people strategy 2018 2021 · operating at safe staffing levels: utilising scht safer nursing care...
TRANSCRIPT
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PEOPLE STRATEGY
2018 – 2021
Version No: 4 (15th May 2018)
Approval Date: 31st May 2018
Review Date: Annual
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Contents 1 About Our Organisation and Workforce ......................................................................... 3
2 Introduction and purpose ............................................................................................... 5
3 Vision for our People ...................................................................................................... 7
4 Key Drivers .................................................................................................................... 8
5 Where are we now – the workforce in 2018 ................................................................. 11
5.1 Vacancy Rates ...................................................................................................... 11
5.2 Sickness Absence................................................................................................. 13
5.3 Staff Engagement ................................................................................................. 14
5.4 Salary Profile ........................................................................................................ 15
6 Strategic Priorities and Initiatives ................................................................................. 16
6.1 Good and Beyond ................................................................................................. 17
6.1.1 Healthy, Engaged Staff .................................................................................. 17
6.1.2 Diversity and Inclusion ................................................................................... 18
6.1.3 Leadership and Continuous Improvement Culture ......................................... 18
6.1.4 The Right Skills .............................................................................................. 19
6.2 Building our 5-Year Plan ....................................................................................... 20
6.2.1 New roles and agile workforce solutions ........................................................ 20
6.2.2 Secure Workforce Supply .............................................................................. 21
6.2.3 Safe Staffing Levels ....................................................................................... 22
6.2.4 Working as a Health and Social Care Economy ............................................. 22
6.2.5 Define the Future Shape of the Workforce ..................................................... 23
6.3 Implementing EPR ................................................................................................ 23
6.3.1 Support Staff to Optimise their Use of Technology ......................................... 23
7 Measures of Success ................................................................................................... 24
8 Managing Risk ............................................................................................................. 24
9 References .................................................................................................................. 24
10 Appendices .................................................................................................................. 25
10.1 SCH NHS Trust Organisational Development Framework 2018-20 ...................... 25
10.2 Strategy on a Page ............................................................................................... 31
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1 About Our Organisation and Workforce Shropshire Community Health NHS Trust was formed in 2011 and serves a population of about 475,000. We provide community-based services for adults and children in Shropshire, Telford & Wrekin and some surrounding areas. These range from district nursing, health visiting and running four community hospitals through to providing very specialist community care through talented and dedicated staff. We have non-clinical specialists in administration, Finance, Human Resources, Training, Education, Learning and Development, Information Management and Technology, Quality and Risk. We employ around 1525 people and spend around £76 million a year delivering approximately one million patient contacts. Our aim is to be the best local provider of high quality, innovative health services near people's homes, working closely with partners so people receive well-coordinated, effective care. People have told us that we should help patients manage their own condition and stay healthy enough not to have to spend time in hospital, unless they really need to. This is especially important as we continue to care for an ageing population whilst developing our clinical services over the next four years. We are committed to leading the provision of new community based models of care in partnership with local health economy providers. Our People Strategy is intended to enable that to happen. New job roles, career pathways and approaches to training are all part of the strategy. Our total staff headcount is 1525, and equates to 1200 full time equivalents. The largest
single professional group is qualified nurses who make up 40% of the total, followed by
administrative and managerial staff at 24%, healthcare assistants at 15% and therapists
(physiotherapists, occupational therapists and others) at 12%. Doctors and dentists
comprise a relatively small proportion of our employees: 18 (10.8 wte) consultants and
salaried GPs, 7 (5.5 wte) Staff Grade doctors and 15 (10.2 wte) Dentists. GP practices
provide medical input for our community hospital inpatient and Minor Injury Unit services and
some Consultants from other NHS providers deliver clinics on behalf of the Trust.
Fig. 1: Comparison of staff Headcount and Contracted Wholetime Equivalent
0
200
400
600
800
HealthcareAssistants
Admin &Estates
Scientific,Therapeutic
and Technical
Medical andDental
RegisteredNurses
Students
Headcount and Wholetime Equivalent
Headcount
Contracted WTE
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In addition to our contracted staff, the temporary workforce (bank employees, agency staff
and seconded employees of other organisations) contributes the estimated equivalent of 111
full time staff.
Fig. 2: Composition of Contracted and Temporary Workforce
Our staff and partners have helped to refresh and develop our vision and values, and we
have seen a steady increase in how engaged our staff feel with the organisation, and the
extent to which they would advocate for the Trust being a good employer – however, we
know there is more to do. The quality of our staff’s experience at work will directly influence
the quality of our patients’ experience in interacting with them – which makes it vital for us to
be a good employer with a positive culture.
0.00
100.00
200.00
300.00
400.00
500.00
600.00
HealthcareAssistants
Admin &Estates
AHPs andother
Therapy
Medical andDental
RegisteredNurses
Students
Contracted and Temporary Workforce
Agency & other employers
Bank
Contracted Staff
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2 Introduction and purpose Welcome to our People Strategy 2018-2021.
