NHS Greater Glasgow and Clyde. Workforce Plan 2012/13

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1 NHS Greater Glasgow and Clyde

2 Contents Foreword by the Chief Executive NHS Greater Glasgow and Clyde 1. Section 1 Background to the NHSGGC Workforce Plan Page 5 This section provides a descriptive overview of NHSGGC, its services, aims and goals. It also describes the processes and structures which govern the development and implementation of workforce plans. This section also provides a progress update on the actions from NHSGGC s 2011/12 workforce plan. 2. Section 2 Demand Drivers & Service Change Page 14 This section describes the NHSGGC population profile, projections and trends and anticipates the likely impact on health services and the health workforce of the future. This section also describes the main service drivers in each part of the organisation and places these changes in the current financial and economic context. 3. Section 3 Defining the Required Workforce Page 29 This section sets out the anticipated workforce change for 2012/13 with a supporting explanatory narrative. 4. Section 4 The NHSGGC Workforce Page 34 This section describes the characteristics of the current NHSGGC workforce by job family. 5. Section 5 - Supplying the Required Workforce Page 40 This section provides an overview of local labour market trends and the actions that NHSGGC are taking to address the issues which impact on the available local labour pool. This section also describes the education and learning programmes which are in place to develop the existing workforce and provide them with the skills which the Board will require in future. 6. Section 6 Implementation, Monitoring and Review Page 47 Appendices This section sets out the governance arrangements for workforce planning in NHSGGC during 2012/13 Appendix 1: 2011/12 Workforce Plan Update Page 49 Appendix 2: 2011/12 Workforce Change Summary Table Page 52 Appendix 3: The 6 Step Methodology Page 53 Appendix 4: Use of National Workload Tools in NHSGGC Page 55 Appendix 5: Glossary of Abbreviations Page 58 Appendix 6: Description of Job Families Page 59 NHS Greater Glasgow and Clyde Page - 2

3 Foreword by Robert Calderwood, Chief Executive, NHS Greater Glasgow and Clyde NHSGGC has a successful track record of delivering major service redesign which has enabled us to provide quicker access to better quality services, while achieving greater value for money. Glasgow s service modernisation plans are delivering an unrivalled suite of purposebuilt healthcare facilities such as the Beatson, the New Victoria and Stobhill Hospitals, the new Gartnavel Royal Hospital, Rowanbank and Skye House at Stobhill, the new Laboratories facility on the South Glasgow Hospital site as well as new health centres such as Renfrew, Barrhead and Alexandria with the culmination being the opening of the new South Glasgow Hospital in As a major Scottish public sector employer NHSGGC needs to play its part in the local economic recovery. In essence, we all have to do more with the same amount of money. Because of these challenges NHSGGC has to make changes to the way we work and deliver savings to balance our budget. However, we are committed to improving quality and standards even further, and completing one of the most exciting and ambitious modernisation building programmes in the history of the NHS in Scotland. NHSGGC employs 38,800 staff in multiple locations over a large geographical area and all of us are striving to apply ever improving models of best practice to meet the needs of the people we serve. We need to challenge ourselves every day to see if what we do today remains the best way to do it tomorrow. If we can t learn and adapt and don t change then we can t do things better. Constantly improving quality, together with improving access, is what people rightly expect from their NHS. During 2012/13 the Board will have in place 263 schemes from every area of the NHS Board, including the Acute Services Division, individual Community Health Partnerships (CHPs), Partnerships and Corporate Services to delivery cost releasing efficiency savings. They range from simple efficiency savings that local managers are taking forward to a handful of bigger service change proposals and, of course, these proposals will be the subject of discussion with staff and their trade union representatives through our partnerships arrangements. We have grouped these schemes into a number of themes which include procurement, service redesign, productivity improvement and review of management and administration costs. Take management and administration costs as an example. We recognise that this group of staff play a key role in the delivery and quality of our NHS services. However, we have acknowledged the Government s requirement to reduce senior management posts by 25 per cent by In the past two years we have reduced these posts by around 13 per cent through turnover, non-replacement of vacancies and redesigns. We will continue to look at all our managerial posts with a view to reducing further so that we can achieve the 25 per cent target, but also ensure that we have the management and leadership we need to develop and drive change. NHS Greater Glasgow and Clyde Page - 3

4 Similarly, we are committed to reviewing our administrative support posts as we believe that as a result of new mobile technologies and digital dictation, many senior staff no longer need the same level of personal support. These administration staff, through new modern ways of working, can cover a number of senior staff and therefore slim down our costs in these areas. Our target is to reduce these posts by around one third through turnover, non-replacement of vacancies and redeployment. The shift in the balance of care away from inpatient care is fundamental to the modernisation of NHSGGC. It is significantly reducing the need for a patient to have an overnight stay in hospital and is allowing us to deliver reduced inpatient bed numbers. These changes allow us to use funds in a different, more efficient way. Some commentators have equated these reductions to hospital bed cuts but they could not be more wrong it s the modernisation of the NHS. If inpatient bed and ward numbers are reducing, it doesn t mean that the staff working in them will lose their jobs, it means that they will be asked to work in new ways to deliver the new models of healthcare that are being developed, models that are being welcomed by our patients and are improving their experiences of the care they receive. We are not trying to do less, we are trying to balance all of these challenges but with the fundamental aim of achieving higher quality, clinically effective, efficient and value for money services. As we move forward with the saving schemes identified to improve efficiency and effectiveness we will continue to work with the trades unions and with those teams and individuals whose posts and services will be directly affected. This continued engagement is an absolute commitment, as is the NHSScotland core employment term and condition that there will be no compulsory redundancies. To underline the importance of staff being positively engaged in and shaping the changes we need to make and the focus on improving quality for patients, as well as reducing costs, we have developed a corporate change programme, Facing the Future Together. This programme recognises the challenges of change for us all. We know that staff are our best source of ideas and energy to improve services to patients and to make us more effective. Facing the Future Together will help us to create the staff engagement we need to unlock that energy and those ideas. This plan sets out our aims and ambitions for our workforce during 2012/13 and I look forward to working with you in the year ahead to achieve these aims. NHS Greater Glasgow and Clyde Page - 4

5 Section 1 Background to the NHSGGC Workforce Plan NHS Greater Glasgow and Clyde Page - 5

6 1.1 Introduction to the Workforce Plan NHSGGC is required by the Scottish Government to develop and publish an annual workforce plan which sets out the strategic direction for workforce development and the resulting changes to our workforce over the next year and beyond The Workforce Plan has been developed using the NHS Scotland six steps methodology and the NHS Careers Framework. Both of these workforce models enable us to take a coherent view of the workforce across all job families and sub-groups. The Career Framework in particular is a useful tool for modelling and implementing workforce change and we are promoting and encouraging the use of this tool in NHSGGC Local workforce planning activity is managed within the Acute Services Division and within the Community Health (and Care) Partnerships. In addition, there are workforce plans which focus on cross section issues and plans based on service delivery models e.g. Stroke Services and Children s Services The workforce implications of service change and redesign are also set out in NHSGGC s financial and service plans at Board and Divisional/CH(C)P level. These workforce implications are further analysed in the project implementation documents (PIDs) which are prepared to support any significant service change and which set out the financial, workforce and equality impacts of any proposed changes as NHSGGC is committed to achieving full integration of workforce, financial and service plans. All of the above workforce information is analysed and summarised by the workforce planners in order to develop the NHSGGC Workforce Plan It is critical therefore that all workforce plans whether stand alone documents or set out as part of wider service planning documents are signed off by a wide range of stakeholders including local management teams, service managers and planners, financial managers and local staff side representatives and partnership forums It is recognised by all stakeholders that the redesign and service change plans set out in this workforce plan are at varying stages of development and implementation. In addition a number of the projects are still the subject of continuing discussion with staff side and therefore outcomes may change as consultations are completed. This flexibility is reflected in the narrative of the plan. Some of these plans will change in response to external influences and events and this may affect projected workforce change Regular updates on progress against the aims and targets set out in the Workforce Plan will be provided to the Corporate Management Team (CMT) Area Partnership Forum (APF) and other stakeholder forums. 1.2 An overview of NHS Greater Glasgow and Clyde NHS Greater Glasgow and Clyde is the largest NHS Board in Scotland and covers a population of 1.2 million people. Our annual budget is 2.9bn NHSGGC employs circa 38,800 headcount staff. As such, NHSGGC is the largest employer in Scotland and the largest NHS employer in the UK. NHS Greater Glasgow and Clyde Page - 6

7 1.2.2 Table shows the breakdown of NHSGGC staff by Job Family Staff in post by Job Family As at 31st March 2012 Job Family Headcount WTE % Of WTE Workforce Adiminstrative & Clerical - Support to Clinical Staff 4, % Adiminstrative & Clerical - Office Services 1, % Allied Health Profession 3, % Management (Non-AfC) % Healthcare Sciences 1, % Medical and Dental 3, % Medical and Dental Support % Nursing and Midwifery 16, % Other Therapeutic 1, % Personal and Social Care % Support Services 4, % Total The Board s services are planned and provided through the Acute Services Division and six Community Health and Care Partnerships, working with six local authorities The Acute Services Division delivers planned and emergency services from 23 sites including 7 accident & emergency centres and 3 minor injuries units. Services include medicine and emergency services, surgery, maternity services, children s services, cancer treatment, tests and investigations, older people and rehabilitation services. In our hospitals in 2010/11 there were 470,125 A&E attendances, 384,361 new outpatient attendances, 166,840 day cases and 284,814 inpatient stays. Specialist regional services are also provided to a much wider population The six Community Health and Care Partnerships are responsible for the full range of community based health services delivered in homes, health centres, clinics and schools. These include health visiting, district nursing, speech and language therapy, physiotherapy, podiatry, mental health and addictions. The CH(C)Ps work in partnership to improve the health of their local populations. Each year, over 1 million patients are seen by GPs and practice staff. There are over 1.5 million visits to patients by health visitors and community nurses NHSGGC is currently undergoing a significant clinical change programme which is supported by a capital investment programme in its facilities which will transform health care delivery in the West of Scotland. The Acute Services Review will see services delivered on fewer sites with increased technology and greater synergy between services resulting in reduced bed numbers and reduced lengths of stay. The implementation of the Mental Health Strategy has also resulted in a reduction in long stay in-patient facilities with an increase in specialist services to support clients living in the community. In Primary Care, the development of the Community Health (and Care) Partnerships has resulted in new service delivery models and the emergence of new roles spanning health and social care. NHS Greater Glasgow and Clyde Page - 7

