Developing the Healthcare Workforce Future Arrangements Stakeholder Forum Event

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Developing the Healthcare Workforce Future
ArrangementsStakeholder Forum Event
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Progress to Date

• From Design to Delivery
• Option Appraisal
• Proposed Operating Model
• HEE Progress
• Authorisation Timetable

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New Structures

• Health Education England
• Local Education and Training Boards
• Centre for Workforce Intelligence
• Department of Health

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NW LETB Arrangements

• One NW LETB
• 3 delegated sub groups
• Shared services
• Three LETBs
• NW coordinating group
• Shared services
• Option appraisal consultation
• Summit 24th May

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LETB core functions and responsibilities

• Producing annual education and training plans to
  ensure supply of the local healthcare workforce
  is in line with national priorities
• Holding and allocating funding for education and
  training
• Commissioning high quality, good value education
  and training in line with professional needs and
  the Education Outcomes Framework
• Securing partnerships with clinicians, local
  authorities, health and well-being boards,
  universities etc.

Health Education England
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LETB Operating Principles

• Local Decision Making
• Inclusive Approach of Providers
• Good Governance
• Sound Financial Management
• Stakeholder Engagement
• Transparency
• Partnership Working
• Quality and Value Year on Year Improvement
• Security of Supply
• Accountability

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NW LETB development

• Review of membership and governance
• Organisational development programme
• Structures for end of July
• MD appointments August September
• Pre authorisation process
• Authorisation
• Approval December January
• Go live April 2013

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Health Education England

• Health Education England (HEE) will, from October
  2012, operate as a Special Health Authority
  (SpHA), accountable to the SofS.
• Chair, Sir Keith Pearson
• CE, Ian Cumming
• First meeting 28th June
• Other directors appointed July onwards

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HEE core functions and responsibilities

• Providing national leadership
• Supporting development of Local Education and
  Training Boards (LETBs) vital to the delivery
  of the new system
• Promoting high quality education and training
• Allocating and accounting for NHS education and
  training resources
• Ensuring security of supply of the workforce.

Health Education England
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Health Education England key projects

• HEE Approach to Quality
• HEE Operating Model
• HEE Organisational Structure
• HEE Workforce Planning, Information and
  Analytical Capability Requirement
• Financial Strategy
• HEE LETB Annual agreement
• LETB Authorisation Process
• Comms Stakeholder Management
• Governance Arrangements including all advisory
  Bodies
• Transition Planning (incl HR)
• Estates, Infrastructure and Corporate Services
• Safe Transition of Critical Functions
• LETB development

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Education Outcomes Framework
1. Excellent education
Ensure the health workforce has the right
skills, behaviours and training, available in the
right numbers, to support the delivery of
excellent healthcare and health improvement
Excellent experience for staff (inc. students /
trainees) and patients
2. Competent and capable staff
Effectiveness
3. Flexible workforce receptive to research and
innovation
4. NHS values and behaviours
Safety
5. Widening participation
Aim Domains Quality

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Key timescales

• April 2012 SHA LETB sub-committees established
• April 2012 HEE/LETB People Transition Policy
  published
• June 2012 HEE established as a Special Health
  Authority
• April September 2012 HEE Board recruitment
• October December 2012 LETB authorisation
• October 2012-March 2013 HEE recruitment
• October 2012 HEE commences in shadow form
• April 2013 HEE and LETBs operational

Health Education England
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• Authorisation Process
• and Plans

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The Authorisation Process Capability and capacity
will be demonstrated through a combination of
self-assessment, submission of evidence,
clarification process and Board to Board
assessment
The diagram below summarises the current thinking
of the proposed authorisation process. Each stage
will strike a balance between robustness and
proportionality.
Proposed authorisation process
Review of evidence
Clarification process and pre-meets
Self-assessment
Submission of evidence
Board-to-Board assessment
Framework Guidance Issued
Joint production of LETB Authorisation Framework
between HEE and key stakeholders. LETB
engagement will be achieved through interviews,
multi-LETB conference calls and workshops.
LETBs will self assess their progress against
criteria and identify where they need
development. The framework should be
sufficiently designed to allow LETBs to assess
which gaps they themselves need to fill in order
to meet the criteria.
Once LETBs are satisfied they can either
demonstrate how they will meet the required
thresholds they will submit documentary evidence
to support their position.
Once LETBs submitted evidence is sufficient to
suggest that they would be capable of operating
with devolved authority a Board-to-Board
assessment session will be held to discuss the
submission and consider potential scenarios and
case studies.
Clarification of the submission as necessary will
take place between HEE and LETBs. Individual
sessions between HEE and LETB staff may be
required. Feedback on submission will also be
provided.
HEE will review the evidence supplied, assess it
against the evaluation criteria. Key areas for
consideration will be identified and a decision
taken on whether what LETBs need to do to move
onto the next stage.
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Principles of AuthorisationA set of principles
underpinning the development of the authorisation
process have been proposed
Safe Transfer - Supports a safe transfer of
functions from SHA to LETB
Transformational Outlook LETBs must
demonstrate intent to deliver material
improvements to Education and Training Outcomes
Outcome Led- LETBS must be focused on delivering
outcomes in line with the Education Outcomes
Framework and relevant to their local area
Robustness- The process must be robust in
genuinely assessing LETB capability and
capacity  
Proportionality- The process must recognise the
evolving nature of the LETBs and be proportionate
to the risks
Equitable- A process that fairly and equitably
delivers outcomes appropriate for differing LETB
readiness for authorisation
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Domain StructureThe Authorisation process will
expect LETBs to demonstrate capability and
capacity against six different domain areas.
Domains Criteria
Vision Leadership 1.1 Shared vision and understanding. 1.2 Long term plans and strategies. 1.3 Strong leadership capability.
Meaningful engagement with key partners 2.1. Meaningful engagement with patient groups. 2.2. Engagement with the broad spectrum of professionals. 2.3. Engagement with key regional and national stakeholders. 2.4. Establishing robust arrangements for working with other LETBs. 2.5 Analysing and acting on information from engagement activities to translate into improvement plans and actions.
Governance 3.1 Constitutional and governance arrangements. 3.2 Effective internal controls. 3.3 The LETB has fit and proper processes and safeguards in place to effectively identify and manage conflicts of interests.
Effective Financial Control 4.1 Ability to carry out the requirements of a finance function. 4.2 Effective financial planning. 4.3 Effective financial control, capacity and capability.
Organisational Capability 5.1 Workable organisational capability plan. 5.2 Capability to deliver organisational needs. 5.3 Assessment of operational and delivery models.
Outcome Led Improvement 6.1 LETBs have prioritised areas for outcome improvement. 6.2 There is a robust programme to deliver the identified outcome improvements. 6.3 The LETB has the internal set up to deliver the programme.
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NW Appraisal