Jaki Lowe, Director of People Steve Gregory, Director of Nursing and Operations
Our staff and the roles they carry out are at the heart of delivering high-quality, person-
centred care, whether they do that directly or indirectly. Our vision as a Trust can only be
realised if we continue to develop individuals and the whole workforce, and use their
collective efforts in the most productive way. This People Strategy is therefore one of our
‘enabling’ strategies – setting out how we will enable our workforce to deliver our overall
organisational vision and strategic objectives. The strategic objectives with particular
relevance to workforce include the delivery of safe, high quality services, the new models of
care envisaged in our clinical ambitions, and ways of working that are efficient and
sustainable.
Close working with partner organisations is a key part of our Trust vision, in the interests of
integrated services for patients. Alongside this, our local health economy is taking a much
more collaborative approach to service planning, in line with national policy. This People
Strategy reflects themes within the local multi-agency Sustainability and Transformation
Plan, and recognises the need to be part of an employment ‘network’ with other local health
and care organisations, both for workforce planning and wider development aims.
This strategy outlines our workforce priorities for the next three years, and sets out our
ambitions for leadership and culture, recruitment, retention, diversity and inclusion, skills
development and talent management – all of which are central to our health, wellbeing,
effectiveness and productivity.
The People Strategy enables the delivery of other key Trust strategies by supporting the
workforce change elements – as shown in the diagram below.
At the same time, delivery of this People Strategy is underpinned by a range of more specific
strategies and policies to put the different strands into practice – again, as shown in the
diagram.
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Fig. 3: Role of People and People Strategy
National & STP Workforce Strategies
Quality Strategy
Clinical Strategy
Trust Strategic Goals,
Objectives and Values
IM&T Strategy
Estates Strategy
People Strategy
Organisational Development Framework
Culture Working Group
Implementation Plan
HR
Resourcing Strategy
(recruitment)
Health & Well-Being Strategy
“Everyone Counts”
Equality and Diversity plan
People
Management Policy
Framework & workforce
metrics
The strategy will be supported by an operational workforce plan each year. It will be reviewed each year to ensure it remains aligned with the Trust’s clinical vision as the details and deliverables are defined in more detail. That in turn will allow the shape of our future workforce within this strategy to be modelled and articulated in more detail. The main governance forum for assurance on the People Strategy will be the Quality and Safety Committee, supported by the HR and Workforce Group.
The vision and goals we are working to enable are:
Our Trust Vision
We will work closely with our health and social care partners to give patients more control over their own care
and find necessary treatments more readily available. We will support people with multiple health conditions,
not just single diseases, and deliver care as locally and conveniently as possible for our patients. We will
develop our current and future workforce and introduce innovative ways to use technology.
Trust Goals
This overarching vision will be delivered through four strategic goals agreed by the Trust Board:
To deliver high quality care
To support people to live independently at home
To deliver integrated care
To develop sustainable community services
Our Objectives
Safe
Caring
Effective
Responsive
Well-led
Designed around the patient
Increased range of services
Making best use of technology
Delivered in sustainable environments
Financial sustainability
Our Values
Improving Lives
Everyone Counts
Commitment to Quality
Working Together for Patients
Compassionate Care
Respect and Dignity
Our People Strategy helps to deliver these
These help to deliver our People Strategy
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3 Vision for our People
In the coming years we will build on the strong base of our staff’s skills and commitment in order
to develop a modern and vibrant community workforce with the energy and confidence to
achieve our ambitious vision for care. We will foster an innovative culture of continuous
improvement that continually seeks out better ways of delivering excellent care to the population
we serve. Our clinical staff will become genuinely mobile by embracing new technology. We will
develop confidence in new and extended skills to deliver seamless care working closely with our
health and social care partners, at the right time and in the right place, as locally and conveniently
as possible. To do this we will have to break with some old assumptions and self-imposed
boundaries, supporting our people to change and develop broad portfolios of skills in the care of
frail elderly people, children, and people with complex multiple co-morbidities, dementia and other
mental health issues. We will grow our own skills, taking full advantage of the support available
for apprenticeships, support workers and advanced practitioner development programmes. We
will retain the people we employ, offering appropriate and flexible employment models for different
stages of life, and recognising the impact of the physical environment on productivity and
wellbeing.
Working with local partners we will create multi-disciplinary teams based around natural
geographies, using a shared set of skills across the pathways, and including some staff with more
specialist knowledge.
We will also make sure that our workforce is sustainable, and we will minimise the spend on
expensive agency staff in favour of permanent employees in whose development we can invest,
and who will look to us to help forge their careers.
We will actively promote diversity and inclusion in our workforce, as we believe that Everyone
Counts and a diverse workforce will foster innovation, improve decision-making and better
support the diverse needs of our patients.
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4 Key Drivers These are the key drivers for our People Strategy, taken from our clinical, quality and IMT
strategies, our Trust strategic objectives, and the system-wide STP. These are the service
delivery, patient and business needs and changes which our People Strategy will help to
enable.
