South London Membership Council 22 October 2013 09:00 17.00 One Drummond Gate, Victoria, London, SW1V 2QQ 09:00 Registration and Refreshments 09:30 Welcome and introductions Richard Sumray Chair, Health Education South London (HESL) 09.40 Health Innovation Network: Update since last meeting Dr Chris Streather MD, Health Innovation Network (HIN) 09.50 Group Session One Priorities for Health Education South London for 2014/15 Aurea Jones Director of Workforce, Health Education South London (HESL) Martin Livesey Head of Finance, Health Education South London (HESL) 11.00 Break and Refreshments (HESL Board will break out to meet from 11.15 12.45) 11.15 Health Innovation Network: Diabetes workstream update Dr Charles Gostling Diabetes Clinical Director, (HIN) 11.35 Health Innovation Network: Patient Experience cross cutting theme. Group Session Two Gathering patient stories and using Human Centred Design (IDEO) to turn feedback into improvements. Paul Hodgkin Patient Opinion & Sam Hudson Überology 13.15 Lunch 14.15 Health Education South London: Feedback from HESL Board Meeting 14.25 Group Session Three Health Education South London: Continuing Professional and Personal Development (CPPD) Richard Sumray Chair, Health Education South London (HESL) Dr Marilyn Plant GP/Strategic Lead for CPPD 15.05 Break and Refreshments 15.15 Doctors Advancing Patient Safety (DAPS) Toolbox HEE Better Training, Better Care Inspire Improvement! Project Dr Will Barker Guy s & St Thomas NHS Foundation Trust 15.25 South London Innovation and Recognition Awards Julie Screaton 16.15 Networking time and Drinks reception 17.00 Ends MD, Health Education South London (HESL) Dr Chris Streather MD, Health Innovation Network (HIN)
South London Membership Council 22 October 2013
Welcome Richard Sumray MBE Chair Health Education South London
Health Innovation Network Update Chris Streather Managing Director
Priorities for Health Education South London: 2014/15 Aurea Jones, Director of Workforce Martin Livesey, Head of Finance
Membership Council: Priorities Aurea Jones, Director of Workforce Martin Livesey, Head of Finance
Overview The aim of the session is to: update the council on our workforce planning process for education commissions in 2014/15 review how this has informed our emerging priorities for investment debate our relative investment priorities between medical and non-medical future commissions and Workforce Development to inform the Board s decision-making. Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 6
Last time we met We looked at the workforce planning process and voted to: protect Continuing Personal & Professional Development or Workforce Development funding expand our planning to incorporate primary care and social care Work with our Higher Education Institutions and Providers to improve attrition Review salary support We provided background reading from the Kings Fund to support discussions today Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 7
Since June The Workforce Planning Advisory Group met and: considered workforce and education planning processes for 2013/14 looked at employer demand forecasts considered the workforce supply model reviewed outcomes from the process Medical workforce planning process is currently to: Review quality data: GMC trainee survey, quality visit information, local specialty trainee surveys, performance indicators for commissioned specialties Review workforce forecast returns from lead employers Once HEE finalise 2014 numbers, agree apportionment in London Considered how changes to training may be implemented Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 8 8
Since June During that time, we: met approximately 250 stakeholders to test workforce demand and supply modelling, to arrive at a more accurate, and collaborative, vision of future workforce and education needs met with other London LETBs and HEE national, and the Commissioning Board to test our workforce planning assumptions Held a Workforce Planning Board seminar to consider how we develop the process in future to meet our strategic challenges. This work is condensed to form our draft Investment Plan that the Board will consider in detail today. Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 9 9
Informing our priorities Our HESL Five Year Workforce Skills Development Strategy Embedding a population health approach in all we do Developing Community Education Provider Networks Supporting service transformation through workforce development, excellent education and training Supporting the development of inter-professional training to improve the delivery of integrated care Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL The King s Fund Analysis Workforce and service design go hand in hand: the workforce must be aligned to the work, not the other way round. Health and social care is a team game: developing effective teams is just as important as individual excellence. Reverse the inverse training and investment law : some funding should be switched from training the most highly qualified professionals to training health care assistants and other unqualified staff. Most of the future workforce is already working in the NHS: more of the training budget should be spent on continuing professional development of existing staff. Support nationally, act locally: locally led change supported by a national framework is the best way to redesign the workforce. 10 10
Planned commissions Our commissions are largely unchanged from 2013, with the following exceptions: Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL Type of commission + or - No. of commissions % terms Non-medical commissions Children s nursing 12 5% Learning Disability nursing 5 20% Mental health nursing 20 10% District Nursing 7 20% Midwifery 11 5% New commissions Practice Nurse 70 Return to practice 50 Emergency nurse practitioner 24 Medical commissions Core Surgical Training posts 9 Share of GP expansion 24 11