8 1.2.7 All of the above redesign is accompanied by the challenge of redesigning the workforce in a way that ensures a high quality, fit for purpose and affordable service in the years ahead Facing the Future Together is a Board-wide strategy and represents a fresh look at how staff support each other to do their jobs, provide an even better service to patients and communities, and improve how people feel about NHS Greater Glasgow and Clyde, as a place to work Facing the Future Together covers five main areas: Our Culture: To meet the challenges we face we need to improve the way we work together and we all need to take responsibility for achieving that; Our Leaders: All our managers should also be effective leaders. Leadership is management plus. It is more than managing transactions, it is managing with vision and with imagination, with a drive for positive change and with a real focus on engaging staff and patients; Our Patients: We want to deliver a consistent and effective focus on listening to patients, making changes to improve their experience and responding better to vulnerable people; Our People: Our aim is to develop a workforce which feels positive about being part of the Division; feels listened to and valued; and where all staff take responsibility to identify and address issues in their area of work in terms of quality, efficiency and effectiveness, with a real focus on improving the care we deliver to patients; Our Resources: We know that we need to reduce our costs over the next five years. We want staff to help us decide how to do that in a way which targets areas of less efficiency and effectiveness and areas where we can improve quality and reduce cost. 1.3 NHSGGC - Aims, Objectives & Goals NHS Greater Glasgow and Clyde aims to Deliver effective and high quality health services, to act to improve the health of our population and to do everything we can to address the wider social determinants of health which cause health inequalities The NHSGGC Corporate Plan for sets out the strategic priorities which will achieve this purpose, and the outcomes the Board will deliver over the next three years. The Corporate Plan sets out strategic priorities for the organisation in the period as: 21st Century Hospital Services: moving to fewer sites; planning for the new SGH in 2015 and planning for 2015 onwards; Developing primary care services: addressing demand and prescribing costs; primary / secondary interface; matching resources to need; Comprehensive system of community services: supporting people to stay at home; using change fund effectively; 1 The NHSGGC Corporate Plan for NHS Greater Glasgow and Clyde Page - 8

9 Improving the quality of the services we provide: focusing on evidence of effectiveness; identifying and addressing barriers to high quality care; balancing the 6 dimensions of quality; Vulnerable children and families: focusing on parenting, maternity care and gender based violence and achieving the right balance between universal and targeted services; Prevention, health improvement and early intervention: interventions which are most cost effective / biggest impact: smoking, alcohol, anticipatory care, 0-5s; Health inequalities: removing discrimination; responding to different needs; assessing the impact of savings plans The workforce planning process links with the strategic goals of NHSGGC as outlined within the Corporate Plan and other strategic documents such as the Quality Framework to demonstrate a clear and consistent strategic direction, acknowledging the tensions between some of our existing priorities and the workforce and financial constraints that the Board faces As with the Board s Corporate Plan for the Workforce Plan needs to respond to these issues and provide a strategic framework for managing workforce change during this period The Workforce Plan is developed as part of an extensive and inclusive process including the Board Planning and Policy Framework groups and wider stakeholders including staff and patients. NHSGGC s Corporate Plan will provide the platform to develop new planning guidance for the period 2013 to 2016, including a single set of priority outcomes and a clear financial strategy Importantly the Corporate Plan will provide the direction for our planning and policy frameworks for the next three years. These frameworks provide the detailed requirements for each of our key services and ensure that the development plans across the organisation deliver the changes we prioritise The Scottish Government has set out its vision for the NHS in Scotland in the 2020 strategic narrative. In our Corporate Plan we set out the changes we will make to move towards this vision during the period and NHSGGC s vision is that by 2020 everyone is able to live longer healthier lives at home, or in a homely setting Underpinning the narrative is the National Quality Strategy 2 which highlights the six dimensions of quality safe, effective, person centred, timely, efficient and suitable and focuses on action to ensure the first three. In NHSGGC we have recognised that a comprehensive approach to quality needs to focus on balancing all six dimensions and supporting the organisation to manage the tensions between them with a particular focus on maintaining quality within a financially constrained environment. The approach to improving quality in NHS Greater Glasgow and Clyde has three main strands: The Quality Policy Development Group; Specific quality programmes and Initiatives; and 2 The Healthcare Quality Strategy for Scotland, Scottish Government (May 2010) NHS Greater Glasgow and Clyde Page - 9

10 Outcomes focused planning and performance arrangements The commitment to quality has been articulated and communicated across NHSGGC and this is reflected in the Workforce Plan and in supporting learning and education programmes which are focused on improving person centred care The Quality Strategy and our NHSGGC response is not a new or separate set of activities but a fundamental commitment which underpins all our activity and ensures that every member of our workforce is focused on improving quality in their services and in NHSGGC as a whole NHSGGC s Corporate Plan will demonstrate how the Board will make progress in improving quality and safety and the Workforce Plan will demonstrate how our staff will support this. The performance of the workforce will continue to be measured by Scottish Government Health, Efficiency Access and Treatment (HEAT) targets and standards. 1.4 NHSGGC Workforce Planning Processes & Outputs Workforce planning is a statutory requirement and was established in NHSScotland in 2005 with the publication of the original guidance to all NHS Boards described in HDL (2005)52 National Workforce Planning Framework 2005 Guidance This document provided NHS Boards with a base for establishing workforce planning as a key element of their planning process In December 2011 the Scottish Government Published CEL 32 4 which replaced the guidance in HDL (2005) 52. CEL 32 provides NHS Boards with a consistent framework to support evidence based workforce planning. The key aim of this framework is to ensure the highest quality of care for patients by ensuring NHSScotland has the right workforce with the right skills and competences deployed in the right place at the right time. The provisions of CEL 32 sit within the Healthcare Quality Strategy for NHSScotland which aims to build upon quality healthcare services in Scotland and ensure all work is integrated and aligned to the Quality Ambitions This Workforce Plan has been developed in line with the recommendations set out in CEL 32 (2011) and uses the NHS 6 Steps to Integrated Workforce Planning Methodology 6 a workforce model which enables us to take a coherent view of the workforce across all job families and staff groups. The main aim of the 6 Steps Methodology is to set out in a practical framework those elements that should be in any workforce plan. Use of the Six Steps Methodology across workforce planning within NHSGGC ensures that decisions made around the design of services and the recruitment of the future workforce are sustainable, realistic and fully support the delivery of quality patient care, productivity and efficiency NHS Six Steps to Integrated Workforce Planning Methodology NHS Greater Glasgow and Clyde Page - 10

11 1.4.5 A description of the key stages in the 6 Steps methodology is attached to this document as appendix CEL 32 presents two clear obligations on NHSGGC with regard to workforce planning: Firstly to develop a Board Workforce Plan to be available on the Board s website; Secondly to provide detailed workforce projections for each of the NHS Job Families, (using a nationally agreed template format) which will be signed off by the Board s Chief Executive Officer and submitted to the Scottish Government NHSGGC s workforce planning process and the content of this workforce plan have informed the completion of the workforce projections which are set out in section 3 of this document Along with the submissions from other NHSScotland Boards the projections will allow the Scottish Government to develop a national picture of trends across all staff groups and will inform annual student intake to the controlled groups of staff including medical, dental and nursing and midwifery. 1.5 Workforce Plan Governance & Partnership Engagement NHSGGC is committed to agreeing and delivering workforce plans in consultation with a wide range of stakeholders, including staff, trade unions and professional organisations. Processes and structures have been established to achieve this and these are set out below The NHSGGC Workforce Plan Reference Group is the partnership group which oversees the development of the workforce plan. This is a corporate group with representation from all parts of the service, some professions and functions and from the staff side. The group supports the development of the NHSGGC plan and sense checks the plan before it goes onto the full APF, CMT and Staff Governance Committee of the Board As this group is a large and formal forum, in 2012/13 a sub-group was formed called the Workforce Plan Core Group and this group was given the responsibility of overseeing the plan development on a weekly/monthly basis to ensure full service and staff engagement While the single system plan is in development, local service and workforce plans are also being prepared in CHPs, CHCPs and the Acute Services Division The Draft Workforce Plan is then reviewed by: The Corporate Management Team; The Area Partnership Forum; The Staff Governance Committee. NHS Greater Glasgow and Clyde Page - 11