Quality Strategy There is a clear link between staff experience and staff wellness with patient experience and patient outcomes. To deliver our Quality Strategy we need a workforce that is:
Skilled and knowledgeable: through standardised competency-based clinical education and training
Motivated and innovative: with visible leadership and a ‘speak up for safety’ culture
Healthy and Engaged: supporting and developing staff to feel engaged, valued and empowered in leading and driving quality across the organisation
Working in new ways: with an integrated workforce model to support our vision for sustainable services
Deployed into the right roles: through planned recruitment and effective succession planning
Operating at safe staffing levels: utilising SCHT safer nursing care acuity model to support safe staffing and developing our internal staff bank
Clinical / Transformation Strategy New roles and skills, more talent management
New models of care will support a shift of services from acute to community settings. Such
models include community hubs, new local urgent care models, Teams around the Practice
and Integrated Community Services, together forming Neighbourhood Care Teams. To
achieve this and to support the expansion of admission avoidance and care coordination
services we will need to develop new roles and skills and use robust talent management. We
will develop our ability to deliver integrated care through partnerships.
The Clinical Strategy also envisages more engagement of staff in illness prevention and
health promotion in all their contacts, and this will need to be supported in their approach.
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Fig. 4: Neighbourhood Care Teams
Efficiency/new technology
In tandem we will need to devise more efficient ways of working, optimising effectiveness
and efficiency, and to implement new technologies for health records and mobile working.
System-wide working
The clinical strategy sees us developing an increased culture of cooperation with patients
and partners in the health and social care economy, which will apply equally to our efforts on
workforce – i.e. planning in a joined-up way.
IM&T Strategy Over the next 5 years the Trust will create a truly mobile clinical workforce supported by
sophisticated clinical systems and robust infrastructure. Staff will be encouraged and
supported to use information and knowledge to improve the quality of services. Appropriate
IT hardware will be made available to staff along with full training in its use and in the
Information Governance responsibilities that go with it.
GPs
Mental Health
Community Nursing
Allied Health Professionals
Voluntary Services
Social Care
Public Health practitioners
Care Navigators
Emergency & Specialty Care
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Sustainability and Transformation Plan The Sustainability and Transformation Plan (STP) is the joint work of local health and care
organisations in Shropshire, Telford and Wrekin, to plan their services together by place for
the next five years, rather than planning by individual institutions.
The STP models of care describe three key components:
Reconfigured hospital care
Care closer to home through neighbourhood models
Health prevention
This strategy directly address the second and third of these components.
Shropshire, Telford & Wrekin STP People Strategy Produced March 2018 by the STP Strategic Workforce Group, in which Shropshire
Community Health plays a pivotal role.
In order to support the delivery of the STP vision for the local population, the strategic aim for workforce is to Develop a sustainable workforce that is fit for purpose, is supported by modern technology and can deliver evidence-based care in new ways that suit user’s lifestyles and where they live The strategy identifies a number of actions under 4 broad priorities: 1. Attract, Recruit and Retain 2. Workforce Planning and Modelling 3. Education 4. Leadership
The immediate workforce challenges the STP addresses are:
recruitment challenges including adult registered nurses, mental health nurses and doctors
system workforce transformation to meet the gaps with new roles such as Advanced Clinical Practitioners, Assistant Practitioners, Physicians Associates and Wellbeing Apprentices
Other more general themes in the STP which impact on our People Strategy include:
Supporting prevention and wellness programmes being delivered across the workforce as well as in communities
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Support for creation of more community capacity to manage the shift in care closer to home, with a new clinical model in the shape of Neighbourhood Care Teams (see fig. 4 above) to be developed using Community Fit data
Care and wellbeing services centred in rural communities
Urgent care provided in rural areas for defined populations by community, acute and primary care providers all working together, with more integrated pathways of care
Commitment to seven day per week services
System-wide work on reducing the deficit and optimising efficiency, including reducing reliance on agency and developing smarter ways of working to increase efficiency - for example making the most of technology
National Workforce Strategy for the NHS Published in December 2017 and titled ‘Facing the Facts, Shaping the Future’ this is based
on 6 broad principles:
1. Securing the supply of staff 2. Training, educating and investing in the workforce 3. Providing career pathways for all staff rather than just ‘jobs’ 4. Ensuring that people from all backgrounds have the opportunity to contribute to, and
benefit from, healthcare. 5. Ensuring that the entire NHS is a modern model employer with flexible working patterns,
career structures and reward mechanisms 6. Ensuring that in the future service, financial and workforce planning are intertwined
5 Where are we now – the workforce in 2018
5.1 Vacancy Rates
As described in section 1, we have a headcount of 1528 staff equating to 1201 whole time
equivalents (as at 30th April 2018). The temporary workforce contributes the equivalent of 68
full-time equivalents.
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Fig. 5: Current Vacancy Rates
The long standing groups which have been hard to recruit to are medical staff, dentists and
qualified nurses in community hospitals, although concerted efforts to recruit to these
nursing roles have improved the position.
More recently, vacancy rates have been high for allied health professionals who are required
in new/developing services in Integrated Community Services (ICS) and Telford & Wrekin
Musculo-skeletal Service (TeMS), although the position continues to improve.
There is a focus on reducing expenditure on agency staff, principally nursing staff in
Community Hospitals.
