North Wales Social Care and Community Health Workforce Strategy
March 2018
CONTENTS INTRODUCTION 4 PARTNERSHIPS • North Wales Regional Partnership Board 5 • North Wales Workforce Board OUR SHARED COMMITMENT 6
RESOURCES • Economic Significance 6-8 • Economic Pressure • Workforce planning & development
SCOPE 8-9
CONTEXT – LEGISLATION • Social Services and Well-Being (Wales) Act 2014 • Well-Being of Future Generations (Wales) Act 2015 9-11 • Regulation and Inspection of Social Care (Wales) Act 2016 • The Parliamentary Review of Health and Social Care in Wales
CONTEXT – NATIONAL & REGIONAL PROGRAMMES • Regional Partnership Board Programme • North Wales Population Needs Assessment • Betsi Cadwaladr University Health Board Workforce and Organisational Strategic Priorities 11-13 • Social Care Wales Business Plan • The Care at Home Strategic Plan • National Commissioning Board • Association Directors Social Services Cymru Workforce Policy Group
NORTH WALES CITIZENS PANEL 13-15
THE WORKFORCE 15 WORKFORCE DATA • Local Authority Workforce Data • Social Workers • Occupational Therapy • Commissioned Care Workforce 16-26 • BCUHB Workforce Data • Children’s Workforce • Mental Health Workforce • Welsh Language
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W R F RC C P T CI S • eadership • Safeguarding • Welsh anguage • Integration • Information Advice and Assistance 2 - 5 • Community Conversations Strength Based Approaches • Commissioning and Contracting Skills • Social alue Based Provision • Advocacy • Specialist Skills • BC HB Workforce Priorities
G R A C • Shared ision 5- 6 • perating Principles • Guiding Principles I R I P TATI 6
RTH WA S W R F RC STRAT GIC PRI RITI S • Sta ilising the Workforce - • earning and evelopment • Workforce Intelligence and Planning R F R C S 0
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I TR CTI
The strategy sets out our strategic commitment as a orth Wales Regional Workforce Partnership for the social care and community health sector confirming our priorities over the ne t years until 2021
The orth Wales Workforce Strategy ( WWS) has een developed y the orth Wales Workforce Board ( WWB) and is our commitment to having a oined-up approach to the workforce challenges and opportunities across the sector
The Strategy supports em edding the principles within the Social Services and Well- eing (Wales) Act 201 and is aligned to the orth Wales Regional Partnership Board Priorities
The Strategy has een produced ointly with partners and discussions with partner organisations
This strategy was endorsed y the orth Wales Regional Partnership Board in Fe ruary 201
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PART RSHIPS
NORTH WALES REGIONAL PARTNERSHIP BOARD NORTH WALES WORKFORCE BOARD
The orth Wales Regional Partnership Board ( WRPB) which is a Statutory Board under Part of the Social Services and Well- eing (Wales) Act 201 has agreed its work priorities for partnerships and integration which provides the conte t and scope for the orth Wales Workforce Strategy This work is led through the orth Wales Workforce Board ( WWB)
The WWB has een in e istence for years and reports to the WRPB The WWB has gone through a num er of transitions over this period developing and changing to meet the needs of the sector and align with the Social Services and Well- eing (Wales) Act 201
The mem ership reflects a wide range of organisations that are part of the Social Care Community Health Workforce and reports to the WRPB
orth Wales Workforce Board em ership
North Wales Social Care & Well-being Domiciliary Care Higher Education Services Improvement Wales Collaborative omiciliary Care Wales
1 Third Sector
Social Care Care Forum Local Authorities Third Sector Wales Wales
Betsi Cadwaladr • Care Forum WFurtherales Safeguarding University Health Education Board
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T T
e are committed to or ing together, through a confident, engaged, motivated, no ledgeable and properly s illed or force to support integration, recognising the value of all partners.
The health and social care sector is large, gro ing and economically significant.
t is important to continue to raise the profile of the sector via the egional ills artnership, to secure future funding for training and s ills development as ell as promoting the opportunities of the sector to
the ider population. upporting entry level programmes, career opportunities and or force development programmes at all levels.
ECONOMIC SIGNIFICANCE The health and social care sector in orth Wales is large growing and economically significant it is recognised as an area of growth within the orth Wales conomic Am ition Board’s Regional Skills Plan and work is ongoing to ensure it continues to e a significant priority as part of the skills priority statement
Health and Social Care in orth Wales currently operate as su sectors Health including the HS employing around 1 00 staff in BC HB social care through local authorities 5 FT staff and through commissioned service staff employed y 6 usinesses and 12 000 workers and finally there are private health services including pharmacies opticians and dental services and the provision of early years care (child minder and nurseries) for children’s services. This brings a total of around 44,000 staff.
A pro ect to e plore the full economic impact of the social care sector is currently underway and will report efore the ne t regional priority skills assessment is completed
The sector is also important to the Government’s priorities around employability and the foundational economy y providing entry level o s ranging from porters and cleaners to higher skilled o s of health and social care support workers
The current pu lic spend for the HS to provide all services in orth Wales is around 1 illion and on social care for all services 260million per year In addition an S survey in 2015 estimated an additional 1 of
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private spending on health and social care including opticians, dentists, medicine, therapies, counselling and self funded social care to another 40million in orth ales.
ECONOMIC PRESSURE
e ill continue to or together sharing resources in order to ensure that they can be best utilised and to provide optimum opportunities for the development and stability of our current and future or force.
There are a number of pressures on resources ithin the sector including both financial and people, that are challenging.
