developing the workforce required to deliver integrated care martin rayson divisional director –...
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Developing The Workforce Required To Deliver Integrated Care
Martin RaysonDivisional Director – HR & OD
London Borough of Barking & Dagenham
Principles of Workforce Integration
• Focus on better outcomes for people with care and support needs
• Workforce integration involves the whole system• Overcome resistance to change – acknowledge how it
affects people’s roles• Address workforce issues from the beginning - manage
engagement• Process matters – gives messages, demonstrates the
workforce is valued• New relationships, networks and ways of working
Lessons From Scotland
• Sound governance arrangements need to be quickly established• Previous audit reports on community planning partnerships have
highlighted the importance of – shared leadership, which takes account of different
organisational cultures– a clear vision of what the partnership wants to achieve, with
a focus on outcomes for service users– a shared understanding of roles and responsibilities, with a
focus on decision-making– an effective system for scrutinising performance and holding
partners to account.
Lessons From Scotland (cont.)
• There is a pressing need for workforce planning to show how an integrated workforce will be developed
• Health and social care services are personal services; it is important that staff have the skills and resources they need to carry out their roles, including providing emotional and physical support and clinical care.
• Developing a suitably skilled workforce is crucial to the success of integrated health and social care services.
21st Century Public Servant is …
• Rethinking public services for an age of “perma-austerity”• Working co-productively with citizens• Recruited for generic skills as well as technical expertise• Expecting a “zig-zag” career• Combining public service ethos with commerciality• Working within fluid organisations, with silos• Displaying dispersed rather than heroic leadership• Rooted in locality• Learning from others and expects to continually improve and
adapt
New Public Service Age
New Relationships With Citizens
Distributed & Collaborative Leadership
New Roles/New Skills
2nd February 2016
Closing the Gap HPMA/PPMA Event
Learning from Integrated Care Workforce Initiatives
in the West Midlands
Julian MellorProgramme Manager - Integrated Care
www.hee.nhs.uk
Context• Increasing numbers of older
adults/increased longevity• Increasing numbers with
complex co-morbidities / LTCs
• Need to reduce emergency admissions, length of stay and facilitate effective discharge from hospital
• Improving the experience of people who use services
• Develop a fit for purpose workforce delivering appropriate care in the right setting
• NHS Five Year Forward View • Care Act 2014• Framework 15 – HEE Strategic
Framework 2014 - 2029• New Care Models - Better Care Fund,
System Transformation Plans, Vanguards
www.hee.nhs.uk
Delivering Integrated Care
From an approach based on: To an approach based on:
Patients Population health management
NHS workforce Health and social care workforce - statutory, private and voluntary sectors ….and wider!
Organisations Places
Workforce plans primarily focused on the NHS workforce
Integrated system-wide workforce planning
www.hee.nhs.uk
Integrated Care - Definitions
Integrated care is person centred co-ordinated care: “I can plan my care with people who work together to understand me and my carer(s), allow me control and bring together services to achieve the outcomes important to me.” (TLAP/National Voices, 2013)
“Care which is intended to improve the quality of care for individual patients, service users and carers by ensuring that services are well co-ordinated around their needs”. (Kings Fund)
www.hee.nhs.uk
Programme Board –
bringing partners together
Acute Trusts
Patient & Practitioner reference groups
Community Health Trust
Local Authorities
(Social Care)
Mental Health Trust
Better Care Boards
CCGs
Crucial role of care co-ordinator
Consider the wider workforce, including: independent sector
providers, social care, informal carers
ICT is an enabler but don’t over rely on it - process and interpersonal communication are more important
BEST PRACTICE
RESEARCH Multi-disciplinary teams should be built around models of continuous learningTake care with
recruitment to new roles – use value based approaches and ensure buy-in from the team
Knowledge of local population and services is very important
Service redesign and workforce development need to go hand in hand
Co-location helpful - more important for team members to align their goals and work together
Patient engagement is important to sustain integrated services, that are responsive
www.hee.nhs.uk
Learning about Integrated Working
www.hee.nhs.uk
Older Adults Workforce Integration Programme - Pilots
Project Theme Lead Organisation
Integrated Care Model Pathfinder Healthcare Developments CIC
Falls and Fractures - Care Homes University Hospitals Birmingham NHSFT
