Implementing Change Workforce Modernisation

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Implementing Change - Workforce Modernisation

• Carys Kinsella
• Associate Workforce Designer
• Changing Workforce Programme

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Implementing Change - Workforce Modernisation

• Why do we need to change the workforce?
• What patients and staff want from good leaders
• Leadership is part of role and service redesign
• Changing Workforce Programme
• Leadership starts on the skills escalator
• Permission to lead is permission to change

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Why Role Redesign?

• Workforce planning review Health Service of all
  the talents.
• NHS Plan HR in the NHS
• Modernisation Agency - inclusion of specific
  workforce focus
• Wanless Report

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New Ways of Working

• Better for patients, better for staff

• More staff working differently

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Our Approach

• Patients perspective
• Staff perspective
• Create an atmosphere to give it a try
• Consider all the workforce
• Measure the benefits (?)
• Learn the lessons and share good practice

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New Ways of Working Patient Expectations
Fewer faces and hand-offs
Good quality care
Enough staff to provide care
Staff with enough time
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New Ways of Working - Staff Expectations
Varied and interesting jobs
To feel valued
Rejection of arbitrary constraints
Job enrichment / personal development
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What Are The New Ways of Working ?
Skill mix up and down
Increasing depth
New roles
Expanding breadth
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Outputs
Improved patient care
Enhanced job satisfaction
Improved staff retention
Contribution to skills escalator and travelator
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Moving to Mainstream
Modernisation Agency
Human Resources / DoH
CHANGING WORKFORCE PROGRAMME
WTD
Toolkit local change
Role Redesign Team
NEW WAYS OF WORKING TEAM
Agenda for Change
Database
Spread ADP
Medical Contracts
WDCs/SHAs
Retention Recruitment
Delays
Lead Themes
NHS
13 National Pilots
18 National Pilots
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Kotters 8 Steps to Transformation
Establishing a sense of urgency
Forming a powerful coalition
Creating a vision
Communicating the vision
Empowering others to act on the vision
Planning for and creating short-term wins
Consolidating improvements and producing
more change
Institutionalising new approaches
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New roles

• 160 roles tested
• 70 new roles implemented
• All levels of career framework
• Support workers - Consultant AHPs
• Health, Social care and education

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Emergency Care Practitioner

• Priority to improve emergency care
• Process map of patient journey
• Patient need
• Identify competencies
• Develop training packages
• Trial sites - evaluation

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What are they?

• Generic Emergency Care Worker
• Paramedic / Nurse / AHP by background
• Practitioner level
• Work across Emergency / Unscheduled Care Pathway
• Primary Care, Pre Hospital, AE etc
• Assess Patients on behalf of GP
• See / Treat / Refer / Discharge Pre-hospital
• Work as Minors / Majors Practitioner in AE etc

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Progress so far

• 17 pilot sites identified - 300 ECPs being
  trialled
• Finalised measures and develop reporting tool
• Developed educational programme
• Identified learning outcomes for programme
• Developing competency framework
• Finalised practise outcomes
• Developed Protocols and Guidelines
• Developed Patient Group Directions
• Evaluation commissioned - to assess benefits
  prior to further spread

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Measures

• 20 patients discharged to self care at scene
• Further 9 patients dealt with by ECP
• Patient journey time halved

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Blockages to Change

• History and habit, fear!
• Organisational culture
• Current systems - pay, regulation, titles
• Professional bodies
• Lack of joined up thinking
• Education Training
• Poor interpretation of policy

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Evidence/Measures

• Small - scale change
• Time to evaluate
• Quantifiable facts - win people over with data
• Emotional buy-in - evidence must be relevant

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• Carys KinsellaAssociate Workforce
  Designercarys.kinsella_at_doh.gsi.gov.uk0787
  6030169
• www.modern.nhs.uk