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Transforming the Workforce with the Calderdale Framework

Lesley Horton Dental Services Manager

Shaun Raval Associate Dental Director

24th March 2011

Calderdale Framework

Recognised workforce planning tool focusing on tasks rather than jobs– Skills to plan workforce as vacancies arise– Skill sharing, blurring boundaries– Skills in delegation, delegating tasks safely

and effectively– Competency based workforce

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WHY BOTHER ! ?

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National Context: Leitch Report - The skills agenda High Quality Care for All – Darzi

review Skills for Health Health & Social Care Bill 2007 A High Quality Workforce 2008 Transforming Community Services

2009

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Local Context:

Demographics of workforce

Reduction in investment

Increased demand for community based services

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Reasons for delegation and skill sharing:

Improves patient experience – ‘right person at the right time with the right skills’

Increasing demand on services Maintain service quality whilst

controlling costs

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Risks in delegation (professional)

Variation in what is delegated

Variation in how task is to be delivered

Variation in documentation

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Risks in Delegation (assistants):

Lack of skill/training to fulfil task (unknown competence)

Unable to understand /follow written plan

Unsure when to seek help/abort task

Boundary not clear

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Potential Benefits of The Calderdale Framework

For Organisations

Consistency & Safety Reduction in Risk Efficient & Effective Improved Productivity Flexible Competent

Workforce Improved Patient

Experience Employer of Choice Provider of Choice

For Teams & Individuals

Builds Effective Teams around the Patient

Personal & Team development needs-Links to KSF

Clear Roles & Responsibilities

Safe Skill Sharing Transferable Skills Job Satisfaction

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So, How do You do it……?

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1Awarene

ss Raising

2 Service Analysi

s

3Task

Analysis

4Competenc

y Identificati

on

5Supporti

ng Systems

6Trainin

g

7Sustaini

ng

7 Stages to Successful

Implementation

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New Ways of working:

Tasks mainlyKnowledge &Skill based

Tasks mainly Skill& Rule based

Qualified staff;consider

Blurring professionalboundaries

Allocate to Level 4worker

Tasks Knowledge& Skill based

with protocols available

Delegate to Level 2/3worker

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Risks Managed Through:Competences: Reduce variation in WHAT tasks aredelegated & HOW they are deliveredDocumentation: Standardised Communication: Clarity re : when to seek help/stop Feedback & supervision.ValidationProfessional review

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So What…….??

Meeting the QIPP Agenda

Quality – provides evidence based careInnovation – new ways of working across

professional boundariesProductivity – freeing up specialists to

provide specialist carePrevention – patients not waiting for

care/rehabilitation

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Outcomes

Competency based workforce

Consistency

Transferable, flexible workforce

Cultural changes

Improved patient pathway, reduced length of stay

Improved patient experience, less ‘hand offs’

Valued workforce, clarity re roles and responsibilities

Dental service

Staff awareness

Staff training

Champions

Role of Champions Ensure local core competences are created in your service area Ensure local service specific competences are generated in your

area Ensure appropriate staff are trained in local core and service

specific competences Ensure all multidisciplinary staff are aware of their role in developing

and implementing the Calderdale Framework Ensure induction process for staff in each area includes local

service specific competences Feedback to steering group and contribute to evaluation of the

implementation of the Calderdale framework via the Project Implementation Group

Raise the profile of the Calderdale framework both to internal and external markets

Lead the Dental implementation team in delivering the Calderdale framework and agreed outcomes

Dental service

Dental Working Group, (re-training)Complete Service analysisTask analysisDevelop templatesAgree Competency TitlesComplete CompetenciesValidate Competencies

Competency Title

For each sub task discuss and gain consensus on the following statements.

GO Stop & ConsiderRisk Identified

Comments –Can this risk be managed ?

Is information gathering +/- decision making involved ?

Is clinical reasoning involved ?(if YES, would a protocol make this safe?)

Is the task carried out frequently?

If clinical – is response to the task immediate?

If clinical does the task require high levels of manual skill?

If clinical is this reversible?

Is ongoing assessment & reasoning required throughout the task in order to adjust input?

Is the task procedure complex?

Are protocols available to follow? Or could protocols be written to support the task?

Are the consequences of error serious?

Is the probability of error occurring high?

Dental competencies

GA paediatric exodontiasPlaque IndicesTopical Fluoride applicationDomiciliary AssessmentOral hygiene for nurses & hospital staff

(cross over from community hospitals)Oral health promotion

Contact details;Lesley.horton@nyypct.nhs.ukShaun.raval@nyypct.nhs.uk

Further information;http://www.evidence.nhs.uk/aboutus/Page

s/AboutQIPP

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