Falls Prevention – Health and Social Care
Walsall Council
Complete Care Programme (community)
Birmingham Community Healthcare NHS Trust
Integrated Care and Support (GPs) Solihull CCG
Competency Based Education and Training Programme – Care Homes
Shropshire CCG
Acute Care
Diagnostics
Self Care
Specialist Treatment
Primary Care
More Investment In Workforce Here
Prin
ciple
s And
Fra
mew
orks
For
Inte
grat
ed W
orki
ng
(Wor
kstr
eam
3)
Workforce Com
petencies And Development Program
mes
(Workstream
4)
Support Self Care And Digital Innovations (Workstream 1)
Kais
er P
yram
id M
odel
Mindset And Culture ShiftINTEGRATED
CARE THEME
Long Term System Vision And Workforce Profile
(Workstream 2)
Integrated Care Transformation Theme: Workstreams and Relationship with other
Transformation Themes
Lead
ersh
ip T
hem
e
Mental Health Theme
Acute, Urgent &
Emergency Care Theme
Primary & Community Care Theme
www.hee.nhs.uk
Key Messages
1. Alignment of leadership and OD with workforce development initiatives2. The definition of the workforce3. The need for integrated system workforce planning4. Workforce redesign – roles and competencies5. Approaches to learning and development
www.hee.nhs.uk
1. Leadership & OD
• Workforce development in isolation?• The importance of OD and systems leadership in
promoting integrated working• Sustaining integrated working• Experience of pilot projects• The “Leading Integrated Workforce Solutions”
Programme
www.hee.nhs.uk
2. Defining the Workforce
Everyone, including paid and unpaid/informal carers, working in health and social care settings, including people’s own homes.
Workforce integration v integrated working • Relationships• Understanding each others perspectives• Good communications• Trust
www.hee.nhs.uk
3. Integrated System Workforce Planning• Across health and social care economies• To reflect new models of care• HEE North Central and East London• Aligned with local commissioning priorities and plans• The offer: helping commissioners to identify and address
workforce implications• HEE North West – Devolution, Workforce Planning and
development of tools
www.hee.nhs.uk
Integrated System Workforce Planning Challenges
• Definitions: the system, the workforce, the plan?• Timescales• System leadership• Intelligence gathering – demographics/long term conditions,
trends and projections,• Workforce intelligence: health, social care, PIV
www.hee.nhs.uk
4. Workforce Redesign Options
New (alternative) worker
New work
Old worker
Old work
increasing the numbers of nurses, doctors, and other health professionals
expanding the job descriptions of existing workers, such as community matrons, to include work previously not done by anyone
handing off existing tasks to other workers, such as nurse practitioners and general practitioners with specialist interests
creating new jobs for work previously not done by anyone, such as genetic counselors, and lay providers to support self-care
Redistribution Creation
Capacity expansion Retraining
Source: Bohmer, Imison. Health Affairs 2013
www.hee.nhs.uk
Skills, Competencies, Roles
• Common principles, values, behaviours based on outcomes for patients/service users
• Competencies, skills and knowledge for the wider team
• Care Co-ordination and Navigation • Supporting workforce transition, eg acute to
community settings• Apprenticeships
www.hee.nhs.uk
5. Learning and Development
• Emphasis on learning together, training, networking, job rotation
• Expand Multi Professional Learning opportunities• Common foundation and part of CPD• Role of HEIs and other training providers
www.hee.nhs.uk
Conclusion
• HR Practitioners • HR Business Partners• Learning and
Development Specialists
• Terms and Conditions?• New Organisational Structures?• Changing the way we work √• Change management/OD √• Systems Leadership √• Integrated workforce planning √• Creating shared opportunities for
learning √
www.hee.nhs.uk
Further InformationJulian Mellor – Programme Manager
E-mail: julian.mellor@bhamcommunity.nhs.ukTel: 0121 466 7474Mobile: 07720 343443Website: www.hee.nhs.uk
Journal article – Institute of Ageing and Health www.iah-wmids.org.uk
Skills for Health & Skills for Care blog: how can the health and social care workforce meet the challenge of integrating services? Access from here
Scenario Planning
Case Study – Muriel
• As HR and OD practitioners, when we see a case study like Muriel's, what problem are we trying to solve?
• What questions should we ask to answer this
question?
• What are your main learning points today?
• What action will you take to use this learning in your professional practice?
• What additional learning and development do you plan to undertake to further develop in this area?
For more information on our HR Competency Framework, please take one of our packs or visit our website
http://www.hpma.org.uk/branches/london/ hrod-competency-framework
Please remember to complete our
feedback survey to collect your e-
certificate at this link -
https://www.surveymonkey.co.uk/r/ClosingtheGapSurvey
Thank you for attending
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