Better Health Better Care: Identifying Workforce Challenges for the 21st Century

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Better Health Better Care Identifying Workforce
Challenges for the 21st Century
Jim McGoldrickChair NHS Fife Introduction and
Welcome
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Better Health Better Care Identifying Workforce
Challenges for the 21st Century
Paul MartinCNO and Interim Director for Health
Workforce
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(No Transcript)
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Workforce response to Better Health Better Care

• Today is the launch of our consultation on the
  development of a workforce framework (name to be
  confirmed!)
• Today is about listening, and the start of a
  series of discussions
• Our aims?
• To understand the drivers for change, e.g.
  changing demographics
• To enable consistency in development of the
  workforce
• To provide a strategic, but flexible approach
• To raise the profile of workforce

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Why now?

• As weve seen from the video, now is the right
  time because
• Changes in society
• Changing demographics
• Individuals want to be more involved in shaping
  services
• Need for more personalised services
• Changes in technology
• All of these impact on NHSS.

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NHSScotland is changing too..
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. change in Administration

• Scottish Governments Purpose
• is to create a more successful country, with
  opportunities for all of Scotland to flourish,
  through increasing sustainable economic growth.
• Scottish Governments Vision for Scotland
• to enable us to live longer, healthier lives
  tackle the significant inequalities in Scottish
  society ensure our children have the best start
  in life and get support when they need it and
  ensure public services are high quality,
  continually improving, efficient and responsive
  to local peoples needs
• Better Health, Better Care Action Plan

My own prescription for health is less paperwork
and more running barefoot through the grass.
Leslie Grimutter
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Better Health, Better Care

• People (patients and healthcare providers) at the
  heart of the service redesign - a mutual NHS in
  Scotland
• Boosting patient participation
• Improved healthcare access - local, community
  focussed care
• Improved public health and tackling health
  inequalities
• Planning and delivery of sustainable healthcare
  services
• Fresh look at role design, competence and skills
  development, quality, attraction and retention,
  productivity and driving change through
  stakeholder engagement

Strange but True Your skin weighs twice as much
as your brain.
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changing impact of NHSScotland

• Contribution to the countrys health and economy
  is growing.
• Accounts for 27 of public sector, and 6 of
  total employment in Scotland
• Recent and significant growth in workforce
•  

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21st Century Scotland

• Good employment rate across Scotland, but issues
  in areas of deprivation
• Increasingly tight labour market
• Challenging global labour market - fewer
  attractive overseas opportunities
• Remote/rural recruitment difficulties
• Demographic changes impacting on service
  requirements and workforce

The clinical term for hairy buttocks is
daysypgal
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changing environment

• Tight financial environment
• Productivity rates in Scotland lower than those
  for the UK as a whole
• 2.2m days lost through ill health in Scotland
  every year
• 40 adults have poor literacy and numeric skills
• Shift in the workforce to support shift in the
  balance of care

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What does this mean for the workforce?
What is required?
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A workforce that tackles health inequalities

• Tackling causes and consequences of health
  inequalities including working environment and
  individual behaviours
• Build peoples capacity to improve their health
  and wellbeing
• Engaging with families with high risk of poor
  outcomes
• Ensuring a holistic approach to early years
  service provision and early intervention
• Considering the wider impact - out with hospital
  settings e.g. pre-employment training and first
  destination work opportunities

Life expectancy would grow in leaps and bounds
if green vegetables smelled as good as bacon.
Doug Larson
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Challenge assumptions!

• As major Scottish employer (6.5 of total
  employment in Scotland), what is NHSS role in
  recruiting jobless citizens?
• How proactive should NHSS be in taking a
  proactive health promotion role across wider
  society?
• Local authorities should play the key role in
  tackling poverty true or false?
• We need to get our own house in order before we
  can influence the behaviour of others true or
  false?

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A workforce that enables real
shifts in the balance of care

• Multi-disciplinary team working across
  professional, organisational and geographical
  boundaries
• Joined up and flexible workforce across public,
  private and voluntary sectors health and social
  care
• Resources aligned to deliver new pathways of care
  to improve outcomes
• Considering the impact of changing demographics
• Support and advice to enable independent living,
  to avoid hospital admission
• New ways of delivering services

A phenomenal experience!
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Challenge assumptions!

• Hospitals always have, and always will represent
  the core element of NHSS provision?
• Hospitals without walls?

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A workforce that ensures quality .

• flexible workforce in right place at right time
  to deliver right service in right way
• Adapting to remote and rural issues
  economically active, but travel further to
  access services, lower proportion of young people
• Delivering patient centred care that is
  respectful, compassionate and responsive to
  patient needs, values, preferences
• Making health care in Scotland safer still
• Improving the use of technology to modernise the
  NHS

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Challenge assumptions!