The orth ales ocial are or force is under significant pressure through changes in the ay services are delivered and the implementation of ne legislation and regulation as ell as the continued and pro ected demands across the sector, ith the continued sustainability of the mar et at ris . Therefore a significant priority of the trategy is to address the or force and sector sustainability issues across the mar et through an engaged, collaborative and supportive approach, including having sufficient resources to meet training and development needs across the health and social care or force and implementing and embedding ne legislative and regulative re uirements including ocial ervices ell being ales) ct 0 4, the ell being of uture enerations ales) ct 0 and the egulations and nspections of ocial are ales) ct 0 .
n addition to these pressures are the need for us as a region to have robust or force planning in place to support the supply and demand needs across the sector including training and development and recruitment and retention.
The orth ales egional ills lan states that “With BREXIT now being triggered, we now need more than ever to invest in the skills and talents of our domiciled current and future all-age apprenticeships in North Wales, to support employers, our key and growth sectors, and our current & future workforce” “With a current reliance on European Social Fund (ESF) and European Regional Development Fund (ERDF) for delivery of funding to projects supporting skills and employment across North Wales, the questions over future replacements of funding to support these areas of activity on the skills and employment agenda are still yet to be agreed and made clear.”
WORKFORCE PLANNING & DEVELOPMENT
s a partnership e are committed to continue to share the no ledge, s ills, e pertise and e perience of the ide range of people that contribute and invest in our orth ales ocial are and ommunity ealth or force.
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The has a small amount of resources through grants and ocal uthority partner funding, ho ever other resources that support or force planning and or force development are held ithin individual organisations, these are either core funding or grant based funding, hereby there are conditions associated ith ho the funding can be spent.
The region has and continues to or collaboratively through both the delivery and funding of or force development, recruitment and training activities, funding that has supported this has been provided through a varied range of resources including • orth ales egional ollaborative Team • ocial are or force evelopment rogramme • ocial are in artnership • ocial are ales • pprenticeships • or force ducation and evelopment ervices • Third ector • rivate ector • areers ob ervices and rogrammes • urther and igher ducation nstitutes
or the purpose of this strategy e have identified the follo ing or force sectors • ocal uthorities ocial are ervices • ealth in the conte t of integrated services and the interface ith social care provision • rivate and ndependent ector • The Third ector • ndividual mployers • arers
The orth ales or force strategy is not a static document and ill continue to gro and develop alongside changes in the sector having a or force strategy that responds to the needs of the social care and the community health or force.
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ue to the si e and comple ities of the social care and community health or force the strategic priorities are not able to cover all aspects, but e have ta en a pragmatic approach focussing on areas of need ris , hilst referencing other areas including other or force programmes initiatives.
The orth ales or force strategy recognises the value of our ider partnerships such as the orth ales olice, elsh mbulance ervice Trust, and the orth ales ire escue ervice. Through the implementation plans, lin s to oint or ing initiatives and activities ith these services ill be ac no ledged and built upon here appropriate.
T T – T
e will respond to the impact of the new legislative framewor s on the wor force and identif changing roles, tas s, responsi ilities, s ills and nowledge re uired.
The orth ales ocial are and ommunity ealth or force is in a time of unprecedented change hereby they are re uired to deliver services differently ith a focus on prevention, protection, intervention, partnership and integrated or ing, coproduction and empo erment re uiring a different emphasis on or force s ills and training.
The sector provides a wide range of care and support across a range of settings including people’s homes, residential and nursing homes, hospitals and community settings, ma ing it one of the most diverse or forces across a range of organisations and people including social care, health, the independent sector including private and third sector organisations and carers.
elivering the ocial ervices ell being ales) ct 0 4 re uires that not only health and social care partners deliver integrated services, but that there is a greater emphasis on partnership or ing ith other sectors such as housing, education and corporate services, to meet an individual’s needs.
The introduction of ne or ing practices in meeting the re uirements of the ocial ervices and ell being ales) ct 0 4 is li ely to lead to s ills gaps in the social care and health or force reflecting the substantial changes in social care and health organisations, including the introduction of ne legislation and the re structuring of services.
Social Services and Well-being (Wales) Act The range and level of preventative services needs to be sufficient to meet the needs of the population promote ell being and prevent delay or reduce the need for formal care and support.
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“Increase the level of effective early intervention / preventative services, access to information and advice for everyone, and well-being support for those who need some help, more people will be able to be supported without need for managed intensive support, fewer citizens will need care and support planning for managed, complex care”.
