Accelerated Learning Event: Developing the Healthcare Workforce for London Thursday 9 June 2011 Cumberland Hotel, London

1. Accelerated Learning Event: Developing the Healthcare Workforce for London Thursday 9 June 2011 Cumberland Hotel, London W1C 1LZ

2. Objectives and purpose of the day Anne Tofts

3. Welcome to the ALE Our overarching objective is to improve the quality and safety of care for today’s and tomorrow’s patients. What today is about: To promote a common understanding of the proposed system design across stakeholder groups. To work together, as representatives of the system, to test and develop the system design To identify solutions to some of the known challenges, such as clear governance and accountability To use the development of this system to strengthen existing arrangements rather than just restructure To build a platform for further system design work What today is not about: Starting the design from scratch or unpicking the design principles. Solving all problems - the focus is on the workforce and education commissioning system and the responsibilities attached to it Style and approach for the day: The usefulness of today is dependent upon contributions from everyone Openness, honesty and constructive criticism is welcomed ‘Suspend disbelief’ for the scenario session and work with the examples to test the system Suggestions from participants? Key points: Style and approach: Encourage views to be expressed by participants Key points: Style and approach: Encourage views to be expressed by participants

4. Agenda for the day Key points: Explain marketplace session and scenario testing in more detail.Key points: Explain marketplace session and scenario testing in more detail.

5. Overview of the current system Janice Sigsworth, Director of Nursing, Imperial College Healthcare NHS Trust

6. Liberating the NHS: Developing the Healthcare Workforce In December 2010, DH issued the white paper Liberating the NHS: Developing the Healthcare Workforce with a vision to deliver the following:

7. London’s response to the white paper London’s response was based on significant stakeholder engagement including open events and speaking at existing meetings, web-based surveys and individual stakeholder interviews. This engagement enabled the collation of core themes with significant support across the whole system. From these, design principles were developed leading to a ‘strawman’ and supporting narrative. Healthcare Workforce Transition Executive (HWTE) established to oversee this work. London’s response to DH was submitted 31 March 2011. Further engagement since the white paper response: Open events during May to get further input on the emerging system design Today’s ALE And from the DH, the Accelerated Solutions Event, Delphi survey and future forum discussions In addition to inputting via these events, further views following today’s ALE can be submitted via: education.programme@london.nhs.uk

8. There was broad agreement on a number of system design issues

9. Introducing the London Operating Model (LOM) Sheree Axon Director of Transition, NHS London

11. Feedback from the DH following the Transition Assurance process in April, is that they have been impressed with the work that has taken place in London as part of the transition. This has included the successful setting up of 37 GP consortia and the creation of the six clusters across the capital. We have been asked to continue the good work and develop proposals for how the health service will be run in London as part of the modernised NHS. We have some design principles which will shape our proposals. Patients, their care and safety remain central to everything we do. Quality of services must be improved whilst better using constrained resources. The proposal must be able to manage local and London-wide issues whilst ensuring there is flexibility in the system to change and adapt where necessary as we go through the transition. The proposals must be sensitive to the capacity and capability in the system and must also be more cost effective. We have to think outside organisational boundaries. The proposals we produce will be brought together into one document, which will be called the London Operating Model (LOM). We are working to a tight timetable to make the best use of the ‘pause’ in the Bill process and plan to submit the document to the DH on the 16 June 2011. At this stage all that is required by the DH are proposals only.

12. The proposals will also set out how the London arrangements fit with the development of the new ‘receiving’ organisations nationally (such as the Trust Development Agency, Health Education England, and Public Health England). The process of developing the LOM is being led by functional working groups to develop specific proposals with key stakeholders ensuring detailed and wide-ranging input across all levels of the system to the proposals that will be submitted. We are the only SHA and region that has been asked to do this work. This is in recognition that in London we face a unique set of immediate challenges and that change cannot wait. Put simply, doing nothing whilst we wait for the transition to be completed is not an option. Other regions have their own challenges but our work may be useful in helping to shape developments across the country.

15.

16. System transition – supporting the transfer of functions, posts and people from the ‘sending organisations’ i.e. the SHA, hosted bodies and services, PCTs and eventually clusters, to the ‘receiving organisations’ being established as part of the Health and Social Care Bill 2011, or as transitional management arrangements, or already established employers e.g. Monitor – economic regulator. This programme has over 4000 posts in scope across at least 33 employers, over a timescale from 2011 to 2013. Public Health Transition – as part of wider system transition, supporting the transfer of Public Health functions posts and people across London to Public Health England by 2012 and Local Authorities by 2013. There are just under 1000 posts in scope for this activity. Implementing the London Operating Model for transition – as part of wider system transition, supporting the earlier alignment of existing functions to the emerging new system arrangements, ensuring a grip on finance and performance during transition, whilst enabling continuity for as many functions, roles and people as possible. In addition, some design and build activities as follows: Organisation Design and development support to ‘emerging destinations’ such as GP Consortia and Commissioning Support Units and the workforce and education commissioning system over the same period (2011 – 2013). There could be up to 40 potential destinations in London.