12 1.5.6 In addition to this formal consultation process the workforce planners provide progress briefings to Board committees and groups as requested e.g. Area Clinical Forum, Area AHP Committee, Area Medical Committee. 1.6 Update on actions arising from the 2011/12 Action Plan An update on actions arising from the 2011/12 Workforce Plan is attached to this document as Appendix Workforce Change 1 st April 2011 to 31 st March A summary of the workforce change in 2011/12 can be found in appendix Other Agencies & Stakeholders NHSGGC works with a variety of partner organisations as part of our service redesign and workforce planning processes. Local authority partners are key members of CH(C)P workforce planning activities As key stakeholders in the workforce planning process our structures ensure that, where appropriate, a variety of groups are sighted on the impact of our workforce plans e.g. Independent Sector, Carers Groups, Housing Sector. 1.9 West Region Workforce Planning Network (WRWPN) The West Region Workforce Planning Network was established to provide a forum for west Boards workforce planning leads to share good practice, identify key issues and provide workforce planning support at a regional level. The network is chaired on a rotational basis by a Board workforce planning lead Regional workforce planning work streams are progressed through the Regional Planning infrastructure with workforce planning manager input as required being co-ordinated by the West Region Workforce Planning Network. Regular updates on the workforce implications of Regional Service Plans are also provided to the West of Scotland Human Resources Directors at their monthly meetings The West Region Workforce Planning Network provides support across a number of national and regional work streams; Regional Chemotherapy Group; Regional Oral Maxillofacial Services Group (OMFS); Regional Child & Adolescent Mental Health Services (CAMHS); Regional Child Health Group; Regional Paediatric Clinical Network; Regional Neonatal Managed Clinical Network; Regional Medical Workforce Group; National Allied Health Professions Strategic Group; National Nursing & Midwifery Steering Group. NHS Greater Glasgow and Clyde Page - 12

13 1.9.4 All of the above groups are supported by a Workforce Planning Manager from the West Region who ensures that the workforce implications of any service changes arising from these groups are recognised and communicated to the appropriate stakeholders NHS Greater Glasgow and Clyde Page - 13

14 Section 2 Demand Drivers & Service Change NHS Greater Glasgow and Clyde Page - 14

15 2.1 The NHSGGC Population Profile The biennial Director of Public Health reports set out in detail the changing health profile of people living in Greater Glasgow and Clyde and the factors which influence it These reports highlight some significant improvements in recent years. Overall life expectancy has risen, rates of premature mortality have fallen, with particular improvements for coronary heart disease. Cancer survival has improved significantly across a range of cancers. However, there remain many significant health challenges and marked inequality across NHSGGC Our population is relatively young compared to other parts of Scotland, although this varies significantly between local authority areas. Women predominate in the older age groups. The current age profile is shown below It is a population with high levels of deprivation compared to the rest of Scotland. 30.4% of people in NHSGGC live in the 15% most deprived data zones (Scottish Index of Multiple Deprivation). This ranges from 3.1% in East Dunbartonshire, to over 50% in North and East Glasgow Overall, average life expectancy in NHSGGC is well below the Scottish average (see below). Again, there is considerable variation between different parts of NHSGGC. 7 All reports available at NHS Greater Glasgow and Clyde Page - 15

16 2.1.6 Healthy life expectancy in NHSGGC is even lower compared to the Scottish average. People in NHSGGC live for many years in ill health, with the consequent impact on quality of life, economic and societal contribution and need for services. Over the past 10 years, the gap in healthy life expectancy between the 20% most deprived and the 20% least deprived areas has increased from 8 to 13 years. Life Expectancy at Birth (by Gender)* CH(C) P Male Female East Dunbartonshire East Renfrewshire Renfrewshire Inverclyde West Dunbartonshire Glasgow City NHSGGC Scotland * Source National Records of Scotland (NRS) The Director of Public Health reports a number of major health and health behaviour challenges in NHSGGC. In almost every indicator, the same marked inequalities in health outcomes can be seen between the most affluent and most deprived areas. Factors which contribute to this include: high levels of alcohol consumption and alcohol related health problems; high rates of drug dependency; growing rates of obesity; growing numbers of people with long term conditions, including those with multiple long term conditions; despite significant success in supporting people to stop smoking, smoking rates remain high particularly in deprived areas and in some particularly vulnerable groups such as pregnant women; Rising levels of dementia and depression The reports also highlight the interdependence between these issues, and the rising numbers of people with multiple health and social concerns. We must recognise how people s life circumstances can affect the health choices they make. Many of these issues have a long term impact and high disease burden, affecting employment, mental health, social participation and ability to benefit from existing health services As well as direct measures of health and health behaviour, NHSGGC faces challenges in a number of key determinants of health. Most significantly: children and families living in poverty; high levels of unemployment, including youth unemployment; impact of the recession and tax and benefit changes, particularly disability benefits; isolation and loneliness with high numbers of people living on their own. NHS Greater Glasgow and Clyde Page - 16

17 2.2 Health as a Driver of Demand The inequalities and poor health in our population drive high levels of hospital admissions, GP consultations and use of a wide range of other services. Age is a major driver of service use, with the majority of contact with the NHS in the last few years of life NHSGGC s rates of emergency admissions are significantly higher than the Scottish average, and these have a very clear social gradient In primary care, the biggest drivers of demand for services are age and deprivation The health and inequalities issues identified above therefore have a very real and direct impact on our services in terms of use of services and capacity to benefit. The age profile of our population is already changing and getting older, accounting for rising numbers of admissions We have made huge improvements in health outcomes and treatment for many people. For example, the massive reductions in waiting times and shift to day case surgery for the vast majority of cases, and our improvements in cancer survival rates. We see many more patients more quickly and with better outcomes We know that not everyone has benefited from these improvements. One of the key challenges in meeting our aspirations will be how we address unmet need and differential uptake of services which lead to the health gap and premature mortality for people in equality groups or living in persistent poverty All of the above factors have major short and long term implications for individual and population health which must be considered by NHSGGC when developing the future workforce. There is strong evidence which points to the health benefits of employment and the Board is developing recruitment strategies which recognise this and seek to ensure the are opportunities and pathways for all groups to enter the workforce. 2.3 Population Projections and Trends Greater Glasgow and Clyde s population is expected to continue to rise from 1,194,675 in 2008 to a peak of 1,198,174 in 2013 at which point it is expected to start a modest long-term decline, to reach 1,196,943 in During this time, the age profile of the population will change markedly. The number of children and young people will decline, and there will be a steep rise in the proportion of older people. This will impact differently across Greater Glasgow and Clyde with areas like East Dunbartonshire and East Renfrewshire already experiencing significant rises in numbers of older people. 8 Tomlinson et al, The Shape of Primary Care in NHS Greater Glasgow and Clyde, GCPH Source NRS (formerly GRO(S)) NHS Greater Glasgow and Clyde Page - 17

18 2.3.4 In many ways, this represents a success story with many people living longer and healthier lives. Active older people make a substantial social and economic contribution. However, as people get older they are also more likely to need health services. Women predominate in the older age groups and many experience poverty which aggravates poor health and multimorbidity. If we carry on with current rates of service use, with a larger population of older people, there will be substantial rises in emergency admissions and demand for care home placements and home care A significant rise in the number of people with dementia is also expected, with consequent challenges both for dementia services and for the way in which all services for older people are delivered. At the same time, NHSGGC will see a growth in the number of single person households. New legal duties to ensure age equality in public services will also shape the way we respond to these changes As well as the demographic changes, our work on the impact of the recession in Glasgow suggests there is likely to be a short and long term impact on health, with rising unemployment linked to poorer mental health and lower income, both of which are in turn linked to longer term ill health Whilst we will not see the full impact of these trends during , they are all issues we are currently beginning to face and will be a critical period in reshaping services to meet these pressures and the expected long term demographic changes The pressure from the ageing population will make current models of service and workforce unsustainable and unaffordable very quickly. Service redesign and workforce plans must address the above challenges to ensure an affordable, flexible and adaptable workforce which meet the needs of the changing population. NHS Greater Glasgow and Clyde Page - 18

19 2.4 The Financial Environment NHSGGC, like the rest of the public sector, continues to operate in a challenging financial environment. We have an operating budget of around 2.9 billion, of which approximately 50% of the budget ( 1.4 billion) is the salary cost of the workforce. For 2012/13, we have received an increase in funding of 2.4% from the Scottish Government. This figure includes: Funding to support the 18 week referral to treatment target. This funding previously came to us as earmarked funding, so is not new ; Funding to cover the step up costs of implementation of the Change Fund ; Funding for the cost of prisoner healthcare, previously provided by the prison service The combined cost of these items is around 1.4%, leaving 1.0% for all other cost pressures and developments We anticipate that average pay costs will increase by around 1.0% over the coming year. This rise results from a number of factors: The Low Pay Agreement, where staff earning less than 21,000 per annum receive a minimum annual pay increase of 250; The continued impact of incremental pay progression arising from Agenda for Change pay arrangements. We have not yet reached a steady state where savings from leavers (salaries of leavers less salaries of new starts) offset incremental increases across the rest of the workforce; and A reduction of 0.3% in the rebate for employers national insurance contributions for contracted-out staff. This increases the effective rate of national insurance that we pay; As NHSGGC continues to pay all staff at rates above the Scottish living wage, the living wage is not an additional cost pressure for 2012/13." Our financial plan has identified a need for efficiency savings of 59 million during financial year 2012/13. These savings will be secured through a number of routes, in particular: Efficiencies through amended procurement; Efficiencies from the prescribing budget; Changes to the NHSGGC estate; and Efficiencies through the redesign of services It is likely that we will continue to operate in a constrained financial environment. As around 50% of costs are salary related, securing efficiencies from the redesign of services, while continuing to maintain and improve the quality of service to patients, will be the main driver of our approach. New workforce models will have to be affordable as well as adaptable to ensure long term sustainability. NHS Greater Glasgow and Clyde Page - 19

