Hampshire & Isle of Wight Workforce Strategy 1 Workforce Strategy - Developing the Workforce of the Future Our workforce is our greatest asset to deliver safe high-quality services to our population. This strategy sets out the overarching workforce framework to help partners establish the partnership and principles to develop the workforce that will deliver better care across Hampshire and the Isle of Wight (HIOW). The strategy focusses on; • The One Hampshire and Isle of Wight Workforce • A Workforce Focussed on Prevention • A Clear Career Framework – From the Support Workforce to Consultant Practitioner • A General Practice Workforce for the Future • Workforce Productivity • The Impact of Technology The ‘One Hampshire & Isle of Wight Workforce’ The underpinning principle of the strategy is a fundamental change from regarding the workforce solely at an organisational level to viewing the workforce across the entire footprint to enable optimal health and care outcomes to the whole population, with a particular focus on our shared values, integration, prevention and patient activation. This strategy therefore includes not just employed staff in the NHS, general practice and social care settings but also the recognition that unpaid carers, care workers in the independent care sector and our enormous wealth of volunteers are also key to the improving the life of our population. By integrating and working together effectively, staff from all agencies can more easily identify which people are most at risk - for example, of going into hospital - and then assemble a combined package of care, support and lifestyle advice to keep them healthier and independent for longer. Older people and people with long- term health conditions will be the first to benefit from this. To unpin this development system leaders have agreed to adopt the principles developed by the ‘My Life a Full Life’ Vanguard initiative to underpin our developing partnership. The framework describes the collective ambition and shared values for the health and care workforce in HIOW, and the commitments and actions of the partners to develop and implement a workforce that will transform and integrate services. A key principle of this approach is “One Trusted Professional’ at the forefront of an integrated, patient-centred service. We will further develop our workforce to have a breadth of knowledge and competences to provide more streamlined care for those with multi-morbidities. Our networked clinical staff will agree protocols and pathways to avoid duplication of assessments/diagnostics as patients move through the system. This approach is being developed in the SHIP pioneer maternity network. This project embodies our aspiration for a high quality responsive service focused on patient need. The aim is to further embed our current informal partnership, breaking down the barriers and boundaries across 4 NHS maternity providers and 8 CCGs. This will create a more ‘family focussed’ maternity service that offers women a clear, consistent menu of informed choice. Each woman will have a named midwife who works across boundaries utilising an agreed set of clinical guidelines. The named midwife can navigate 2 women through pathways into any maternity facility. This will enable the wider service to responds to peaks and troughs of activity in individual centres. This will require developing a flexible workforce which works across current geographical boundaries. This network will also standardise competence, skills, training and practices and support and promote multi-disciplinary education and training through a virtual maternity academy to ensure the consistent provision of training for all provider of care on the maternity pathway including GPs. This will be achieved by remodelling funding arrangements and developing and implementing supportive IT systems. In addition we will; Work in partnership across the system to improve recruitment and address skills shortages and ensure no one organisation is left with a staffing shortfall. Manage the workforce market more effectively and decrease reliance on agency workers by creating a HIOW concordat and a county-wide bank system. Further facilitate the reconfiguring and networking of services and specialist skills across organisations which is essential to achieve the ambitions outlined in this plan. Develop a HIOW wide recruitment and retention strategy which values and acknowledges the contribution of the whole workforce including carers and volunteers. Address the significant gap in our domiciliary workforce and paid carers, as part of our plan to address delayed transfers of care and ensuring the whole system works more efficiently by developing new public/private partnerships for employment and career development across health and social care. Develop agreements between employers on training and development. Undertake joint workforce planning across organisations and sectors to enable delivery of care in the most appropriate setting to ensure optimal outcomes. Supporting our Hidden Workforce – Carers and Volunteers While considering the One Hampshire and IOW workforce we need to be aware of the huge contribution made by the unpaid carers and volunteers in our society. Approximately 10% of our population provide unpaid care to family members or others because of long- term physical or mental ill health or disability, or old age. Of these approximately 39,437 people (40% of whom are over 65) provide over 50 hours of unpaid care, and 21,513 people provide between 20 and 49 hours of care. Our ageing population and increases in long-term, degenerative conditions, such as dementia means there is growing pressure on care systems and carers. Carers UK estimate that there will need to be a 40% increase in the number of carers required by 2037 and highlight the importance of bringing about a step change in the way that carers are recognised, identified and supported systematically throughout the HIOW health and social care system. It is vital that unpaid carers have access to the appropriate support. Under the new Care Act, carers have the right to request advice and information about services from local authorities. In HIOW, support is provided by a range of providers. Adult services in Hampshire provides access to the Take a Break service and Shared Lives scheme for carers that are eligible based on completion of a carer’s assessment. Respite care and other support is also provided by various charities, including the Princess Royal Trust in Hampshire and Carers IW on the Isle of Wight. Carers UK is a national charity that aims to improve carer’s lives by providing direct support, as well as representing carers by working with carers’ groups and volunteers in local communities and with local authorities to improve services. Early identification of carers will help to avoid or reduce any detrimental effect on the health and wellbeing of carers themselves and therefore their capacity to provide care. Portsmouth NHS Trust is introducing Carer Passports to help staff in the planning of care and appropriate support. As part of the 15 year 3 Strategic Framework Health Education England are working with partners to develop an education and training strategy to include patients and carers1. The drive to integrate care will require closer collaboration between services and the increased involvement of the voluntary sector. Charities are key to this and it is vital that they are involved in strategic decisions around service transformation. The National Council for Palliative Care is one of the Department of Health’s Third Sector Strategic Partners and works closely with the DH and partner charities to assist strategic work with the voluntary sector to improve health and social care in all settings. The engagement of this sector will be increasingly important in future models of care. A Workforce Focussed on Prevention It is clear that we must transform our system from one that treats people when they are ill to one that empowers our population stay healthy for as long as possible. Transformation of the workforce will be a key aspect in achieving this significant step-change. To support and upskill our workforce to enable a person-centred approach to prevention and public health we will utilise the UK Public Health Skills and Knowledge Framework (PHSKF) and extend and build on the innovative work already being undertaken in our system; Making Every Contact Count (MECC) is a behaviour change intervention whereby health and social care staff are trained to recognise and seize opportunities to provide brief advice to patients on healthy living. This initiative empowers patients and aims to reduce morbidity and mortality risk factors for local populations and provide cost savings through prevention, as well as empower both staff through skills development. It is currently being implemented across HIOW, not only in NHS trusts but also in local authorities and fire and rescue services. Public Health Practitioner Development increases capacity in our system by enabling non- specialist staff in public health to become registered practitioners. Youth Health Champions supports young people to be trained in health and wellbeing in order to become a Youth Health Champion. Once trained they can support their peers through health advice and promotion within their settings (i.e. School; Youth Club). Reducing Obesity By Education (ROBE) is an educational app for health professionals which focuses on childhood obesity. The app (currently in development with an expected prototype to be available for testing by the end of 2016) will enable health professionals to gain core knowledge around childhood obesity along with practical skills and tools to support them in practice. Public Health Apprenticeship is a new standard being developed. The role will work as part of a team, providing high quality advice and support on healthy lifestyles, facilitate behaviour change and deliver health promotion campaigns. This will provide opportunities for organisations to recruit apprentices into this role to support local prevention and public health. This programme is in the early development phase and we would look to implement this as soon as it is available.