• • • • •
Well-being of Future Generations (Wales) Act 2015 • • • • • • •
• • •
Regulation and Inspection of Social Care (Wales) Act 2016 • • •
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•
The Parliamentary Review of Health and Social Care in Wales
N – N I N I N
Regional artners ip oard rogra e
ort Wales opulation eeds Assess ent out people’s care and support needs and the support needs of carers in North Wales. It aims to show how well people’s needs are being met and the
North Wales to meet people’s care and support needs and the support needs of carers. It will help us make
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• • • •
Social Care Wales siness Plan • • •
The Care at Home Strate ic Plan “The workforce needs the knowledge, skills and values to be able to deliver outcomes focussed, flexible care and support at home. Social Care Wales should drive the development and delivery of a workforce strategy, inclusive of carers and communities, with a range of partners”
“To achieve the vision of this strategic plan, people need to commit to making changes together. Work needs to begin now. We have developed a plan that shows some of the first things that need to be done. We will work with people across Wales to plan what improvements need to be made, and how they will be achieved”
ational Commissionin oard
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• • • • • •
ssociation irectors Social Services Cymr Wor force Policy ro • • •
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• • • • • • •
• • • • •
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• • • • • • • • • • • Don’t like people who judge • • • • •
• • • • •
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D
o i l e le oll te nge o d t in el tion to egi te ed nd o i ioned e e i e in luding the • o ile o o i ioned e e i e • o ile o do i ili e e i e n ge wo king in le • o ile o dult e ho e n ge wo king in le • o ile o o i l wo ke in le • o ile o the e identi l hild e n ge nd wo ke in le
he highlight o the l te t d t epo t e o dl o e ed
he o th le ono i ition o d epo t t te th t lthough he lth nd o i l e e not identi ied e ono i d i e the e on ide ed e to th t de on t te o e e ge g owth nd p odu ti it nd e p oje ted to pe o well into the utu e eing o igni i nt i po t n e to o th le nd it e ono
he t le elow how the pe ent ge top th ee indu t ie o e plo ent ed on the en u o e h o l utho it in o th le identi ing the he lth nd o i l e e to in o th le one o the l ge t e plo e nd the e o e ont i ute igni i ntl to the e ono
he o th le ition o d e lth du tion et il nu tu ing o i l e ngle e w nedd onw Den igh hi e lint hi e e h
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D
e will wo k togethe e to to e u e on i tent o u t nd e ning ul d t to uppo t wo k o e pl nning nd de elop ent
he e e nu e o h llenge in e u ing on i tent d t o o g ni tion e to nd thei wo k o e whil t e e e o t h een de to ou e u te d t the e i e iden e to ugge t th t o e o the d t p o ided need u the inte og tion t i knowledged th t o ing o w d we hould on ide how thi n e hie ed in o de to h e ette wo k o e intelligen e o wo k o e pl nning nd utili e e ou e e e ti el
h o l utho it i e ui ed to oll te in o tion out di e tl e plo ed t o o i l e i e dep t ent on n nnu l i to p o ide to el h o e n ent to e in luded in the nnu l tion l t ti ti
u e o Do i ili e t u li ied
omiciliary Care ocal thority 1400 120% 1200 100% 1000 80% 800 60% 600 400 40% 20% 200 0 0% Domiciliary Care Managers Deputy Domiciliary Care Managers Domiciliary Care Workers
Staff in Post Qualified Percentage Qualified
u e o e identi l e t u li ied
Residential Care ocal thority
800 120% 700 100% 600 80% 500 400 60% 300 40% 200 20% 100 0 0% Residential Care Managers Deputy Residential Care Managers Residential Care Worker
Staff in Post Qualified Percentage Qualified
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u e o Do i ili e t plo ed uppo ting dult nd hild en nd
omicilliary Care Staffin ata
TOTAL DOMICILIARY SERVICES FOR ADULTS (DSA) TOTAL DOMICILIARY SERVICES FOR CHILDREN (DSC)
2014-15 2015-16
he e h een light edu tion in the number of domiciliary care staff in adults and children’s services.
u e o e identi l e t plo ed uppo ting dult nd hild en nd
Residential Services Staffin ata
TOTAL RESIDENTIAL SERVICES FOR ELDERLY TOTAL RESIDENTIAL SERVICES FOR ADULTS TOTAL RESIDENTIAL SERVICES FOR AND ELDERLY MENTALLY INFIRM PEOPLE WITH LEARNING DISABILITIES (RSALD) CHILDREN AND YOUNG PEOPLE (RSCYP) (RSEEMIP)
2014-15 2015-16
hil t dult with le ning di ilitie h een ll in e e e identi l e i e o the elde l nd e identi l hild en nd oung people e i e h e een ll edu tion
e ill or to ether on a roaches to social or or force lannin and develo ment to meet the emer in and future re uirements for ocial or ers or force.
e ill su ort ocial or ers develo ment ath ays throu h a re ional a roach to the first years in ractice.
o l D t i oll ted nnu ll to in o egion l pl nning nd identi ke the e hi d t olle tion i unde t ken the o l o e n ent D t nit – le D t nit in p tne hip with the o i l e
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ales the ssociation of irectors for ocial ervices ymru ymru and the elsh ocal overnment ssociation .
ithin orth ales it is not identified that there are si nificant recruitment issues across the hole re ion for social or ers ho ever there is some evidence to su est that more s ecialist roles are difficult to recruit to and certain areas have identified some areas of concern based due to com etitive rates and the re uirements of s ecific hi her rades. he a e rofile of the social or or force may sho differences as more e erienced ocial or ers leave the sector throu h ocal uthority transformation ro rammes and e may have a youn er social or or force hilst the ational ro ramme su orts continued develo ment and su ort additional a roaches may need to be considered in su ortin a youn er less e erienced or force.
he staffin data sho s that ithin ocal uthorities there has been a sli ht increase of ocial or ervices in Adults and Children’s & Young People.
Social Wor ers Staffin ata
TOTAL SOCIAL WORK SERVICES FOR ADULTS TOTAL SOCIAL WORK SERVICES FOR TOTAL HOSPITAL/CLINIC SETTINGS (H/CS) (SWSA) CHILDREN AND YOUNG PEOPLE (SWSCYP)
2014-15 2015-16
he continued rofessional develo ment of social or ers is identified as an on oin riority to su ort their rofessional develo ment.
he orth ales eads of ervice hildren’s and dults have been or in ith trainin mana ers across the re ion to create a consistent learnin and develo ment ath ay for ocial or ers ithin their first years of ractice. his includes a core ocial or trainin ro ramme across the re ion.