20 2.5 Acute Services Division Drivers The Acute Services Division is the largest division within NHS Greater Glasgow and Clyde. At the end of March 2012, the Division employed 28,414 staff, 24,336.3 WTE The Division has produced its own Workforce Plan in accordance with the Scottish Government revised workforce Planning guidance. The Acute Services Division will produce a plan each year which will support the Board Workforce Plan The Acute Services Division has a proven track record in implementing and adapting to change. In the last few years we have opened 2 new Ambulatory Care Hospitals at Stobhill and the Victoria as well as the new Beatson West of Scotland Cancer Centre. In 2011 we successfully implemented the Vale Vision and integrated inpatient services in the North and East of Glasgow from Stobhill Hospital onto the GRI site In addition, a wide range of services have been redesigned, modernised and in some cases centralised to single site working to provide centres of excellence, including renal and vascular services All of this has been achieved through significant hard work, involvement and commitment of staff working in these areas and it is important to acknowledge the level of effort and engagement from all groups of staff to support the change agenda to date The next few years will see further significant change as part of our continued efforts to deliver high quality clinical care from centres of patient excellence which will ensure that we will: Provide patient focused, high quality services within our existing sites and for those transferring to the new South Glasgow hospital through the On the Move programme; Implement redesign programmes throughout the organisation to improve upon the current services we offer to patients and promote a culture of continuous improvement; Support innovative and best practice underpinning service models in all acute sites; Ensure new workforce models are in place through early identification of anticipated changes to workforce and skill mix requirements; Maximise the use of technology and IT systems to support new ways of working On the Move is the Acute Services Division s programme to support the redesign of services leading to 2015/16 when the new Adult and Children s hospitals will open in South Glasgow To deliver a workforce appropriate for these new developments we are also undertaking reviews of service delivery across the Acute Services Division. Seven working groups have been established: NHS Greater Glasgow and Clyde Page - 20

21 1. Capacity and Emergency Patient Flows; 2. Inpatient Elective Care; 3. Outpatient Day Case; 4. Ambulatory Care; 5. Clinical Support Services and Buildings; 6. Primary Care/Community Interface; 7. Paediatric These will be supported by 3 advisory groups: Information and activity, Workforce and I.T. Staff partnership are engaged within all work streams Underpinning the On the Move programme, is the requirement to continue to improve the quality of care, increase efficiency and productivity thus reducing inpatient beds and inpatient sites In delivering the new South Glasgow Hospital the Acute Services Division will see a reduction in inpatient beds across Glasgow and Clyde. This will be achieved through improvements to discharge planning arrangements and reduced lengths of stay, with a focus on treating patients as day cases where clinically appropriate A new bed model is being implemented which will ensure skill-mix and staffing levels are in line with best practice. Bed reductions are being delivered through a combination of service redesign and improving average lengths of stay for patients Across the Division, nurse to bed ratios have been agreed to ensure they reflect best-practice, together with skill-mix changes to ensure we have the balance of professionally qualified staff and appropriately trained support staff These changes are being implemented utilising, where available, national workload planning tools. A detailed description of available workload tools and how these are being applied within NHSGGC is contained in appendix The new South Hospital will present a significant logistical challenge to the Division in bringing almost 10,000 staff together onto a single site. Approximately 6,500 staff will be required to move onto the New South Campus. The move will be planned on a phased basis The new laboratory on the South Glasgow site opened in March, Investment was also agreed for the University Tower laboratories development at Glasgow Royal Infirmary. Building work commenced late 2011 and will open in 2014/ The laboratory strategy delivers a hub and spoke style of service delivery where there will be 2 large laboratories one at the New South Glasgow Hospital, and the other at Glasgow Royal Infirmary with smaller laboratories providing emergency cover and immediate results at each of the primary acute hospitals. The new laboratory will affect over 750 existing laboratory staff who will move from various locations across the Board area. The movement of staff commenced in April 2012 and will conclude late summer NHS Greater Glasgow and Clyde Page - 21

22 Throughout the Acute Services Division services are reviewing service delivery and workforce models in the context of the new South Glasgow Hospitals. For example the Pharmacy Prescribing & Support Unit (PPSU) has completed a wide ranging modernisation of all components of its areas of responsibility In Acute Care (and Mental Health) services, PPSU modernisation and centralisation was designed to release pharmacy staff to patient focused duties and was facilitated by the introduction of large scale robotics and sophisticated information technology, to create a single point of distribution for medicines in NHSGGC, replacing 14 existing pharmacy stores The previous multisite model was operated by 140 distribution staff; this has been reduced to 40 staff operating the new distribution centre. There have been benefits in cost saving, efficient stock control, error reduction and dispensing time: Pharmacists are taking on additional roles e.g. independent prescribing; Technicians are engaging in patient facing delivery of care and are authorised to check prescriptions in aseptic and regular dispensaries; Administration staff are also undertaking a wider range of support and co-ordination functions Skill mix review is a feature of this development with increasing responsibility being assigned to specialist technicians who support the GPs and the Prescribing Support Pharmacists Advances in information technology are central to these developments with a particular focus on prescribing, medicines management and pharmaceutical care in NHS hospitals, integrating with the e-health record. To promote the safe, effective and efficient use of medicines, we anticipate an IT infrastructure supporting the emergency care summary, medicines reconciliation, electronic prescribing / medicines administration and the immediate discharge letter. While this approach will gather pace with the arrival of the new South Hospital, the pharmacy workforce also needs to be responsive to ambulatory care developments and the shifting balance of care from acute to primary care services. 2.6 Community Health (and Care) Partnerships Drivers Our Community Health Partnerships provide a wide range of community based services delivered in homes, health centres, clinics and schools. These include health visiting, district nursing, speech and language therapy, physiotherapy, podiatry, mental health, addiction and learning disability services. Staff delivering these services work closely with other local health professionals, including GPs, dentists, pharmacists and opticians to plan and develop services across the CHP area. Community Health and Care Partnerships (CH(C)Ps) carry out the same functions as CHPs but have been established as strategic partnerships between Local Councils and NHSGGC. CH(C)Ps bring together both NHS and Local Authority responsibilities for community-based health and social care services within a single, integrated structure and are responsible for NHS and Local Authority employed staff. NHS Greater Glasgow and Clyde Page - 22

23 2.6.2 Within NHSGGC there are 3 Community Health Partnership and 3 Community Health & Care Partnerships (both structures are subsequently referred to as CH(C)Ps: Glasgow City CHP; Renfrewshire CHP; East Dunbartonshire CHP; East Renfrewshire CHCP; West Dunbartonshire CHCP; Inverclyde CHCP The aims of our CH(C)Ps are to: provide a unified focus for the NHS s relationship with the various councils and to have a more local focus for the management of services ensuring strong local connections; generate efficiency and consistency in support services and management costs, and ensure devolution of service delivery, health improvement, inequalities and planning activity; provide a strong basis for better connection with primary care contractors; better reflect the pattern of flows into secondary care services to provide a more robust platform for the engagement required to drive change across the primary and secondary care interface; and, achieve streamlined committee arrangements which ensure appropriate overall governance in a consistent and efficient way Our CH(C)Ps face a number of key challenges which are described in more detail within each of the CH(C)P s development plans. In summary, the key challenges for during 2012/13 will be in the following areas: Making further progress in implementing the Board s Primary Care Framework to improve access working with GPs, community health staff, secondary care clinicians and other primary care professions; Developing an approach to tackling poverty in collaboration with key partner agencies; Implementing a number of key service changes in: Older People s Services through implementation of the Change Fund and reducing delayed discharges to meet national targets, and reducing the number of acute hospital bed days lost due to delays; In Child & Maternal Services by implementing the requirements of Getting it Right for Every Child, and contributing to the implementation of Board wide programmes; In Community & District Nursing services by increasing the time spent in face to face contact with patients; By improving access to Community and Inpatient Mental Health Services; and, By taking forward Health Improvement programmes with partners designed to tackle inequalities and achieve improvements in: reducing smoking; alcohol screening; NHS Greater Glasgow and Clyde Page - 23

24 child obesity; reducing suicides; and cardiovascular disease. By meeting the financial challenge by delivering efficiency savings and financial balance; Progressing the implementation of the Board wide organisational programmes such as Facing the Future Together; By understanding the implications of emerging proposals for the integration of health and social care services; By mainstreaming approaches within our services that promote equality and help tackle health inequalities The workforce implications of these priorities are being addressed through a variety of planning groups Older People s Services Planning for older people s services is the responsibility of the Reshaping Care for Older People Strategy Group which includes representation from social work services, the voluntary sector and independent sector. This group is tasked with developing a joint strategy for older people s services, and shifting the balance of care away from hospital and institutional settings to support people to live at home The workforce implications of this strategy during 2012/13 will be identified as part of: A review of District Nursing and AHP teams; The Implementation of Change Fund plans and associated recruitment to identified posts Child & Maternal Services NHSGGC has established The Healthy Children Programme Steering Group to oversee the implementation of CEL 15 (2010) - Refresh of Health for all Children (Hall 4) - Reinforcing the Key Messages 10. The changing nature and content of the agenda for the Healthy Children Programme Steering Group reflects the current and future policy and legislative directions detailed within a number of national policies and frameworks e.g. Refreshed Maternity Framework for Scotland 11, Child Poverty Strategy for Scotland A workforce plan for Children and Family Teams will be produced which will develop a workforce which is structured, equipped and sufficiently resourced to deliver on the emerging policy and practice agenda. More specifically, one of the key strategic objectives will be to shift the balance of care to a child and family centred approach based on the principles of Getting it Right for Every Child 13. The workforce plan will guide and set the framework for this change process. 10 CEL15 (2010) Refresh of Health for all Children, Scottish Government (April 2010) 11 A Refreshed Maternity Care Strategy for Scotland, Scottish Government (February 2011) 12 Child Poverty Strategy for Scotland, Scottish Government (March 2011) 13 Getting it right for every child, Scottish Government (September 2009) NHS Greater Glasgow and Clyde Page - 24