Finance 2013/14 The chart below shows the spend profile for 2013/14 for an expected forecast outturn of 413m This shows that the majority of funding is spent on the Future Workforce 92% 9.38% 4.28% 2.16% 1.50% 21.15% Future Workforce: Non-Medical Future Workforce: Undergraduate Medical & Dental Future Workforce: Postgraduate Medical & Dental Future Workforce: Student Support 31.78% 29.75% Workforce Development Education Support Running Costs Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 12
Finance 2014/15 The chart below shows the spend profile for 2014/15 for the base plan position of 417m This shows only small changes in the percentage profile other than between undergraduate and postgraduate medical - largely due to funding changes resulting from national tariff movements 9.16% 4.24% 21.23% 2.10% 1.41% Future Workforce: Non-Medical Future Workforce: Undergraduate Medical & Dental Future Workforce: Postgraduate Medical & Dental Future Workforce: Student Support 33.36% 28.50% Workforce Development Education Support Running Costs Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 13
Finance Key Facts Educational activity Cost pa Cost over 3 years Student nurse without salary support 20,000 52,000 Student nurse with salary support 32,000 83,000 District Nurse 38,000 Emergency nurse practitioner 11,000 Practice Nurse 5,000 Return to practice 5,000 Undergraduate medical placement 42,000 Postgraduate medical placements: Foundation year 1 31,000 Foundation Year 2 34,000 Core Specialty training 36,000 Higher Specialty training 41,000 GP (hospital) 40,000 GP (practice) 74,000 Dental Foundation Year 1 101,000 Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 14 14
Scenarios A 2% change to LETB spending would amount to 8.3m Modelling 2% up Increased workforce development spending, particularly: Service reconfiguration in SW London and SE London Further development/extended coverage of the Community Education Provider Network (CEPN) approach Modelling 2% down Postgraduate medical decommissioning - 1.5m Non-medical decommissioning - 3.0m Contingency reduction to 0.5m - 1.2m Review of salary support criteria - 0.3m Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL Workforce development reduction (one off) - 2.3m 15 15
Discussion Now that you ve heard about possible priority areas for investment, we need your views Each table will work together for the next 30 minutes On your table please discuss the following question Question: What are the 3 key messages you would like the board to take into account when reviewing the investment plan, and why? Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 16 16
Break and refreshments @HINSouthLondon @HealthEdSL
Diabetes Workstream: Update Dr Charles Gostling Diabetes Clinical Director, Health Innovation Network
Diabetes Programme Progress Report Dr Charles Gostling, Joint Diabetes Clinical Director October 2013
Diabetes high level themes 1. Supporting self-management including patient education and care planning 2. Adopting new technologies 3. Enabling an integrated care system for diabetes (new models of care and working across organisational boundaries) Work group meetings were held over the summer with a wide range of attendees from across south London including service providers, service users, commissioners and representatives from industry. We have now developed a project plan that outlines the key programmes we will be developing.
Clinical problems scoped in planning workshops 9 July: workshop on self management was attended by over 30 participants from across health and social care Key priorities and emerging themes: Improve systems and processes for encouraging people with diabetes to participate in education and training programmes to support self-management. Work with commissioners and providers to increase the choice of education programmes available, including development of online courses, culturally sensitive methods of delivery and short taster courses. Looking to adopt and defuse IT solutions to help people improve their ability to monitor and manage their routine care Improve care planning by promoting direct patient access to GP records including personal medicines information, blood glucose and other important test results.
Clinical problems scoped in planning workshops 31 July: workshop on the adoption of new technologies attended by over 30 participants from across health and social care Key priorities and emerging themes: Work with teams in primary care to identify the cohort of people with type 1 diabetes, being managed by their GP, community service or other, whose condition might be improved if they had improved access to care and self management technologies. Improve self management in people with type 1 diabetes through the adoption of appropriate technologies such as insulin pumps and continuous blood glucose monitors.
Clinical problems scoped 11 September: information fed into major stakeholder workshop Enabling an integrated care system for diabetes, new models of care and working across organisational boundaries Issues Causes Potential solutions/ innovations Prioritisation
Planning workshop 11 September: over 70 participants from across health and social care and representatives from industry Key priorities and emerging themes: Working across the network to develop and defuse the LAS community response hypoglycemia urgent care pathway. Working with providers, area prescribing teams, London Procurement and pharmaceutical companies to identify current uptake and usage of therapeutic agents to ensure good compliance with NICE guidance. Working with industry to develop tools to start to identify high and low risk patients who would most benefit form having care delivered in new ways - such as being managed via phone clinics or via tier three multidisciplinary teams.
