WORKFORCE REVIEW OF CHILDREN AND FAMILY HEALTH SURREY. Appendix 1

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1 WORKFORCE REVIEW OF CHILDREN AND FAMILY HEALTH SURREY Appendix 1 This appendix outlines the services that we ARE consulting with, because there are proposed changes to their current service structure - although this may not affect every job role in that structure. a s (Health Visitors and School Nurses) b. Therapies (OT, Speech & Language, Physio and Dietetics) c. Administration d. Immunisations In the tables overleaf, we have used the notation, which means Whole Time Equivalent. This is a way of representing the hours available in a decimal format. A of 1.00 means that there is one whole time vacancy available of 37.5 hours. Similarly, a of 0.80 means the hours available are 0.80 x 37.5 = 30 hours, and so on. If this causes readers any confusion, please speak with your Clinical Services Manager about this. Page 1 of 48

2 1a 0 to 19 services appendix This service is managed by four quadrant-based Clinical Service Managers; Julie Dalton (North West), Caroline Hornby (NE), Karen Moore (SW) and Anita Lamb (SE) services across Surrey are best described by sub-dividing into their two constituent parts of Health Visiting (1a (i)) and School Nursing (1a(ii)), and then further sub-dividing by quadrant. The information contained within this appendix was correct at 19 February Page 2 of 48

3 1a (i) Health Visiting service structure North West quadrant Base Role Band Runnymede Borough (based at Egham Health Centre and Addlestone Surgery) Clinical Team Lead Health Visitor Practice Teacher / Health Visitor Headcount Health Visitor Community Nursery Nurse Vacancies () (2.60) Surrey Heath Borough (based in Camberley Berkshire Road) Clinical Team Lead Health Visitor Practice Teacher / Health Visitor Health Visitor Community Nursery Nurse (1.78) Woking Borough (based at Goldsworth Park Health Centre) Woking Borough (based at West Byfleet Health Centre) Clinical Team Lead Health Visitor Health Visitor Community Nursery Nurse Clinical Team Lead Health Visitor Health Visitor Community Nursery Nurse Asian Link Family Health Worker (3.93) (0.60) (1.60) Totals Page 3 of 48

4 North East quadrant Base Role Band Epsom / Ewell Borough (based at Epsom Clinic) Elmbridge Borough (based at Molesey Clinic) Elmbridge Borough (based at Walton Health Centre Spelthorne Borough (based at Ashford Clinic and Sunbury Health Centre Clinical Specialist / Practice Teacher Headcount Practice Teacher Health Visitor Community Nursery Nurse Clinical Practitioner Health Visitor Community Nursery Nurse Clinical Lead Professional Practice Teacher Health Visitor Community Nursery Nurse Clinical Team Lead Health Visitor Community Nursery Nurse Vacancies () (1.00) (3.00) (1.00) (1.00) (1.60) (1.00) (5.60) (1.00) (5.00) Totals South West quadrant Base Role Band Guildford Borough (based at Jarvis Centre) Waverley Borough (based at Milford Hospital) Guildford Borough (based at Villages Headcount Clinical Lead Health Visitor Community Nursery Nurse Vacancies () Clinical Lead (1.00) Health Visitor (1.79) Community Nursery Nurse Health Visitor Community Nursery Nurse (0.60) Page 4 of 48

5 Send) Waverley Borough (based at Cranleigh Medical Practice) Waverley Borough (based at Farnham Hospital) Guildford Borough (based at Ash Vale Health Centre) Health Visitor Community Nursery Nurse Clinical Lead Health Visitor Specialist (Infant-feeding) Health Visitor Professional Lead Health Visitor Health Visitor Health Visitor Community Nursery Nurse (1.20) Totals South East quadrant Base Role Band Mole Valley Borough (based at Leatherhead Clinic and Medwyn Health Centre) Reigate and Banstead Borough (based at Tattenham Health Centre) Clinical Specialist / Professional Practice Teacher Clinical Practitioner * Professional Practice Teacher Health Visitor Community Nursery Nurse Health Visitor Community Nursery Nurse Headcount Vacancies () *(postholder counted in another service) Totals Page 5 of 48

6 1a (ii) School Nursing service structure North West quadrant Base Role Band Runnymede Borough (based at Egham Health Centre) Surrey Heath Borough (based at Camberley Health Centre) Woking Borough (based at Woking Community Hospital) Headcount School Nurse Staff Nurse Community Nursery Nurse School Nurse / Practice Teacher / Team Lead School Nurse Staff Nurse Community Nursery Nurse School Nurse Staff Nurse Community Nursery Nurse Vacancies () (0.40) (0.64) Totals North East quadrant Base Role Band Epsom and Ewell Borough and Tattenham part of Reigate and Tattenham Borough (based at Epsom Clinic) Elmbridge Borough (based at Molesey Clinic) Spelthorne Borough based at Ashford Clinic Headcount Clinical Specialist Professional Practice Teacher School Nurse / Professional Practice Teacher School Nurse / Mentor Staff Nurse Vacancies () (1.04) Clinical Health Assistant Clinical Specialist Professional Practice Teacher School Nurse Staff Nurse Clinical Health Assistant Clinical Lead School Nurse Staff Nurse Community Health Page 6 of 48