25 The Workforce Plan will establish new workforce models for: Children and Family Teams; Health Visitors; Nursing Staff (including School Nurses); Nursing support staff (including dental nursing support) The Workforce Plan will also make recommendations in relation to the leadership of teams and level and type of administrative support which teams should receive Community & District Nursing NHSGGC s Community District Nursing service faces the challenges of an ageing population and an increase in long term conditions In light of this NHSGGC has established a review of district nursing services to include all district nursing teams across NHSGGC within the following context: The purpose of the review is to undertake a detailed analysis of the current district nursing service workforce, workload and working practices across NHSGGC This initial work will inform the design and development of a model of district nursing which is; fit for future purpose, builds on good practice, addresses key drivers for change and fits with the national modernisation Career Framework for district nursing which was published in January Our aim is to ensure that NHSGGC s future service model will be embedded in caring, enablement, respect for diversity and the promotion of rights and value base approaches to care The review of district nursing will align with the Board s service improvement agenda by incorporating the Leading Better Care programme within the context of developing the leadership skills of band 7 and band 6 district nurses and team leaders in leading for quality and service improvement The review will also focus on improving the efficiency and effectiveness of front line teams. Both of these programmes will be rolled out in public health nursing A programme Board has been established to oversee the review of District Nursing with representation from all partnerships and other key stakeholders. Each of NHSGGC s community partnerships is in the process of establishing local implementation groups to take forward the review on a local basis Mental Health Services Workforce planning activity for Mental Health Services is coordinated via the Glasgow City CHP Workforce Development Group. For Mental Health and related services there are a range of specific proposals which will influence the workforce during 2012/ These include: The review of Crisis and Community Care Mental Health teams; NHS Greater Glasgow and Clyde Page - 25

26 The reconfiguration of existing forensic wards at Leverndale Hospital; The development of proposals to consolidate mental health beds currently based at Parkhead Hospital on the Stobhill Hospital site During 2012/13 it is our intention to establish a strategic review which will explore the longer term future service models and configuration arrangements for the full range of community, out of hours and inpatient services. The drivers for these proposals are the anticipated reduction in bed levels arising from balance of care shifts, more effective management of inpatient episodes and discharge processes reducing lengths of stay In relation to in-patient services the review process will explore the following: Acute admissions sites: This may involve a shift from acute admission sites for adult mental health. The implications for sites involve the closure of Parkhead hospital which has already been approved and a reprovision of beds on the Stobhill site; Specialist ward functions: For our specialist rehabilitation and intensive psychiatric care wards we will consider the future bed model and options for further reconfiguration of intensive psychiatric care provision; Continuing care: We will explore the potential to reconfigure adult continuing care wards into more cost effective ward configurations. We will finalise the proposed arrangements for the reprovision of elderly mental illness (EMI), functional and adult continuing care from Ravenscraig hospital. We will explore options for the remaining two wards at Ruchill Hospital and absorption of the adult and older people s mental health beds within existing sites and contracted capacity; Addictions: Consider the workforce implications of future bed models for addictions co-morbidity beds and the potential consolidation of addictions admissions services for the entire Board area on one site at either Gartnavel or Stobhill Hospital; Older people s Mental Health Services: Investigate the impact of improving lengths of stay on the required number of in-patient beds and number of service delivery sites; Learning disability bed provision: Investigate the impact of improving lengths of stay on the required number of in-patient beds and number of service delivery sites Health Improvement The link between population health on demand for services has been clearly identified earlier in this document (section 2.2) and NHSGGC recognises that it is essential to have a health improvement workforce that is fit for purpose and that can respond to the challenges of improving health and reducing inequalities in health In February 2011, the Health Improvement Workforce Planning Advisory Group published a workforce plan based on current and future roles that is NHS Greater Glasgow and Clyde Page - 26

27 affordable within the financial framework and where the core skills and competencies are available to meet the requirements for improving health and tackling health inequalities as outlined in the planning and policy frameworks The main outputs and recommendations from this report will be available and shared at a variety of meetings, groups and forums during summer Prison Healthcare Services On 1 st November 2011 the responsibility for prison healthcare services transferred from the Scottish Prison Service (SPS) to the National Health Service. There are currently three prisons within the NHSGGC geographical area (HMP Barlinnie and HMP Greenock and a third new build prison near Bishopbriggs, HMP Low Moss, which opened in March The directly employed staffing complement for the existing prisons within NHSGGC boundaries is approximately 64.5 WTE staff. This staff group comprises mainly nursing and administrative staff. Prison Care staff in post at Barlinnie and Greenock Prisons transferred to the NHS under statutory TUPE/COSOP arrangements as at 31 st October The workforce plan for prison healthcare services indicates that an additional complement of approximately 28 WTE directly employed staff will be required for the new build at Low Moss Oral Health Services The Oral Health Directorate published its first Workforce Plan in 2009 and initial work has commenced on convening a Workforce Planning Group to develop a new Workforce Plan during 2012/ Independent Contractor Groups NHSGGC has made considerable progress in implementing the NHS Board s primary care framework. The involvement of GPs and other primary care staff in the planning and delivery of services has increased with the introduction of localities. providing the basis for engagement and involvement in decision making at a local level with GPs, other contractors, and community based services. Access to primary care services continues to improve with the NHSGGC achieving the 48 hour access target. Activity profiles have been developed on a pilot basis to better inform local discussions about what influences demand on primary and secondary care services. NHSGGC have also undertaken QoF sessions in each sector involving nearly all GP practices reviewing referral patterns and activity in key areas in conjunction with secondary care clinicians. NHSGGC aims to build further on this work in 2012/13 by improving the communication and interface between primary and secondary care, developing approaches to anticipatory care to reduce emergency admissions and, where appropriate, develop locality groups across NHSGGC to ensure primary care clinicians and staff play a key central role in planning and decision making in the CHP. NHS Greater Glasgow and Clyde Page - 27

28 Within NHSGGC workforce planning issues are considered as part of the GP Practice Support & Development Group The role of the group is to facilitate discussion and good practice around HR/OD issues relevant to General Practice and to provide guidance and direction around these issues with a view to fostering consistency across Glasgow and Clyde The Group will take account of input and recommendations from national legislation and policy, local issues and stakeholder s views. NHS Greater Glasgow and Clyde Page - 28

29 Section 3 Defining the Required Workforce New Renfrew Health and Social Care Centre NHS Greater Glasgow and Clyde Page - 29

30 3.1 NHSGGC Workforce Projections 2012/ NHS Boards have two primary obligations as set out in CEL 32 (2011); firstly, to produce a Board Workforce Plan and secondly, the production of detailed workforce projections. This document sets out the latter The tables below summarise the workforce projections for 2012/13 workforce change which will result in an overall reduction of WTE. Workforce Change Projections 2012/13 by Division Whole-time equivalent Acute Division Glasgow City CHP 10.6 West Dunbartonshire CHCP 6.3 Renfrewshire CHP 1.6 Inverclyde CHCP 3.5 Mental Health Services Health Information & Technology 23.5 Shared Corporate Services and Finance 12.0 NHSGGC Total Summary of 2012/13 workforce projections by Job Family (WTE) Workforce Change Projections 2012/13 by Job Family Whole-time equivalent Administrative Services Allied Health Profession 29.1 Management (Non-AfC) 11.0 Healthcare Sciences 30.4 Medical & Dental 8.4 Medical & Dental Support 5.0 Nursing / Midwifery Other Therapeutic 8.5 Personal & Social Care 0.0 Support Services 54.3 NHSGGC Total Administrative Services The changes being made within administrative services workforce are being driven by two main factors. Over the last year, administrative support to senior managers and clinicians has been reviewed. New technologies such as digital dictation and mobile computing aligned to agile working methods mean that senior staff no longer require the level of administrative support that has been provided in the past. This will continue to be implemented during 2012/13 as part of the reduction in the overall administrative support to senior staff by one-third. The continued implementation of the e-health strategy including the Electronic Patient Record and the new single Patient Management System will allow us to provide an improved service with a reduced level of staff particularly within health records. NHS Greater Glasgow and Clyde Page - 30

31 3.1.6 Allied Health Professions During 2011/12, significant work to review existing AHP services was undertaken as part of the Board s AHP redesign project. This has resulted in the introduction of new management arrangements and the introduction of new ways of providing AHP services. Within Acute Services, the AHP service changes include a move to 7-day working for physiotherapy and occupational therapy and skill-mix changes, including the introduction of level 4 Career Framework posts which will improve opportunities to progress if desired On 20 June 2012 the Scottish Government released a National Delivery Plan for AHPs which will apply to AHPs from across Health and Social Care and provide a strategic platform for future AHP activity. It sets out a range of actions which require AHPs to be more visible, accountable, and demonstrate impact to the organisation and communities they serve. The plan covers a 3 year period from Healthcare Scientists The opening of the new laboratory on the site of the Southern General and the move to single-site working for pathology services has enabled redesign of the workforce. Laboratories in Gartnavel are undertaking service redesign to implement a new way of working which complements the completion of the new laboratory. The completion of the new laboratory is a key milestone in the delivery of the Acute Services Review within NHSGGC. This work will continue through 2012/13. Laboratory Medicine in NHSGGC is at an advanced stage in its modernisation strategy. This takes account of the preexisting Clyde strategy and overall laboratory strategy of implementing a hub and spoke network of labs, extending its working day and increasing automation in order to improve efficiency Medical and Dental In the medium-term (by 2015) there are plans to implement the Scottish Government guidance within CEL 28 (2009) which requires all NHS Scotland Boards to make reductions of 40% in the middle grade medical workforce and of 25% in junior grade medical staff (although it was recognised that final number would vary depending on specialty and Board) By 2015/2016 NHSGGC anticipates that the middle grade medical trainee workforce will reduce by 37% and that junior medical trainee doctor numbers will fall by approximately 29% In 2012/2013 the Board will start to see the effect of the reduction in training grade numbers, with reductions in the number of trainees in Anaesthetics (12.5 WTE), Obstetrics and Gynaecology (9 WTE), Emergency Medicine (4 WTE), Clinical Radiology (3 WTE), Cardiology (1 WTE), Rheumatology (1 WTE) and Mental Health (2 WTE) Whilst some of these posts are being changed to junior core training posts, others are being disestablished, with funding returned to the Board by NES. As a consequence, it is anticipated that the Board may see an increase in the number of consultant and specialty doctor medical staff. NHS Greater Glasgow and Clyde Page - 31