reas to be considered and addressed via the strate ies riorities include • ecruitment to social or osts at a hi her rade • he continued monitorin of recruitment and the im act of chan es in em loyer models that may im act on or force lannin for social or ers • utcome of the ocial or evie and ossible im act on future ro rammes • he demand and su ly of social or de ree students across the re ion includin the rovision of lacements and recruitment of students otential o ortunities for eo le ho are unable to ive u em loyment to study this should be monitored as art of or force lannin
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A A A
o al ata is ollated annuall to in or regional planning and identi e the es his data olle tion is underta en the o al o ern ent ata nit – ales ata nit in partnership ith the o ial Care ales the Asso iation o ire tors or o ial er i es C ru A C ru and the elsh o al o ern ent Asso iation A
upational herapists ha e a signi i ant role to pla in deli ering he o ial er i es and ell eing ales Act 2014 through the promotion of individual’s well eing he no ledge and s ills o the upational herapist in supporting indi iduals to aintain and i pro e ell eing in orporating all o upational therap approa hes is invaluable supporting individuals to maintain independence and in supporting an individual’s re o er
he ne l laun hed upational herapists in o ial Care earning and e elop ent ra e or re ognises the i portan e o the role o o upational therapists and supports the ontinued learning and de elop ent o upational herapists supporting their role in ulti dis iplinar tea s and the deli er o ser i es
he region ill or together to ensure a regional interpretation o the ra e or ensuring a onsistent approa h is applied a ross o al Authorities
n or ation re ei ed ro o al Authorities identi ies that re ruit ent and retention o upational herapists a ross the region is i ed ith so e e perien ing no issues and others identi ing that the re ruit ent o elsh spea ing upational herapists is ore di i ult
l nd r ni ersit is the onl pro ider o the degree in upational herap hi h is ull ti e this ill need to e onitored under or or e planning to understand the i pa t this has on the uture suppl o upational herapists and in parti ular elsh pea ers
A
e will wor together as a sector to address retention and recruitment pressures developing cross sector and regional approaches
“ he data from wor force surve s indicates both high levels of wor force turnover and at least a uarter of the wor force leaving the sector each ear to ta e up emplo ment elsewhere
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Regulation and Inspection of Social Care (Wales) Act 2016, demonstrating significant resource implications within the sector.
The recent • • • •
10,000 WORKERS
85% Private and Independent Sector
15% Third Sector
In 2015… Out of those that left their roles 42% left the sector 33% left to work for another sector provider.
Reduction in the Number of 22% unknown providers… Adults Commissioned Care Providers by 9
Commissioned Care Providers From 2014—2015 Older Peoples Services by 19 • There was a reduction in the number of staff moving from one provider to another by 22% • There was a reduction in the number of staff leaving the sector by 8.5%.
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ocal Authorit of sur e s returned n s on w nedd Conw en ighshire lintshire Wre ham
Commissioned Care Sector 3000 100% 2500 80% 2000 60% 1500 40% 1000 20% 500 0 0% Domiciliary Care Managers Deputy Domiciliary Care Managers Domiciliary Care Workers
Staff in Post Qualified Percentage Qualified
Commissioned Care Sector 4500 100% 4000 3500 80% 3000 60% 2500 2000 40% 1500 1000 20% 500 0 0% Residential Care Managers Deputy Residential Care Managers Residential Care Worker
Staff in Post Qualified Percentage Qualified
o f m loyees Per r anisation
m loyees nder m loyees
m loyees m loyees
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C W R RC ATA
The age profile of the organisation remains roadl consistent with pre ious ears, the ageing wor force is a challenge for C , with around 1 of the wor force in the age and 6 and o er and therefore at or approaching possi le retirement. The of the wor force aged 0 and under is 1 .6 .
The challenges that impact on the ealth oard and ultimatel our patients are, the shortage of registered nursing staff and the difficult that oth primar care and nursing homes ha e in recruiting and retaining registered nurses.
The wor force plan illustrates the aseline position of the whole organisation at the 2 th e ruar 201 . The current headcount of staff (e cluding an staff) is 1 ,11 which e uates to 1 , full time e ui alents ( T ). ursing idwifer are the largest staff group at around of C total. The Additional Clinical Ser ices (Assistant and Support wor er) staff group is the second largest in num er and represents 1 .6 of the wor force.
The wor force composition across all pa ands continues to e predominantl female at 1 , ( ) headcount ersus the male headcount at , 2 (21 ) This pro ides an 0 20 percentage split which has not de iated o er recent ears. 2 of females wor part time compared with 16 of males, which again has een fairl t pical o er recent ears.
The forecasted change in the wor force ased on a three ear trend anal sis during 201 1 is 1 , 0 , ( T ) which is a 2 increase in our wor force. or the ne t three ears if there is no change in these trends we anticipate a increase at the end of 2020 ta ing C wor force to 1 , 0 ( T ). Clearl there is wor to do around new wa s of wor ing, s ills mi and wor force transformation. These pro ections and assumptions will need to e re ised annuall .
Staff turno er has decreased slightl o er the last 2 ears from . in arch 201 to .60 in e ruar 201 it is difficult to estimate at present whether this trend will continue. The turno er data a o e e cludes medical and dental training grades.
Sic ness a sence rates ha e reduced since 201 16 with the a erage rate to e ruar 201 eing . which is 0. 1 a o e the C target of . , ut still represents a significant impro ement.