An indication of possible future retirements driving recruitment needs is given by data
showing 24% of Medical staff will be over the age of 55 by May 2017, compared to 21% of
qualified nurses and 18% of Allied Health Professionals.
0%
2%
4%
6%
8%
10%
12%
14%
16%
Difference between Budget Establishment and Staff in Post in March 2018
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5.2 Sickness Absence
Fig. 6: Sickness Absence 2016-2018
Sickness absence has risen in 2017/18 and costs the trust over £2m per year. The main
causes of sickness are stress and anxiety and musculoskeletal issues, which we are working
to address in our Health and Wellbeing Strategy.
Filling our vacancies and reducing sickness absence will reduce our dependence on agency
staff, bringing down costs and improving quality and safety.
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5.3 Staff Engagement
The 2017 results from the NHS Staff Survey show levels of staff engagement that have
maintained a position slightly better than the average for Community Health Trusts. This is a
trend that has improved year-on-year since 2012 (see graph below.) Improving advocacy,
involvement and motivation will attract new recruits, promote innovation and continuous
improvement and increase productivity.
Staff Engagement SCH 2014
SCH 2015
SCH 2016
SCH 2017
Community Trust 2017 Average
Overall Staff Engagement Score 3.76 3.83 3.84 3.84 3.78 Score on a scale of 1-5
I would recommend my organisation as a place to work
Ad
voca
cy
51 55 55 57 57
% of replies agreeing / strongly agreeing with the statement
If a friend or relative needed treatment, I would be happy with the standard of care provided by this organisation
69 72 73 74 73
Care of patients / service users is my organisation’s top priority
69 74 75 76 76
I am able to make suggestions to improve the work of my team / department
Involv
em
ent 76 78 78 80 76
There are frequent opportunities for me to show initiative in my role
72 73 72 73 72
I am able to make improvements happen in my area of work
62 60 59 60 57
I look forward to going to work
Mo
tiva
tio
n
54 58 58 57 57
I am enthusiastic about my job 69 75 76 76 74
Time passes quickly when I am working 79 83 85 83 81
Fig 7: Staff Survey Results 2011-17: Engagement and Advocacy
3
3.1
3.2
3.3
3.4
3.5
3.6
3.7
3.8
3.9
2011 2012 2013 2014 2015 2016 2017
Overall engagement
recommendation ofTrust
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5.4 Salary Profile
Fig. 8: SCH Salary Band Profile vs. National Average for Community Health Trusts as at
May 2018
This chart shows the full-time equivalent staff in each salary band in Shropshire Community
Health. For comparison, the national average proportions are given, scaled down to show
the equivalent numbers at SCH.
Compared to other Community Health Trusts, Shropshire employs a lower proportion of
Band 3 and 4 staff and more Bands 2, 5 and 6. On the face of it this may suggest that our
optimum profile would include a higher proportion of Healthcare Assistants and Assistant
Practitioners. However the shift of acute activity into community settings may reinforce and
extend the need for registered staff. This will become clearer as the community model is
firmed up.
0.0
50.0
100.0
150.0
200.0
250.0
300.0
350.0
Band 1 Band 2 Band 3 Band 4 Band 5 Band 6 Band 7 Band8a
Band8b
Band 8c Band8d
Other
National Average equivalentFTE
Shropshire Community HealthFTE
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6 Strategic Priorities and Initiatives The overall strategic priorities to address in this strategy mirror those of the Shropshire
Community Health Plan on a Page 2018/19 namely:
PRIORITY 1 : GOOD AND BEYOND: Safe, Caring, Effective, Responsive, Well-led
PRIORITY 2: BUILDING OUR 5 YEAR PLAN: Sustainability and Transformation
Plans
PRIORITY 3: IMPLEMENTING EPR: Optimising the use of Technology
Our strategic workforce initiatives to address each of them are set out in this section. In
addition our Organisational Development Framework at Appendix 1 sets out our vision for
delivering organisational development as we continue to enhance quality care provision.
Our Key Ambitions
Develop a sustainable, resilient cadre of advanced clinicians so we are self-sufficient in critical skills
Expand the scope of registered professionals’ roles to improve continuity of care
Strengthen the unregistered workforce by creating different routes into employment
Attract the new staff we need by offering innovative new models of employment and genuine career prospects
Create a culture of positive physical and mental health in the workforce
Step up our leadership and management capability to drive through the changes we need
Foster a genuinely diverse workforce and ensure fairness and equality in all we do
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6.1 Good and Beyond
6.1.1 Healthy, Engaged Staff
In the period of the strategy we will:
Work with our health and social care partners to support the health and wellbeing of
our workforce.
Continue to raise the profile of the health and wellbeing of our staff in line with our
values.
Introduce a range of physical activity schemes for our staff, and develop our network
of Health and Wellbeing champions around the county as they promote health and
wellbeing for our people.
Support staff to remain at work whilst it is beneficial for their health and wellbeing.
Improve access to therapy services for staff.
Develop a range of mental health initiatives for staff, including access to counselling
services, improving skills development for managers and leaders in recognising,
managing and preventing stress.