Projects being taken forward in 2013-14 1. Improving self-management of insulin therapy through better access to appropriate use of technologies 2. Improving the management of unscheduled care by developing pathways for the management of hypoglycaemia care in the community 3. Improving access to Structured education and related support for selfmanagement 4. Review the use of insulin management for people with Type 2 diabetes to optimise care and support the effective use of resources. 5. Improving the prevention care and treatment of diabetic retinopathy by sharing test information across care settings
Feedback from working group participants Everyone was open to ideas Diagnostics Company representative Best thing was Table discussions and information sharing especially when ones ideas and comments get highlighted Organisational Processes Service user Opportunity for active input form all delegates Pharma representatives Excellent and motivational speakers giving succinct presentations Commissioner Best thing was Broadness of discussions Clinician Clear process for decisionmaking with a large number of stakeholders
Key milestones and delivery dates February to April Completed Wide engagement with expert groups and stakeholders to identify priority workstreams. Identify areas of good practice locally and nationally. Identify NICE guidance best practice standards and current delivery performance against quality measures. July to early September September Organisational October Processes Completed Planning workshops with wide range of stakeholders to identify key themes and issues in workstream as part of project planning. Continue to collect detailed data on areas of good practice locally and nationally. Conduct further analysis of and base line service provision and delivery performance against quality measures. In progress Scope 5-6 potential projects for feasibility and impact on care. Identify volunteers for task and finish groups with membership from all sectors. October In progress Present Project Initiation proposals to AHSN Board on 10 th October. Fully develop the priority project work plans and task and finish groups to deliver priority project aims and objectives October to March 14 Started October 2013 Work with stakeholders and task and finish groups to implement and monitor agreed objectives as outlined in the project work plan. Work with stakeholders to develop further proposals for follow on project or new priorities for taking forward in 2014-15
And yet more Develop the HIN website to support information exchange Be a focus for innovative ideas Cross cutting themes: CLARHC HESL Research networks Patient experience London Connect Support NHS England strategic clinical networks Work with other HIN workstreams Musculoskeletal, Dementia, Alcohol and Cancer
Patient Experience cross cutting theme Paul Hodgkin, Patient Opinion Sam Hudson, Überology
Using stories to inspire change Patient Opinion, Überology Using Human Centred Design Technique - IDEO
Needs, patterns, themes Talk about the stories. What did you find interesting? Share the patterns, needs, themes that jumped out.
Generating Improvement ideas Warm up Get into pairs. Identify person A and person B. Round 1: Person A, suggest new ideas for ice cream flavour. Person B must say NO to each idea and give a reason why it wouldn t work. 3 minutes!
Generating Improvement ideas Round two Person B to suggest ideas for a new business. Person A say YES to each idea and build on it to make it bigger. 3 minutes!
Creating the right atmosphere for ideas. 1. Defer judgment. There are no bad ideas at this point. There will be plenty of time to judge ideas later. 2. Encourage wild ideas. It s the wild ideas that often create real innovation. It is always easy to bring ideas down to earth later! 3. Build on the ideas of others. Think in terms of and instead of but. If you dislike someone s idea, challenge yourself to build on it and make it better. 4. Stay focused on topic. You will get better output if everyone is disciplined. 5. Be visual. Try to engage the logical and the creative sides of the brain. 6. One conversation at a time. Allow ideas to be heard and built upon. 7. Go for quantity. Remember there is no need to make a lengthy case for your idea since no one is judging. Ideas should flow quickly.
How might we.? Themes to. solutions Choose a theme from earlier on. Come up with some how might we? solutions. Aim to come up with as many ideas as you can.
Storyboard your solution Get into pairs. Choose a solution you like. Build on your idea using your storyboard. Make it as engaging as possible to someone who doesn t know anything about your idea
the end Think of one word that sums up how you feel now. Thank you for taking part!
