cheshire and merseyside planners updates mike burgess workforce strategy
TRANSCRIPT
Cheshire and Merseyside Planners
Updates
Mike Burgess
Workforce Strategy
Topics
• NHS operating plan and triangulation
• Workforce planning feedback 2011-2016
• Workforce Assurance Frameworks
• Health Visitors
• Data Quality
Cheshire and Merseyside Planners
Operating Plans 2012-2013
Each cluster submitted:• Detailed Narratives• 9 KLOES• Workforce numbers and costs• 3 Key workforce questions• Health visitor plans• Other priority areas• Activity, finance and workforce information for triangulation
3 lots of analysis and triangulation were undertaken by the SHA
OPERATING PLANS TRIANGULATION
AMBER
AMBER
AMBER
Workforce
3. Does the plan include sickness absence, skill mix changes, productivity and agency costs?
Cheshire, Warrington & Wirral Cluster holds regular contract performance meetings with its Providers and workforce metrics (e.g. FTE/headcount and workforce costs) are monitored and triangulated in order to assure ourselves along the 9 Key Lines of Enquiry of the Operating Framework (Annex 5 in the guidance) that Providers can deliver a safe service with an integrated financial framework, delivering the commissioned activity with a skilled and competent workforce. Triangulation referred to in narrative between activity, workforce and finance and challenge to providers
The Cluster already gathers workforce metric data (e.g. sickness absence, turnover, FTE and headcount) from the Electronic Workforce Information Portal (eWIN) and from the NHS Information Centre (iVIEW). Triangulation occurs between workforce, activity, finance and quality indicators and some and benchmarking across Providers.The Cluster is developing a single “Provider” HR Performance report that will provide a set of workforce metrics for all Provider organisations in the Cluster area. The metrics will include: - Sickness Absence Turnover Headcount FTE Skill mix Temporary staffing spend Change in total earnings Salary/basic pay of total earnings Cost (total earnings) per FTE Workforce trajectory: Actual vs Plan Workforce trajectory: Clinical & Non-Clinical Staff Group breakdown
1. 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?
2. 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?
A more comprehensive narrative on workforce assurance that details the process, the actions taken on eWIN, HR performance reports, using the Workforce Assurance framework templat, demand for narratives to answer the KLOES and 3 key workforce areas
WorkforceSummary - The PCT Cluster has recognised the requirements demanded from the Workforce Key Lines of Enquiry (KLOES) and 3 narrative questions and described what they needed to do in order to respond to the demand. The report (pages 75-82) outlines further detail of the current actions, pending work and future programmes going forward around workforce assurance, managing the cluster workforce and working with providers. Requires additional evidence to demonstrate what providers are actually undertaking to make this answer a stronger one
AMBER
Cheshire, Wirral and Warrington NHS Cluster
GREEN
AMBER
AMBER
Detailed submission received for the 9 KLOEs, please refer to 6 page report
Workforce linked through the main transition programmes in the plan. Evidence in the narrative of changes and triangulation of activity, finance and workforce
NHS Merseyside actively monitors and reviews its provider workforce performance indicators including sickness absence, staff turnover, agency staff spend, and equality and diversity indicators. In addition, we regularly performance monitor the outcomes of the staff survey to ensure these are attributable back to quality patient care. Workforce changes are closely monitored which is co-ordinated by the Director of HR and OD, the Medical Director, and the Director of Nursing. As a workforce team we use EWin to go good effect to benchmark workforce trends and best practice and have won an NHS North West award for our use of EWin during 2011.
1. 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?
2. 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?