7 Assistant (2.15) Totals South West quadrant Base Role Band Guildford Borough (based at Jarvis Centre) Waverley Borough (based at Farnham Hospital) Headcount Clinical Lead / Specialist Practitioner School Nursing Specialist Practitioner School Nurse Community Staff Nurse Community Nursery Nurse Specialist Practitioner School Nurse Community Staff Nurse Community Nursery Nurse Vacancies () (1.00) Totals South East quadrant Base Role Band Mole Valley Borough (based at Leatherhead Clinic and Medwyn Health Centre Clinical Specialist Professional Practice Teacher Headcount School Nurse Staff Nurse Clinical Health Assistant Vacancies () (0.52) (1.00) Totals Page 7 of 48

8 1a (iii) Reasons why we need to change this The reasons for change within the 0 to 19 Service are as follows: The proposed 0 to 19 structure for the CFHS partnership presents a requirement to streamline the current posts that have come together to form the partnership of CFHS and align the clinical teams with the new workforce model. The proposed structure enables clear lines of accountability and responsibility to be held at each level, to ensure clinically safe and effective service delivery to children and families across Surrey. Within the proposed future structure, there will be a 0 to 19 Clinical Team Leader for each borough in each quadrant. Within the proposed future structure, there will be a 0-19 Practice Teacher for each borough in each quadrant. This practice teacher may be either a health visitor or a school nurse practice teacher. The 0 to 19 Clinical Team Leaders within each quadrant will report to the 0 to 19 Clinical Service Manager for that quadrant. The 0 to 19 quadrant teams will include: Health Visitors, School Nurses, Staff Nurses, Nursery Nurses and School Health Assistants supported by specialist roles that work across Surrey. Under your contract of employment, you may be required or permitted to work at or from any of the Company s Establishments. Page 8 of 48

9 1a (iv) Proposed future service structure West Surrey Head of West Surrey North West Clinical Service Manager 0-19 South West Clinical Service Manager 0-19 West Infant Feeding Coordinator 0.8 Band 7 Runnymede Integrated Public Health Team Clinical Team Leader 1.0 Band 7 Practice Teacher 1.0 Band 7 Surrey Heath Integrated Public Health Team Clinical Team Leader 1.0 Band 7 Practice Teacher 1.0 Band 7 Woking Integrated Public Health Team Clinical Team Leader 1.0 Band 7 Practice Teacher 1.0 Band 7 Guildford Integrated Public health Team Clinical Team Leader 1.0 Band 7 Practice Teacher 1.0 Band 7 Waverley Integrated Public health Team Clinical Team Leader 1.0 Band 7 Practice Teacher 1.0 Band 7 Health Visitors 7.2 Band 6 Nursery Nurses 3.7 Band 4 School Nurse 1.0 Band 6 School Nurse 1.0 Band 5 School Health Assistants 0.8 Band 4 Health Visitors 7.5 Band 6 Nursery Nurses 3.7 Band 4 School Nurse 1.0 Band 6 School Nurse 1.0 Band 5 School Health Assistants 0.8 Band 4 Health Visitors 10.4 Band 6 Nursery Nurses 5.3 Band 4 School Nurse 1.0 Band 6 School Nurse 1.0 Band 5 School Health Assistants 0.9 Band 4 Health Visitors 12.2 Band 6 Nursery Nurses 6.2 Band 4 School Nurse 3.0 Band 6 Staff Nurse 2.0 Band 5 School Health Assistants 1.8 Band 4 Health Visitors Band 6 Nursery Nurses 5.2 Band 4 School Nurse 1.0 Band 6 Staff Nurse 1.0 Band 5 School Health Assistants 0.7 Band 4 Page 9 of 48

10 Team Structure North West Quadrant Borough Role Band Clinical Team Leader Practice Teacher Health Visitor Runnymede School Nurse Staff Nurse Community Nursery Nurse School Health Assistant Runnymede Total Surrey Heath Woking Clinical Team Leader Practice Teacher Health Visitor School Nurse Staff Nurse Community Nursery Nurse School Health Assistant Surrey Heath Total Clinical Team Leader Practice Teacher Health Visitor School Nurse Staff Nurse Community Nursery Nurse School Health Assistant Woking Total North West Quadrant total Page 10 of 48

11 South West Quadrant Borough Role Band Clinical Team Leader Practice Teacher Health Visitor Guildford School Nurse Staff Nurse Community Nursery Nurse School Health Assistant Guildford Total Waverley Clinical Team Leader Practice Teacher Health Visitor School Nurse Staff Nurse Community Nursery Nurse School Health Assistant Waverley Total South West Quadrant total Page 11 of 48