Promote staff resilience through Schwartz rounds, clinical supervision, coaching and
mentoring.
Provide proactive support to leaders and managers to ensure the maintenance of a
healthy working environment recognising the impact of the physical environment on
productivity and wellbeing.
Develop health and wellbeing interventions that will make the most difference to our
workforce based on the most common causes of sickness absence, for example
musculo-skeletal issues and stress.
Actively support staff and leaders through periods of ill-health through excellent
Occupational Health and Counselling provision, benchmarking and reviewing our
services and developing, refining and publicising Occupational Health management
pathways.
Monitor progress using health and wellbeing metrics from a range of sources
Provide timely and relevant management information to enable the development of a
value-adding approach to health and wellbeing.
Good and
Beyond
Healthy
Engaged Staff
Diversity and Inclusion
Leadership and Continuous
Improvement Culture
The Right Skills
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6.1.2 Diversity and Inclusion
Our recent Staff Survey has demonstrated that staff with protected characteristics don’t
always feel as positive about their experience of working with us as we would like. In the
period of the strategy we will:
Support the development of an Equality, Diversity and Human Rights Strategy for our patients and our workforce.
Use a range of workforce diversity reporting including the Workforce Race Equality Standard (WRES), Gender Pay gap reporting and the Workforce Disability Equality Standard (WDES) to help us better understand the diversity of our workforce.
Improve collection of data across all the protected characteristics within our workforce.
Ensure the development and delivery of appropriate action plans to enhance the diversity and employment experience of our workforce.
Seek to ensure the diversity of our workforce is representative of the diversity of our community as a whole.
Continue to enhance the diversity of our workforce, for example through Enable
programmes for people with disabilities.
Create Diversity Staff networks to support this important work.
6.1.3 Leadership and Continuous Improvement Culture
In the period of the strategy we will:
Develop a culture where our staff feel valued, involved and fulfilled in the work they
do.
Communicate appropriately and effectively to support staff in managing change.
Support leaders to set clear expectations and support staff to meet them.
Work with our services to support their strategic direction, and enhance our HR
business partnering approach to support the organisation.
Provide leadership development programmes ranging from staff supervision and
support, training and use of the NHS Leadership Framework 360 degree feedback
tool through to executive coaching and leadership mentoring.
Facilitate change processes in a way that aligns our Vision and Values, ensuring that
we support staff throughout.
Support and encourage our leaders to be visible and develop the skills to manage
their people effectively and in line with our Values.
Deliver HR services in line with CIPD (Chartered Institute of Personnel and
Development) professional standards.
Provide a people-management policy framework that embodies our Values and sets
high standards for everyone to aspire to.
Develop innovative new approaches to people management / processes.
Develop staff side’s skills in representing and supporting staff.
Use workforce metrics to generate insight and add value.
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6.1.4 The Right Skills
We must ensure people have the right skills to deliver care safely and effectively. To
do this we will continue to improve our mechanisms for identifying, delivering and
monitoring the uptake of statutory and mandatory training. We will regularly review
and update the training offered to ensure the highest quality of training and full
assurance of staff skills.
We will develop a competency framework for all roles starting with the core skills for
the non-registered and junior registered frontline workforce and clinical and non-
clinical leadership roles.
Our Preceptorship policy sets a consistent standard for providing newly qualified
employees with the support and guidance they need to operate safely and
independently. Feedback has confirmed its impact in attracting and retaining new
staff. Following evaluation, we will broaden the current focus on adult nursing to
include all professional groups, and so ensure that all services are equipped and
ready to recruit, develop and retain newly-qualified staff.
We will facilitate and monitor professional revalidation using the functionality of ESR
Self Service.
We will develop and promote available clinical skills training, encouraging the sharing
of knowledge and skills. We will implement a structured development programme for
qualified staff, ensuring the retention of key skills.
In the period of the strategy our specific workstreams will include:
Management and coordination of CPD funding streams for staff
Clinical Education
Mandatory Training
EPR (RiO) support
Human Factors
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6.2 Building our 5-Year Plan
Our vision is to support leaders to develop and implement innovative and effective
workforce solutions for the delivery of care.
6.2.1 New roles and agile workforce solutions
Our ambitions for new roles and skills will support the shift from acute to community care.
In the period of the strategy we will:
Work with our health and social care partners to shape the health and care labour
market to avoid skills shortages and thus reduce unhelpful competition over
limited resources.
Build a network approach to employment i.e. work with our partners in the health
and social care economy, to identify, develop and support new models of care
(e.g. population based care, multi-speciality community providers, primary and
acute care systems, urgent and emergency are networks etc.).
Create a receptive culture for change through our organisational development
approach and make sure there are sound support structures and governance for
any new roles.
Cultivate strong links with workforce and training bodies.
Support change with strong communications and engagement.
Consider the design of roles and teams to maximise staff health and wellbeing
and productivity.
Building Our 5
Year Plan
New Roles
Secure Workforce
Supply
Working as a Health and Social Care Economy
Define the Future Shape
of the Workforce
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6.2.2 Secure Workforce Supply
Our vision here is to attract and retain appropriately skilled staff who share our values.