3. Does the plan include sickness absence, skill mix changes, productivity and agency costs?
Workforce
Workforce - Significant improvment in providing plans and evidence for the 9 KLOES. System wide changes is one of the 3 main key areas that requires more detailed response
AMBER / GREEN
NHS Mersey Cluster
Cheshire and Merseyside Planners
Workforce Plans 2011-2016
Workforce Plan Feedback 2011-2016
On eWIN
https://northwest.ewin.nhs.uk/toolbox/workforce_planning_process/
Resources Workforce Planning Process: 2011 - 2016 - Initial Feedback Workforce Planning Process: 2011 - 2016 - Detailed Feedback Slide pack for the Cheshire and Merseyside NLG on Workforce Plans Slide pack for the Cumbria and Lancashire NLG on Workforce Plans Slide pack for the Greater Manchester NLG on Workforce Plans
Informing process for this year via NLGs – Network Leadership Group LETBs – Local Education Training Boards HEE – Health Education England DH – Department of Health
Coverage
COVERAGE in the PlansNursing and Midwifery Submissions: Good
Allied Health Professionals: GoodModernisation and new roles: Good
Healthcare Scientists: AverageMedical and Dental demand: Good
Narrative submissions: Good
Ocs code Trust name Cluster Org TypeREM AINTREE HOSPITALS NHS TRUST Merseyside Acute -MediumRXA CHESHIRE AND WIRRAL PARTNERSHIP NHS FOUNDATION TRUST Cheshire Mental Health and Learning DisabilityREN CLATTERBRIDGE CENTRE FOR ONCOLOGY NHS FOUNDATION TRUST Cheshire Acute -SpecialistRJR COUNTESS OF CHESTER HOSPITAL NHS FOUNDATION TRUST Cheshire Acute -SmallRJN EAST CHESHIRE NHS TRUST Cheshire Acute -SmallRTV FIVE BOROUGHS PARTNERSHIP NHS TRUST Merseyside Mental Health and Learning DisabilityRY1 LIVERPOOL COMMUNITY HEALTH NHS TRUST Merseyside Community Provider TrustREP LIVERPOOL WOMENS HOSPITAL NHS TRUST Merseyside Acute -SpecialistRW4 MERSEY CARE NHS TRUST Merseyside Mental Health and Learning DisabilityRQ6 ROYAL LIVERPOOL AND BROADGREEN HOSPITALS UNIVERSITY NHST Merseyside Acute -TeachingRBS ROYAL LIVERPOOL CHILDRENS NHS TRUST Merseyside Acute -SpecialistRVY SOUTHPORT AND ORMSKIRK HOSPITAL NHS TRUST Merseyside Acute -SmallRBN ST HELENS AND KNOWSLEY HOSPITALS NHS TRUST Merseyside Acute -MediumRBQ THE CARDIOTHORACIC CENTRE - LIVERPOOL NHS TRUST Merseyside Acute -SpecialistRBT THE MID CHESHIRE HOSPITALS NHS TRUST Cheshire Acute -SmallRY7 THE WIRRAL COMMUNITY NHS TRUST Cheshire Community Provider TrustRET WALTON CENTRE FOR NEUROLOGY AND NEUROSURGERY NHS TRUST Merseyside Acute -SpecialistRWW WARRINGTON AND HALTON HOSPITALS NHS FOUNDATION TRUST Cheshire Acute -MediumRBL WIRRAL UNIVERSITY TEACHING HOSPITAL NHS FOUNDATION TRUST Cheshire Acute -Teaching
Challenges – Health EconomyLiverpool area at a glance• The health of people in Liverpool is generally worse than the England average. Deprivation is higher than average and
32,400 children live in poverty. Life expectancy for both men and women is lower than the England average.• Life expectancy is 11.5 years lower for men and 7.8 years lower for women in the most deprived areas of Liverpool
than in the least deprived areas (based on the Slope Index of Inequality published on 5th January• 2011).• Over the last 10 years, all cause mortality rates have fallen. Early death rates from cancer and from heart disease and
stroke have fallen but remain worse than the England average.• obese. A lower percentage than average of pupils• About 21.1% of Year 6 children are classified as obese. A lower percentage than average of pupils spend at least
three hours each week on school sport.• Levels of teenage pregnancy, GCSE attainment and tooth decay in children are worse than the England average.• Estimated levels of adult 'healthy eating' and smoking are worse than the England average. Rates of hip fractures,
smoking related deaths and hospital stays for alcohol related harm are higher than average.• Priorities in Liverpool include smoking, alcohol misuse and obesity
Includes: Liverpool
Other profiles include: St. Helen’s, Knowsley, and Sefton as part of Merseyside
The above facts are priorities in Liverpool and overall for Merseyside will challenge NHS Providers in ensuring that the
workforce of today are equipped and have the skill set to deal with tackling health inequalities particular among females,
heart disease, cancer and reducing alcohol related harm as key priorities.