12 North East Surrey Interim Head of North East Surrey North East Clinical Service Manager 0-19 FNP Supervisor East Infant Feeding Coordinator 0.8 Band 7 FNP Nurses 4 Band 7 Admin 0.8 Band 4 Elmbridge Integrated Public Health Team Clinical Team Leader 1.0 Band 7 Practice Teacher 1.0 Band 7 Epsom Integrated Public Health Team Clinical Team Leader 1.0 Band 7 Practice Teacher 1.0 Band 7 Spelthorne Integrated Public Health Team Clinical Team Leader 1.0 Band 7 Practice Teacher 1.0 Band 7 Health Visitors 14.5 Band 6 Nursery Nurses 7.3 Band 4 School Nurse 2.0 Band 6 School Nurse 1.0 Band 5 School Health Assistants 0.8 Band 4 Health Visitors 7.3 Band 6 Nursery Nurses 3.7 Band 4 School Nurse 1.0 Band 6 School Nurse 1.0 Band 5 School Health Assistants 0.7 Band 4 Health Visitors 9.1 Band 6 Nursery Nurses 4.8 Band 4 School Nurse 2.0 Band 6 School Nurse 1.0 Band 5 School Health Assistants 1.0 Band 4 Page 12 of 48

13 North East Quadrant Borough Role Band Clinical Team Leader Practice Teacher Health Visitor Spelthorne School Nurse Staff Nurse Community Nursery Nurse School Health Assistant Spelthorne Total Elmbridge Epsom Clinical Team Leader Practice Teacher Health Visitor School Nurse Staff Nurse Community Nursery Nurse School Health Assistant Elmbridge Total Clinical Team Leader Practice Teacher Health Visitor School Nurse Staff Nurse Community Nursery Nurse School Health Assistant Epsom Total North East Quadrant total Page 13 of 48

14 South East Surrey Interim Head of South East Surrey South East Clinical Service Manager 0-19 Mole Valley Integrated Public Health Team Clinical Team Leader 1.0 Band 7 Practice Teacher 1.0 Band 7 Reigate and Banstead Integrated Public Health Team Clinical Team Leader 1.0 Band 7 Practice Teacher Tandridge Integrated Public Health Team Clinical Team Leader 1.0 Band 7 Practice Teacher 1.0 Band 7 Health Visitors 6.9 Band 6 Nursery Nurses 3.3 Band 4 School Nurse 2.0 Band 6 School Nurse 1.0 Band 5 School Health Assistants 0.83 Band 4 Health Visitors 14 Band 6 Nursery Nurses 7.2 Band 4 School Nurse 2.0 Band 6 School Nurse 1.0 Band 5 School Health Assistants 0.83 Band 4 Health Visitors 7.21 Band 6 Nursery Nurses 3.6 Band 4 School Nurse 1.0 Band 6 School Nurse 1.0 Band 5 School Health Assistants 0.83 Band 4 In the South East quadrant, due to the contractual agreements between CSH and FCHC, the total staff numbers will be split accordingly with CSH having 43% of the workforce and FCHC having 57%. Because of the geography of the area, this means that CSH has the whole of the Mole Valley team and FCHC has the whole of the Tandridge team. The Reigate and Banstead team has been split to reflect the total quadrant share of the staffing, once these two teams have been excluded. Page 14 of 48

15 Borough Role Band Mole Valley CSH (84.3% of total contract) FCHC (15.7% of total contract) Clinical Team Leader N/A Practice Teacher N/A Health Visitor N/A School Nurse N/A Staff Nurse N/A Community Nursery Nurse N/A School Health Assistant N/A Mole Valley Total N/A Reigate and Banstead Tandridge Clinical Team Leader Practice Teacher Health Visitor School Nurse Staff Nurse Community Nursery Nurse School Health Assistant Reigate and Banstead Total Clinical Team Leader 7 N/A 1.00 Practice Teacher 7 N/A 1.00 Health Visitor 6 N/A 7.20 School Nurse 6 N/A 1.00 Staff Nurse 5 N/A 1.00 Community Nursery Nurse 4 N/A 3.60 School Health Assistant 4 N/A 0.83 Tandridge Total N/A South East Quadrant Total = Page 15 of 48

16 1a (iv) Post matching The table below indicates how the new posts align to existing posts. The definitive match indicates that the current post closely matches that of the post in the proposed future staffing structure. The potential eligible staff groups indicate further current posts that may be suitable for the post in the proposed future staffing structure. New Post Title Band Definitive Match Potential Eligible Staff Groups Clinical Team Lead, 0 to 19 Practice Teacher, 0 to 19 Infant Feeding Coordinator Homeless Health Lead 7 Clinical Team Leader Practice Teacher, Clinical Specialists Infant Feeding Coordinator Homeless Health Team Lead Health Visitor 6 Health Visitor School Nurse 6 School Nurse Staff Nurse 5 Nursery Nurse 4 School Health Assistant 4 Staff Nurse, school staff nurse Community Nursery Nurse, Clinical Health Assistants, School Health Advisors School Health Assistant Professional Lead, Practice Teacher, Health Visitor, School Nurse, clinical specialist Clinical Team Leader, Health Visitor or School Nurse with Practice Teacher qualification Clinical Specialist, Clinical Team Leader, Practice Teacher, Health Visitor Professional Lead, Practice Teacher, Health Visitor, School Nurse (having undertaken the additional field of practice) School Nurse (having undertaken the additional field of practice) Health Visitor (having undertaken the additional field of practice) Registered Nurse NVQ3 (in child care) and above. NNEB, or any relevant qualification. NCMP Asian Link Worker Page 16 of 48