• Future workforce likely to consist mainly of
  women, many of whom are likely to work part time
  are our employment systems and practices fit
  for purpose?
• Women make up over 75 of the current NHSS
  workforce 45 of our current medical workforce
  but only 29 of our consultant workforce. Why?

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A workforce thatis best value

• Ensuring efficient provision of services
• Ensuring best value
• Delivery of workforce related efficiency and HEAT
  targets
• Using available levers like modernised pay and
  TC systems, to ensure effective workforce
  contribution to HEAT and to achieve wider
  sustainability and environment aims
• Right information at right place at right time

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Challenge assumptions!

• UK rate of labour productivity (as measured by
  GDP per hour worked) is 2.8 higher than Scotland
  why?
• Sharing resources across organisations and
  sectors will simply dilute the impact of NHSS
  resources, and move away from best value true
  or false?
• 2.2 million working days lost each year through
  ill health in Scotland and NHSS has highest level
  of sickness absence across the public sector
  why?
• Better service delivery relies on recruiting more
  staff true or false?

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A workforce that is integrated .

• Workforce is main catalyst for change
• Workforce directly supports delivery of HEAT and
  wider objectives
• Mainstreaming
• Robust and integrated workforce planning
• Workforce planning part of wider planning
  framework to support sustainable service planning
  and safe service delivery at every level
• Ensure workforce planning and development
  supports all service needs e.g. remote and rural

Strange but true Your hearing is less sharp
after eating too much.
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Challenge assumptions!

• Why dont workforce plans and financial plans add
  up?
• There is workforce information and intelligence
  at all levels do we have the ability to cut
  this data to meet our planning needs?

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A workforce that is working well

• Ensuring staff are recognised, rewarded and given
  the opportunity to develop the skills they
  require
• Leadership and talent management
• Ensuring staff feel valued and are engaged
• Exemplary employment practice dignity at
  work, work-life balance, tackling violence and
  aggression, etc

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Challenge assumptions!

• Only 43 of NHSS staff would recommend
  NHSScotland as a good place to work why?
• Line management is often most important feature
  of good employment experience true or false?

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How can we tackle these challenges?Heres some
ideas to start our discussions .
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Some ideas workforce planning and development

• Improve workforce intelligence, more dynamic
  workforce planning, better workforce planning
  capabilities
• Integration of workforce planning move towards
  capacity and delivery plan
• Closer relationship between SG health
  directorates and wider SG directorates
• Closer links between workforce planning and
  education, training and development e.g. changing
  patterns of training, joint degree level
  training, focus on existing workforce, training
  in the prevention role?
• Development of new roles e.g. community
  nurses, physician assistants, pedagogy model
  across health and social care

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Some ideas the employee experience

• Recruitment and retention esp. remote and rural
  areas
• Joint recruitment across boards, sectors, CHPs
• Appropriate training, safe working environment,
  treated fairly and well informed staff
  governance, self assessment and peer review
• Partnership working at all levels
• Health promoting workplaces, working well, and
  support staff to take greater responsibility for
  their own health
• Implementation of health inequalities delivery
  plan
• Best employment practice e.g. review of PIN
  guidelines
• Staff survey 2008 with actions at local and
  national level

Strange but true a ducks quack doesnt echo?
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Some ideas pay and benefits realisation

• Review leadership framework and plan
• Raise awareness of total reward ie pay and
  wider benefits
• Effective use of competencies, careers framework
  and KSF so skills and experience match need all
  staff are working at an appropriate level
• Use modernised pay, terms and conditions to
  ensure effective and efficient workforce
• Delivery of HEAT and efficient government
  targets including workforce KSF and sickness
  absence targets
• Efficiency and productivity programme
• Ensure best value links with local authorities
  and other public sector providers
• Support workforce to implement and deliver
  e-health, telehealth, eKSF and eHR

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Still need to ensure business as usual

• Services meet patient needs and support strategic
  policy objectives
• The right staff in the right place with the right
  skills at the right time doing the right things
• Efficiency and effectiveness of the workforce
• Organisation in financial balance and meeting
  audit requirements
• Being safe and working in partnership to meet
  aims of staff governance standard

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• Moving towards a brave new world .

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What next?

• This NHSScotland event is the first step of the
  consultation process mini plenary and think
  tank today
• Role of partnership
• Regional discussions
• Your role
• be part of the discussions
• tell us the priorities

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Questions

• Do you recognise the analysis? What is missing?
• What do you think the priority actions should be?
• How do we get to the future whilst managing the
  present?
• Talent wins games, but teamwork and intelligence
  wins championships.
• Michael Jordan