Lunch @HINSouthLondon @HealthEdSL
Feedback from Health Education South London Board Richard Sumray MBE Chair
Continuing Professional and Personal Development (CPPD) Dr Marilyn Plant GP/Strategic Lead for CPPD
CPPD Review Marilyn Plant
Who we are? The Project Team Senior Responsible Owner Dr Marilyn Plant HESL Review Lead Sean Farran Project Manager Katie Adams Project Support Nate Hill Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 42 42
Health Education England 13 Local Education and Training Boards What do we mean by Continuing Personal and Professional Development (CPPD)? The work of LETBs is considered in two categories Future workforce Workforce Development - including CPPD Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 43 43
Health Education England 13 Local Education and Training Boards Why the need for a review? More than 90% of budget spent on Future Workforce Small proportion on developing existing workforce Essential that this resource is used effectively to support strategic priorities Needs to be fit for purpose for both now and the future Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 44 44
Health Education England 13 Local Education and Training Boards How is CPPD funding currently allocated? Direct allocations Funding given directly to eligible organisations as part of a Learning and Development Agreement (LDA) For non-medical staff for those without professional qualifications (bands 1-4) Trusts can spend it on educational activity and are required to report what they have spent through an on-line system PORTAL Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 45 45
Indirect allocations Notional sums of money for healthcare providers to commission education and training at various contracted providers across London Contracts currently in place with 9 universities and two trusts as education providers Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 5 46
Bidding processes Remainder of CPPD budget Applications accepted for funding or specific programmes/projects Strategic investment fund 2013/14-250k reserved at four Higher Education Institutions in south London for CCG/practice use Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 6 47
Health Education England 13 Local Education and Training Boards Example of direct allocation per Organisation in SL 900,000 800,000 700,000 600,000 500,000 400,000 Direct Funding (via LDA) 300,000 200,000 Bands 1-4 Bands 5+ 100,000 0 Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 48 48
Health Education England 13 Local Education and Training Boards Example of indirect allocation per organisation in SL Indirect Funding (contract) Bands 1-9 SW LONDON & ST GEORGES MH, 282,878 YOUR HEALTHCA RE, 70,668 ST GEORGES, 937,174 BROMLEY HEALTHCARE, 99,018 CROYDON HEALTH SERVICES, 356,217 EPSOM &ST HELIER, 457,905 SOUTH LONDON HEALTHCARE, 611,156 GUYS AND ST THOMAS, 1,505,395 SOUTH LONDON & MAUDSLEY, 607,047 OXLEAS, 404,904 KINGS COLLEGE HOSPITAL, 905,743 Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL LEWISHAM HEALTHCARE, 369,775 KINGSTON HOSPITAL, 292,122 49 49
Example of categories by which the organisations in Health Education England 13 Local Education and Training Boards SL currently spend CPPD Unknown Staying healthy Services and project management Service improvement and quality Research skills Quality care Planned care Personal and people development People management Older people's health Mentorship Mental health Maternity and Newborn Long term conditions Learning disabilities IT Health, safety and security Health science topics Equality and diversity End of life Decision making skills Communication Clinical Practice - Unknown Children's and young people's health Acute/urgent care Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 2,147 11,275 37,004 164,432 224,700 6,118 1,515 3,015 218,028 5,250 23,736 56,735 288 53,178 190,249 579,048 349,128 448,559 394,880 367,075 484,418 501,502 788,629 801,549 1,150,448 0 200,000 400,000 600,000 800,000 1,000,000 1,200,000 1,400,000 50 50
Health Education England 13 Local Education and Training Boards Links to the priorities in the HESL Workforce, Skills and Development Strategy A reminder Chapter 3 - At the Forefront of Change Chapter 4 - Recruitment and Retention Chapter 5 - Life Long Learning Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 51 51
Chapter Health Education 3 - At the Forefront England of Change 13 Local Education and Training Boards To achieve a workforce that: Our focus will be: Works effectively as a key enabler of system change, engaging with local communities and providers of services Has the ability to manage change and ensure the quality of training is maintained Retains and supports its good people during major change programmes, using their skills to empower patients to inform that change Shows continuous improvement based on contribution to and the application of the most up-to-date clinical evidence, and feels empowered to innovate at all levels and professions Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL Maintaining and enhancing multi-professional leadership Developing productive relationships between staff, students and patients Developing workforce planning systems to reflect the demand on all providers of care Enhancing the quality of supervision and learning for all our learners, and supporting the development of all staff providing NHS funded services in South London Ensuring workforce development programmes enable staff to work effectively within different settings and across organisational boundaries Ensuring effective collaboration with our Academic Health Science Network to design and spread innovation 52 52