17 1b Therapies appendix This service is managed by four quadrant-based Clinical Service Managers; Shellan Majid (North West), Sarah Chidede (NE), Shirley Homan (SW) and Linda Smullen (SE). For ease of understanding, we have sub-divided therapy services in Children & Family Health Surrey under the following four headings; 1b (ii) 1b (iii) 1b (iv) 1b (v) Occupational Therapy (OT) Speech & Language Therapy (SLT) Physiotherapy (Physio) Dietetics To note, there are two contracts delivered by therapists in addition to the main CFHS contract. These are: An SLT contract with Guildford Schools Confederation in the South West Quadrant A Physio and Dietetics contract with Epsom & St Helier University Trust in the North East Quadrant. These additional contracts account for the extra provision required in these quadrants and is detailed in the proposed workforce model. To note, in the South East quadrant, due to the contractual agreements between CSH and FCHC, the total staff numbers will be split accordingly with CSH having 86% of the workforce and FCHC having 14%. The information contained within this appendix was correct at 19 February Page 17 of 48

18 1b (i) Reasons for change We have included the reasons for change at the start of this appendix, because they are the same for all four services; The proposed therapies structure for the CFHS partnership presents a requirement to streamline the current posts that have come together to form the partnership of CFHS and align the clinical team with the new workforce model. The proposed structure enables clear lines of accountability and responsibility to be held at each level, to ensure safe and effective service delivery across Surrey, for example there will be a Clinical Team Leader for each relevant therapy service in each quadrant. The proposed quadrant teams will include therapists who are able to deliver care for more specialist pathways. These pathways may be delivered across quadrants to gain optimum benefit from specialist skills. The proposed changes include a rationalisation of job descriptions and roles, to ensure equality of service delivery and sharing of specialisms across Surrey. Page 18 of 48

19 1b (ii) Occupational Therapy (OT) service structure Head of WestSurrey Head of NorthEast Surrey (Interim) NorthWest Surrey Clinical Service Manager Therapies South West Surrey Clinical Service Manager Therapies North East Surrey Clinical Service Manager Therapies North East Surrey Clinical Service Manager Therapies - Mid Surrey Occupational Therapists Therapy Occupational Therapists Therapy Occupational Therapists Therapy Occupational Therapists Therapy 1.4 Band Band band 5 03 Band Band Band Band band Band Band Band 3 1 Band Band band Band Band Band Band band Band Band 4 4 Page 19 of 48

20 Base Role Band Headcount Vacancies () North West Surrey Berkshire Road Clinic White House White House / Berkshire Road Clinic Mid Surrey Bourne Hall Health Centre Bourne Hall / Ashtead Clinic North East Surrey White House South West Surrey OT Team Leader Occupational therapist OT Assistant OT Clinical Specialist Specialist Occupational therapist Occupational Therapist OT Assistant OT Team Leader Occupational Therapist OT Assistant (0.80) (1.00) (0.80) (1.00) (2.00) Farnham Hospital Jarvis Centre OT Team Leader Specialist Occupational Therapist Occupational Therapist OT Assistant Occupational Therapist OT Assistant (0.10) (1.20) (0.36) Totals Page 20 of 48

21 Proposed future service structure Occupational Therapy For each quadrant Role OT Clinical Team Leaders (aiming for 1.0 per quadrant) Band per Quad rant Total across county CSH (84.36% ) FCHC (15.7%) OT Clinical Specialists Occupational Therapists OT Assistants Totals Page 21 of 48

22 1b (iii) Speech & Language Therapy service structure Head of WestSurrey Head of NorthEast Surrey (Interim) NorthWest Surrey Clinical Service Manager Therapies South West Surrey Clinical Service Manager Therapies North East Surrey Clinical Service Manager Therapies North East Surrey Clinical Service Manager Therapies - Mid Surrey Speech and Language Therapy Speech and Language Therapy Speech and Language Therapy Speech and Language Therapy 1.55 Band Band 6 3 band Band Band Band band Band Band Band 6 2 band Band Band 3 1 Band Band Band Band 4 Page 22 of 48

23 Base Role Band Headcount Vacancies () North West Surrey White House Chertsey Health Centre, Woking Community Hospital, White House and Goldsworth Park SLT Clinical Team Leader SLT (Dysphagia specialist) SLT White House Goldsworth Park & White House White Lodge Mid Surrey SLT Assistant CAS / MAP Coordinator Epsom Clinic Highly Specialist SLT Bourne Hall Specialist SLT Tattenham, Dorking, Molesey & Leatherhead Clinic Bourne Hall, Ashtead and Molesey Clinics North East Surrey White House SLT SLT Assistant SLT Clinical Team Leader SLT SLT Assistant (0.60) (1.00) (1.00) (2.60) (1.00) Page 23 of 48

