shaping the letb system for 2015 and beyond 13 th july 2015 #hewmtransforms

Shaping the LETB System for 2015 and

Beyond

13th July 2015

#hewmtransforms

Welcome

Jenny PriceHead of Innovation,

Health Education West Midlands

#hewmtransforms

www.hee.nhs.uk

Housekeeping

www.hee.nhs.uk

#HEWMtransforms

Setting the Scene

Jenni OrdChair,

Health Education West Midlands

#hewmtransforms

www.hee.nhs.ukwww.wm.hee.nhs.uk

Aims of Today

Through engagement with West Midlands health and care system leaders, today we will;• provide the vision and context for the revised LETB Operating Model• outline the Transformation Themes and Enablers • inform how we transform the health and care workforce across each of

the transformation themes –identifying the workforce priorities • understand the current work being undertaken that is related to each

theme • explore how the model will work in practice, including stakeholder

engagement requirements and approach to communication


Key Drivers for change

Five Year Forward View• New Models of Care

– E.g. Vanguards

• 10 points plan for Primary Care• Prevention • Urgent Care

HEE 15 Year strategy• Adaptable & flexible workforce• Safe high quality care• Support co-production & self management


Beyond Transition

One HEE• Efficient / Effective / Aligned• Revised operating model• How we are responding to system

transformation and new models of care


Where we have come fromFeb

15

• HEWM Board Engagement Event – focusing on how want to more engaged and enable large scale change

13th March

• HEWM Board -Translate discussions from engagement event and discuss proposed model

16th March

• Sharing Event - How will best practice in workforce transformation be taken up across multiple organisations? How do we avoid duplication?

8th May

• HEWM Board- Implementation plan for revised operating model agreed, focusing on transformation at scale

Today

• Inform the workforce priorities for the Transformation themes and explore how the model will work in practice


Within the West MidlandsNew Models of CareVanguards – Multi speciality providers ( MSP)• Dudley CCG and Partner• Vitality (Handsworth and Sandwell area)Transformation Boards e.g.• Future Fit ( Shropshire)• Transform (North Staffordshire)• Better Care Fund ( Birmingham,

Staffordshire, Warwickshire and Worcester)

• Worcester review• Birmingham 0 – 25’s Mental Health

Services• Unit of PlanningPrime Ministers Challenge Fund

• 5 LETCs• Core Business driven by

Workforce planning

• Transformation themes• Leadership• Integrated Care• Acute and Emergency Care• Primary and Community Care • Mental Health and Learning

Disabilities

• Enablers• Networks and Partnerships

– SAfHE– AHSN


Where are we going?

Revised operating model:• LETC ownership of core deliverables• 5 Regional transformation themesAdvantages:• Clarity on funding and return on investment• Prioritisation of workstreams• Building on system engagement to drive change


Today we must

• Ensure we focus on the workforce challenges• Consider how we can truly transform the

current and future workforce– Large scale– At pace– Sustainable change

• Assess how the transformation makes an impact on patients and service users

Creating Large Scale

Transformation

Professor Guy DalyNon-Medical HEI Representative, LETB

Mandy ShanahanHEE LETB Director- West Midlands#hewmtransforms


HEE Priority Commitments

• Primary and Community Care• Mental Health, Learning Disabilities and

Dementia• Birth, Children and Young People• Public Health and Prevention


Connecting HEE, LET Bs and LET Cs• Motivation is to ensure connections and impact• Therefore have West Midlands wide priorities

and projects• that will have an impact• and can be governed and held to account

• Building on and learning from the example of successful West Midlands-wide Advanced Practitioner project


Learning from the Advanced Clinical Practitioner Project (1)• Advanced Clinical Practice (ACP) Regional Project • Led by Prof Mark Radford and Arden, Herefordshire

& Worcestershire LETC• To develop an agreed (knowledge and skills)

Advanced Clinical Practice workforce • Inclusive approach, multi-professional focus


Learning from the Advanced Clinical Practitioner Project (2)• Agreed name

Masters award Advanced Clinical Practice (180 M Credits) PGD in Advanced Clinical Practice (120 M credits) PGC Advanced Health Assessment and Clinical Decision Making (60

M credits)• Agreed curriculum framework and assessment

Clinical health assessment , decision making , clinical case management, Non-Medical Prescribing

Research methods, Clinical Leadership, Dissertation/Innovation Project

• Agreed entry criteria• Agreed pricing arrangements

Revised Operating ModelLETB

AHW LETC

BC LETC

BS LETC

SaS LETC

MHI LETC

Enablers

5 x Transformation Them

es

Network of Networks

www.hee.nhs.uk

Focus on Geographical LETCs

BC LETC

Theme

Theme

Theme

Transformation Theme

Geog

rap

hic

al O

rgan

isati

on

Theme

Theme

LETC structures stay constant. Strong stakeholder voice and chaired by CEO

Principles of Operation for Geography LETCSUndertake core business: Workforce Planning and Development; Education; Quality Assurance; Placements capacity and quality

In addition:•Lead, scale and spread•Identify priorities and act as conduit for local intelligence to influence and assure “Hub”, “LETB Board and LETCs•Collaborative working •Widening participation