We need diverse, talented and capable staff of all ages to support the delivery of our
strategic vision. In the period of the strategy we will:
Recruit
Develop our recruitment processes and practices to ensure they are of the
highest quality, flexible and responsive to the needs of the business.
Identify areas for collaborative recruitment across the STP footprint streamlining
recruitment processes and functions to deliver an effective and efficient
recruitment service for the Trust and the local health and social care economy.
Advertise posts and promote opportunities in our organisation using a variety of
channels including social media to reach a diverse audience.
Ensure a proactive and value-adding approach to recruitment using management
information to e.g. targeted initiatives adapted to the needs of particular
geographical locations, staff groups or ‘hard to fill’ posts.
Ensure we recruit and retain staff who are fit and proper to care for our patients,
using Values Based Recruitment supported by existing checking mechanisms.
Develop a range of employment pathways into the Trust to ensure our future
workforce supply, and act as a socially responsible employer in our communities
e.g. work experience schemes. Use the pathways to further employment
opportunities for under-represented groups.
Adopt new and innovative approaches to safeguard workforce supply in support
of patient care, such as apprenticeship programmes, associate nursing and
assistant practitioner posts.
Expand our Apprenticeship offer and develop our apprentice employment model
to improve recruitment and retention and fill key skills gaps. We will maximise the
use of the apprenticeship levy and increase our range of apprenticeship
providers.
Widen the use of values-based recruitment to support high quality recruitment
decisions.
Develop a more structured approach to succession planning, identifying teams and roles which could present a challenge in terms of workforce supply and developing our approach to mitigating these risks.
Building our 5-
year Plan
New Roles and Skills
Secure Workforce
Supply
Working as a Health &
Social Care Economy
Define Future Shape
of the Clinical
Workforrce
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Retain
Offer appropriate and flexible employment models for different stages of life, to help people remain in employment with us.
Ensure that during recruitment we enable candidates to form an accurate view of employment with us, so that they form realistic expectations.
Reinforce the concept of careers not jobs, through the development of our approach to talent management that ensures we develop and retain people with our most important skills.
Implement a structured development programme for staff.
Further develop our rotational roles both internal to the Trust and across the
health and care economy, to support the principle of best care closer to home
and shift care from acute to community. This process will be assisted by joint
training, and rotations through different care settings.
Create recognition and reward mechanisms tailored to our specific needs and
reflective of the needs of the people we aim to recruit and retain.
Develop employment models to support the delivery of patient care and ensure
retention of key skills, for example rotational models between services/employers
or annualised hours.
Further develop our approach to bank and flexible working solutions, and work
with our health and social care partners to create a collaborative bank of staff to
support flexible workforce deployment and enable workers to have greater control
over their own working hours/pattern.
6.2.3 Safe Staffing Levels
In the period of the strategy we will:
We will work with operational and Quality teams to understand and define safe
staffing levels for our community services. We will use benchmarking, guidance
from recognised authorities and modelling to understand the staffing levels
required to deliver safe and effective care. Monitoring will be undertaken to
identify trends and exceptions to reduce the risk of staffing incidents.
We will support operational teams to improve rostering skills helping staff to
adjust where necessary to a fairer, more transparent and more efficient system.
6.2.4 Working as a Health and Social Care Economy
In the period of the strategy we will work with our STP partner employers to:
Define and articulate a Shropshire Employment Offer and branding attract
people to live and work in our area.
Support the development of a joint long term (10 year) workforce plan with
associated recruitment and retention initiatives.
Work collectively with education providers to maximise our use of resources.
Maximise opportunities for rotation of staff and other development opportunities
between employers, including the implementation of shared rotational apprentice
roles.
Develop a collaborative approach to recruitment across partner employers.
Work collectively to develop an STP approach to a shared staff bank.
Support clinical teams as they deliver shared care for patients.
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6.2.5 Define the Future Shape of the Workforce
In the period of the strategy we will:
Support the design and implementation of new and integrated workforce models
(e.g. following tenders or service redesign) and support our staff as they change.
Work with clinical and non-clinical teams to design a workforce suitable for their
service.
Apply strategic workforce planning principles in support of our business,
contracts and services, developing the profile of our workforce to ensure it is fit
for purpose.
Develop and enhance our workforce including Advanced and Extended Roles
and Support Worker/Assistant Practitioner Roles.
Utilise our strategic workforce planning methodology to assist colleagues in
designing the most appropriate workforce models for their service. This will
include the ability to model the impact of workforce changes on activity and
finance and vice versa. Operational managers will be equipped with skills in
practical role analysis and work design.
6.3 Implementing EPR
6.3.1 Support Staff to Optimise their Use of Technology
In the period of the strategy we will support staff as they apply technology in the
workplace including:
Implementing the Electronic Patient Record (EPR)
Helping staff adjust to changed culture and working practices as a result of
technology
Engaging teams as they realise the benefits of EPR
Facilitate the transition to mobile and lone working, recognising the effects on staff
who will be more often working in physical isolation from managers and
colleagues.