32 Over the next 5 years NHSGGC anticipates that the middle grade medical workforce will reduce by 37% and that junior doctors numbers will fall by approximately 29%. These reductions will be offset by increases in consultant (6.5%) and specialty doctors (63%) numbers as the Board moves towards the trained doctor service model outlined in CEL Medical and Dental Support A review of the Board s community and salaried dental service was undertaken during 2011 and published in early The workforce implications of this review will feed into the overall Oral Health Workforce Plan which is in its early stages. It is anticipated that a review of existing services in the community will give rise to efficiency savings within the support professions associated with dentistry Nursing and Midwifery The main driver of workforce change within nursing is the continued implementation of the Acute Services Division s bed model. This reduces the overall complement of beds across the Division in preparation for the opening of the New South Glasgow Hospitals. This is being achieved by improving patient pathways and efficiency and reducing average length of stay where appropriate. The nationally approved Nursing Workforce and Workload Acuity Planning Tools will continue to be applied where appropriate Within Partnerships, the redesign activity in Mental Health Services continues in both inpatient and community settings. Redesign activity is underway within the Mental Health Crisis Service and reviews of the Primary Care Mental Health and Learning Disability nursing teams will be progressed. Existing ward configurations within Elderly Mental Health and Low Secure Forensic services are also being reviewed Reviews of Community Children s and District Nursing services have also commenced and the workforce implications of these reviews will be progressed, in partnership with staff and their representatives Other Therapeutic Over the last two years the Pharmacy Prescribing & Support Unit (PPSU) has completed a wide-ranging modernisation of its service. In Acute and Mental Health Services this modernisation has been designed to release pharmacy staff to patient-focused duties. This was facilitated by the introduction of largescale robotics and information technology to create a single-point of distribution for medicines within the Board. Across Community Health Partnerships, PPSU has supported the development of Prescribing Support Teams, which are delivering cost-efficiencies and improved quality of prescribing practice. These changes in practice have been underpinned by ongoing skill-mix review for all groups of staff. This work will continue and it is anticipated further efficiencies will be secured within the Pharmacist workforce. NHS Greater Glasgow and Clyde Page - 32

33 Senior Managers A target of 25% reduction in senior managers was set by the Scottish Government in 2010 for completion in NHSGGC is on target to achieve this reduction in line with the SGHD directive Support Services There are a number of redesigns underway within the Facilities Directorate including a review of CSSD (Central Sterile Service Department). A service redesign within sewing rooms and the laundry areas will contribute to the support services workforce reduction.. As part of the Acute Services Review the number of sites and consequently the size of the NHSGGC estate will reduce Within the Estates function a working group has been established to review future skill needs of the Estates workforce. The aim is to create new flexible education and training pathways which will support the development of existing and new staff Personal & Social Care NHSGGC recognises that it is essential to have a health improvement workforce that is fit for purpose and that can respond to the challenges of improving health and reducing inequalities in health The main outputs and recommendations from the Health Improvement Workforce Plan are available and are currently in the process of being communicated at a variety of meetings, groups and forums The NHSGGC Health Improvement workforce is primarily employed by individual CH(C)Ps and it will be their responsibility to implement the recommendations contained within the plan depending upon local requirements NHSGGC is committed to supporting staff affected by organisational change through the application of the principles and processes set out in the Workforce Change policy. This support takes the form of redeployment into suitable vacancies and where appropriate retraining and upskilling. Every effort is made to ensure the continued employment of staff ensuring where possible, that employee skills and experience are retained for the benefit of the organisation. A joint working group has been established to review the current workforce change policy. NHS Greater Glasgow and Clyde Page - 33

34 Section 4 The NHSGGC Workforce The New South Glasgow Hospitals Campus NHS Greater Glasgow and Clyde Page - 34

35 4.1 Characteristics of the NHSGGC Current Workforce On 31 March 2012, NHSGGC employed 38,834 permanent staff, 33,352.4 WTE. NHSGGC has a predominantly female workforce, with 79% of the workforce being female. NHSGGC All Staff In Post as at 31st March 2012 (Headcount & WTE) Gender Profile (All Staff by Headcount) Female 79% Male 21% Headcount WTE The split between female and male does vary between Job Families. The table below provides detailed figures. Job Family Gender Split Female Male Administrative Services 84% 16% Allied Health Profession 87% 13% Executive 55% 45% Healthcare Sciences 62% 38% Medical and Dental 48% 52% Medical and Dental Support 94% 6% Nursing and Midwifery 87% 13% Other Therapeutic 80% 20% Personal and Social Care 80% 20% Support Services 50% 50% A summary of the make-up of the NHSGGC workforce by Job Family is shown below: All NHSGGC Staff (Headcount by Job Family) 0 2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 18,000 Adiminstrative (Clinical Support) Adiminstrative(Office Srvcs) Allied Health Profession Management (Non-AfC) Healthcare Sciences Medical and Dental Medical and Dental Support Nursing and Midwifery Other Therapeutic Personal and Social Care Support Services , ,658 3,045 1,896 3,754 4,633 4,934 16, The chart below shows the workforce by job families by pay groupings. Pay bands are grouped by Agenda for Change bands 1-4, 5-9 and non-agenda for Change bands such medical grades, senior managers (who retained existing pay arrangements) and other grades including staff TUPE d into NHSGGC. NHS Greater Glasgow and Clyde Page - 35

36 Administrative Services Allied Health Profession Staff In Post as at 31st March 2012 (Headcount by Job Family & Pay Band Descriptor) Executive Healthcare Sciences Medical and Dental Medical and Dental Support Nursing and Midwifery Other Therapeutic Personal and Social Care Non AfC (Medical/Dental/Snr Manager/Non Exec Board Members) Support Services 4.2 The NHSGGC Workforce characteristics have been analysed by job family and are shown in the section below by headcount and age profile. This, and other demographic data is used to analyse individual workforces as part of the service and workforce redesign process. 4.3 Medical and Dental Staff On 31st March 2012 the NHSGGC medical and dental workforce comprised approximately 1400 headcount consultant staff supported by 602 other career grades. Trainee medical and dental staff account for 1752 headcount. Although medical and dental staff in training are employed by NHSGGC, funding for these posts is provided by NHS Education for Scotland. These training posts are rotational and are therefore removed when calculating Board turnover figures Medical & Dental Staff (Headcount by Grade) Consultant Other Medical Grades Training Grades NHSGGC All Medical & Dental (exc. Training Grades) Age Profile (Headcount) Nursing and Midwifery The nursing and midwifery workforce is the largest job family within NHSGGC comprising 44.5% of the workforce. The majority of the nursing and midwifery workforce are employed in posts at pay bands 5 and 6 and 7 although there are also significant numbers of staff within pay bands 2 and 3. NHSGGC Nursing & Midwifery (Headcount by Pay Band) 900 NHSGGC Nursing & Midwifery Age Profile (Headcount) Non AfC (Prison Service TUPE) A 8B 8C 8D NHS Greater Glasgow and Clyde Page - 36

37 4.5 Allied Health Professions NHSGGC s allied health professions workforce is concentrated across the 5, 6 and 7 pay bands and exhibits a younger age profile than other job families NHSGGC Allied Health Professions (Headcount by Pay Band) 140 NHSGGC Allied Health Professions Age Profile (Headcount) Non AfC A 8B 8C 20 (Prison Service 0 TUPE) Healthcare Science Staff Healthcare sciences is predominantly comprised of AfC bands 6 and 7. This workforce also contains a higher proportion of staff at bands 8A and above in comparison to the overall NHSGGC average due to the career structure within the healthcare science disciplines. The healthcare science age profile is distinctive in that it exhibits a double-peak with a large number of staff in their late 20s and early 30s and the other peak being in the late 40s through to late 50s. NHSGGC Healthcare Sciences (Headcount by Pay Band) 80 NHSGGC Healthcare Sciences Age Profile (Headcount) Non AfC A 8B 8C 8D Administrative Support Staff NHSGGC s administrative support workforce is concentrated across AfC pay bands 2 to 4. that the administrative support job family encompasses a wide range of duties including many where administrative staff are directly involved in supporting clinical staff. 72% of the administrative workforce is directly involved in providing direct support to clinicians. The administrative workforce exhibits an older age profile with over 70% of the workforce aged over 40. NHSGGC Administrative Support (Headcount by Pay Band) 300 NHSGGC Administrative Support Age Profile (Headcount) Non AfC A 8B 8C 8D Support Services Staff Support Services consists primarily of catering, domestic, estates (including skilled trades), portering, transport and sterile services. The majority of staff are employed at band 2. As with our administration staff, support services exhibits an older age profile with over 75% aged 40 or above. NHS Greater Glasgow and Clyde Page - 37

38 NHSGGC Support Services (Headcount by Pay Band) 250 NHSGGC Support Services Age Profile (Headcount) Non AfC A 8B Other Therapeutic Staff The Other Therapeutic Staff Group is made up largely of psychology and pharmacy staff. This workforce has an even distribution across bands 5-7. There are also a large number of staff employed across bands 8A-8D. The age profile suggests a younger workforce with over 56% of the workforce aged under Non AfC NHSGGC Other Therapeutic (Headcount by Pay Band) A 8B 8C 8D Personal and Social Care Staff 5 NHSGGC Other Therapeutic Age Profile (Headcount) Personal and Social Care comprises health improvement and spiritual care staff. It is a relatively small workforce at 336 headcount mainly employed across bands 5-7. The age profile shows a relatively even distribution NHSGGC Personal & Social Care (Headcount by Pay Band) A 8B 8C 8D NHSGGC Personal and Social Care Age Profile (Headcount) Management Grades (Non Agenda for Change) Some management posts are not covered under the Agenda for Change terms and conditions and as such only an age profile is shown. 68% of this workforce are aged over 40. NHSGGC Management Non AfC Age Profile (Headcount) NHS Greater Glasgow and Clyde Page - 38