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CHILDRENS’ WORKFORCE
The North Wales Workforce Board has agreed priorities for the children’s workforce which include: • Identifying workforce implications of ‘outcome based’ service models • or ing with partners across the Region to support shared training opportunities • ligning and wor ing with the amily ustice oard Training ub roup to enhance the role of practitioners as experts within the court arena • eveloping the s ills of oster Carers to support older children with complex and challenging needs – lin ed to the ational ostering ramewor programme
In relation to Children’s services the orth Wales opulation Assessment identifies a wide range of needs deli ered through a range of ser ices from earl inter ention and pre ention to loo ed after children. There has een an increase in the num er of children’s needs in relation to areas such as Child se ual e ploitation, self harming and disabled children and increased concerns in areas such as bullying, sexting and children’s mental and emotional well eing. There ha e een a num er of training and e ent initiati es to raise awareness of emerging themes. owe er, as ser ice models are de eloped, and further wor is underta en in esta lishing the wor force needs through ualit data, it is en isaged there will e emerging wor force themes identified.
The table below shows the provision of Independent Residential Children’s and Young Peoples Care Providers in orth Wales. Independent C Residential Care ro iders in orth Wales. um er of independent um er of independent um er of registered ate of count pro iders settings eds As a 201 1 6 162 As 1st a 201 1 0 1 Change il 12 Source CCSR
Although the num er of pro iders is unchanged this does not reflect that pro iders included in the count for 201 ha e since een ta en o er other pro iders (one of which was alread present in the region) and two new pro iders ha e entered the mar et place.
Social Care Wales will e de eloping a loo ed after children strateg uilding on the wor underta en in residential childcare. oo ed after children are among the most ulnera le in our societ and there is a pressing need to impro e the suppl and ualit of ser ice pro ision within orth Wales ensuring that those supported ha e ser ices and staff that can meet their needs.
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The Welsh overnment is developing an early years childcare and play workforce in Wales year workforce plan The plan offers proposals under three key themes: up skilling the e isting workforce attracting high uality new entrants and developing leaders and future leaders in the sector With an aim to ensure all those caring for our young children are e uipped with the necessary skills and competencies to support children to develop physically socially emotionally and cognitively
The childcare offer which is currently being piloted in Flintshire, Gwynedd and Anglesey is to provide 30 hours a week of combined early education and childcare for working parents of 3 and 4 year olds, up to 48 weeks a year.
The associated value of providing uality childcare includes: • Economic benefit – access to free childcare will remove this as a barrier to returning to employment • Tackling overty – enabling parents to return to or increase their employment, improving families’ prospects • Benefits for the child – supporting e isting child development pathways
Consideration of the sustainability to meet the demand is being considered as part of the pilot pro ects as well as meeting childcare demands in holiday periods
In addition to this there is a Welsh Language pro ect which aims to increase the use of the Welsh Language within early year settings
TA A T F
The population needs assessment also identifies that an overarching strategy which includes better coordination across key partners, should consider the re uirements of the workforce to meet the outcomes of the strategy including si e, roles, skills and knowledge development.
The population needs assessment identifies that the prevalence of mental health is likely to rise from to people by It has identified the need to increase the workforce in order to meet demand particularly in relation to increased capacity within the mental health teams family involved models services available outside of the normal provision and the continued development of provision for early intervention and prevention particularly in relation to those whom e perience low level depression and an iety
Betsi Cadwaladr niversity Health Board are leading on the development of an Integrated ental Health Strategy for North Wales of which one aspect is workforce the findings of which will be shared
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W LS L G G
We will continue to embed the Welsh Language through local regional and national programmes in line with ore than ust Words and the Welsh Language ct ensuring that those in receipt of services are able to do so in the language of their choice
The elsh anguage at work survey shows a variation of elsh peakers across the region including spoken and written elsh, the use of the elsh anguage is more prominent on the est side of orth ales than the ast.
There a number of activities within the orth ales ealth and ocial are ector that have received recognition of their good work through the ore Than ust ords show case event 0 including • The orth ales ore Than ust ords egional Forum which was awarded a special commendation for their work in the development of the forum which promotes collaboration, in order to fulfil the requirements of the Welsh Government’s strategic framework – and to improve the uality and availability of elsh language services in health, social services and social care – for the benefit of patients, their families, and the public in orth ales • pecial commendation eveloping a ilingual orkforce – etsi adwaladr niversity ealth oard n order to be able to provide the best service to patients the health board needs to develop a bilingual workforce. nderstanding the needs of the population is essential to inform the planning and delivery of services in orth ales
The Active ffer anguage hoice cheme – etsi adwaladr niversity ealth oard atients with dementia can revert to their first language as their condition deteriorates. etsi adwaladr niversity ealth Board have piloted a “Language Choice” Scheme for dementia patients on the Glaslyn Ward at Ysbyty Gwynedd with the aim of planning services and the workforce in order to realise the active offer principle set out in ore than ust ords. This scheme ensures that the organisation takes responsibility for offering a elsh language service by pairing elsh language dementia staff with elsh speaking patients.