Developing strategies to support staff and teams in overcoming any adverse
effects and manage risks to health and safety
Sonia Orr: Head of OD and Leadership: Jan 2018 Page 24 of 31
7 Measures of Success These are the measures we will use to monitor and evaluate the success of the People
Strategy:
Vacancy rates
Recruitment KPIs
Sickness absence / attendance rates
Turnover and reasons for leaving
Bank and Agency Utilisation
Appraisal completion rates
Mandatory Training completion
Staff Survey results
Number of apprenticeships
Workforce Race Equality Standard
Workforce Disability Equality
Standard
Gender Pay Gap reporting
Occupational Health KPIs
HR Casework Report
Workforce Profile
Number of apprentices securing
employment with us after completion
of apprenticeship
Talent Management KPIs
STP Workforce Strategy KPIs
EPR KPIs
Workforce Skills Profile
8 Managing Risk Workforce risks feature in our risk registers at all levels, and are managed and mitigated in
line with the leads assigned in each register. The HR and Workforce Group reviews all the
risks related to workforce to identify themes, trends and areas for further action based on
considering them collectively.
The principal workforce risks to be addressed by this strategy are our:
Ageing workforce;
Ability to recruit and retain staff in key roles (e.g. nurses, dentists);
Availability of specific skills (locally and nationally) in challenged services;
Capacity to deliver transformation and organisational change.
9 References Imison, Castle-Clarke, Watson (2016), Reshaping the workforce to deliver the care patients need, Nuffield Trust NHS England (2016) Leading Change, Adding Value: a Framework for Nursing, Midwifery and Care Staff Edwards N (2014) Community Services: how they can transform care, The King’s Fund NHS England (2016) Leading Change, Adding Value: a framework for nursing, midwifery
and care staff.
Health Education England (2017) Facing the Facts, Shaping the Future: A draft health and
care workforce strategy for England to 2027
Shropshire, Telford and Wrekin STP Strategic Workforce Transformation Group (2018)
People Strategy
Sonia Orr: Head of OD and Leadership: Jan 2018 Page 25 of 31
10 Appendices
10.1 SCH NHS Trust Organisational Development Framework 2018-20
Shropshire Community Health NHS Trust
Organisational Development Framework
2018-20
Sonia Orr: Head of OD and Leadership: Jan 2018 Page 26 of 31
Organisational Development approach to High Quality Service Provision
Introduction
The function of Organisational Development (OD) within Shropshire Community Health NHS
Trust is overseen by the Executive Director of Nursing and Operations and is managed by
the Head of Organisational Development & Leadership. The OD team creates and is the
guardian of this framework and acts as agent of change, improvement and development
throughout our organisation.
The idea of the OD Framework is to draw together the strategic objectives, priorities and
values of our Trust and interpret them as a model for the design, development and delivery
of our services. At its centre is the culture through which our Trust will achieve sustainable
success.
Scope
The OD Framework applies to all Trust services, to all locations and to all staff groups. It is
the glue that binds our staff together and helps to give our Trust its brand and identity with
regard to the ‘way we do things around here’; leading to consistent high standards of safe
and patient-focused care.
Background
In 2013 our Trust set out its approach to OD with the creation of the 2013-17 OD
Framework. This mirrored the structure of the Care Quality Commission (CQC) Well Led
Domain and was divided into three main strands:
Strand One: Organisational Culture and Leadership Strand Two: Staff Development Strand Three: Staff Engagement and Empowerment
In order to implement this approach, a Culture Working Group (CWG) was formed to
develop and deliver an implementation plan; organised into the following five key areas:
(NHS Strategic Projects 5-Box model: embedding a service culture)
In 2016 it was recognised that much of the work in the OD Framework was well underway,
and both the framework and the CWG Implementation Plan were updated to be responsive
to our refreshed strategic priorities:
1. ‘Good’ and Beyond
2. Our 5 Year Plan
3. Implementing Electronic Patient Record
Sonia Orr: Head of OD and Leadership: Jan 2018 Page 27 of 31
Governance
The OD Framework is reviewed annually by the OD team and managed by the CWG, whose
outputs are reported quarterly to the Quality & Safety Committee.
Board
Q&S Committee
CWG OD Framework
The OD Framework runs alongside and supports the People & Workforce Strategy 2016-20,
Quality Strategy 2016-19, Clinical Strategy 2016-19 and the Staff Support & Supervision
Policy 2017.
This 2018-20 OD Framework has been refreshed once again to take into account the 2017
publication of the CQC Well-led Key Lines of Enquiry (KLOEs).
Sonia Orr: Head of OD and Leadership: Jan 2018 Page 28 of 31
CQC definition of Well-led:
“By well-led, we mean that the leadership, management and governance of the organisation
assures the delivery of high-quality and person-centred care, supports learning and
innovation, and promotes an open and fair culture”.
CQC Well-led Domain KLOEs
Sonia Orr: Head of OD and Leadership: Jan 2018 Page 29 of 31
The CQC recognises that Trusts need to develop leaders in order to create strong cultures
based on values and behaviours. Therefore, to build on this going forward, the focus of this
framework will centre on the following CQC Well-led KLOEs:
W1: Is there the leadership capacity and capability to deliver high-quality, sustainable
care?