The way we do business around here: new ways of working

Transformation Theme Rationale LETB Exec Sponsor/Chair

Leadership “Leadership essential to deliver 5YFV and integration” Paula Clarke


Mental Health, Learning Disabilities and Dementia

“LETB priority Parity of esteem

Focus in Mandate and 5YFV”

Caroline Donovan


Primary and Community Care

“Workforce planning – insufficient workforce

Increasing placement capacity - mandate requirement

Crucial to deliver 5YFV and Integration, NHSE 10 point plan”

Martin Wilkinson


Integrated Care “Ageing population living longer with long term conditions

Crucial to deliver 5YFV

Supports admission avoidance and early discharge”

“What patients want- patient voice”

Tracy Taylor


Acute and Emergency Care including Emergency Medicine

“Medical Workforce planning – reduction in junior doctors providing service”

“Patient Safety Risk Emergency Medicine shortages

UC activity levels and pressures on patient care e.g. RTT

Andy Hardy


Enablers

Underpinning delivery of 15 year Strategic Framework and 5yr Forward View, LETC work and Transformation covering:• Flexible Workforce • Research and Innovation Capability• Compassion• Patient and Public Involvement

Wider workstreams on:• Healthcare Scientist Commissioning• Genomics


Governance

• LETB reframe how they will operate in the revised operating model

• Increasing scrutiny, challenge and support to Local Delivery Plan

• Strengthened governance through LETC and Transformation Theme reporting

• Increased focus on matrix working• LETB commissioned work to strengthen role of LETC in

revised operating model• Utilise the network of networks

Large Scale Change

West Midlands Mental Health Institute

Local Education and Training Council

Caroline Donovan - MHI LETC ChairDr Sharon Binyon - MHI LETC Vice Chair

#hewmtransforms


Beyond individual trust interests

Maintaining Board level membership – all Trust engaged

Good mix of members from HR, Nursing and Medical backgrounds

Every Trust leading an innovation theme with robust Programme Management

Integration of the Post Graduate School of Psychiatry- whole workforce consideration

Ability to focus on key issues - LD, dementia and psychological skills for the whole workforce.

National Lead eg Safer Staffing, Learning Disabilities.

What has worked well

www.wm.hee.nhs.uk

workforce innovation through collaboration, sharing best practice

and building sustainable

relationships

Upskilling the workforce in psychological approaches

Raising the profile of Careers in psychiatry Medical

psychotherapy

Safer staffing tool- MH & LD inpatient

& community

Creating innovative solutions for the

learning disability workforce

Liaison & diversion workforce modelling

Substance misuse

workforce

Assistant practitioner programmes

Advanced practice roles

Dementia education for the entire

workforce across the patient pathway

Primary care workforce

training

Cross sector relevance

Specialist MH/LD service focus

Specialist MH/LD service focus/ national lead

www.wm.hee.nhs.uk

Identifying how members can influence core business – tangible impact

Quality review; identifying challenges and working with hei providers to find solutions to problems (RMN curriculum)

Workforce planning and education commissioning; improving plan quality and assuring data to inform decisions that impact upon individual trusts and HEIs (clinical psychology commissions)

Horizon scanning-Looking to the future impact of service commissioning changes upon the workforce and our ability to train (substance misuse)


• Need to ensure integration of mental health across all the transformation themes

• Plan to identify a lead for Primary/ Community Care and Frail Elderly/ Integration

• Need to consider if Mental Health LETC membership needs to be broadened beyond Mental Health Providers and HEIs

• Programmes need to be embedded and learning shared

Going Forward with new Model

Widening Participation Partnership Forum

Working Model

Dr Teresa Hewitt-MoranSenior MHI LETC Lead

#hewmtransforms

HEWM

HEETalent For Care

Get In Get On

Go Further

Black Country LETC

WP Sub Group

Skills AcademyPeter Presland

Chair Mandy

Shanahan

Chair Teresa Hewitt

Moran

LETC Subgroup

Representative

LETC Workforce

Development Specialist

Assistant PractitionerProgramme Manager

LETC Workforce

Development Specialist

Widening Participation Stakeholder

Forum

WP Sub Group

Arden LETC

WP Sub Group

SAS LETC

WP Sub Group

Bham LETC

Regional Director

Skills For HealthRegional Director

Skills For Care

What we need from you

Jenny Price

#hewmtransforms

Key themes/ headlines/priorities from

the Transformation Theme Workshops

#hewmtransforms

LETB Question and Answer Panel

#hewmtransforms

WM AHSN Supporting the Spread of Innovation 13 June 2015

Chris Parker CBEManaging Director

West Midlands [email protected]

AHSNs

“……. to support the spread of innovation across the NHS in England” “……. to align clinical research, informatics, training, education and healthcare delivery in their respective regions, with the twin objectives of improving healthcare and generating wealth”

National AHSN coverage

5.6M populationDiversity +++

Core Objectives of AHSNs:

1. Focus on the needs of patients and local populations.

2. Build a culture of partnership and collaboration.

3. Speed up adoption of innovation into practice to improve clinical outcomes and patient experience.

4. Create wealth.

5. Establish Patient Safety Collaborative.

WMAHSN mission

The WMAHSN will lead and catalyse co-operation, collaboration and productivity between its members1 and accelerate adoption of innovation in order to improve health, care and wealth promotion for stakeholders2.