• A key strength is that we started 8 months ago
• Lots we can build on and lots we have learnt
• Now need to re-fresh and revise
• Strong emphasis on stakeholder engagement,
  capacity and capability

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LETB Authorisation TimetableThe current focus of
work is to define and clearly communicate the
process through which LETBs will be authorised.
5th April 2012 Framework design begins
Late June 2012 Guidance issued
July 2012 Guidance published

• Authorisation is a process of gaining assurance
  that each LETB is ready to make effective
  decisions in a way that engages with all relevant
  stakeholders to ensure security of supply of the
  workforce, and has appropriate governance
  arrangements to support this and deal with
  conflicts of interest as and when they arise.
• There are likely to be three possible outcomes
• Fully Authorised- LETBs have demonstrated they
  are capable of taking on all responsibilities
  delegated to them.
• Authorised with conditions- LETBs have
  demonstrated they are capable of taking on some,
  but not all of the responsibilities delegated to
  them, and must meet certain conditions before
  assuming full responsibility.
• Not authorised- LETBs have not demonstrated they
  are capable of taking on delegated
  responsibilities. A future assessment of
  readiness for delegation will be required.

April 2013 LETBs formally begin operations
Authorisation Process (Oct 2012-March 2013)
Self-assessment July-October 2012
Current focus of work
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• Non-Medical Education Commissioning Process

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Education Commissioning Plan 2013-14

• To meet the requirements of the authorisation
  process
• 2 stage consultation
• 1st stage July/August - to guide development of
   draft plan
• 2nd stage August/September to test assumptions
  in draft plan
• Integrated with workforce planning process
• Provider focused

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What are your organisations key priorities and
challenges for education and training?

• Short Term 1 year
• Medium Term 1 to 3 years
• Long Term 4 years plus
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• Consider within context of patient need in
  relation to
• service change/transformation
• Profession specific requirements
• Whole workforce
• New roles and new ways of working
• Education capacity and capability

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• Stakeholder Engagement Update

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HEE advisory structure
Health Education England
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NW Stakeholder Model
Example Networks
Cheshire Merseyside LETB
CM Sub-Regional Forum
HRD Forums
Core Professional Forum
Workforce Strategy Networks
Cumbria Lancashire LETB
CL Sub-Regional Forum
Deanery Networks
Regional Advisory Partnership
Finance Directors Network
GM Sub-Regional Forum
Greater Manchester LETB
PVI Networks
Affiliate
Associate
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Core Professional Forum
Core Profession Member
Medicine (including General Practice)
Dentistry
Nursing Midwifery
Pharmacy TBC 18th July
Healthcare Science Angela Douglas
Allied Health Profession Lesley Walters
Applied Psychology (including psychological therapy) Tricia Hagan
Public Health Gill Sadler
Wider Healthcare Team Judith McGregor
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Regional Advisory Partnership
Advisory Member
Education (to include FE, HEI, Medical Deanery)
Social Care Alix Crawford
Information, Research Innovation (to include AHSNs, HCLU, NIHR, MAHSC, HIECs)
Private, Voluntary Independent Sector
Clinical Commissioning
Health Wellbeing Boards
Centre for Workforce Intelligence Dianne Mardell
Leadership Academy Deborah Arnot
Workforce Modernisation Helen Kilgannon
Staff Side Peter Forster
Local HealthWatch, Patient Participation Groups (PPGs)
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Additional Measures..

• Wider Stakeholder Forum members
• Network directory
• Communication Update
• eWIN site
• Partnership Agreement

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Partnership Agreement

• Core purpose
• Key elements
• Introduction to workshop