Workforce Strategy Update 15 February 2012

1. Workforce Strategy Update 15 February 2012

2. NHS Operating Plans 2012/13 • Feedback on the initial plans • Process for the full plans led by PCT Clusters • Pending ROCR approval on forms • Health Visiting Trajectories • Nine Key Lines of Enquiry

3. Initial Feedback • Feedback to PCT Clusters and PCT Cluster HR leads • PCT Clusters RAG rated for workforce covering: • All clusters were amber as we received some initial information • Workforce and workforce cost trajectories • Health visitor trajectories need in the forms / plans • 9 KLOEs • 3 Key workforce questions in the narrative • Based on the aggregation of lead PCT and providers within the cluster

4. Process for the full plans For each PCT For each PCT (Not lead PCT Commissioner) For each PCT +Provider (where the PCT is lead commissioner) the following: Workforce and pay-bill template completed Some information on Workforce Assurance (9 Key Lines of Enquiry) Health Visitor plans from PCT + Provider if they have Health Visitors (as per Resources in the NHS operating guidance) Template: ESR extraction Tool Pending ROCR approval (ROCR/OR/0190/002)

5. Process for the full plans As a PCT Cluster you will need to complete the following: • Aggregated workforce and pay-bill plans for PCTs (including their providers) on the template that are in your PCT Cluster: • The plans need to be triangulated with finance, activity, performance and quality to ensure they are affordable and deliverable for the PCT Cluster • Complete the answers for the 9 key Lines of Enquiry for the PCTs / Providers in the cluster • Answer the workforce questions in the narrative regarding QIPP, assurance and key workforce performance indicators • Answer the workforce indicators in the technical guidance • Your answers will be rag rates in the assessment of your plans

6. Triangulating plans • Can we afford the activity we are delivering and will need to deliver? • Do we understand the financial pressures of supply and demand? • Do our investments deliver value for money ? • Do we have the workforce capacity to deliver the activity ? • Do we have the right skills ? • Do we have the plans in place to respond to future workforce demand? Workforce Finance Activity • Have we modelled future demand? • Are changes in activity affordable ? • Do we have capacity in the right areas? • Are health systems balanced to need? • Do we understand the likely changes in activity?

7. Workforce questions in the PCT cluster narrative • Has workforce assurance been completed using the safety and quality assurance framework and Key Lines of Enquiry at Annex 5 and what was the outcome? • Does the narrative clearly set out what ‘system wide’ changes are expected in activity and patient flows and the subsequent impact of the shape of the workforce? (see separate slide) • Does the plan include sickness absence, skill mix changes, productivity and agency costs?

8. Key lines of enquiry Additional information will be available to help you answer these questions

9. Pending ROCR approval

10. Timescales

11. Data Quality update 06 February 2012

12. Communicating data quality • eWIN excel & PDF report • ESR leads via Sue Hodkinson • Deputy HRDs • ESR SIG • Regular presentations & updates • Regional update • HRDs forum • eWIN reports • In development for rollout mid-Feb • All eWIN users who have access to benchmarking

13. Data Quality Update – North West Score

14. Data Quality Update – Priority Areas

15. Data Quality Update

16. Data Quality Update – how can we improve priority areas? • Equality and diversity • Quick fix = did not disclose / unknown • Historical fixes = identifying current members of staff with unknown data and asking them to complete data validation form • Long-term solution = putting processes in place to capture information with new starters • Area of work • Field not many trusts use in reporting • Lack of clarity on how it should be used • Ideas for improvement?

17. Data Quality Update – how can we improve priority areas? • Destination on Leaving is blank • Quick fix = did not disclose / unknown • Historical fixes = checking files and manually inputting data • Long-term solution = putting processes in place to capture information on termination forms • Destination on Leaving is NHS organisation but NHS organisation is blank • As above – anything more we can do?

18. Data Quality Update – Error Count Reduction Top Ten Error Count Reductions Bottom Ten Error Count Reductions: please note the effect of the demerge on some trusts

19. Data Quality Update – Final Score Analysis Top Ten Final Score Increase Bottom Ten Final Score Increase: please note the effect of the demerge on some trusts

20. Cheshire and Merseyside Scores

21. eWIN DEMO

22. Good Practice Guidance • Aim of document • Brief overview of data quality methodology • Resource for trusts • In place of a case study • Can we add to it? • Can we include more methods for data validation? • Frequently asked questions about specific areas, e.g. Health Visitors, Medical Directors

23. Health Visitor update 06 February 2012

24. Health Visiting • Current numbers and actual against PCT Cluster trajectories • Data cleansing • Delivering the commitment