Challenges – Health Economy
• Cheshire West and Chester at a glance
• The health of people in Cheshire West and Chester is mixed compared to the England average. Deprivation is lower than average, however 10,810 children live in poverty. Life expectancy for men is higher than the England average.
• Life expectancy is 10 years lower for men and 7.5 years lower for women in the most deprived areas of Cheshire West and Chester than in the least deprived areas (based on the Slope Index of Inequality published on 5th January 2011).
• Over the last 10 years, all cause mortality rates have fallen. Early death rates from cancer and from heart disease and stroke have fallen and are similar to the England average.
• About 19.4% of Year 6 children are classified as obese. A higher percentage than average of pupils spend at least three hours each week on school sport.
• 68.4% of mothers initiate breast feeding and 14.0% of expectant mothers smoke during pregnancy.
• An estimated 20.5% of adults smoke and 22.7% are obese. Rates of road injuries and deaths and hospital stays for alcohol related harm are higher than average.
• Priorities in Cheshire West and Chester include tackling smoking, reducing inequalities in heart disease and childhood obesity.
Includes: Cheshire West and Chester
Other areas include: Cheshire East, Wirral, and Warrington,
Challenges for Providers
• Cash Improvement Plans (CIPs)• Cash Releasing Efficiency Savings (CRES)• Cost avoidance service reform plans• 1.5% Tariff reduction• QIPP savings and level 3 adoption and implementation• Rationalisation of services across economies• Meeting Monitor Authorisation Assessments and Criteria• Delivering against CQC Assessments • Changes to the commissioning and provider landscape• Demanding health populations• Governance and regulations• High concentration of specialised trusts and services
Medical WorkforceEWTD and Other
Availability of Junior Doctors in general and to cover wards
Availability of Junior Doctors with limited hours to support outpatients / endoscopy lists
Compliant rotas, but non-compliant services because of gaps
Medical revalidation
Looking at Consultant job plans and Pas
Immigration restrictions causing issues
Service reconfigurations
Managing transition and New service models
Engagement and consultation using precious FTE and PAs
Insufficient consultant numbers for sustainable out of hours rota
Vacancies at:
A & E Consultants & Middle Grades
Haematology and Dermatology Consultants & Middle Grades
Consultant obstetrics and Gynaecology
Clinical Psychologists, Consultant Neurophysiologists and Consultant Radiologists
Locums (medicine, emergency medicine, A&E, Respitory and T&O)
Radiography and Radiology
Medical WorkforceVacancies Continued:
Consultant Otolaryngologist Consultant General Surgery Cellular Pathology Consultants (potentially linked to uncertainty over provision due to regional QIPP scheme
• Consultants in haematology, radiology and emergency medicine
• Speciality doctors in emergency medicine and ophthalmology
Recruitment to specialist Consultant posts:
• Histopathology
• Microbiology
• Radiology
• Chemical Pathology
• Cardiology- Imaging
• Acute Physicians
• Anaesthesia
• Ophthalmology
• Elderly Medicine
Non-Medical WorkforceGeneral Reduced demand for nursing newly qualified across providers Initiatives in place to split posts to recruit, but expensive on headcounts Over supply of physiotherapists but on limited band 5 posts due low turnover in higher bands Very weak on health care scientist demand from the plans. Very little data submitted by providers with a health care
scientific workforce Recruiting the out-turn of qualified health visitors but no additional supply in the system to further boost supply The implementation of new technology will undoubtedly present challenges and will include training in use of
programmes and equipment, provision of correct equipment in order to undertake role and the constant need to ensure programmes are updated as required.