24 Base Role Band Headcount Vacancies () South West Surrey Jarvis Centre Buryfields & Farnham Hospital Farnham Hospital SLT Clinical Team Leader Specialist SLT (0.20) (1.00) SLT (1.00) SLT Assistant Totals Proposed future service structure - Speech & Language Therapy For each quadrant Role SLT Clinical Team Leaders (aiming for 1.00 in each quadrant) Band per Quadr ant Total across county CSH 84.3% FCHC 15.7% SLT Clinical Specialists SLT Dysphagia Feeding Clinic (NW Quadrant only) n/a SLT (SW Quadrant only Guildford School Confederation contract) n/a Speech & Language Therapists SLT Assistants Totals Page 24 of 48

25 1b (iv) Physiotherapy service structure Head of WestSurrey Head of NorthEast Surrey (Interim) NorthWest Surrey Clinical Service Manager Therapies South West Surrey Clinical Service Manager Therapies North East Surrey Clinical Service Manager Therapies North East Surrey Clinical Service Manager Therapies -Mid Surrey Physiotherapy Physiotherapy Physiotherapy Physiotherapists 1.78 Band Band Band Band Band Band Band 7 2 Band Band Band Band Band 3 Page 25 of 48

26 Base Role Band Headcount Vacancies () North West Surrey Berkshire Road Clinic, Camberley Goldsworth Park, Woking Berkshire Road Clinic, Camberley and White House Berkshire Road Clinic, Camberley Mid Surrey Bourne Hall Clinic Epsom General Hospital and Woodlands School Epsom General Hospital, Bourne Hall Clinic and Woodlands School Epsom General Hospital North East Surrey White House Physio Clinical Team Leader Specialist Physiotherapist Physiotherapist Physio Assistant Specialist Physiotherapist Clinical Specialist Physiotherapist Physiotherapist Physio Assistant Physio Clinical Team Leader Physiotherapy Specialist Physiotherapist Physio Assistant (0.80) (0.40) (1.20) Page 26 of 48

27 Base Role Band South West Surrey Farnham Hospital Jarvis Centre, Guildford Jarvis Centre, Guildford & Farnham Hospital Physiotherapy Professional Lead Physio Clinical Team Leader Specialist Physiotherapist Headcount Physiotherapist Physio Assistant Vacancies () (0.60) (1.40) (0.36) Totals Proposed future service structure Physiotherapy For each quadrant: Role Band per Quadr ant Total across county CSH (84.3%) FCHC (15.7%) Physio Clinical Team (aiming for 1.00 per quadrant) Physio Clinical Specialist Physio Clinical Specialist (ESHUT contract in North East quadrant only) n/a Physiotherapists Physio Assistants Totals Page 27 of 48

28 1b (v) Dietetics service structure Head of NorthEast Surrey (Interim) North East Surrey Clinical Service Manager Therapies - Mid Surrey Dietetics 0.8 Band 7 1 Band Band 4 Base Role Band Mid Surrey Epsom Hospital Headcount Paediatric Dietician Clinical Team Lead Paediatric Dietician Clinical Team Lead (for ESHUT contract in the NE quadrant) Paediatric Dietician Dietician Assistant Vacancies () (0.40) (0.60) (0.60) Totals Proposed future service structure - Dietetics Role Band Paediatric Dietician Clinical Team Lead Paediatric Dietician Dietician Assistant Total 1.40 Please note, there are current discussions between Surrey Downs CCG and Guildford and Waverley CCG re: future dietetics services. In addition, Dietetics services provided through Epsom and St Helier University Hospital Trust also support the current provision. Page 28 of 48

29 1b (vi) Post matching The table below indicates how the new posts align to existing posts. The definitive match indicates that the current post closely matches that of the post in the proposed future workforce structure. The potential eligible staff groups indicate further current posts that may be suitable for the post in the proposed future workforce structure. New Post Title Band Definitive Match Clinical Team Lead OT / SLT / Physio Specialist OT / SLT / Physio Paediatric OT / SLT / Physio Paediatric OT / SLT / Physio OT / SLT / Physio Assistant OT / SLT / Physio Assistant Clinical Team Lead, Clinical Specialists in appropriate therapy Clinical Team Lead, Clinical Specialists in appropriate therapy Any Band 6 therapist in appropriate therapy Any Band 5 therapist in appropriate therapy OT / SLT / Physio Band 4 Therapy Assistant in appropriate therapy OT / SLT / Physio Therapy Assistant in appropriate therapy Potential Eligible Staff Groups Any OT / SLT / Physio Band 7 in appropriate therapy Any Band 6 therapist in appropriate therapy Page 29 of 48

30 1c Administration services This service is managed by Bev Blackman. For ease of understanding, we have organised the current workforce structure by geographical base in each quadrant. The information contained within this appendix was correct at 13 February Page 30 of 48