25. Health Visitors: Overview • The Department of Health Call for Action on Health Visiting Implementation Plan • (February 2011) sets out an aspiration to raise the current North West establishment • of Health Visitors to a minimum of 1,808.8 FTE by 31st March 2015. • The current positions and trajectories are available on eWIN • http://northwest.ewin.nhs.uk.boilerhousestudio.co.uk/priorityareas/home • Or, by contacting Adrian.Hackney@northwest.nhs.uk

26. Health Visitors: Current Positions • PCT Cluster performance as at Nov-11 • NHS North West will soon be writing out to all providers asking them to complete a manual return on a monthly basis. The template will capture staff in post (Health Visitors and FNPs) and vacancies. • Initial template will ask for two returns; as at Dec-11 and as at Jan-12. Subsequent submissions will only ask for the position as at the end of the previous month.

27. Health Visitors: Data Cleansing • In November 2001, a data cleansing exercise was completed by all providers in the North West. In support • of this national priority area, the Department of Health produced clarification regarding the definition of • Health Visitor.The regional data cleansing exercise was completed by all Health Visitor providers and we • thank you for all your hard work and efforts. • As a result of the Nov-11 data cleansing • exercise, the North West Health Visiting • workforce reduced in October and then • increased in Nov-11 in line with some • data cleansing and new trainees entering • the system. • However, from local sources we are aware that Dec-11 numbers have dropped again • which is partly due to misinterpretation of the coding guidance by some providers removing • Health Visitors with small clinical components to their role from the ESR N3H workforce • NHS North West has been in contact with these organisations and is seeking to resolve these issues.

28. Health Visitors: Coding Queries • How do I code an individual who holds a Health Visitor qualification and their post requires this qualification although their role is not wholly clinical? • The whole WTE of this individual should count towards your Health Visitors numbers (N3H) as • although they may not be wholly clinical based, their role counts towards the Call for Action • implementation plan. • How do I code Health Visiting Managers? • If the manager is involved (directly or indirectly) in any clinical work or in safeguarding and they hold • the professional Health Visitor qualification and the role requires this, they should be wholly coded as • a N3H. If they are not involved (directly or indirectly) in any clinical work or safeguarding, • they should be coded against the Managers matrix regardless of whether the individual in question • holds a professional registration or not. • Further details are in Data Bulletin 5 (to be published on eWIN w/c 13th February)

29. Health Visitors:Health Visiting Week • North West Health Visitor Week , w/c 5th March • Unite Union/ CPHVA Conference, Manchester, 6th March • Health Visiting Roadshow, Manchester 9th March (RCN/DH) • eWIN Case Studies/Hot Topic

30. eWIN updates06 February 2012

31. eWIN North West: Update • Knowledge Exchange & Sharing Best Practice • NHS Merseyside wins eWIN Award at the 2011 HRD Conference, given to the organisation which has had the greatest overall success with the use of eWIN since it went live in 2010. • eWIN continues to develop an expanding wealth of information relevant to HR/workforce/finance and QIPP • All resources relating to the NHS Reforms and Developing the • Healthcare Workforce can be accessed via the eWIN Home Page • Recent new eWIN material includes Agile Working, a case study from Lancashire Care FT; and an Overview of the NHS Operating Frameworkand a briefing from Chris Jeffries on Developing the Healthcare Workforce – from Design to Delivery • On 20 February 2012, Chris Jeffries will be running a WebEx session on eWIN about the new NHS healthcare arrangements. Register via eWIN, please note - places will be limited.   • Organisations are reminded that new case studies for eWIN are always most welcome – on all aspects of workforce planning/HR development, no matter how large or small an individual project. Further details are available via the eWIN Home Page, or contact christine.stewart@northwest.nhs.uk

32. eWIN North West: Update • Benchmarking Service • Priority Area Dashboards now on eWIN enable NW organisations to benchmark themselves against key workforce metrics relating to the children’s and young person’s workforce. Simply go to eWIN’s Benchmarking site to access data (updated monthly) on Health Visitors, Midwives and School Nurses • The eWIN team is able to offer WebEx tutorials on any • specific aspect of eWIN. Please contact • emma.hood@northwest.nhs.uk if you would like to • arrange a WebEx.  • Next data update due: 27th February 2012 • New features from February 2012: • Woven Data Quality reports available though the QIPP • Dashboards • Added functionality in the benchmarking summary pages to show the calculations used in the metrics.