Chapter Health Education 4 Recruitment England and Retention 13 Local Education and Training Boards To achieve a workforce that: Enables social mobility, increasing participation from those who might not otherwise consider further education, and is representative of the community it serves Demonstrates the highest potential to develop and deploy the skills, attributes and behaviours patients need Represents value for money by translating investment in education and training into productive careers representative of the direction of health and social care Always has the patient s interest at heart by acting in line with the NHS Constitution s values Works in an integrated and supportive environment that values individual and collective contributions Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL Our focus will be: Attracting and developing a diverse workforce that reflects the diversity of our population Promoting best practice in recruitment to programmes across our network of members Targeting the use of CPPD funding to support the workforce s career planning and development and Lifelong Learning Embedding the NHS s values in staff from the point of recruitment and throughout their working lives Developing clinical and educational trainers and supervisors to ensure high quality learning environments for all staff and learners 53 53
Health Education England 13 Local Education and Training Boards Chapter 5 Life Long Learning To achieve a workforce that: Has the skills, attributes, values and behaviours to promote wellbeing and to provide high quality care needed by patients Is trained and educated to reflect the way it increasingly operates: in multidisciplinary, inter-professional teams and in community-based roles encompassing prevention of ill-health, and promotion of re-ablement, recovery and rehabilitation Is trained and educated through qualityassured outcomes-based learning methods that fit with the way our students, trainees and staff learn best Has clear and visible, values-driven leadership at all levels and in all professions Recognises the importance of, and is equipped to enable, patient education and empowerment Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL Our focus will be: Supporting HEIs and employers to embed the NHS Constitution s values across their organisation Developing community based education provider networks Fostering placements that provide opportunities for all learners in community and hospital learning environments Integrating quality assurance processes across all areas Prioritising leadership development across all domains Creating environments in which opportunities for inter-professional learning are maximised Embedding principles of patient empowerment in all programmes of learning 54 54
Health Education England 13 Local Education and Training Boards What have we achieved so far in Phase 1? Scoping exercise Engagement Collated emerging themes Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 55 55
Health Education England 13 Local Education and Training Boards Who have we engaged with to date? Phase 1 Engagement & scoping exercise CCGs:- Bexley Bromley Croydon Kingston Richmond Sutton Trusts:- GSTT KCH SLAM St. Georges Bromley Healthcare Higher Education Institutions Engaged with:- Greenwich St. George's, University of London Kings College London Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL Work in progress - to be continued 56 56
Values and engagement matrix Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 16 57
Stakeholders identified as priority for future engagement Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 17 58
Members Health Education activity England 13 Local Education and Training Boards Lessons learnt from engagement Table top exercise 20 minutes Rank themes Discuss and answer the 2 questions on the worksheet Plenary discussion Q&A Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 59 59
Next Health steps Education England 13 Local Education and Training Boards Phase 2 - establish Task and Finish group Health Education South London www.southlondon.hee.nhs.uk @HealthEdSL 60 60
Break and refreshments @HINSouthLondon @HealthEdSL
Doctors Advancing Patient Safety (DAPS) Toolbox : HEE Better Training, Better Care Inspire Improvement! Project Dr Will Barker Guy s & St Thomas NHS Foundation Trust
HE - SOUTH LONDON MEMBERSHIP COUNCIL MEETING Will Barker 22 October 2013 www.dr-toolbox.com
Day 1
2009 study identified 6% increase in mortality in August [1] 2004 2012
While shadowing periods have helped many unknown questions new questions arise post changeover Paper guides frequently lost quickly out of date cumbersome to carry around
If only there was an accessible guide to the hospital With local information on how to do daily jobs written by junior doctors for junior doctors
Demo
Handover guides for all F1/F2 firms Bleeps of doctors & MDT Extension numbers for wards, secretaries Reference guides specific to the hospital How to make speciality referrals within the hospital How to request specific investigations within the hospital Downloadable forms A resource for teaching and post graduate medical education
Provide specific, local information on how to get things done in hospitals Improve the efficiency (and learning environment) of junior doctors. Increasing time for training Improve patient safety by facilitating a better handover between rotating doctors
Set up a Toolbox for your Trust Complete your own QI Project Develop your leadership skills YOUR TRUST NEEDS
F1/F2s act as Editors for your Site Compile useful information from colleagues Add information to site Ensure Continuity YOUR TRUST NEEDS
Set up roles within Team Baseline survey Gather relevant bleeps and extensions nos Begin to input data Send out forms for handover guides Upload common forms Finalise site & add to intranet Launch Repeat Survey Ensure continuity December Changeover
Trainee time Approx 1hr per week Establishing Relationships PGME & FSD IT Surveys Accuracy Completeness Continuity
Editors (F1/F2s) Trust FS Director Hospital IT Toolbox Team Foundation School Deanery/LETB NHS Medical Director Health Education England
Completed Audit Cycle/QI Project Involvement in Patient Safety/Change Poster Presentations Grand Round Presentations Publications Toolbox Certificates Leadership Awards Foundation School Merits Helping your Colleagues! YOUR COLLEAGUES NEED
www.dr-toolbox.org References: 1. Jen MH et al. Early in-hospital mortality following trainee doctors' first day at work. PLoS One. 2009 Sep 23;4(9):e7103 2. Doctors Advancing Patient Safety (DAPS)
