Chris Lamb –Project Manager (Workforce Modernisation)

1. Chris Lamb –Project Manager (Workforce Modernisation) Competence based Workforce transformation

2. CAREER FRAMEWORK The Career Framework provides guidance for NHS and partner organisations on the implementation of the flexible career and skills escalator concept, enabling an individual member of staff with transferable competency based skills to progress in a direction which meets workforce, service and individual need 9 More Senior Staff 8 Consultant Practitioners 7 Advanced Practitioners 6 Senior Practitioners 5 Practitioners 4 Assistant Practitioners 3 Senior Assistants/Technicians 2 Support Workers 1 Initial Entry Level Jobs

3. Career Framework Common language and currency offering: Consistency – provides an structure that is easy to understand Progression- means of articulating achievements and identify options available for progression Flexibility- national consistency with flexibility for local health organisations

4. Levelling Jobs • 1.Knowledge, Skills, Training and Experience • 2. Supervision • 3. Professional and vocational competence • 4. Analytical / Clinical Skills and Patient Care • 5. Organisational Skills and Autonomy/Freedom to Act • 6. Planning, Policy and Service Development • 7. Financial, Administration, Physical and Human Resources • 8. Research and Development

5. What are National Occupational Standards (NOS)? Description of what successful performance of a work activity needs to be like Starting point is patient and service need regardless of who or where delivered Transparent, objective and transferable UK wide Developed through a process of research and consultation within the sector

6. Outcome model adopted by all Sector Skills Councils Start with defining the goal i.e. what the sector and its customers need – high quality, cost effective health care Focus on what needs to be done – not who does it or where it is done Set at the level of individual performance Describe applied knowledge and skills are Known as National Occupational Standards (NOS)

7. Benefits of an outcome model Education and learning focussed on workplace needs Assessment against criteria expected in the workplace Workforce flexibility rather than entrenched approaches Consistency in practice across locations and practitioner groups

8. What functions can the competence based Career Framework be used for? Personal Development Organisational Development Career Framework for Health Service Improvement

9. Applications of the Career Framework • Public Health • Allied Health Professions • Healthcare Scientists • Psychological Therapies • Heath Informatics • Local applications – West Midlands

10. Wider Healthcare Team Scientists Nurses and Midwives Doctors AHP Other e.g. Public Health / Health informatics etc. Career Framework Model Single database Of Levelled Roles And Jobs = Levelled Roles and Jobs

11. Diagnostic Radiography Occupational Therapy Physiotherapy Dietetics Director of AHPs Head of Pharmacy & Dietetics 9 Occupational Health Manager Consultant Radiographer Stroke Manager Dietetic Manager 8 Clinical Specialist Advanced Practitioner Radiographer Physio Team Leader Community Food Worker Team Leader 7 Specialist OT Senior Radiographer Specialist Physio Community Dietitian 6 Occupational Therapist Radiographer Physiotherapist Dietitian Basic Grade 5 OT Assistant Assistant Practitioner Radiography Assistant Practitioner (Falls) Support worker for Community Dietitian 4 OT Support Worker Radiography Helper Technical Instructor Community Food Worker 3 Domestic Porter Physio Assistant Healthcare Apprentice 2 Pre-employment 1 CareerFramework for AHPs Director of AHPs

12. How can it be used? Service Managers/ Commissioners Define the competences that services, teams and individuals must have in order to meet patient needs . Develop the team to reflect these.

13. How does it help an organisation? • Workforce planning • Workforce modelling • Workforce implications of service redesign • Succession planning

14. Calderdale and Huddersfield Foundation Trust To identify: Potential workforce solutions for optimising quality and productivity To identify opportunities for staff progression Contribute to the DARZI next stage review Identify training needs.