1. Academia, business, commissioners, care providers, agencies and networks.

2. The resident population of the West Midlands.

WMAHSN Operating Method

• Membership organisation:• Members• Partner organisations• Corporate partners

• Stakeholders


• Networks• Services• Opportunities process (“Push and pull of

innovation”)


• Networks:• Person-centred care• Digital (WIN)• Innovation, adoption, improvement• Patient safety (collaborative)• Genomics and precision medicine• Healthy living/active ageing• Education and workforce development• Clinical trials and evidence• Mental health


• Networks• Services


• Networks• Services:

• Digital Innovation Service for Health (DISH)• Person-centred healthcare service• Innovation and adoption service


• Networks• Services• Opportunities for innovation process (“Push

and Pull”)

Opportunities for Innovation process

• Proposals shortlisted against criteria: • Regional scalability • Fit with WMAHSN priorities and business plan • Fit with the NHS Outcomes Framework and FYFV • Clear deliverables, outcomes measures and quality

indicators • Evidence of support across the region • Consistency with other WMAHSN themes • Patient/carer involvement • Evidence of additional investment


• Priority areas:• Medicines optimisation and adherence • Patient experience and feedback • Open data • Mental health • Long term conditions • Wellness and healthy ageing • Patient safety


• Themes:• Digital health • Patient-centered care • Education and the workforce of the future • Wealth creation • Evidence and adoption

AHSNs

“……. to support the spread of innovation across the NHS in England” “……. to align clinical research, informatics, training, education and healthcare delivery in their respective regions, with the twin objectives of improving healthcare and generating wealth”

WMAHSN long-term vision

The West Midlands AHSN will be pivotal to the generation and maintenance of a healthier region in which there is equitable access to high quality, efficient, effective, patient-centred care that delivers the best clinical outcomes and patient satisfaction through faster adoption of innovation.

Key Messages

• WMAHSN a regional asset• Education, training and workforce of the future• Innovation• Joint appointment• Networks, services and opportunities process

West Midlands AHSN4, Greenfield CrescentBIRMINGHAMB15 3BE

Tel: 0121 452 [email protected]

http://www.wmahsn.org/

mailto:[email protected]

Making the Model Work in Practice

Jenny Price

#hewmtransforms

Call to Action

Jenni Ord, Chair HEWMMandy Shanahan, LETB

Director HEWM

#hewmtransforms

www.hee.nhs.uk

What we heard from the workshops (1)

Acute and Emergency Medicine Transformation Theme• What is the future model of care and therefore the

workforce needed – look to Acute and Emergency Care Vanguards/ engagement with CCG

• Supply: demand – medicine, 7 day working e.g. supporting services e.g. diagnostics

• Challenge custom and practice around roles e.g. what does a doctor do?

• How do we support new roles that are emerging and the transition into these

• Enhance how people navigate use of the acute/ emergency care system

www.hee.nhs.uk

What we heard from the workshops (2)

Integrated Care Transformation Theme• Hear more from service users/ patients• Cross cutting focus with other themes (avoid duplication)• Focus on service user rather than pathways look at high

users, prevention, self management• Work with commissioners to clarify service vision and

therefore the workforce requirements to deliver this• How do we manage the knowledge transfer

• Principles of integrated working, what new behaviours needed to work in a new environment, common skill set, OD/ culture and leadership requirements

• Supporting the existing and future workforce- aligning the education development

www.hee.nhs.uk

What we heard from the workshops (3)Leadership Transformation Theme• Inclusive approach • More effective communication• Focus on talent management• System leadership and enabling behaviours• Diagnostics to determine what it is we are trying to fix• OD to join leadership and service improvement to• Development of associate approachPrimary and Community Care Transformation Theme• Greater use of Allied Health Professions • Compartmentalising healthcare does not help- we need to remove barriers• Use AHSN to spread many of the innovations at scale• Defining the message from a patient perspective• Work with the ‘movers and shakers’ of innovative models such as Vanguards

www.hee.nhs.uk

Next Steps

17th July

• HEWM Board update on event

Late

July

• Inaugural Transformation Theme Steering Groups

August

• Development of Project Initiation Document (PID)and Investment Plans

11th Septemb

er

• HEWM board to receive PIDs and Investment Plans for Transformation Themes

www.hee.nhs.uk

Next Steps

17th July- HEWM Board update on event

Late July- Transformation Theme Steering Groups

August- Development of Project Initiation Document (PID)and Investment Plans

11th September- HEWM board to receive PIDs and Investment Plans for Transformation Themes

shaping the letb system for 2015 and beyond 13 th july 2015 #hewmtransforms

Documents

care workforce

workforce transformation

hewmtransforms slide

new models of care slide

change slide

practice slide

system transformation

communication slide