South London Membership Council Awards presentation
Networking and drinks reception @HINSouthLondon @HealthEdSL
November 2013 South London Membership Council 22/10/2013 Developing communication with our membership Since the last meeting we received an interesting message from a Council member who wondered about his continued membership and how effectively he was contributing to its work. It was a timely message as Health Education South London and the Health Innovation Network planned Meetings are an important way of engaging with the South London Council membership but they are not the only way the agenda for the October South London Membership Council. The agenda was designed to take account of what we hoped would be a lively morning looking at the priorities for education and training in 2014/15. We want to encourage Council members to ask questions, not only during SLMC meetings, but at any time. We re now working with this Council member to explore some of the issues he raised. Health Education South London relies on its relationships with its Members and stakeholders to carry out its work as you will see in the following report. Both the Health Innovation Network and Health Education South London view the joint Membership Council as a crucial way to inform their members and are keen to listen to the contributions they make. They will be contacting you to find out more about the information you would like to have, and how you can become more involved in HESL s programmes of work including the Community Education Provider Networks (CEPNs) and the clinical themes recently established by the Health Innovation Network. Consulting on workforce planning Health Education South London has reviewed its workforce planning assumptions and recommendations for the south London health and healthcare workforce with the other London Local Education and Training Boards, HEE and commissioners. These are the assumptions that have been summarised to develop the draft investment plan considered at the HSEL Board meeting that took place during the Membership Council. Since the June Membership Council meeting, over 250 stakeholders have been involved in testing workforce demand and supply modelling to help arrive at a more accurate and collaborative vision of future education and workforce needs. The Workforce Planning Advisory Group met and considered workforce and education planning processes for 2013/14 looking at employer demand forecasts and considering the workforce supply model. The Group also reviewed outcomes from the process. For medical workforce planning, the process is currently to:
Review quality data: GMC trainee survey, quality visit information, local specialty trainee surveys, and the performance indicators for commissioned specialties; review workforce forecast returns from lead employers; consider how changes to training may be implemented; and once HEE finalise the 2014 numbers, agree the apportionment in London. South London Innovation and Recognition Awards 2013 The October South London Membership Council included the launch of the Innovation and Recognition Awards. The innovation stream of the awards attracted over 90 applications for funding releasing an average of 50,000 to 14 proposals. Doing things differently is now a firmly embedded principle for organisations leading the way in imagining and developing new ways of providing care. Much of this work involves introducing training and education programmes to support the cultural change that is often discussed but is difficult to realise. The South London Innovation and Recognition Awards were introduced to acknowledge those who have made a significant impact on the way care is provided, and the quality of the patient experience. While the innovation awards provide essential funding to kickstart and support just some of the excellent ideas and projects in South London that our stakeholders believe can make a real difference to patients. Congratulations to all the 2013 winners. Progress on the winning projects will be closely followed by the Membership Council. You can see images from the whole day, including the awards ceremony here. Winners of the inaugural South London Innovation and Recognition Awards, which help recognise and develop projects covering a broad range of education and innovation projects across South London. 2
2013 Recognition Award Winners Outstanding Contribution to the Local Community Best Learning and Development Strategy Widening Participation Initiative of the Year Gillian Harman, Bromley Healthcare Adult Safeguarding and Dementia team at Guy s & St Thomas NHS Foundation Trust Assistant Clinical Technologist Apprentice Scheme (ACTAS), King s College Hospital, Guy s & St Thomas NHS Foundation Trust St George s Healthcare NHS Trust: Education & Development Team Excellence and Innovation in Healthcare Education and training Inter-professional Collaboration of the Year Best Healthcare Education and training programme Mehool Patel, Anne Ellis and the Medical Education Department from Lewisham Healthcare NHS Trust CARDS project, Faculty of Health, Social Care and Education, Kingston & St George s University of London Growing against Gangs & Violence: Association of Surgeons of Great Britain and Ireland; The Royal College of Surgeons; The Home Office; Metropolitan Police Service: Safer Neighbourhood Teams, Safer Schools Partnerships, Central Operations, Specialist Operations, and Specialist Crime Directorates Jonathan Birns, Mehool Patel & South East London Geriatric Medicine Training Programme Group The Clinical Education Team at Guy s & St Thomas NHS Foundation Trust Innovation funding award winners Organisations receiving funding Royal Borough Kingston Activate Kingston St George's Healthcare NHS Trust University of Greenwich St Christopher's Hospice Sutton & Merton IAPT University of Greenwich, The Metro Centre Merton CCG, Sutton CCG, St Raphael s Hospice St George's Healthcare NHS Trust King s College London, King s College Hospital