31 1c (i) service structure North West Quadrant Base Role Band Addlestone Health Centre Berkshire Road Clinic, Camberley Goldsworth Park Health Centre Grove Medical Centre, Egham Walton Health Centre West Byfleet Health Centre Weybridge Health Centre The White House, Addlestone Administrator Health Visiting Administrator Health Visiting Administrator Speech & Language Therapy Child Health Manager (West) Administrator Immunisations Administrator Health Visiting Child Health Administrator Administrator Health Visiting Administrator School Nursing Headcount Vacancies () (0.62) (1.00) (1.00) Administrator Administrator Health Visiting Administrator Health Visiting Administrator Therapies * *(postholder counted in another service) Administrator Therapies Administrator Speech & Language Therapy (0.73) Administrator Therapies White Lodge Administrator Therapies (0.49) Totals Page 31 of 48

32 North East Quadrant Base Role Band Ashford Clinic Epsom Clinic Ewell Court Clinic Molesey Clinic Shepperton Health Centre and Ashford Clinic Staines Health Centre Sunbury Health Centre and Ashford Clinic Headcount Safeguarding Administration team manager/ PA Director of Children Service Administrator Health Visiting Immunisation Administrator School Nurse Administrator Administrator Health Visiting Senior Administrator Administrator Child Health Office Manager Child Health Administrator Child Health Administrator Senior Administrator Administrator Administrator Health Visiting/ Clinic Coordinator Administrator Administrator/ Clinic Coordinator Vacancies () (1.60) Totals Page 32 of 48

33 South West Quadrant Base Role Band Ash Vale Health Centre Buryfield Clinic, Guildford Cranleigh Health Centre Farnham Hospital Jarvis Centre, Guildford Milford Hospital Villages GP Practice, Send Headcount Administrator Health Visiting Administrator Therapies Administrator Speech & Language Therapy Administrator Health Visiting Administrator Children s Continuing Healthcare Administrator Speech & Language Therapy Administrator Occupational Therapy Administrator Health Visiting Administrator Speech & Language Therapy PA to Lead for Specialist Services Secretary Administrator to Children s Community Nursing Receptionist / Office Assistant Administrator Therapies Administrator School Nursing Administrator Health Visiting Administrator Health Visiting Administrator Health Visiting Administrator Health visiting Vacancies () (0.64) Totals South East Quadrant Base Role Band Headcount Vacancies Page 33 of 48

34 Leatherhead Clinic Medwyn Hospital, Dorking St Johns Court, Redhill Tattenham Health Centre Senior Administrator Tribunal Administrator Administrator Administrator Child Health Manager (East & West) Children s Community Nurse Administrator Child Health Administrator Administrator () (1.00) Totals Page 34 of 48

35 1c (ii) Reasons why we need to change this Our proposal is to consider moving to quadrant based teams with leadership from a 'quadrant team leader' providing team support and direction. The manager of the team would then focus on the performance of the team as a Quadrant Admin team leader and provide professional support so our teams are safe and well supported. The CFHS administration service and Child Health Information service (CHIS) would be led by an Administration manager. The post-holder will have the following direct reports; the four Quadrant leads, the Community Children s Nursing senior administrator, the Children Continuing Healthcare team administrator and the CHIS office managers. The new structure would create a generic administrator role across different services which would be better able to meet clinical service needs. This would be achieved by the teams being based in hubs within quadrant bases. The teams could provide cross cover and standardise administration approaches and processes across the county. The new structure would provide create a clearer career path and meet development needs for administrators. We are proposing that there will be no PA (personal assistant) or dedicated clinic reception roles in the future workforce structure. We are proposing that Antenatal referrals will to be processed in both Child Health teams and triaged by the Health visitor team. We propose Immunisation admin support will sit with the Child Health Structure due to the wider data reporting and close relationship and delivery of both services. School nursing support will sit within the 0-19 Administration team. Page 35 of 48

36 Exclusions Administrators with 50% or less work in CFHS have not been included in the Administrator consultation. This is because the majority of their work sits in adult services. Safeguarding administrators will be included in the Safeguarding service consultation. Administrators providing support to the Safeguarding team due to the specific skills and resilience required with increased risk to vulnerable children. The administrators need supervision and support from the clinical team due to the emotional resilience required. Page 36 of 48

37 1c (iii) Proposed future service structure North West Quadrant Base Role Band Quadrant Administration team lead Central base in NW Quadrant Administrator for 0-19 to be agreed Administrator for Therapies Total 6.70 North East Quadrant Base Role Band Quadrant Administration team lead Central base in NE Quadrant Administrator for 0-19 to be agreed Administrator for Therapies South West Quadrant Total 7.00 Base Role Band Quadrant Administration team lead Central base in SW Quadrant Administrator for 0-19 to be agreed Administrator for Therapies Total 4.90 South East Quadrant Base Role Band Quadrant Administration team lead Central base in SE Quadrant Administrator for 0-19 to be agreed Administrator for Therapies Total 3.10 Page 37 of 48