39 4.12 Turnover Turnover within NHSGGC for 2011/12 was 6.6%. This is up slightly on 2010/11 which was 6.5%. A turnover level of 6.6% for the Board results in around 2200 WTE of leavers. Turnover does vary between job families, with the highest turnover within Other Therapeutic at 10.67% - if the two smaller Job Families (Personal and Social Care and Management-non AfC) are excluded - where the percentages are exacerbated by their size. The lowest is within Medical and Dental at 4.3%. A table summarising turnover in 2011/12 is shown below. Leavers/Turnover April 2011 to March 2012 (exc. Doctors in training) Job Family WTE % Turnover Adiminstrative & Clerical - Support to Clinical Staff % Adiminstrative & Clerical - Office Services % Allied Health Profession % Management (Non-AfC) % Healthcare Sciences % Medical and Dental % Medical and Dental Support % Nursing and Midwifery % Other Therapeutic % Personal and Social Care % Support Services % Total % NHS Greater Glasgow and Clyde Page - 39

40 Section 5 Supplying the Required Workforce NHS Greater Glasgow and Clyde Page - 40

41 5.1 NHSGGC s Local Labour Market Within the NHSGGC geographical area unemployment has begun to decrease over recent months but remains volatile as the economic recovery continues Glasgow, which accounts for the majority of the Board s population, has had the highest unemployment rate of all local authorities within Scotland from 2003 up to Four out of the six local authority areas covered by NHSGGC are below the Scottish average employment rate Although recruitment generally, is not difficult in the current economic environment NHSGGC still experiences some challenges when seeking to fill vacancies. The location of posts, the level of experience, specialist skills required and the nature of the contract or working pattern all impact on the ability to fill a vacancy Other factors which impact on the Board s ability to recruit are: Location: The NHSGGC Board area includes a mix of urban and rural population centres and the requirement to travel significant distances can lead to a limited candidate pool; Candidate availability: Certain skill sets are in high demand by both private and public sector. In the case of Sonographers, a long standing problem with recruitment was addressed by providing inhouse training to develop an in-house workforce. This approach was also used in Laboratory sciences, Ophthalmology, Audiology and Medical Physics; Contract Type: Flexible posts which require less than 16 hours can be challenging to fill When areas of difficulty are identified by services, HR and Recruitment work with them to identify solutions and approaches which will alleviate recruitment difficulties. 5.2 NHSGGC Socially Responsible Recruitment In NHSGGC the importance of employment in helping to tackle poverty and income inequality is well recognised and this link is articulated in the policy framework outcomes for This policy commitment recognises the link between worklessness and ill health which has been evidenced through research and which is set out in NHSGGC s policy paper on Employability, Financial Inclusion and Responding to the recession Definition of Employability: Enabling people to progress towards employment, get into employment, stay in employment and move on in the workplace There is also a strong evidence base showing that work is generally good for physical and mental health and well-being. Worklessness is associated with poorer physical and mental health and well-being. Work can be therapeutic 14 Scottish Government Definition NHS Greater Glasgow and Clyde Page - 41

42 and can reverse the adverse health effects of unemployment and is generally good for health and well being NHSGGC employs 1,215 (1,053.5 WTE) in the age group. This represents 3.2% of the total workforce. The majority of young employees, 1,166 ( WTE), are within the age group with 49 (28.8 WTE) aged Approximately 63% of the employees are employed in job roles requiring post school qualification and experience. The actual number of jobs open to young people in the NHS without a substantial period of post school education is limited In this context, NHSGGC is committed to providing access to work experience and training for young people, particularly those young people who face barriers and challenges in finding employment and may require additional support to prepare them for employment. This work experience and training is relevant to jobs within the NHS and the wider economy. 5.3 Community Benefits Programmes As part of the new South Glasgow Hospital build, the Board has worked with Brookfield Multiplex to maximise employment opportunities for local people and support new entrants get into the construction industry. So far, 285 posts have been filled and 82 of these posts have gone to year olds, 185 are new entrants into the construction industry and 47 are apprenticeships. The project aims to provide 88 apprenticeships in total. 5.4 Schools Engagement and Work Experience Programmes The schools engagement programme and school work experience placements are core activities which inform important career related choices for school aged pupils while introducing the world of work. We currently offer approximately 300 school work experience places per year. 5.5 Partnership Programmes The Employment Partnership Programme in the City CHP (North East Sector) is an exemplar of a partnership arrangement between NHSGGC and a college partner (John Wheatley College) which offers young people an opportunity to gain work experience within the community health services while engaging in a formal course of study at the college. The College has provision for engaging those sitting lowest on the employability ladder and therefore furthest from the labour market e.g. using Skills for Work SVQ as a starting point for upskilling and movement towards longer term employment Pre-employment training initiatives such NHS Works have been very successful in previous years but the current economic climate and workforce environment have resulted in a significant decrease in the number of job vacancies available for pre-employment training schemes. As a result, 50% of NHS Works trainees successful in gaining employment have taken up non- NHSGGC posts. While the programme was originally designed to recruit NHS staff any job outcome supported by NHSGGC pre-employment training is deemed to be a positive outcome and demonstrative of the Boards commitment to the agenda. This highlights the important role that NHSGGC based training and work experience, delivered in partnership with local NHS Greater Glasgow and Clyde Page - 42

43 employability agencies, can play in securing employment with other employers at a time when our vacancies are constrained. 5.6 Modern Apprenticeships Since December 2009, 10 apprentices have completed a Level 2 Business & Administration programme in Health Records and are now employed in substantive posts while another three apprentices are in the final stages of a Level 3 Life Sciences programme within Diagnostics. These programmes were tailored for those with relatively high academic attainment and an ability to make an easy transition into the workplace. The Scottish Government have committed to a record number of 25,000 modern apprenticeship places in each year of the current administration and at the recent National Economic Forum highlighted the crucial role of work experience and modern apprenticeships in tackling youth unemployment. 5.7 Educational Placements In addition to all of the above activity NHSGGC provides clinical placements for students from local higher education and further education establishments to support achievement of professional qualifications. We are also providing work experience to newly qualified nursing graduates through the intern/oneyear job guarantee scheme and have appointed 304 to date. The one-year job guarantee scheme is a national scheme which was agreed by the SGHD in full partnership with staff side. Its purpose is to enable newly qualified nursing staff, who have not yet secured permanent employment, to consolidate their training and skills. The nurses are deployed as registered practitioners but are over and above the funded establishment and are not used as cover for permanent vacancies. The posts are also rotational to maximise the experience for the interns. On completion of the year s internship the nurses can apply for any available vacancies but NHSGGC is not expected to offer them permanent employment in the Board It is evident that there is a wide range of valuable activity underway within NHSGGC which supports young people towards employment ranging from capacity building to transitions into NHSGGC jobs although there is the potential to increase this particularly by creating modern apprenticeship opportunities In this time of economic and financial difficulty in the economy as a whole, and subsequently the public sector, there is a significant risk that young people will be particularly disadvantaged in securing employment. As a major employer in the west of Scotland NHSGGC has made a policy commitment to employability and will be expected to support the Scottish Government Youth Strategy with an effective package of support for unemployed young people In recognition of the above factors NHSGGC has developed a new programme of activities in support of youth employment and this includes: The establishment of 50 new Modern Apprenticeships in 2012/13 in NHSGGC; New Programmes for pre-employment training and work experience (Work Tasters, Get Read for Work, Training for Work) to support young people into jobs within other employers; NHS Greater Glasgow and Clyde Page - 43

44 A programme of support activities aimed at vulnerable young people who have barriers to employment and are furthest from the labour market. 5.8 Learning & Education for the NHSGGC Workforce In NHSGGC we are committed to ensuring that all our employees have access to training, learning and educational opportunities which will help them do their jobs, keep up to date with changing skill needs and new technology and develop new skills and competences which will enable them to move on in their careers if they wish Learning and education advisers are located in all services and in addition to the specialist advice they can offer, many staff and managers also deliver training, education and development as part of their role. Some training is delivered by the Practice Development Teams and Practice Education Facilitators across NHSGGC and others by functional experts working in areas such as Health and Safety and Infection Control In respect of individual employees we support individual and team learning needs including: induction for new staff- we see induction not as an event, but as a process that starts before the staff member takes up post and continues after he or she moves into the service setting; each new staff member will have an induction programme tailored specifically to his or her needs; the statutory and mandatory training appropriate to job roles; formal education leading to academic credit and SVQs; clinical skills training for all professions in clinical areas; role development new and changing services mean new and changing roles for staff, and we will support role changes with the right education; service-user safety and managing risk we offer learning and education to help provide services that are safe and sound; promoting equality and diversity activity aimed at ensuring highquality services are provided for all; encouraging integrated working supporting the development of new teams and new ways of working; management and leadership developing potential in this key area of service Some of this learning and education activity is provided in-house, but NHSGGC also works with universities, colleges and external agencies to provide the widest options for employees In addition, we continue to maintain and develop working relationships with our social work partners to deliver joint training and learning and education initiatives NHSGGC s most important commitment is ensuring that every employee has a Personal Development Plan which looks at current and future development needs. For staff on AfC terms and conditions of service this PDP is linked to NHS Greater Glasgow and Clyde Page - 44