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W R R E M ETE ES
T T S S W W A T the individual’s n
S
L S G S G G W LS L G G L G
“WHAT MATTERS” C S G B S C C C S S SS S C C S
S
C G L SC L Y C SS G C C G C S WL G
W G S LL G
S LLS C Y S C S
W C C C S C CY C L S C L S S LLS C L S G C S SS SS G C S S C S
S
S
G C C S C C
S S S S L S S C C Y C Y S G L S S S C L S L C C
EA ERSH
ffective management and leadership skills are crucial in the transformation of services and cultures working together across sectors to drive the changes required engaging and supporting communities to develop services and activities to meet the needs of individuals within their communities Supporting succession planning within the sector will support the opportunity to address recruitment of managers
nsuring leaders are equipped to implement new legislative requirements including the role of esponsible ndividuals and the ew ealth and Social Care nduction ramework
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SA G A D NG
The North Wales Safeguarding Board Workforce and Training group is developing a collaborative approach to the safeguarding orkforce and training to respond revie promote and ualit assure regional safeguarding learning and development The group are currentl developing their Action lan hich ill identif orkforce and training needs
Children’s Safeguarding Board he ll in th ee a eas have een identi ied as the st ate i i ities the North Wales Children’s a e ua din a d and issin a e hild en h dis la ha ul se ual ehavi u esti use
dults a e ua din a d he th ales a e ua din dults a d st ate i i ities ut es adults h a e the su e t adult te ti n lans a e i ved as a esult all a en ies a ss th ales nsistentl delive in hi h ualit adult te ti n se vi es a din t a eed est a ti e The risk that vulnerable adults and ‘adults at risk’ suffer or become subject to abuse or neglect is edu ed e ause sta and the u li a e ull a a e the need t sa e ua d te t and n hat t d i the e is a sa e ua din issue he e ates e e tivel and eets its statut es nsi ilities evel ent a e i nal a a h t assist adults h sel ne le t
The North Wales Adults and Children’s Workforce Development and Training Group is e in identi in t ainin needs and ensu in that t ainin is vided n an inte a en and individual anisati nal asis t assist in the te ti n and eventi n a use and ne le t adults and hild en and ill e ain a i it
he i len e a ainst en esti use e ual i len e ales t he i len e a ainst en esti use and e ual i len e ales ill la es duties n iniste s un ils and ealth a ds t u lish st ate ies ai ed at endin d esti a use ende ased vi len e and se ual vi len e he e is a th ales e i nal t ate i a d is n in and the a d ill devel a e i nal st ate
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o el e o the a t e o e we w ll o t e to eate a lt e o ha e that e o es the espo s l t o se e se s to as o a se e th o h the e o elsh e s that elsh spea als a e t eate w th espe t a t as the the p e e e la a e a a t o t
The statutor responsibilit of ocal ealth Boards and ocal Authorit Social Services Departments to ensure that peoples’ well being outcomes are supported and that their care and support needs including their language need are accuratel assessed and met ill provide some significant challenges ithin certain local authorities here the Welsh anguage is not as idel spoken roviders ill also need to be able to recruit Welsh speakers in order to meet the needs of those accessing their services and providing the Active ffer as set out in ore than ust Words and the Welsh anguage Act
A continued approach to activel promoting the use of the Welsh language and culture supporting staff to develop their Welsh language skills creating the right environment here staff feel confident in using the Welsh language irrespective of their skills level and ensuring that language needs of individuals are met is an integral part of safe high ualit service provision
e w ll s ppo t wo o e e e e ts a e a s the e es a el e o se es ta a p oa t e app oa h a a ha e a oss the se to lea wo o e e es a oss the so al a e a o t health se to
ntegrated Working ulti Disciplinar pskilling Workforce le ibilit – Whilst there are a number of approaches on delivering integrated services this strateg focuses on those areas as detailed in art of the Social Services Well being Wales Act
The ke aims of cooperation partnership and integration are described as follo s • To improve care and support ensuring people have more sa and control • To improve outcomes and health and ell being • rovide co ordinated person centred care and support • ake more effective use of resources skills and e pertise
As The North Wales egional artnership Board e are re uired to prioritise the integration of services in relation to
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• l e people w th o ple ee s a lo te o t o s l e e t a • eople w th lea sa l t es • a e s l o a e s • te ate a l s ppo t se es • h l e w th o ple ee s e to sa l t o ll ess
he has set o t to el e a a t o s p o a e that o t es to l o the esta l she pa t e sh ps a the e elop te at o oppo t t es
e w ll s ppo t the e elop e t a t a o o at o e a ss sta e sta e s the a e al e owle ea le o pete t a o e t e ta the ht o e sat o s a p o a e a ass sta e
o at o e a ss sta e l the ee o the ease owle e o t eso es – he ease e a o the p o s o o o t ase se es to s ppo t the p e e tat e a e a s e e o e to eet t e e a s o se es owle e o these se es w ll e pa a o t s post people to a ess se es epe e tl a eet the low le el ee s so e lo al a tho t es le o t ess p o s o s has e a e th s l a ol ta se to sta e e w th the tea s
e ill ork ith ational and egional rogra es to develop a suite of training infor ation and tools that supports the e edding of this cultural shift across the sector
app oa hes a to s ppo t a e powe t e s to eep the epe e e e a l the ho es o lo e a a h e e o t o es that a e po ta t to the t is a preventative approach that strengthens a person’s resilience and seeks to avoid futu e ses t ea hes o t to lo al people e o a the to e ol e a e s es the a e t eate as e als
l o t o es o se a t e l ste a al s s o o at o a lt o e sat o s – he t e th ase pp oa h o ses o what the al a o oth te s o the s lls a eso es ha the t a t o al app oa hes wh h has ee ase o a o el o a e a a e e t a the p es pt o o se es w th ele e ts o st e th ase app oa hes wh h appea s to
30 have created an ele ent of dependenc on services as oppose to one here the ill need to ork in colla oration ith service users ith the ai that practitioners esta lish and ackno ledge the capacit skills kno ledge net ork and potential of oth the individual and their local co unit his is a a or cultural shift across services here services ill need • to have greater kno ledge and a areness of co unit resources • ti e to prepare for assess ents skills in supporting self assess ent and third part assess ents • changing e pectations of those accessing services here the assess ent is a colla orative process ith the individuals • roadening and e edding the skills re uired to have outco es ased conversations and support i ple entation of the ational utco es ra e ork re uiring a significant cultural shift across the health and social care orkforce • ntegrated ssess ent docu ents across health and social care have een developed to support a ne assess ent process ased on colla orative conversations ith individuals
e ill or ith the sector to audit the training needs of commissioning and procurement practitioners and identif their training re uirements
utco es ased approaches ill re uire skills develop ent across health and social care staff in particular for co issioners procure ent practitioners and legal advisers revie ing onitoring officers
e ill also re uire ne odels for securing services and changes to deliver across the independent and third sectors co productive co issioning ill re uire different relationships and a co it ent fro oth commissioners and providers to maximising the voice and control of ‘service users’ in planning and delivering ho care and support ill support the to achieve their ell eing outco es