Vacancies Clinical Coders Clinical Audit Managers Optometrists Specialist practitioners in District Nursing and School Nursing Therapy staff, Specialist Nurses and OPD (Operating department practitioner) Vascular surgery scientists Occupational health specialists Clinical Scientists / Medical Physicists
Non-Medical Workforce
Vacancies Continued:
• Clinical Scientists (potentially linked to uncertainty over provision due to regional QIPP scheme)
• Biomedical Scientists within blood sciences (due to multi-disciplinary nature of the laboratory and uncertainty over QIPP changes)
• District Nursing out of hours
• Diabetes Specialist Nurses
• Sonographers (potentially due to no direct access degree course)
• Chaplaincy (particularly relevant following the removal of national recruitment and retention premia RRP)
• Ophthalmological nurse
• ENT specialist nurse
• Specialist ENT nurse practitioner
• Microbiologist
• Senior ECG Technicians
Cheshire and Merseyside Planners
Data Quality
Data Quality update – north west score
SHA Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12 Rank
Position from previous month
NHS East Midlands 6,230 6,360 6,640 6,710 6,725 6,750 0 6,950 6,970 10 →NHS East of England 6,220 6,410 6,430 6,660 6,790 6,880 0 7,030 7,055 9 →NHS London 6,360 6,445 6,510 6,735 6,845 6,935 0 7,130 7,200 8 →NHS North East 7,425 7,585 7,650 7,945 7,990 8,135 0 8,210 8,430 4 →NHS North West 7,375 7,480 7,795 8,195 8,540 8,785 0 9,095 9,160 1 →NHS South Central 7,290 7,390 7,580 7,660 7,960 8,060 0 8,005 8,160 6 →NHS South East Coast 6,695 6,835 7,140 7,485 7,960 8,185 0 8,415 8,440 3 →NHS South West 7,595 7,835 8,055 8,320 8,515 8,580 0 8,740 8,800 2 →NHS West Midlands 6,920 6,875 7,185 7,395 7,510 7,580 0 7,660 7,715 7 →NHS Yorkshire and Humber 7,360 7,505 7,425 7,745 8,000 8,045 0 8,175 8,345 5 →
• NW retained first place Dec ‘11 to Apr ‘12
• Error count reduced by 5.1% (-1,039 errors) Mar to Apr 2012
Data Quality update – priority areasTOTAL ERROR COUNTQUERY ID Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Mar-12 Apr-12 Month Change % ChangeALL 40980 44267 41183 36279 30340 26591 20428 19389 -1039 -5.1%
ACTIVE EMPLOYEESQUERY ID Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Mar-12 Apr-12 Month Change % Change
7.1 507 571 506 385 333 340 270 229 -41 -15.2%16.1 6893 7533 6952 5878 4017 3103 2681 2498 -183 -6.8%19.1 6888 7525 6932 5850 4023 3119 2704 2474 -230 -8.5%31.1 8460 9385 8430 6565 5234 4011 3552 3376 -176 -5.0%40.1 6426 6692 6277 6139 5862 5215 4364 4184 -180 -4.1%
ASSIGNMENTSQUERY ID Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Mar-12 Apr-12 Month Change % Change
2.1 4536 4454 3998 3958 3847 3859 1178 1265 87 7.4%9.1 209 199 195 121 99 98 55 55 0 0.0%9.2 72 65 62 32 15 18 7 16 9 128.6%9.3 254 249 10 10 10 9 10 10 0 0.0%9.4 256 251 24 23 22 21 21 21 0 0.0%9.5 8 7 7 8 7 6 1 1 0 0.0%9.6 6 5 4 4 2 1 1 1 0 0.0%
EX-EMPLOYEESQUERY ID Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Mar-12 Apr-12 Month Change % Change
30.1 3952 5218 5208 5312 5165 5160 4032 3759 -273 -6.8%33.1 192 274 294 268 274 261 310 325 15 4.8%
Data Quality update – HIGH IMPACT priority areas
• 40.1 Recruitment Source is Blank: 20.6% of total errors
• 19.1 Sexual Orientation is Blank: 12.8% of total errors
• 31.1 Disability is Blank: 17.4% of total errors
• 16.1 Religious Belief is Blank: 12.9% of total errors
• 30.1 Destination on Leaving is Blank: 19.4% of total errors
• 2.1 Area of Work is Blank: 6.5% of total errors
Data Quality update – TEN HIGH IMPACT TRUSTS BY ERROR COUNT
Organisation Name
Org NameTotal Error Count by Organisation
North West Rank
Bridgewater Community Healthcare NHS Trust 630 59Tameside Hospital NHS Foundation Trust 787 60Aintree University Hospitals NHS Foundation Trust 825 61East Lancashire Hospitals NHS Trust 1092 62Royal Liverpool And Broadgreen University Hospitals NHS Trust 1125 63Manchester PCT 1191 64Cumbria Partnership NHS Foundation Trust 1195 65Mersey Care NHS Trust 1306 66Lancashire Care NHS Foundation Trust 1364 67Central Manchester University Hospitals NHS Foundation Trust 4149 68
