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The Calderdale Framework A Facilitation Tool for a Flexible and Competent Workforce

The Calderdale Framework is a transformational tool for developing a competent and flexible workforce. It focuses on engagement, potential to change, embedding, risk, staff development, best practice, and governance.

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The Calderdale Framework A Facilitation Tool for a Flexible and Competent Workforce

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  1. The Calderdale FrameworkA Facilitation Tool for a Flexible and Competent Workforce Developed by:Rachael Smith & Jayne Duffy

  2. The right person, doing the right thing at the right time, RIGHT!

  3. The Calderdale Framework: “a transformational tool for a competent & flexible workforce” • CF is the result of evaluation & further development of Saunders original Functional Model of Delegation. • Developing a competent & flexible workforce using the Calderdale Framework • R Smith & J Duffy, IJTR 2010; 17(5):254-262 • www.calderdaleframework.com • (Please refer to reading/reference list for further articles)

  4. Why Bother ….! ? The National Challenges • Demographic challenges –workforce and patients • Fiscal challenges • Safety and quality challenges –Francis, Keogh, Berwick, Cavendish • Modernising medical careers = early specialisation- GAPS in less ‘sexy’ areas • Five Year Forward Plan -INTEGRATION

  5. Why Bother….! ?Local Challenges: • Longstanding medical and non medical staffing recruitment difficulties • Reduction in numbers of junior doctors • Changing demands of the service • Ability to offer career development opportunities • Regular rotation of junior doctors impacts on continuity of care

  6. What does this mean to us? • INCREASING DEMANDS ON OUR SERVICES • PATIENT DRIVEN SERVICE PROVISION • MAINTAIN QUALITY & PRODUCTIVITY WHILST CONTROLLING OR REDUCING COST • ENSURE REGISTERED PRACTITIONERS ARE FREE TO UNDERTAKE TASKS ONLY THEY MUST DO • IMPROVE SKILLS BASE OF THE WORKFORCE TO PROVIDE FLEXIBILITY & CONTINUITY

  7. HEYH response: • Development of both Assistant Practitioners and Advanced Practitioners is a regional priority. • Regional steering group being formed to ensure consistency and rigour. • Investment in Calderdale Framework methodology to support this.

  8. So how can we do this? • Service Improvement Initiatives • Workforce development and new ways of working using The Calderdale Framework.

  9. Calderdale Framework: 7 stages Focus on Engagement Focus on Potential to Change Focus on Embedding Focus on Risk Focus on Staff Development Focus on Best Practice Focus on Governance

  10. 2 Service Analysis Captures ‘as is’ in detail Captures ideas to improve What is the service? When & where delivered? Staffing How well are patients needs met ? What could be different? What functions and tasks are carried out? Who does what now?

  11. 3 Task Analysis KNOWLEDGE BASED RISK ANALYSIS FREQUENCY TRAINING IMPLICATIONS RULE BASED SKILL BASED

  12. Stages 2 & 3 - ‘New Ways of Working’ Tasks mainly knowledge & rule based & highly specialist Remain with current profession Registered Practitioners consider Skill Sharing/Advanced Practice Tasks mainly knowledge & rule based Allocate to Assistant Practitioner Tasks rule & knowledge based with protocols available Delegate to support worker Tasks mainly skill & rule based

  13. Assistant Practitioner Definition: • ‘An assistant practitioner is a worker who competently delivers health & social care to & for people. They have a required level of knowledge & skill beyond that of a traditional healthcare assistant or support worker. The Assistant Practitioner would be able to deliver elements of care and undertake clinical work in domains that have previously only been within the remit of registered professionals. They may transcend professional boundaries. They are accountable to themselves, their employer and more importantly the people they serve’. Skills for Health 2009

  14. Advanced Practitioner definition : ‘An Advanced Clinical Practitioner is a professional who has acquired the expert knowledge base, complex decision making skills and clinical competencies for expanded practice the characteristics of which are shaped by the context and/or country in which s/he is accredited to practice.’ (HEYH Advancing Clinical Practice task & Finish Group 2014)

  15. Benefits of The Calderdale Framework • For Teams & Individuals • Builds Effective Teams around the • Patient • Personal & Team development needs- • Links to KSF (in UK) and PDP • Clear Roles & Responsibilities • Safe Skill Sharing • Transferable Skills • Job Satisfaction For Organisations • Consistency & Safety • Reduction in Risk • Efficient & Effective • Improved Productivity • Flexible Competent Workforce • Improved Patient Experience • Employer of Choice • Provider of Choice

  16. Hybrid Support Worker Jack’s wife , Margaret said, “ Under the direction of the therapists, Cath the rehab assistant undertook speech and language therapy exercises and movement exercises. To the relief of both of us Jack’s speech returned and his walking has improved, giving him more independence. Thank you to all.” Margaret

  17. Assistant Practitioner (New type of worker) Nicky Byrne, team leader (MacMillan Rehab) said: • “ Michelle is now competent to take her own non complex caseload, including elements of assessment (to protocol) previously done by Health Professionals. This means patients are seen quickly by one person and complex cases have access to the specialist skills they need”

  18. Health Professional Skill Sharing (level7) Nicky Hill, Emergency Department Occupational Therapist said “ Competency training was completed around tasks that are traditionally uni-professional, to allow Health Professionals to share skills in order to complete all aspects of the assessment & treatment. This enhances the patient experience and journey by reducing the number of disciplines involved, subsequently speeding up the assessment & discharge planning process” OT News May 2010; 18(5):25

  19. Health Professional Advanced Practice (level 8) Physiotherapy led outpatient orthopaedic clinic: First assess Order X rays and scans & tests –read & interpret these. Prescribe Inject List for surgery, Refer on Give advice Review & monitor.

  20. NEW WAYS of WORKING:STAFF VIEWS “ Confidence and skills increased” “Allay fears of role erosion” ” ” “Still ensuring quality services” “Enables health professionals to focus on more complex interventions” “ Beneficial for patients- they don’t have to wait for another assessment” “ Able to apply new knowledge and skills with real benefit to patients” “ Increase knowledge of wider initiatives and policies”

  21. The Combinations are Limitless …… ‘alternative approaches are needed to develop a sustainable workforce that is flexible enough in its work practices to manage the complex changes facing the NHS’. Gita Milhora, Kings Fund UK

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