Workforce

What is needed to support the delivery of Healthy Ambitions?

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A number of workforce and education themes run through all or many of the pathway recommendations:

  • Increasing emphasis on prevention means more staff are needed in public health and in primary and community care with the skills to deliver the health inequalities and well being agenda – e.g. a widespread ability to undertake brief interventions
  • Additional services provided in primary and community care (such as diagnostics, minor surgery, home births, emergency treatment and choosing to die at home) mean:
    • Making the best use of highly skilled staff – using GPs to see more complex cases and making better use of people such as community pharmacists
    • Developing new and extended roles for other staff, e.g. assistant practitioners in mental health and audiology, maternity support workers and staff who work across health and social care, and more specialist roles for nurses e.g. in diabetes and asthma care
  • Better managed care means more dedicated staff to work as care coordinators/care navigators
  • An increased focus on leadership for staff at all levels. This means we must develop capacity to systematically identify and develop talent, and in particular harness the existing potential of the clinical professions. Alongside local programmes, the SHA is taking steps to develop expertise in:
    • Defining leadership needs
    • Designing and delivering leadership interventions and/or commissioning leadership development which adds value.

Delivery of most workforce and education elements of pathways is dependent on:

  • Increasing practice placement training capacity & supporting placement quality particularly in primary and community care settings
  • Improving clinical skills facilities across the region – high quality simulated learning environments are increasingly vital to deliver fast responsive health services closer to the patient
  • Much closer alignment of strategic workforce planning with service and financial planning. Commissioners and providers must work together with their HR staff at local level to understand the workforce and education implications of service changes for patient pathways.

Who is taking this forward and where is it happening?

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  • PCTs and providers are working with the SHA and Deanery to identify and address workforce risks and education needs requiring a system-wide approach
  • New clinical placements have already been created in diverse settings such as GP practices, occupational health departments, BUPA and Corus. A project to create multidisciplinary advanced training practices in primary care has begun.
  • The MPET review should facilitate creation of the training and education infrastructure in primary and community care by funding placement costs for staff other than doctors and dentists
  • The SHA is investing substantially to ensure that up to date, high quality clinical skills facilities are accessible to all localities.
  • All 10 universities in Y&H are mapping their healthcare provision against Healthy Ambitions pathways to be able to respond to the needs of health communities or individual organisations.
  • Credit-based contracts for continuing professional development (CPD) with each university in Y&H are flexible enough to accommodate bespoke programmes for individual (or groups of) organisations. Educational content to meet Healthy Ambitions pathway recommendations can therefore be designed and delivered locally. Details of all education provision commissioned by the SHA are available in the Guide to Funding on the SHA website. http://www.yorksandhumber.nhs.uk/reports_and_publications/#F A CPD search engine to provide direct links to CPD courses supported by the SHA is being developed.

Risks and Issues

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Recruitment difficulties in particular staff groups may be a risk to delivering Healthy Ambitions, both now and in the longer term if not tackled. In many cases they are reinforced by the age profile of the current workforce.

Solutions are many and varied but include new and extended role development (e.g. midwifery support workers and family practitioners); increased education commissioning (e.g. radiographers); creation of new training posts for doctors; additional consultant appointments; improved preceptorship programmes for newly qualified nurses and midwives; return to practice programmes (e.g. for nurses and midwives), and in some cases international recruitment. Funded apprenticeships and basic level qualifications are available through the SHA/LSC partnership and the Support Staff Learning and Development Fund.

Many of the workforce and education implications are alrWeady being addressed through educational contracts. For example End of Life Care is included in all pre-registration curricula. CPD programmes have been commissioned that focus on communication skills training for palliative care and inter – professional advanced communication skills training is available for all sectors.

Some – such as supporting more widespread role development in the pharmacy workforce and understanding the workforce implications of the rainbow model for the staying healthy pathway – are still to do.

More detail is available in the SHA’s publication ‘Workforce Ambitions’ which sets out what is happening, what is planned and what is still left to do.

Who will make sure that this work happens

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Tim Gilpin, Director of Workforce and Education and the workforce and education team will work with pathway delivery boards and task groups, health communities, clinical networks, PCTs and NHS Trusts, universities and a wide range of stakeholders to ensure that this work is taken forward.