• The error counts from these organisations account for 70.5% of NW errors
• We want to work with organisations to improve their error count
• Please contact [email protected] if you need assistance in resourcing data quality improvement projects
Data Quality update – TRUST ANALYSIS by FINAL SCORE INCREASE
• Five organisations in the North West in April 2012 had maximum scores of 10,000
• Congratulations to:
Warrington PCT Central And Eastern Cheshire PCT Halton And St Helens PCT Bolton PCT Knowsley PCT
ACCESSING EWIN REPORTShttps://northwest.ewin.nhs.uk/benchmarking Select QIPP Dashboard
ACCESSING EWIN REPORTShttps://northwest.ewin.nhs.uk/benchmarking
Navigate to the Woven Data Quality Reporting “speed-o-meter” and select graph
ACCESSING EWIN REPORTShttps://northwest.ewin.nhs.uk/benchmarking
• 4 data reports are available and a data guidance page
• All reports can be exported to PDF• Free WebEx demonstrating reports on 15th May 2012 - 2.00pm (1 hour)• For more information on events visit https://northwest.ewin.nhs.uk/events/upcoming
Data Quality update – priority areas KEY
Query ID Descriptor2.1 Area of Work is blank 7.1 Ethnic Origin is blank9.1 Staff Group is Nursing & Midwifery staff but grade is lower than AfC band 5
9.2Qualified Nursing & Midwifery Occupation Code but grade is lower than AfC band 5
9.3 Staff Group not Medical & Dental but Grade code starts K, L, M, Y or Z 9.4 Occ. code not Medical & Dental but Grade code starts K, L, M, Y or Z 9.5 Staff Group Medical & Dental but Grade code doesn't start K, L, M, Y or Z 9.6 Occ. code Medical & Dental but Grade code doesn't start K, L, M, Y or Z
16.1 Religious Belief is blank 19.1 Sexual Orientation is blank30.1 Destination on Leaving is blank31.1 Disability is blank33.1 Destination on Leaving is NHS organisation but NHS org is blank40.1 Recruitment Source is blank
Cheshire and Merseyside Planners
Health Visitors
NORTH WEST PERFORMANCE – 2011/12
The North West target for Mar-12 health visitors was 1386.0 FTE
The Feb-12 ESR downloads show the current North West performance.
NHS Operating plans
•The NHS Operating Framework plan for Health Visitors was submitted on the 19th April.
•To ensure our plans are robust and achievable, NHS NW carried out extensive modelling to predict the achievable outputs from the system.
•As a result, new targets for 2012/13 and 2012/14 have been formulated.
•End of March 2013 target has changed from 1546.2 to 1463
•1463 is the absolute minimum we have to achieve by the end of 2012/13
NHS Operating plans: NEW TARGETS
CLUSTER LEVEL MODELLING
•Modelling for 2012/13 has also been carried out on a PCT Cluster basis.
•End result is a modelled year end position of 1450 (without any other action in the system to support improvement).
•Sum of all 5 PCT cluster targets is 1473.2 FTE
•The additional 23.2 FTE is the contingency to ensure delivery (achievable through ‘system stretch’)
•Cluster level models have been shared with HV cluster leads and we are awaiting comments before they can be shared further.
HOW WILL WE ACHIEVE OUR ‘SYSTEM STRETCH’?
• Increasing participation rates (increasing the hours of part time staff)
• Decreasing leaver rates
• Retirements and the age profile of current workforce
• Training capacity (Clinical Practice Teachers)
• Retention of trainee student numbers
•Return to Practice
•Conversion of staff registered as Health Visitors but not working in a HV service
FURTHER READING
Briefing 81 - Retaining your health visitor workforce
Contains valuable information on:
•Flexible Working•Preceptorship•Recruitment, selection and induction•Flexible retirement options•Staff Engagement
And many more
https://northwest.ewin.nhs.uk/knowledge/resource/554