15. Project Aims Demonstrate the Strategic application of National Career framework Modernised service models applied to Cancer services Explore the development of level 4 rehab assistant practitioner

16. Macmillan Rehabilitation Team Cancer patient community based rehabilitation Occupational Therapy Physiotherapy Assistant staff /Support Workers Links to Dietetics & SALT

17. Elective Orthopaedic Discharge Team Post operative community based rehabilitation Occupational Therapy Physiotherapy Nursing Assistants / Support Workers

18. Benefits Realisation Define competences based on patient need Generic competences for MDT Development of new role Development of educational requirements Earlier Hospital Discharge Improved effectiveness of service provision Consistency of approach and service delivery Career progression Improved access to education Fewer Re-admissions

19. Outputs Level 3 - Rehab at home (orthopaedics) Assistant Level 3 - McMillan Cancer Rehab Assistant (Community) . Both of these roles are on the basis of carrying out Delegated tasks and are supported by a pre-existing NVQ Level 4 - Assistant Practitioner Rehab at home (orthopaedics) Level 4  - Assistant Practitioner , McMillan Cancer  Rehab. Level 7 - Inter-disciplinary Blurred Boundary Advanced Practitioner (Physio, OT, and Nursing). These posts are supported by short top- up CPD units which have been developed by Huddersfield University.

20. Cornwall School and Family Health Practitioners • Cornwall & Isles of Scilly PCTs position from 2006 onwards: • Vacancies and long term sickness • Service in crisis delivery and risk management • 46% of HV/SN staff over 50 years of age • No funding for SCPHN training backfill-last minute • Small amounts of funding – therefore no forward planning

21. The SCPHN Course • Degree programme not matched to job/ employer or commissioning needs • Focussed on Plymouth demographics only • Programme 7K per student • PCT needed to find 28k to fund each post • Secondment & supernumerary status depleted the workforce • Current HV/SN degree 2 years part time • Linear course-no progression • No competency levels • Prescribing course gap issues • Content of Programme - no mental health / emotional well being • No flexibility to AP(E)L And Cornwall had 9 vacancies!

22. Challenges and Barriers • Part 3 NMC – initially this was an ‘Aspiration’ • NMC – nurses other than qualified Health Visitors/School Nurses can carry out work similar/the same as Health Visitor/School Nurse but cannot be named as such • NMC vs University restrictions and contradictions - differing costs/module lengths/levels of credits • Plymouth already running a validated programme • Integrated Teams with Family Services • Change Management - Resistance • Commissioning and Provider driven as apposed to HEI

23. Making it Happen • Funding from SHA following Approval of Bid • Service Led -Team Leaders • Forums • Unions • Away Days with outside Facilitator Jan-March 2009 • 16 versions of the Programme Draft Document • Meetings - University / NMC • Backing of Chief Exec. and Directors • Significant involvement of Skills for Health and use of the Competence Application Tools • BSc (Hons) Programme developed with University (Alan Hooper, Associate Dean) • Ability to fill vacancies and new School Nurse investment with development posts April 2009

24. Skills & Knowledge Development Framework • Phase1 – Successful appointment to a Band 5 development post • Phase 2 – Graduate Certificate

25. Phase 2: Band 5 Stimulating awareness of public health needs to minimize risk to health NURC 303 20 Degree level credits Acquisition of skills & competences Skills for Health Promoting health and wellbeing of families & individuals within a professional framework NURB 396 20 Degree level credits Acquisition of skills & competences Skills for Health Child, Young People and Families Mental Health HEAB 3 20 Degree level credits Acquisition of skills & competences Skills for Health Band 5 - 60 Degree level credits / Evidenced Portfolios Graduate Certificate Entitled and expected to apply for band 6 post

26. Skills & Knowledge Development Framework Phase 3 Graduate and non-graduate learners Band 6 School health or Family Health Practitioners Phase 4 BSc (Hons) Health Studies

27. Unsought Benefits Traditional Method 1 Health Visitor - £35,000 1 School Nurse - £35,000 Total - £70,000 Cornwall Model 9 Family Health Practitioners - £35,000 9 School Health Practitioners - £35,000 Total - £70,000 for 18 practitioners

28. Commissioning, Competition & Cutbacks • Times are hard and friends are few!!! • Can you really afford not to???

29. Thank you for your Attention Chris Lamb – 07899 8951576 chris.lamb@skillsforhealth.org.uk