacity & capability - Public relations & marketing Health & Well Being (HWB) 1-10 Estates & Facilities (EF) 1-3 Information & Knowledge (IK) 1-3 General (G) 1-8

11. Example of Level Descriptors C2 Personal and People Development Level 1Contribute to own personal development Level 2Develop own skills and knowledge and provide information to others to help their development Level 3Develop oneself and contribute to the development of others Level 4Develop oneself and others in area of practice

12. C2 Personal & People Development, Level 2:

13. Outline for Post

14. Outlines for Post and Individual

15. KSF – What is it? The Knowledge & Skills Framework one of 3 key strands within Agenda for Change: –terms and conditions. –job evaluation –the NHS KSF and its associated development review process (together these form the basis of the career and pay progression strand)

16. Career and Pay Progression Designed to ensure consistency & fairness Normal expectation of progression through pay bands based on applying necessary knowledge & skills to the job Foundation gateway review against subset of KSF outline 2nd gateway review against full KSF outline

17. Pay Structure PAY BANDSIncremental Pay Points within each Band GATEWAY KSF OUTLINE defines the SKILLS & KNOWLEDGE required to perform that job KSF FOUNDATION defines basic SKILLS & KNOWLEDGE expected of person recently in post (6 - 12 months) GATEWAY 9 8 7 6 5 4 3 2 1

18. Pay Structure PAY BANDS 9 8 7 6 5 4 3 2 Progression up through Band determined by annual Development Review Incremental Pay Points within each Band GATEWAY KSF OUTLINE defines the SKILLS & KNOWLEDGE required to perform that job GATEWAY 1

19. DimensionLevel for Post Job Title: Nuclear Medicine Technologist For illustrative purposes only Foundation Band: TBA KSF Outline – Example 1 C1 Communications C2 Personal & people development C3 Health, safety & security C4 Service improvement C5 Quality C6 Equality & diversity 3 3 2 2 3 2 HWB3 Protection of health & wellbeing HWB6 Assessment & treatment planning 2 2 2 1 1 1abcd 2 1 1 1 HWB8 Biomedical investigation & intervention HWB10 Products to meet health & wellbeing needs 2 2 1 - EF1 Systems, vehicles and equipment IK1 Information processing 3 3 1 1

20. DimensionLevel for Post Job Title: Head of Nuclear Medicine For illustrative purposes only Foundation Band: TBA KSF Outline – Example 2 C1 Communications C2 Personal & people development C3 Health, safety & security C4 Service improvement C5 Quality C6 Equality & diversity 4 4 4 4 4 3 HWB3 Protection of health & wellbeing HWB6 Assessment & treatment planning 4 2 4 3 2 3 2 2 3 2 HWB8 Biomedical investigation & intervention2 EF1 Systems, vehicles and equipment IK2 Information collection and analysis 3 3 G4 Financial management G6 People management 4 4 2 2 3 2 3

21. Producing KSF Outlines 1.Confirm job purpose 2.Select specific dimensions 3.Identify levels for core and specific dimensions 4.Compile areas of application 5.Create subset for Foundation Gateway (repeat steps 3 & 4 for FG)

22. Which KSF Outline? Stage 1 OutlineMatrix Stage 2 OutlineStage 1 + Examples of Application Stage 3 OutlineStages 1&2 + FG subset Matrix Stage 4 OutlineStages 1,2&3 + FG subset Examples of Application

23. KSF Drivers NHS Plan Modernisation Agency KSFDG (now KSFG) (KSF Development Group) Under development since ~2000 Handbook published Oct 2004 (version 7)

24. Exeter HCS/CS KSF Involvement KSFDG -> RD&E Trust, wanting HCS / CS example outline for national library / web-site Concern, JE & banding context Contacted IPEM, HPA representatives Contacted CS colleagues: –Biochemists –Clinical Measurements –Molecular Genetics

25. Exeter HCS/CS KSF Developments Departmental Workshop (-> stage 1 outlines) Follow-up Workshop Feb 2005 TH (KSFDG) working closely with small group of CSs at registration stage & line managers (-> stage 2 example outline) Stage 2 KSF Outline –Draft 1 –Draft 2 –Draft 3 -> KSF national library

26. NHS KNOWLEDGE AND SKILLS FRAMEWORK GUIDANCE ON DEVELOPING NHS KSF OUTLINES FOR HEALTHCARE SCIENCE FHCS / KSFDG document Exeter example outline included as appendix ? Incorporation into CSO HCS documentation (Healthcare Scientists Career Framework Supporting Agenda for Change Documentation)

27. NHS KNOWLEDGE AND SKILLS FRAMEWORK GUIDANCE ON DEVELOPING NHS KSF OUTLINES FOR HEALTHCARE SCIENCE Life Sciences Physical Sciences & Engineering Physiological Sciences Common dimensions: –IK1Information processing –IK2Information collection & analysis –IK3Knowledge & information resources –EF1Systems, vehicles & equipment –G2Design & development

28. NHS KNOWLEDGE AND SKILLS FRAMEWORK GUIDANCE ON DEVELOPING NHS KSF OUTLINES FOR HEALTHCARE SCIENCE Physical Sciences & Engineering: –HWB3Protection of health & wellbeing –HWB7Interventions & treatment –HWB9Equipment & devices to meet health & wellbeing needs –EF1Systems, vehicles & equipment

29. How will the NHS KSF be used in Development Review? KSF outline for each post Match individual against post outline Personal development plans agreed and supported Linked to Lifelong Learning

30. Appraisal Appraisal is the process of joint review of an individual’s performance & development at work, and agreement of a plan for future knowledge & skills development

31. The Appraisal Cycle Informal Progress Reviews Formal Appraisal Review Development Organisational Objectives Department ObjectivesIndividual Objectives

