empowering partnerships 17 th july 2014 julie screaton, managing director

Empowering partnerships

17th July 2014

Julie Screaton, Managing Director

Health Education South London

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www.hee.nhs.ukwww.southlondon.hee.nhs.uk

An overview

Who we are

Why partnerships

matter

Building for the future

Health education in the reformed NHS

The LETB model is built on collaboration and shared stewardship of the

workforce system

Sustaining partnerships in challenging times



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Our vision

To design, develop and deliver a workforce that will lead to sustainable improvements in the health and well-being of the population of South London



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Today & tomorrow

• Our investments in the future workforce have to be based upon assumed future models of care

• c60% of staff will be in the NHS in 10 years• But patients also rely on trainees to provide

care today

A delicate balance…..

The scale of the task

Lead in time

• Over 1.3m staff in +300 roles in +1000 organisations

• Treating 1m patients every 36 hours• Boundaries of health and social care

• 13 years to train a Consultant, 10 years to train a GP, 3 years for a newly qualified nurse

• Doctors in training now will still be working in 2060



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We are planning in a changing context

Population-based healthcare

· Patient at the heart of care delivery

· Communities, families, individuals

· Distribution of health and wellbeing within populations

· Predict, prepare, prevent· Proactive care for those at

risk

sustainable service deliveryWorkforce planning, new ways of working, research & evaluation, culture &

environment

recruitment & retention lifelong learningworkforce at the forefront of

change


· Patient at the heart of care delivery

· Communities, families, individuals

· Distribution of health and wellbeing within populations

· Predict, prepare, prevent· Proactive care for those at

risk

Workforce values aligned to population values

· Health and wellbeing· Community engagement· Patient empowerment· Care across continuum· Compassionate care;

dignity and respect


Workforce values aligned to population

values



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This is set against a backdrop of significant financial challenge



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London has unique challengesInequalities in health and quality with 17 years life expectancy difference between boroughs

Inner London has higher levels of adults who smoke and drink, while obesity is a bigger problem in outer London

London is the childhood obesity capital of Europe

A mobile and transient population in some communities makes continuity of care difficult

A diverse population with 42% of people from a minority ethnic group and 100+ languages



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A truly transformational approach is needed to ensure the care system is sustainableSix

characteristics for a high quality, sustainable health and care system in England

Citizens are fully included in all aspects of service design and change empowered in their own care.Wider primary care, provided at scale

A modern model of integrated care

Access to the highest quality urgent and emergency care.

A step-change in the productivity of elective care

Specialised services concentrated in centres of excellence



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We therefore need to develop the workforce to focus on new skills, including supporting citizens to self care

The model for managing care of mostly healthy adults will

be based on enabling patients to play a role in

their own care…

…whereas providers will need to work very differently for managing care of elderly

patients with LTCs

IndividualIndividual

Skills needed

▪ Supporting citizens to self care ▪ Generalist skills▪ Ability to work in multidisciplinary teams▪ Skills bridging the boundary between

health and social care

Skills needed



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We are managing competing priorities

Cost of GP expansion is

£1.1m(-42 acute posts)

Cost ofLiving

ReducedCPPD

budget, further

changes to funding

Safer Staffing

Attrition, retention, ownership

?

Placement Capacity?

£7.5m extra cost over 3 yrs

forN&M expansion

Shortage of senior nurses in specialist

areasFoundation changes - psychiatry

Consultant vacancies

Radiology staffing

GP Expansion by 2015

Foundation changes -

to community by 2017

8% reductionRMN (last year saw

growth)

Urgent & emergencyCare gaps

Shape of Training/Caring

HEI planning?



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We know that London nursing vacancies are higher than England average

Se-ries1

0%

5%

10%

15%

20%

25%

SOURCE: RCN London Safe Staffing report London trusts

RCN Safe Staffing: average 11% nursing vacancies in Londonvs. England average of 6%

England average 6%

London average 11%



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www.hee.nhs.uk

And many of the health and care workforce choose to come to London to train and subsequently move away

Only 37% of graduates in Subjects Allied to Medicine remain in London 6 months

following graduation

Retention of staff by local education commissioners in London is low: e.g.

AHPs

Destination of leavers from London Higher Education Institutions in England (2009/10)

AHP retention %

London LETBs with lowest retention of AHPs

SOURCE: London LETBs call for evidence submission; HENWL migration analysis



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What will it take to build a workforce that can deliver for patients and populations?

Skills and careers

Retention

Lifelong learning

• Training where care is delivered• Changing perceptions of community facing

careers• Educating for flexibility and confidence at the

outset

• Supporting staff through change• Keeping our brightest and best• Making the best use of our assets and resources

• Making the best use of limited resources• Learning across boundaries and professions• Not just for the few



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We can only succeed by working in partnership; the LETBs can be a focal pointWith

employers,commissioners and social

care

With our staff,

students, patients and

citizens

With universities

• Building ownership, commitment and careers• Ensuring education settings align with service

needs• Blurring boundaries, planning for populations

• Forming resilient communities• Embracing self management• Adapting to changing models of care• Harnessing potential

• Getting and keeping the best• Supporting continuous development • Research and innovation – ‘mainstreaming’

agility

empowering partnerships 17 th july 2014 julie screaton, managing director

Documents

population values health

population of south

transient population

diverse population

preventproactive care

outer london london

hoursboundaries of health

risk workforce values