Through the CWG implementation plan, the OD Framework supplements staff access to
national and regional progressive leadership programmes. It commits to enriching our staff
with the skills, knowledge and experience they require to ensure sustainable,
compassionate, inclusive and effective leadership, for example:
Our internal Leadership and Management Programmes
Quality Improvement initiatives such as Human Factors
Undertaking effective, quality PDRs (appraisals)
Staff support and supervision opportunities
New ways of working within locality / neighbourhood models
Succession planning, such as HCA and AP development
W2: Is there a clear vision and credible strategy to deliver high-quality sustainable
care to people, and robust plans to deliver?
This OD Framework, with its associated CWG implementation plan, continues to encourage
and sustain a positive organisational culture which has our employees at its heart. Through
continuous (staff and patient) feedback mechanisms it aims to keep on engaging with our
staff and volunteers to appreciate what is important to them in relation to our vision and
values, for example:
A shared commitment to high quality patient care, such as utilising FFT feedback to
make improvements
Effective and efficient service delivery in the local population, such as supporting the
0-19 service transformation
Being in a good place to work – both individually and in teams – utilising tools such
as staff survey and staff FFT results to shape action planning
W3: Is there a culture of high-quality, sustainable care?
This OD Framework continues to embed our Trust values, leading on relevant workstreams
which arise out of our Culture Working Group (CWG) and Community Trust Leadership
Group (CTLG). The OD Framework sets out an approach to ensure that staff feel supported,
respected and valued as well as having systems in place to tackle inconsistency in
behaviours. It also provides opportunities for staff are able to raise concerns without fear of
retribution. Examples:
Sonia Orr: Head of OD and Leadership: Jan 2018 Page 30 of 31
Freedom to Speak Up Guardian and the associated advocates are available to
provide another arena for staff to speak out safely
Health and Wellbeing initiatives such as roadshows and resilience training
More awareness of high quality PDRs (appraisals) that include behavioural
frameworks and career development conversations
W7: Are the people who use services, the public, staff and external partners engaged
and involved to support high-quality sustainable services?
Both the OD Framework and the CWG, recognise the link between our patient experience
and quality of care with staff and volunteer engagement and empowerment. Therefore the
CWG implementation plan highlights the key role of both staff and patient FFT feedback and
also includes:
The development of the Equality & Diversity strategy by the Everyone Counts Group
Co-production between staff and volunteers in order to be an integral part of service
development
Inclusion of volunteers within key decision-making committees and groups
The opportunity to elicit staff views on their service provision and culture e.g. staff
awaydays
W8: Are there robust systems and processes for learning, continuous improvement
and innovation?
The previous OD Framework set out our commitment to embrace and foster a climate of innovation, learning and new ways of working. In addition to the core mandatory training undertaken by staff, this framework and CWG implementation plan continues to build on this commitment, for example:
Focusing on Continuing Professional Development, such as clinical preceptorship,
HCA accreditation and NMC Revalidation
Promoting the use of standardised improvement tools and methodologies, such as
productive tools and LEAN
Supporting the implementation of our new Electronic Patient Record (EPR) fostering
new ways of working.
Encouraging service redesign and transformation, such as the STP
10.2 Strategy on a Page
To deliver high quality care
Strategic Goals
To deliver integrated
care
To support people to live independently
at home
To deliver sustainable community
services
Strategic Priorities
Good and Beyond
Safe, Caring, Effective,
Responsive, Well-Led
Building our 5 Year Plan
Sustainability and Transformation
Plans (STP)
Implementing Electronic Patient
Record
Optimising the use of technology
People Strategy 2018-2022
A Vibrant Modern Workforce
Diversity and inclusion: ensuring people from all backgrounds have a
positive experience of working for us
Shropshire Community Health NHS Trust Strategy on a Page 2018/19
Leadership & continuous improvement culture: encouraging people
to value & involve each other and communicate appropriately
Healthy, engaged staff: supporting people with their physical, mental
and emotional wellbeing at work
Support staff to optimise their use of technology: facilitating new
ways of working and supporting cultural change
Secure Workforce Supply - Recruit: identify proactive and value-adding
approaches to recruitment, career pathways, apprenticeships and succession planning for our patients and our workforce
New roles and agile workforce solutions: design & deliver employment
solutions that support service delivery for patients, workforce & partners
Improving Lives
Everyone Counts
Commitment to
Quality
Working
Together for Patients
Compassionate
Care
Respect and
Dignity
Our Values
Working as a Health and Social Care Economy: working with our
partner employers on shared and integrated services
The right skills: ensure people have the skills to provide care safely &
effectively
Define the future shape of the workforce: supporting the strategic
design of integrated service & workforce models for care delivery
Safe Staffing Levels: working with colleagues to define safe staffing
levels for community services and improving rostering skill
Secure Workforce Supply - Retain: offer employment models, reward
and recognition packages that support our workforce to work with us