NHS Title of project Interactive Web-based Specialist Exercise Information and Training tool Building Understanding in Integrated Healthcare: A pilot project in community based integration within Core Medical Training Maritime City Developing Cognitive Behavioural Therapy (CBT) skills into an accredited pathway and disseminating skills to clinical staff in order to benefit patients with long term, chronic or life-limiting physical health issues Long-term conditions healthcare training strategy Piloting a Sexual Health/HIV Prevention Community Based Research Partnership in South East London Quality Improvement in End of Life Care: Bringing the Six Cs to the End of Life Care of people in Nursing Homes, Residential Homes and their own homes Listening to Learn: Using women's stories to improve care and communication in obstetrics and midwifery Rheumatology 2020: A vision for a joint venture in exceeding user expectations of the rheumatic disease service in South London: 3
Foundation Trust King's College London South London and Maudsley NHS Foundation Trust CoolTan Arts Bromley CCG, Bromley Healthcare Lewisham and Greenwich NHS Trust, South London and Maudsley Trust Group Rheumatology Initiative Involving Patients (GRIIP) Communicating with Deaf and Hard of Hearing Patients: A training package for healthcare students and professionals Two for one: elearning course development of alcohol elearning package in mental health and physical health care pathways Mental Health Wellbeing advisers Pushing the Boundaries of Diabetes Care in Primary Care Achieving the nine care processes for people with diabetes and serious mental illness comorbidity an educational intervention for care coordination Membership Council: Summary of October meeting During the first session Chris Streather, Managing Director of the Health Innovation Network (HIN), reminded everyone of the purpose of the day. Chris said over the recent months the team had been working hard to build plans across the clinical themes. Chris went on to acknowledge the importance of the synergy and common interests between HESL and HIN and how important it was that the two organisations have a close and productive working relationship. Senior responsible officers have been appointed for all of the programmes being led by HIN which include chief executives from a local authority, acute and community trusts and a commissioner. Clinical leaders have also been appointed. We need to be reaching out to communities and centering care in the community. Council member programmes would be brought together. HIN have five clinical themes: diabetes, musculoskeletal, alcohol, dementia and cancer, and number of cross-cutting themes: patient experience, informatics, London Connect, education and training, wealth creation and research. Chris outlined the importance of two of the cross-cutting themes, patient experience and informatics, and how the two In order to maximise resources, the Network is aiming to creatively bring together new projects with some that already exist. There are two programmes the Network is currently trying to blend: My Healthlocker, lead by SLaM, and aimed at people with dementia and their carers; and Coordinate My Care, a pan-london programme led by the Marsden addressing end of life services and support. Myhealthlocker allows users to gather and store their own health information from a variety of sources, including their GP and hospital notes. They can also choose what information they want to share and who they share it with. Myhealthlocker is a joint project between South London and Maudsley NHS Foundation Trust (SLaM) and GPs. Patients who use the service can open a 4
personal profile and will be able to access their own care plan from SLaM and a suite of options from their GP. Health Innovation Network clinical theme leads Diabetes SRO Clinical Directors Andrew Eyres Charles Gostling and Natasha Patel MSK SRO Matthew Hopkins Clinical Director Mike Hurley Cancer Clinical Directors Director Shelley Dolan Nick Hyde Claire Dowling Alcohol SRO Will Tuckley Clinical Director Colin Drummond Dementia SRO David Bradley Clinical Director Hugo de Waal The Membership Council then considered a summary of the outcome of the workforce planning process for 2014/15 and the proposed commissioning numbers. There was a rich discussion about differential funding to the different clinical and professional groups. An informative presentation from Aurea Jones, Director of Workforce and Martin Livesey, HESL s Head of Finance addressed the priorities for 2014-15 updating members on the workforce planning and commissioning process. It was noted that in some areas such as learning disability nursing where much of the workforce is in social care and hidden from NHS workforce planning and district nursing, it is likely that there will be severe shortages in the future. We re good on numbers - but not good on the detail, we need to work with employers to improve data input. We are looking at how we improve the data, and more importantly working through our CEPNs to understand the primary care workforce and with our colleagues providing social care, again to gain a more complete picture of the entire workforce. There were a number of reasons for the shortages in these workforce groups including: the perceived attractiveness of the roles; the impact of the work to increase the number of health visitors in effect recruiting from the same pool of potential entrants; and the lack of placements. HESL s Sean Farran is leading further work to address these issues in community nursing. All of these factors illustrate the complexity of workforce planning and highlighted the importance of working with all stakeholders to better understand the wider workforce issues to ensure that we plan and invest in education and training most effectively. Council member There was an aspiration to increase the numbers of mental health nurses in the places where there was the greatest level of need, and in non-traditional settings in secondary care and the community. Achieving this would mean working very closely with stakeholders. HESL would need to work closely with colleagues across health, local government and the voluntary sectors to build an understanding of the future need for the entire workforce providing NHS funded care. Martin Livesey outlined the spending profiles for this year and 2014/15 acknowledging that 92 per cent of funding was currently spent on training new staff, while only four per cent of the budget was used to develop existing staff. A report from the King s Fund, NHS and social care workforce: meeting our needs now and in the future was shared before the council meeting to help set the context for the discussions. The focus on the supply of undergraduate non-medical staff and the postgraduate medical workforce means that we risk not reflecting the Council and LETB Board s ambition for more investment in CPD for existing staff 5