he financial and orkforce crises ithin care ho e and the do iciliar care sectors are recognised oth nationall and regionall and there are a nu er of progra es that are eing i ple ented to address these difficulties
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S B S P S
e ill suppo t the egional Social alue Business o um to suppo t social value ased social ente p ise co ope ative o ganisations a angements use led and thi d secto p ovide s to develop a sha ed unde standing o the common agenda and to sha e and develop good p actice including he e the e is the oppo tunit to develop social ente p ises and mutual coope atives
or force development ill need to ensure that the or force supporting the development of such usinesses have the relevant s ills and access to support through the partnerships uch as experience in the development of social value usinesses usiness acumen accessing funding and understanding the human resources needs including s ills no ledge and competencies
he ales ooperative entre in their report “Getting Social Business in on the ct” sa s the enefits of or ing ith social usinesses are • ocial usinesses firml place people using services at the heart of the service design and deliver his often results in a etter ualit ell targeted service • he are usinesses anchored in their communities • nvestment in a social usiness sta s in the communit and ill e rec cled for ider economic and social enefits • mplo ees of social usinesses are more motivated having a direct voice in the running of the usiness • s usinesses the reduce costs and improve efficiencies for example through increased staff satisfaction and reduced a senteeism • s usinesses sitting outside of the pu lic sector social usinesses can access a ider range of resources support and funding • ocial usinesses can release the entrepreneurialism that exists in the pu lic sector and its or force • he have freedom to e more flexi le innovative and responsive
dvocac ssessing the eed – he ocial ervices and ell eing ales ct art ode of ractice dvocac re uires practitioners to have significant s ills and responsi ilities to e confident in assessing the individual’s needs for advocac and in the provision of advocac as detailed in the code as follo s • People’s choice to have someone to act as an advocate for them • clear frame or to support and empo er individuals to ma e positive informed choices • clear recognition of the enefits of advocac • he range of advocac availa le to people
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• The key points when people’s need for advocacy must be assessed • When independent advocacy must be provided • The circumstances that impact on peoples need for advocacy • The circumstances when it is inappropriate for certain people to advocate • The arrangements for publicising advocacy services and charging
SP ST S S
There are a number of service areas that will re uire specialist training skills and competencies such as ementia are for dults and enhanced skills in supporting ooked fter hildren with comple care needs these are identified through local authority leads
TS W S T T O WO O
P O T S
have identified a number of key workforce themes through both their strategic and operational plans we will work together to align our approaches in terms of the community health workforce and in particular where there is a social care and health interface
The Strategic priorities for Workforce and Organisational evelopment for etsi adwaladr niversity ealth oard are stated under four strategic themes of • chieving cultural change which better supports staff and through them the patients we serve • Planning for and attracting the staff we need to deliver services now and in the future • nsuring that the staff resource is deployed and used as effectively and efficiently as possible • nsuring that staff have the skills necessary to fulfil their roles
Some of the key workforce themes identified by the Service reas in their operational plans • fficiencies in bank agency locum use • Skill mi changes • Shifting of the workforce from acute to community development of community resource teams • evelopment of localities new models of delivery and employment models being developed • evelopment of advanced practitioners to support the medical workforce shortages
The organisation’s Operational Plan is aligned to our Workforce Strategy which is being progressed with a focus on developing our staff to deliver healthcare closer to patients’ homes through integrated working across health social care ndependent sector and the voluntary sectors corresponding shift in workforce
33 skills is therefore re uired to meet this demand and support the changes to the way services are to be provided This shift is also supportive of the agenda within the Social Services Well being Wales ct
Over the ne t years we will develop a more fle ible sustainable and skilled workforce who will support the delivery of transformational change both within the area teams independent sectors and wider unscheduled care divisions We will develop rewarding and fulfilling career pathways for our workforce and the independent practitioner workforce with an aim to further improve recruitment retention training and engagement of our staff There will be a move towards more generic interchangeable professional roles which reflect the demand for more efficient and effective patient centred clinical care pathways which are underpinned by the ‘Prudent Healthcare’ principles.
Organisational ecruitment hallenges and approaches There are substantial areas of shortage within the registered nursing workforce which is a significant challenge for the etsi adwaladr niversity ealth oard and across the ational ealth Service S both the ability to attract potential nurse applicants is one of the biggest challenges for the organisation These supply and risk issues facing the workforce is providing opportunities for the ealth oard to drive alternative approaches to recruitment across orth Wales the nited ingdom and overseas so that the health board can maintain services and ensure uality of patient care
The recruitment of both registered and non registered nursing staff is a vital component in the delivery of safe effective patient focussed care within orth Wales n order to achieve this there are plans in place in taking a more streamlined collaborative approach to nurse recruitment which includes encouraging student nurses to take up nursing positions as well as recruiting e perienced nurses within
This approach will also align to the proposed “student streamlining” approach as advocated nationally by the Workforce ducation and evelopment Services W S and the S Wales Shared Services Partnership WSSP to align student nurses to nurse vacancies prior to ualifying in order that on successfully registering with the ursing and idwifery ouncil they can immediately take up these posts
ollaborative working between all agencies including nursing the niversities shared services and workforce is proving successful and is essential so that the recruitment process is as effective and streamlined as possible
It is a requirement, as part of the organisation’s Integrated Medium Term Plan (IMTP) annual submission to Welsh overnment that we identify the anticipated future training re uirements for our health professionals and that we detail the education commissioning training places re uired by the ealth oard to ensure a sufficient future supply of healthcare professionals to deliver healthcare services for the population of orth Wales This covers octors urses idwives llied ealth Professionals P ealthcare Scientists S Psychologists and Pharmacists This year submissions have increased substantially for ursing and some PS thus supporting the recruitment gaps in the mid to long term
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hanges in the way we deli er ser ices e will wor to reconfigure ser ices and ensure effecti e commissioning, in the conte t of the ocial er ices and ell being ( ales) ct , the uture enerations ct with ongoing wor being led by the orth ales egional ollaboration Team. The programme is lin ed to the Pooling of udgets arrangements and ffecti e or force Planning discussed abo e.