45 the Knowledge and Skills Framework and is recorded on e-ksf, the electronic monitoring system which all Scottish Boards use In NHSGGC as at April % of staff on AfC had an up to date Personal Development Review recorded on e-ksf. The Board is dedicated to improving this position month-on-month To support the fulfilment of KSF Personal Development Plans, employees have access to a wide range of learning and education resources including: the NHSGGC SVQ Centre which can provide advice and support in identifying an appropriate SVQ for services and employees; open learning sites there are a number of these across the service where employees can access learning materials; e-learning employees can access online learning material direct from their work computer at a time of their choosing. Employees can also use the NHS Scotland e-library, which provides access to thousands of learning and education sources; bursaries these are awarded every year to selected staff who want to take an education course linked to their work All learning and education opportunities and information can be accessed through the learning and education pages on staff net. Because NHSGGC believes that access to learning and education is critical to the provision of high quality services, it has made an explicit commitment to: ensuring equal access to learning and education opportunities for all, regardless of staff grade, gender, race, creed, age and sexual orientation; promoting learning methods that reflect different learning styles; fitting in with staff availability; supporting difference groups of staff to learn together; providing high-quality learning and teaching facilities; making best use of the skills, knowledge and talents of all staff. 5.9 The NHSGGC Education Partnership In the past three years NHSGGC has been working to strengthen its relationship with local universities and further education colleges through the NHSGGC Education Partnership. The Partnership was created with the aim of maximising access to education and training for all employees through the development of more flexible educational pathways which would also meet the skill needs of NHSGGC. NHS Greater Glasgow and Clyde Page - 45

46 5.9.2 NHSGGC is committed to ensuring that, where possible, all internal education and training available to NHSGGC employees leads to a recognised qualification within the Scottish Credit and Qualifications Framework Through the work of the Education Partnership, a new qualification has recently been validated the HNC/HND in Care and Administrative Practice. This transferable and flexible qualification which articulates with related degrees from local universities, is recognised as the appropriate qualification for Health Care Support Workers (clinical and non-clinical) operating at Level 3 and Level 4 of the NHS Career Framework. The qualification has been designed around a series of core modules followed by a choice of clinical and non-clinical options which can be selected depending on job roles and responsibilities The NHSGGC Education Partnership is currently working on new projects for 2012/13 notably: The development of new educational pathways and qualifications for Estates and Facilities Staff at the new Southern General Hospital; A range of multi-agency projects aimed at helping young people to access education, work experience and training in the NHS FE sector. NHS Greater Glasgow and Clyde Page - 46

47 Section 6 Implementation, Monitoring & Review NHS Greater Glasgow and Clyde Page - 47

48 6.1 Workforce Plan Governance & Monitoring Monitoring of progress with the actions and intentions set out in the 2012/13 Workforce Plan will be carried out within the governance framework described in Section 1, paragraph 1.5 of this document The Workforce Plan will be published on the NHSGGC website after it has been approved by the Staff Governance Committee The NHSGGC Area Partnership Forum and the Corporate Management Team receive monitoring reports on the implementation of the Workforce Plan at their regular meetings At local level the initiation and implementation of service plans and redesigns and the consequent workforce implications are also closely monitored and progress reported to local management and partnership groups as appropriate It should be recognised by all stakeholders that the redesign and service change plans set out in this Workforce Plan are at varying stages of development and implementation. In addition a number of the projects are still the subject of continuing discussion with Staff Side and therefore outcomes may change as consultations are completed. This flexibility is reflected in the narrative of the plan. Some of these plans will change in response to external influences and events and this may affect projected workforce change The achievement and implementation of specific actions within the 2012/13 Workforce Plan (paragraph 1.16, Section 1) will be reported with the 2013/14 plan using the template at Appendix 1 of this document NHS Greater Glasgow and Clyde Page - 48

49 Appendix 1: 2011/12 Workforce Plan Update 2011/12 Objective 2011/12 Outputs Progress against projections Accelerated Acute Services Review Reshaping Medical Workforce The workforce projection for 2011/12 was a reduction of 862 WTE spread across a number of job families. The actual reduction was 984 WTE. The projected reduction in Nursing and Midwifery was 402 WTE and the actual reduction 305 WTE. The projected reduction for Administrative Staff was WTE and the actual reduction was WTE The Accelerated Acute Services Review made good progress in 2011/12. The implementation of the required bed model for the opening of the new hospitals was continued and the new laboratory on the South Glasgow site opened in March, Investment was also agreed for the University Tower laboratories development at Glasgow Royal Infirmary and building work commenced late The laboratory strategy delivers a hub and spoke style of service delivery where there will be 2 large laboratories one at the New South Glasgow Hospital, and the other at Glasgow Royal Infirmary with smaller laboratories providing emergency cover and immediate results at each of the primary acute hospitals. Building work continued on the new Adult and Children s Hospitals due for completion CEL28 (2009) required all NHS Scotland Boards to make workforce planning assumptions of reductions of 40% in the middle grade medical workforce and of 25% in junior grade medical staff (although it was recognised that final number would vary depending on specialty) NHSGGC continues to review the requirement for Medical and Dental staff in line with CEL28. KSF & PDP NHSGGC achieved the KSF HEAT target on 31 st March % of staff had a Personal Development Plan recorded on the eksf system. Since then the focus has been on maintaining the momentum and the mainstreaming of KSF to achieve maximum benefit from the investment in KSF. Service redesign through skill-mix changes In February 2012 the Acute Skill Mix Project Evaluation was published. The outcomes were broadly positive and will be taken into account when skill mix changes are being considered as part of service redesign in NHSGGC. A rolling programme of training and education for existing clinical health care support workers at level 2/3 is now being planned in response to the evaluation report. NHS Greater Glasgow and Clyde Page - 49

50 Senior Manager Review Administrative Staff Review Redesign of AHP services A target of 25% reduction in Senior Managers was set by the Scottish Government in 2010 for completion in NHSGGC had 262 WTE staff on Senior Management Grades in posts as at 2010 and reduced this by 18 WTE during 2010/11 and 15 WTE during 2011/12. Administrative support continues to be reviewed in line with the Board s commitment to reduce administrative and secretarial support to senior managers by 33%. The Board will continue to implement new mobile technologies and will ensure that non patient facing administrative services are constantly under review for efficiency savings. During 2011 the APF sponsored the AHP Steering Group as a Partnership Group. The Group had a coordinating role to oversee the work of the various profession specific strands and was populated by relevant professional staff, general managers and trade union / professional bodies as agreed by the APF. There were four strands of work: Dietetics, community based across Board area MSK Physiotherapy, across both Acute and Community Services Podiatry, across both Acute and Community Services Speech and Language Therapy, Specialist Children Services The outcomes of these strands (Speech & Language Therapy, Dietetics, MSK-Physiotherapy and Podiatry) were implemented during 2011 through the implementation of a consistent management model. The structure within each Profession provides for an overall service manager, service managers and team leaders Mental Health Services Reconfiguration In April 2011 the Mental Health Partnership functions were incorporated into the wider NHSGGC organisational structure following the review of services which arose from the introduction of the new Glasgow CHP. Individual CH(C)Ps assumed responsibility for the delivery of Adult In-Patient Mental Health Services for their respective areas. Processes have been established to ensure full engagement of staff partnership forums in the development and implementation of any proposed changes and a range of mechanisms are in place to capture and monitor the combined and cumulative impact of service changes to ensure an effective NHS Greater Glasgow and Clyde Page - 50

51 matching between staff available and service redesign proposals. Implementation of new CHP Glasgow City structure Prison Healthcare Staff The new Glasgow City Community Health Partnership (CHP) came into being in November 2010 replacing the previous structure of 5 separate city CH(C)Ps. The new single CHP for Glasgow is responsible for the provision of primary care and community services to the people of the city. On 1 st November 2011 the responsibility for prison healthcare services transferred from the Scottish Prison Service (SPS) to the National Health Service in NHSGGC. There are currently three prisons within the NHSGGC geographical area (HMP Barlinnie and HMP Greenock and a third new build prison near Bishopbriggs, HMP Low Moss, which opened in March Currently the directly employed staffing complement for the existing prisons within NHSGGC boundaries is approximately 64.5 wte staff. This staff group comprises mainly nursing and administrative staff. Prison Care staff in post at Barlinnie and Greenock Prisons transferred to the NHS under statutory TUPE/COSOP arrangements as at 31 st October 2011 Review of supplementary staffing costs During 2011/12 there has been a reduction in agency staff spend. This reduction has also been noted in Bank/Overtime/Excess changes NHS Greater Glasgow and Clyde Page - 51

52 Appendix 2: 2011/12 Workforce Change Summary Table Staff in post by Job Family movement from 2011/12 As at 31st March 2012 Job Family Headcount WTE % Of WTE 2011/12 WTE March 2011 wte Workforce Variance Adiminstrative & Clerical - Support to Clinical Staff 4, % Adiminstrative & Clerical - Office Services 1, % Allied Health Profession 3, % Management (Non-AfC) % Healthcare Sciences 1, % Medical and Dental 3, % Medical and Dental Support % Nursing and Midwifery 16, % Other Therapeutic 1, % Personal and Social Care % Support Services 4, % Total NHS Greater Glasgow and Clyde Page - 52

53 Appendix 3: The 6 Steps Methodology The 6 Steps Methodology sets out a consistent, practical framework that outlines the elements that should be contained in workforce plans whether they be at departmental, service or Board level. The format of the guidance reflects the 6 Step Methodology to Integrated Workforce Planning and contains workforce planning checklists at each step of the process and sign-posts to other data and information sources that will be of particular help in ensuring that workforce plans are evidence based. Step 1 - Defining the Plan Is the first step in any planning process and outlines why a workforce plan is necessary and how it will support the achievement of wider corporate goals and objectives. The purpose, scope and ownership of the workforce plan is made explicitly clear within this section. Step 2 - Service Change NHS Greater Glasgow and Clyde Page - 53