38 Surrey Wide administration services Base Role Band Central county-wide base to CFHS Administration Manager and be agreed Child Health Information Manager Leatherhead Clinic PA to Director of Children & Family Health Services Children s Community Nursing and Children s Continuing Healthcare Workforce Structure Continuing Healthcare Team Administrator Base to be agreed Community Children s nursing team Administrator Community Children s nursing team Administrator Specialist School Nurses team Administrator Immunisation team Central base in the east of Administrator for Immunisations county Central base in the west of Administrator for Immunisations county Child Health Information System (CHIS) Workforce Structure Central base in the east of CHIS Office Manager county CHIS Administrators Central base in the west of CHIS Office Manager county CHIS Administrators Total Page 38 of 48

39 1c (iv) Organisation Charts Senior Administration Structure Head of Administration Podiatry and Wheelchairs Interim Head of South East Surrey CFHS Admin Manager and CHIS Manager Band 6 NW Quadrant Admin Lead Band 4 SW Quadrant Admin Lead Band 4 NE Quadrant Admin Lead Band 4 SE Quadrant Admin Lead Band 4 CHIS Office Manager East Band 5 CHIS Office Manager West Band 5 Children s Community nurses team administrator Band 4 Continuing Healthcare team administrator Band 4 Quadrant Leads Direct Management: Therapies and Universal (0-19) Structures NW Quadrant Lead Band 4 SW Quadrant Lead Band 4 NE Quadrant Lead Band 4 SE Quadrant Lead Band 4 NW Quadrant 0-19 admin support Band 3 Band 2 NW Quadrant Therapies support Band 2 SW Quadrant 0-19 admin support Band 3 Band 2 SW Quadrant Therapies support Band 2 NE Quadrant 0-19 admin support Band 3 Band 2 NE Quadrant Therapies support Band 2 SE Quadrant 0-19 admin support Band 3 Band 2 SE Quadrant Therapies support Band 2 Page 39 of 48

40 Child Health Information Service and Immunisation Structure Clinical Service Manager for Immunisations Head of Administration Podiatry and Wheelchairs Interim Head of South East Surrey CFHS Admin and CHIS manager Band 6 CHIS Office manager West Band 5 CHIS Office Manager East Band 5 West Imm admin Band 3 Band 2 CHIS administrators West team Band 2 East Imms admin Band 3 Band 2 CHIS administrators East team Band 2 Children s Community Nursing and Children s Continuing Healthcare Workforce Administration Structure Service Lead for Specialist CHIS Admin manager Quadrant lead line management to be agreed Children s Community Nursing Administrator Support Band 4 Continuing Healthcare Administrator Band 4 Children s Community Nursing Administrator Band 3 Specialist School Nurses Administrator Band 2 Page 40 of 48

41 1c (v) Post matching The table below indicates how the new posts align to existing posts. The definitive match indicates that the current post closely matches that of the post in the new structure. The potential eligible staff groups indicate further current posts that may be suitable for the post in the new structure. New Post Title Band Definitive Match Potential Eligible Staff Groups CFHS Administration Manager Child Health and Information Manager 6 Band 6 CHIS Info Lead East and West 5 Band 5 Band 6 CHIS Administrator East and West 2 Band 2 Band 3 CCN and CCHC Administrator 4 Band 4 Band 5 CCN and CCHC Administrator 3 Band 3 Band 4 Specialist School Nursing Team Administrator 2 Band 2 Immunisation Administrator East and West 3 Band 3 Band 4 Immunisation Administrator East and West 2 Band 2 Band 3 North West Quadrant Lead Administrator 4 Band 4 Band 5 North West Administrator 3 Band 3 Band 4 North West Administrator 2 Band 2 Band 3 South West Quadrant Lead Administrator 4 Band 4 Band 5 South West Administrator 3 Band 3 Band 4 South West Administrator 2 Band 2 Band 3 North East Quadrant Lead Administrator 4 Band 4 Band 5 South West Administrator 3 Band 3 Band 4 South West Administrator 2 Band 2 Band 3 South East Quadrant Lead Administrator 4 Band 4 Band 5 South East Administrator 3 Band 3 Band 4 South East Administrator 2 Band 2 Band 3 Page 41 of 48

42 1d Immunisation team This service is managed by Christine Mulligan. This information was accurate at 16 February Page 42 of 48

43 1d (i) service structure Base Role Band Headcount Senior Immunisation Goldsworth Park, Woking Nurse The Grove, Egham Staines Health Centre Immunisation Nurse * Jarvis Centre, Guildford Farnham Hospital Senior Immunisation Tattenham Health Centre, Nurse Epsom Immunisation Nurse Vacanc ies () Totals * postholder has a split role in this team, so already counted elsewhere in this table Page 43 of 48