The Membership Council considered a summary of the outcome of the workforce planning process for 2014/15 and the proposed commissioning numbers. There was a rich discussion about differential funding to the different clinicians and professional groups. During the discussion, Postgraduate Dean Andrew Frankel (pictured left), reminded the audience of an important aspect of workforce planning which relates to medical training - which is that the lead in time from a student through to a consultant - is many years. We must also bear in mind in the planning process that the role of the matured, medical workforce graduate may be very, very different in 10 to 15 years time than the role that we see today. We will need far fewer super specialists, what we may need is a different type of doctor. The views expressed during this session were noted and discussed in the Health Education South London Board meeting that took place after lunch. While the Health Education South London Board met, the Membership Council took part in workshops led by the Health Innovation Network on the theme of patient engagement. After lunch, the Health Education South London board fed back the outcomes of its meeting to the whole Membership Council outlining how the views of the Council have impacted upon their discussions. Diabetes Clinical Theme - Health Innovation Network Dr Charles Gostling (pictured right), Joint Diabetes Clinical Director, described the main areas of work for the Diabetes theme: supporting self-management including patient education and care planning; adopting new technologies; and enabling an integrated care system for diabetes. Two workshops in July had taken place to explore self-management and new technologies, and more than 70 people gathered in September to explore integrated care across South London. Key priorities and emerging themes include: improving systems and processes to encourage people with diabetes to participate in education and training programmes to support self-management; working with commissioners and providers to increase the choice of education programmes available, including online courses, culturally sensitive methods of delivery and short taster courses; improving self-management in people with Type 1 diabetes through the adoption of appropriate technologies; and integrated care across all organisational boundaries, with care managed away from hospital settings wherever possible. The Diabetes team is now currently reviewing the feedback and ideas generated from these events to formalise key project priorities and strategies. 6
Patient Experience Patient experience is one of the Health Innovation Network s cross-cutting themes. The Network is currently working with Patient Opinion, an online feedback platform for health services. Paul Hodgkin from Patient Experience demonstrated the forum and shared examples of how the real-time feedback has helped to improve services and experience. Sam Hudson (pictured right), the Project Manager for the Experience cross-cutting theme, led delegates through a number of human centred design activities, sharing stories of patient experiences and then exploring and building on ideas through a creative how might we? process, to generate ideas for improving the patient experience in South London. CPPD (Continuing Professional and Personal Development) Review Dr Marilyn Plant, (pictured left) SRO for the Strategic Review on behalf of the HESL Board explained what CPPD is and why the review is needed. Only a small proportion of the total LETB budget is spent on developing the existing workforce. It is therefore essential that this resource is used effectively to support strategic priorities. There are clear links between CPPD and the priorities set out in HESL s Workforce and Skills Development Strategy so it is important that the process is fit for purpose for both now and the future. Marilyn reported that phase one of the review had been completed. This has included the initial scoping exercise and stakeholder engagement across South London. Members present at the Council meeting were asked to discuss in groups and rank a list of identified themes regarding CPPD in order of priority. From the feedback given there were three themes that were highly prioritised: Multidisciplinary, whole team approach to topics that transcend organisational boundaries Link to shift of care into the community and out of hospital care Link to assessment of population needs rather than to individual choices or provider preferences However, the shift of care into the community, improving primary care, linking to commissioning plans, networks and sustainability of services and integration were seen as linked. Collectively these four themes were also prioritised. The next steps of the review are for a stakeholder-led task and finish group to be convened to test the findings and agreeing a framework and paper to present to the HESL Board in January. For more information about anything in this paper please contact: info@southlondon.hee.nhs.uk for Health Education South London related queries hin.southlondon@nhs.net for Health Innovation Network related queries For general enquiries please email: engage@southlondon.hee.nhs.uk 7