33. eWIN North West - Developments • Excel tools currently available through eWIN: • Grade Mix Cost Tool • Sickness Absence Costing Tool • Savings Calculator • New QIPP tools are currently in development around • available on eWIN from March 2012. • You can feedback any issues/development requests • to support@ewin.nhs.uk or post your idea • on the eWIN forum in the Development Zone, and • one of the team will be in touch with you. • If you are interested in sharing your idea’s or any tools • you use locally through eWIN, please contact • emma.hood@northwest.nhs.uk

34. eWIN: Regional Expansion • NHS Yorkshire & The Humber • Piloted between August 2011 and December 2011 • 11 organisations participated in the pilot • Roll-out from January 2012 • NHS East of England • Pilot launched on the 28th November 2011 • 12 organisations in the region are participating • Feedback session via WebEx currently underway • Due to roll-out to the rest of the region in April 2012 • NHS South Central: • Pilot launched on the 19th January 2012 • All 25 organisations in the region are participating • Feedback sessions via WebEx due to commence w/c 6th February • Expected Benefits: • Accelerated developments / tools / dashboards around QIPP • Expanded Knowledge Exchange & Sharing Best Practice • Potential for National Benchmarking

35. Workforce Assurance Framework06 February 2012

36. Workforce Assurance Framework • Demonstration of the current tool • Shared with PCT Clusters / HR leads • Shared with a number of trusts for views • Feedback from PCT Cluster leads • Positive • Useful • Next steps • Workshop on Monday to thrash out metrics • Seek wider views

37. Workforce Planning Feedback06 February 2012

38. Workforce Plans 2011-2016 Feedback • Feedback on the plans • Imminent – sharing of reports / analysis • Commissioning education plan • Papers for the Network Leadership Groups • Prepared 3 papers which will be shared shortly • Focus on Medical and Dental workforce planning • Start modelling in more specialty detail supply and demand

39. Areas to Watch • Maternity workforce • Ministers radar – anticipate monthly monitoring • School nursing workforce • Ministers radar – anticipate monthly monitoring • Update on HEE / LETBs • (Information from the SHA and PCT letters issued 31.01.2012) • Big QIPP tickets for health care • New occupation code manual version 10 • http://www.ic.nhs.uk/statistics-and-data-collections/data-collections/information-supporting-our-data-collections

40. Delivering the big tickets NATIONAL BIG HITTERS • National £550M Boorman saving on sickness and absence • National £407M reduction in agency spend by 2014 • £15-20BN QIPP savings nationally by 2015 • 4,200 extra health visitors by 2015 (422 for the North West) • 100% Foundation Trust status for NHS providers • Stringent cash improvement programmes as well as 1.5% reduction in tariff 2012-2013 • Mid-Staffordshire feedback and new accountabilities / governance • Francis Report on staffing (nursing) • Increased regulation of workforce / cost implications • Increased industrial relations environment • Hidden targets and trajectories in the Information Revolution / transparency agenda – will need to recruit back information / ESR experts • Workforce assurance, patient safety and staff safety

41. Delivering the big tickets MEDICAL AND DENTAL Working with provides to understand the following for Workforce Assurance • Consultant and Clinical Productivity • Consultant PAs • Clinic start and finish times – impact on support staff over-time / extra hours • Theatre utilisation and maximisation • Operations flow optimisation tools • Synergistic pre and post operative discharges • Length of stay and bed / unit reductions • Friday to Sunday rotas and cover • Over-reliance on junior doctors and locums • Medical and Dental sickness and absence and cover • Basic Salary versus enhanced payment packages • Specialism's and NHS Litigation Authority premiums • Alternatives via non-medical consultant route

42. Delivering the big tickets REDUCING HEADCOUNT AND FTE • Rationalising back office functions and administration • Consolidation, reconfiguration and realisation • Reductions, re-deployment and redundancies (voluntary) • Closure of services / sites DELIVERING FINANCIAL BALANCE AND SERVICE WITHIN TARIFF • 4% or more Cash Improvement Programmes alongside QIPP • Squeeze on tariff (1.5% NHS operating framework 2012-2013 • Budget cuts in Local Authorities and Social Care (Adult and Children’s) • Front line ideas for QIPP • Cash saving / releasing / generating schemes

43. Delivering the big tickets REDUCING HR TRANSACTION COSTS • Rationalising payroll providers • HR transactions and duplicity • Training and Development • E-Rostering, bank, locum and agency usage • Shared HR and Business Services = optimisation • Minimising down-sizing costs and mistakes • Tackling terms and conditions EFFICIENCY AND EFFECTIVENESS • Eliminating waste, duplication and pointless process • Moving from Transferring Community Services to Transforming Community Services • Maximising productive time and time to care • Stream-lining care pathways and processes