44 1d (ii) Reasons why we need to change this The schools immunisation service is commissioned and funded by Public Health England. At present the service is being supported in various ways across the county by the 0-19 team which is commissioned and funded separately by the Local Authority. The service must operate within its own commissioned budget. The overall aim of the 0 19 years community and school-age immunisation service specification April 2017 March 2020 for Surrey is to commission a community immunisation service that is consistent across the whole county and offers a comprehensive immunisation service to all children and young people educated, registered or resident in Surrey. The Immunisation service specification has widened the scope and increased the coverage of immunisation programmes that the schools immunisation team is commissioned to provide, so that opportunistic vaccination is offered to any child with missing immunisations. The new service specification includes the provision for: Flexible community drop-in clinics (i.e. weekends and evenings) so that all children, but specifically those under 5 years are enabled to catch-up with their vaccinations and to achieve the 95% required for MMR 1 and MMR 2 prior to their 2nd/5th birthday. Clinics will be run monthly at accessible locations across Surrey in each of the localities (East Surrey, Guildford & Waverley, Surrey Heath, Surrey Downs and North West Surrey), they will be run as drop- in opportunistic immunisation clinics for a minimum of 3 hours (client contact time) requiring a minimum 2 nurses and clerical support per session. In exceptional circumstances, a home visit may be arranged to discuss & vaccinate children. The cover rate for immunisations for the school age population has increased to 90% of all girls in year 8 completing the 2 dose course of HPV and 80% of children in year 9 to receive DTd/IPV and Meningitis ACWY. The increase in cover and complexity of the service CFHS is commissioned to provide will require additional year round, senior nurses whilst also ensuring immunisation nurses time is maximised for clinical delivery in school term time. Page 44 of 48

45 These changes will mean that the service will be delivered throughout the year. Service redesign new structure In line with the other community services across Surrey, the Immunisation teams will be configured to work across the CFHS quadrants to ensure good communication and collaboration with colleagues in 0-19 teams. Working in this way will also mean that the work load of quadrant teams will be equitable in terms of size and structure. There will be a Clinical Team Leader for Immunisations in the West and the East of the county ensuring front-line management and clinical expertise is available year round. These posts will be band 7 posts and are responsible for the day to day operational line management of the CFHS immunisation teams across east/west Surrey and the safety and clinical governance of each team. They will report to the Clinical Service Manager for Immunisations. There will be an increase in Senior Immunisation Nurse Posts in each quadrant ensuring the supervision and delivery of the immunisation and vaccination programmes throughout the year. These posts will be band 6 and will report to the Clinical Team Lead for immunisations in the west/east of Surrey. Post holders are required to ensure cover for colleagues across the county. The Immunisation Nurses Posts in each quadrant across Children and Family Health Surrey (CFHS) will be employed to work a six hour shift pattern term-time only, in order to maximise the clinical delivery of immunisations and vaccinations in a variety of community settings including schools. Post holders may be required to work in any school across the county if demand requires it. The Immunisation Assistants will join the immunisation team on an annual basis for the duration of the nasal Flu vaccination programme from the 1 st October to the end of the autumn term, working a six hour shift pattern term-time only. This model of delivery offers the opportunity to employ permanent staff who support school-age screening programmes throughout the remainder of the school year and creates a sustainable skilled workforce focused on the needs of Surrey s school children. It is expected that the increased number of clinical posts in the proposed service structure will reduce the need for bank posts, other than in exceptional circumstances. The clinical delivery of the immunisation team will continue to be supported by administrators with transformation plans reducing the need for manual collection, sorting and data entry. Estates The outcome of the estates review is awaited and no changes are envisaged at present. The immunisation team are responsible for the maintenance and monitoring of vaccine fridges and the cold chain across Surrey. Vaccines should be strategically sited in local hubs to ensure they removed from the cold chain for as little time as practicable and are accessible to nurses transporting them. Page 45 of 48

46 Page 46 of 48

47 1d (iii) Proposed future service structure The proposed model for a Surrey wide immunisation team is that proposed in the intention to tender known as the ITT model and reflects the population in each quadrant. Future funding to deliver Flu vaccinations for additional year groups does however offer an opportunity to consider other models. In future, the Immunisation team will offer a quadrant based service, operating from two teams, one in the west and one in the east of the county. Exact bases will be determined by the two Clinical Team Leaders in liaison with the Estates team. The teams will consist of the following staff; Role Clinical Team Leader for Immunisation Ban d per team Total across county CSH (84.3%) FCHC (15.7%) Senior Immunisation Nurse Immunisation Nurse Immunisation Assistants Totals Please note, this paper focuses on CSH posts only and the above split has been shown to demonstrate the overall split across the partnership. Page 47 of 48

48 1d (iv) Post Matching The table below indicates how the new posts align to existing posts. The definitive match indicates that the current post closely matches that of the post in the proposed future staffing structure. The potential eligible staff groups indicate further current posts that may be suitable for the post in the proposed future staffing structure. New Post Title Band Definitive Match Potential Eligible Staff Groups Clinical Team Leader Clinical Team Leader for 7 for Immunisation Immunisation Senior Immunisation Nurse Senior Immunisation Senior Immunisation Clinical Team Leader for 6 Nurse Nurse Immunisation Immunisation Nurse 5 Immunisation Nurse Senior Immunisation Nurse Immunisation Assistant 4 Immunisation Nurse Page 48 of 48

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