12.11.15
Transforming the workforce to deliver new models of care
Source: NHE Nov/Dec 15
An NHS Providers conference session on the workforce included contributions from Caroline Corrigan, Paul Bytheway, Rachael Addicott and Julie Screaton.
Vanguards don’t need or want a huge wave of fresh clinical roles to deliver new models of care, but instead desire a “transformation” of the current workforce, according to Caroline Corrigan, the recently appointed national workforce lead for new care models at NHS England and Health Education England.
She was speaking during a strand session on ‘Planning your workforce to deliver new models of care’ at the NHS Providers Conference in Birmingham in November, during which she acknowledged that some new roles are needed, but added: “We need to look at how we refresh, extend, and work with the workforce we have to deliver the workforce of the future.”
Only a few weeks into her new role, she added that vanguards want simple solutions, not more complexity. Those who want change must realise that “spreading at scale” is what makes the difference.
At the same session, Rachael Addicott, senior research fellow at The King’s Fund and a contributor to NHE, highlighted some challenges facing providers, from the need to balance planning at national, regional and organisational levels to identifying and developing the appropriate skill mix among the workforce.
She said: “We have heard exciting things about providers working together across a local health economy. For me, this is one of the real opportunities to address these workforce challenges in comprehensive ways.
“This is about coming together to negotiate with agencies around rates, to plan the workforce across the community and have the adaptability and flexibility where people can move across organisations within that local health economy.”
Addicott, who also worked on The King’s Fund’s ‘Workforce planning in the NHS’ report, urged strong alignment between those planning the workforce and those planning national strategy and the ambitions of the Five Year Forward View. “We also need greater consistency and understanding on whether we have the workforce to deliver on these new care models,” she said.
Paul Bytheway, chief operating officer at the Dudley Group NHS FT, discussed the early work of the Dudley Vanguard, which aims to provide integrated, GP-led care across health and social care.
Based on a multispecialty community provider (MCP) model, the Dudley partnership aims to develop teams working “without walls”, taking shared responsibility for delivering person-centred outcomes.
“Our new model of working with GPs at the heart is now in place, co-ordinating community-based care,” he said. The hardest barriers to break down have been linked to line management and organisational boundaries.
“When one team sits across multiple providers, that is where the discussion with people like me tends to be more difficult,” he said. “But you have to keep taking it back to, ‘is the model of care right’? If the patient is at the heart of everything we do, then you must build up from that.
“Our next steps are around organisational development. Not only with us as the trust, but with GPs in the model, with adult social care and also with voluntary care.”
He added that integrating teams like adult social care and acute hospital discharge is difficult, because they have completely different structures and ways of working. “But if we are going to merge completely into an MCP, we have to be able to understand each other and have a core set of values to work on,” he said.
Discussing training and support under the new model, Bytheway said a lot of the roles are not necessarily new, but are instead existing roles “delivered in a different way to maintain the continuity”.
He explained: “When I qualified as a nurse you couldn’t take blood or do phlebotomy. Within two years, every nurse was taking blood or phlebotomy because of junior doctor issues. Every time you work through a crisis there is a different set of skills that become available to a different set of professionals. Just from the Dudley Group, they were very keen to take those on.”
Julie Screaton, director for London and the south east at Health Education England, said at a time of workforce shortages, employers must look into why they are failing to retain staff.
“Our work shows that we can commission 10% more nurses than we do today, but you won’t notice it,” she said. “The biggest single factor in improving the quality of the workforce and your fill rates is retaining what you have got.”
Trusts should look to develop that loyalty and treat the workforce as “ours” as soon as someone enters their training, Screaton advised.
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