32. Appraisal Process All staff should have an annual appraisal review which includes: –Performance Review –Development Review assessment against the KSF Outline –Production of Personal Development Plan (PDP) using the KSF as a development tool –PDP should include any specific objectives that the individual needs to meet in their post

33. Performance & Development Review Performance Review –Focuses on the individual’s performance in the job, including any specific personal objectives –Performance issues must be addressed on an ongoing basis, with no surprises at appraisal Development Review –Focuses on individual’s development of skills & knowledge –KSF Outline forms template for ongoing development

34. Initial Preparation Arrange a suitable time & venue Liaise with your Appraisee –Provide Self Assessment Form & copy of KSF Outline for their job –Remind appraisee to review the evidence in their personal Development Portfolio –Emphasise the positives of appraisal

35. Document Preparation Refer to relevant documents –Previous year’s appraisal records & PDP –Job description –KSF Outline for the job Draft a proposed set of objectives –for discussion during the review

36. Appraisal Meeting Format Introductory remarks, including emphasis on confidentiality Review performance against work objectives Review development against the KSF Outline –Evidence of achievement in appraisee’s portfolio –Identify skills & knowledge to be developed in next period Plan future objectives Identify training & development needs Agree future action

37. Follow Up Actions Complete appraisal review record & PDP –Initially paper documents –Eventually an online process Appraisee reviews appraisal record, can add comments & signs approval Copies of documents for appraiser & appraisee Carry out agreed actions –Ongoing monitoring, review & recognition

38. Managing the Process (1) ? Top-down / Bottom-up? One approach: –KSF Awareness sessions –Departmental Workshops –Individuals have first stab at producing draft outlines for their own posts –NB Line Management Structure

39. Medical Physics Organisational Chart Director of Medical Physics Head of Diagnostic Radiology Physics Prin. Physicist (Brachy.) 0.8wte Prin. Physicist (QC, R/n Th.) 0.8wte Prin. Physicist (Eqpt. Mgr.) Clinical Scientist (Treat. Plan.) Clinical Scientist 0.4wte Part I CS Trainee Chief RT Clin. Tech. (Equip. Man) Specialist. Med. Phys. Technician. Chief Clin. Technologist (RT Mld Rm) Spec. Med. Phys. Tech. 0.59wte Clin. Tech. (Mld Rm/Hot lab) Trainee Clin. Technologist Medical Physics Secretary Secretarial Assistant 0.61wte Clin. Tech. (Mld Rm) 0.81wte Supt. Radiographer Senior X-Ray Engineer Osteoporosis Services Mgr. 0.61wte Senior Technologis t Radiographer Nuc. Med. 0.8wte Radiographer Nuc. Med. Radiographer Nuc. Med. 0.8wte Clinical Technologist Radiographer, BMD 0.42wte Osteo. Services Secretary/ Receptionist 0.59wte Nuclear Medicine Secretary Secretarial Assistant 0.54wte Bank Secretary to DRP Nuc. Med. Nurse 0.52wte Nuc. Med. Nurse 0.35wte Clinical Scientist (Nuc. Med.) 0.5wte23.09.05 Clinical Scientist (QA) Part II CS Trainee X-Ray Engineer Head of Radiotherapy Physics

40. Managing the Process (2) One approach (cont.): –Line managers meeting 19.9.05 –LMs take greater sense of ownership –Fill in gaps, and aim for consistency –Share amongst line managers: Matrix of post levels/dimensions Draft Stage 2 outlines

41. Managing the Process (3) One approach (cont.): –? Common outlines for multiple staff –31.10.05 Stage 1 & Stage 2 outlines –? x.12.05 Stage 3 & Stage 4 outlines –Trust QA/Consistency Panel sign-off

42. Concerns about KSF Influence on banding (particularly if structural change of post) Paperwork involved Time taken to implement Availability of staff to implement Training – funding to implement PDPs

43. Job Evaluation: What It Is A system for comparing different jobs Used for establishing relativities between jobs The basis for grading jobs in the new pay structure Measures jobs not people Based on the demands of jobs Involves analysing jobs under factor headings (e.g. Knowledge and Skills; Responsibilities; Effort)

44. Implementation Timetable

45. KSF Implementation Full implementation for all 1.3 million staff by October 2006, with all gateways fully operational. Outlines and KSF Development Review therefore need to be in place by October 2005 KSF-style PDR mandatory from 1.10.05

46. KSF Implementation Targets 60% of outlines by end August 2005 80% by end of October 2005 100% by end of December 2005 5/28 SHAs made August target RD&E 43% by end of August (Stage 1 outlines)

47. WEBSITES Modernisation Agency: www.modern.nhs.uk/agendaforchange Department of Health: www.dh.gov.uk/PolicyAndGuidance/ HumanResourcesAndTraining/ ModernisingPay/AgendaForChange Web-based KSF at: www.e-ksf.org Find out more at: www.e-ksfnow.org

48. Current Best Web-sites for Modernisation Agency / DH KSF www.wise.nhs.uk (legacy repository for selected work of the M.A.) www.dh.gov.uk (A..Z -> AfC / KSF)

49. Summary KSF Outline identifies the knowledge & skills that a person needs to apply in their post Basis of fair & objective appraisal reviews Guide to development of knowledge & skills Emphasis of appraisal is on review of ongoing knowledge & skills development

50. Current Issues Steep learning curve – new way of working and understanding the philosophy of Agenda for Change. Getting to grips with the sheer scale of the project. Huge implications for time and resources. Forging new working relationships with new/existing stakeholders groups or interested parties. Developing staff confidence and trust

52. Pay Modernisation - Why? Government commits sustained investment in NHS Better services for patients Better staff development Fairer rewards for staff

53. Finally?