The programme of wor is long term, requiring whole systems redesign, and will e ceed the one year plan for and will lead into the de elopment of a proposal for future commissioning of care outside hospital e will wor to de elop more sustainable primary care ser ices, ensuring management of ris and the de elopment of primary care federalisation opportunities.
In line with the ocial er ices and ell being ( ales) ct , we will de elop in partnership with ocal uthorities a plan for the pooling of budgets ia the egional Partnership oard – initially focused on requirement to ha e pooled budgets for are Homes.
H I I The shared ision sets out the strategic intentions of the board to wor collaborati ely and supports the guiding principles of the P .
To deli er the priorities set out in the orth ales ocial are and ommunity Health or force trategy we will ha e a oined up approach that supports wor force training and wor force de elopment across the sector and oint approaches that support the retention and recruitment of the social care and integrated health wor force.
e will bring together resources both funding and people to deli er the priorities set out in the orth ales or force trategy, to ensure that resources are used in the most cost effecti e way to meet the needs of a sustainable and qualified wor force.
P TI P I IP The strategy is owned by the egional Partnership oard, which will hold partners to account for its deli ery and ensure that wor force initiati es are de eloped to meet the priorities and operating principles.
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• • • • •
•
•
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STR T C PR R T ST S TH W R RC
e t the h e e e e the e e e ee th the t e e h e e t e t te the e
• • • the ‘ ’ • • • • • •
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STR T C PR R T – R P T
e ee t t the e t e e t e t e e t he th t t e e t the e t e e e e e t ee t e e the t h e e e t eet the e e e t the t t ee t e e te t t e e e e e e t e h e h e t h t th t h t e e e t te
th th e t e e e the e t th t h the e e ete e t e e h h t e e e e he e e e t t t e he e e t the e th e – t e the e e e te t h e the h h te e the e e e e e t e t th t e ee t th
et e t e th The organisation’s shift in focus require te t e t t e e e ete e e e the e t e e ee e e te th the ht t e e e t e te e e t e e t e e the e h e e e t e e e e e t
e e e t t e te e e e t e t ett e the the t th t e e e the e et ee the he th e e
e ee t e e th t t h e the e e t the e th h • e e e e t – e e e te the t the e e t e e t e e th t e h e the e e t e e h ete e t e e e t e the e e e • te e e e e t e • te t e e t t e e • t t t t t • t te – e e e t t e th t te e e t t the e e h h t e e th the e h e t • e e e e e t e e – e t e e th t t h e t e e e ee the t h the ht e the e e e • e th the e e e e t e e e t e th the t h h te e e e e e e te t h t tte t
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–
onsistenc of ata an infor ation for or force anning re ains cha enging oth nationa an regiona ith the ifferent ata sources across organisations there is an o ortunit to agree a asic ata set hich ou infor future anning
further or is require aroun or force anning in the care ho e sector an i nee to a ign to regiona or force anning un er a oth ithin the ea th oar an regiona ith artners as e as the i ications of oo e u get arrange ents fro on ar s e i ui on the initia ri ar care or force an o e er to a ress current or force cha enges an su ort ne o e s of u ti isci inar or ing at c uster e e
T T T Through the e e o ent of this strateg e are a are that securing or force ata on the Thir ector is an area hich e ou ant to i ro e in the future The e ectation on the Thir ector in e i ering re entati e an co unit ase ser ices nee s to e consi ere as art of our future or force anning
co of the fu orth a es or force oar rogra e can e accesse ia the orth a es ocia are an e eing er ices ro e ent o a orati e e site www.northwalescollaborative.wales
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R F R C S
ocia er ices e eing a es ct htt egis ation go u ana contents enacte htt go a es to ics hea th socia care act ang en
ocia are a es earning esources u htt s socia care a es hu resources
Well-being of Future Generations (Wales) Act 2015 http://www.legislation.gov.uk/anaw/2015/2/contents/enacted http://gov.wales/topics/people-and-communities/people/future-generations-act/?lang=en
Regulation and Inspection of Social Care (Wales) Act 2016 htt egis ation go u ana contents enacte htt go a es to ics hea th socia care regu ation ang en
The ar ia entar e ie of ea th an ocia are in a es htt go a es to ics hea th nhs a es re ie ang en
orth a es cono ics itions oar htt s north a esea co u
egiona i s artnershi orth a es htt s usiness a es go a es s i sgate a regiona s i s artnershi s
ocia are a es or force e orts htt s socia care a es research an ata or force re orts
tats a es htt s stats a es go a es ata ogue ea th an ocia are ocia er ices
ea th in a es htt a es nhs u statisticsan ata
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