17. The marketplace – ‘how to’

18. The marketplace – a ‘how to’ guide Check your name badge for letter category 2. 20 minutes at each of the three market stalls: Education commissioning strategy: Ian Curran, Rob Smith Workforce and leadership development: Jennie Lau, Anne-Marie Archard Marketplace information will help you during the afternoon’s scenario session Please use the feedback boards at each stall for posting your thoughts, comments and questions. This feedback will help inform our next session Marketplace information will remain in place all day

19. The proposed system for London Rob Smith, Director of Strategy and Systems Development, NHS London Fiona Moss, Director of Medical and Dental Education, London Deanery FIONA’S intro against this slide: Janice introduced you to the process for developing the system design And you’ve had a chance to explore further during the ‘marketplace’ In this presentation will explain the detail of the design and address some of the questions that have started to emerge during the market place Before doing so it’s worth re-emphasising what Anne said at the start – this is about Improving the quality and the safety of care for today’s and tomorrow’s patients There is much change even for change junkies but Despite that some things remain certain: Need to train health care professionals Need to train for a more uncertain world The issues raised by stakeholders during the consultation and the design principles developed reflect this context – your contributions today should also do that. Rob will now tell you more about the system design. FIONA’S intro against this slide: Janice introduced you to the process for developing the system design And you’ve had a chance to explore further during the ‘marketplace’ In this presentation will explain the detail of the design and address some of the questions that have started to emerge during the market place Before doing so it’s worth re-emphasising what Anne said at the start – this is about Improving the quality and the safety of care for today’s and tomorrow’s patients There is much change even for change junkies but Despite that some things remain certain: Need to train health care professionals Need to train for a more uncertain world The issues raised by stakeholders during the consultation and the design principles developed reflect this context – your contributions today should also do that. Rob will now tell you more about the system design.

20. London’s Design PrinciplesThe system design issues identified by our stakeholders suggest a series of design principles ROBROB

21. ROBROB

22. ROB The HWTE commissioned the development of a proposed system design based on the design principles (VOICEOVER) Many of you will have seen this diagram before either in previous communications or at our open events. To make the design more accessible I’d like to unpick each part of it and show how it adds up to this system design ROB The HWTE commissioned the development of a proposed system design based on the design principles (VOICEOVER) Many of you will have seen this diagram before either in previous communications or at our open events. To make the design more accessible I’d like to unpick each part of it and show how it adds up to this system design

23. ROBROB

24. ROBROB

25. FIONAFIONA

26. FIONAFIONA

27. FIONA Coherence with national bodies is what the LOM is about (from Sheree’s presentation)FIONA Coherence with national bodies is what the LOM is about (from Sheree’s presentation)

28. ROBROB

29. ROBROB

30. Question and answer session

31. Question and answer session Anne Tofts, Chair Our expert panel: Fiona Moss, Director of Medical and Dental Education, London Deanery Janice Sigsworth, Director of Nursing, Imperial College Healthcare NHS Trust Sheree Axon, Director of Transition, NHS London Rob Smith, Director of Strategy and System Development, NHS London Julie Screaton, Deputy Director, People and Organisational Development, NHS London Helen Jameson, Head of Finance, People and Organisational Development, NHS London

32. Introduction and objectives for the scenario session

33. Introduction and objectives for the scenario session To enable participants to explore the system design through a real life scenario To test the system, identifying problem areas and solutions along a series of themes, for example, accountability, interactions within the system To give participants a greater understanding of how the system would work Key points: - ‘Suspend your disbelief’. Review the ALE style in the objectives.Key points: - ‘Suspend your disbelief’. Review the ALE style in the objectives.

34. The scenario: how it works and what you need to do now How it works: Each table is a component of the proposed system Your facilitators will guide you through the scenario. If required, they can consult our panel of experts for technical and factual questions to help with your response You are encouraged to interact with other components (tables) in the system Complete the three questions within the scenario brief as these will inform the plenary discussions What you need to do now: 1. Receive your scenario pack from your facilitator. This will include: Information about the system component your table is representing The scenario brief 2. Over lunch, review the materials in the marketplace for useful intelligence to weave in to your scenario response. 3. Please be at your tables, ready to start, at 13.30

35. Scenario session guide

36. The scenario

37. Final remarks and close Anne Rainsberry, Director of People & Organisational Development - NHSL

38. Next steps Following today your contributions and feedback will inform: The development of the system design Detailed transition planning Our next steps should be considered in the context of the LOM and the national picture: Meeting with David Nicholson 16 June DH feedback on consultation expected in July Future Forum report expected in July Over the next few months as we continue to develop the design and plan for transition and implementation, prior to shadow operation, HWTE will meet monthly Specify design principles for transition Refer back to Sheree David Nicolson meeting is on the LOMSpecify design principles for transition Refer back to Sheree David Nicolson meeting is on the LOM

39. Thank you for your participation and contributions