Hillingdon Primary Care Workforce Plan 2015-6 Primary Care Transformation Group Tuesday 14 th July 2015 (Version 4 has been to CCG Governing Body OD on Wed 3 rd June and reduced Version 5 has been to GP Biannual on Wed 24 th June)
Hillingdon Team CCG Board CCG Leads Forum Leads Network Leads Network Education Leads: Dr Steven Shapiro CCG Board Primary Care Lead Dr Sabby Kant CCG Clinical Lead for Education and Training Helen Delaitre CCG Head of Primary Care Development Dr Raj Karsandas CCG First5 Engagement Lead Dr Bhavika Vagani CCG First5 GP Forum Lead CCG Nurses Forum Lead Annette Alcock CCG Primary Care Workforce Lead Nicci Hilson CCG Primary Care PCI Lead Dr Anil Raj / Ritu Prasad MetroHealth Dr Kitur Patel WellCare Dr Pinkinder Sahota Concorde Dr Simria Tanvir / Sue Thurlow Clover CCG Events Coordinator
Workforce Objectives Aim To place education, training and workforce planning at the centre of primary care development, to strengthen evidence-based outcomes, leadership, know-how and skills-mix, to promote health, improve patient care and make primary care services sustainable within the environment of integrated care delivery. Objectives To address the challenge of the workforce crisis To support the development of new models of care and new workforce roles To understand the learning needs of the wider primary care workforce To influence the design and promote the uptake of funded training and education To collaborate with funding organisations, education providers, across BHH and with the GP Networks for consistent, quality and best value design and delivery of education programmes To evaluate training programmes and capture peer trainers and leaders To develop a sustainable structure for primary care learning including forums, appraisals, mentoring and innovative ways of delivering training and education
Workforce Cycle Designing education courses for the required workforce Training and upskilling the current workforce Developing new workforce roles within new models of care
2014-5 In Summary Training By Whom For Whom Cost Feedback Business Case Writing Project Management Appraisal & Revalidation Mental Health First Aid Receptionists PCC The Centre PremierIT - HeART MIND Prof Paice & Activation Business Theatre Network Leads (28) Network Leads (13) Nurses (54 at launch / 59 on system) Receptionists (15 in north / 8+ in west /? in south) Receptionists (48) MedicoLegal BPP Uni GPs and PMs (18 in north / 13 in west / 15 in south) 7,680 ( 274pp) 4,943 ( 380pp) 1,909 launch ( 35pp) 9,708 for 70 licences ( 30pp for 3yr) 18,000 (currently 400pp ) 4,230 ( 88pp) 6,855 ( 149pp) 2,445 for follow up 89% positive 93% positive 85% positive More demos Appraiser training 100% positive 5 point increase Reformat 87% positive 100% positive in west & south North negative re facilitator
2014-5 In Summary (continued) Forums and Working Groups First5 GP Forum leads appointed, contact with cohort being made, first social in June PM HR & Training Group band 1-4 non-clinical recruitment and competencies being launched at PM Forum in September Nurses Forum working group convened, lead nurse JD being written for advertisement in June Hillingdon Integrated Care Leadership Programme 16 GPs/PMs doing 12 week course IT Training proposal being consulted on at PM Forum in June Bucks Uni Courses Nurse / HCA Modules 17 nurses doing 20 modules including prescribing 2 receptionists doing assistant practitioner course Mentorship Course PCN Evaluation Masterclasses 148 attendees at first 3 Masterclasses (67; 47; 72)
Current Workforce Picture (case for change) Shortfall in primary care workforce including many staff near retirement Attract, upskill and retain workforce Undergraduate education does not promote primary care careers Work with HEIs and provide placements New models of integrated care rely on increased and consistent primary care management of patients Train new roles and support career pathways
Workforce GPs Care Management: LTCs, continuity of care, patient education Career Pathways: pathways to partnerships, portfolio working Urgent Care: acute episodes, exacerbations, palliative care General Practitioner Educators: placements for students, trainers for registrars, appraisers Leaders: business skills, leadership skills, succession planning Complex Care and Other Specialists: experienced, known patient caseload, enhanced skills, MDT chairing Whole Systems / Integrated Care Agendas
Workforce Nurses Network / ICP / WSIC Funding Bucks Training Assessment Whole Systems / Integrated Nursing Agendas Band 7 Care Management Nurses (enhanced clinical skills and competencies across LTCs) Practice Funding Minor Illness Nurses (prescribing / mental health / paediatrics) General Practice Nurses (core clinical skills) Out of Hospital Service Nurses (diagnostics) UWL Training Report Nurse Mentor Training Primary Care Placements (in Bucks bid ) Nursing Degree (with Accreditation of Prior Experiential Learning?) Primary Care Transition Course (LMC, Bucks, UWL) Joint Working between Acute / Community / Primary Care Nurses Whole Systems / Integrated Nursing Agendas Undergraduate Student Nurses HCAs / HCSWs Acute / Community Nurses
National Competency Framework for Bands 1-4 Workforce HCAs / HCSWs Assistant Practitioner Level 5 Foundation Degree (Bucks) Defining Band 3 / 4 roles? Mapping competencies to roles? Health Care Assistant / HC Support Worker / Higher Apprenticeship / Higher Care Certificate? Clinical Apprenticeship Level 2 / 3 Clinical Modules (LMC, MKM, Annie Bar) Designing training course for HCA/SWs? National Framework (HENWL) Shape of Caring Report Care Certificate (Induction) 15 National Standards (Skills for Care / Health)
Workforce Management Network Employed Network Business Manager / COO Across Practices? Practice/s Business Manager Within Practice Practice Operational / Clinical Services Manager Receptionists Medical secretaries Administrators
Workforce New Roles Nurse Prescribers Independent Pharmacist Prescribers HENWL Scoping / Funding? ICP / WSIC Proposals Band 5 Care Coordinators (clinical or nonclinical?) Physician Associates HENWL Pilot NWL ICP Learning Set & Evaluation Health & Social Care Coordinators Primary Care Navigators Bucks Evaluation Mental Health Navigators
Workforce Priorities From the solutions to the current workforce picture (in the blue arrows) and from the new elements of each workforce group (highlighted in pink), the workforce priorities are: Attract, upskill and retain workforce Work with HEIs and provide placements Train new roles and support career pathways GPs training in leadership, business and MDT skills HCAs care certificate HCAs training in consistent clinical skills Nurses student placements with nurse mentors in GP practice Nurses new care management nurse role and associated training Care Coordinators / PCNs evaluation of current roles, design of new roles and associated training GPs newly qualified career pathways to partnership or with portfolios PMs new business and network manager roles Pharmacist Prescribers new career pathway in GP practice
2015-6 Funding Streams Funding Stream CCG Masterclass CCG Masterclass Bucks University HENWL CCG CPPD Allocation HENWL CCG CPPD Allocation HENWL Indirect CPPD Courses How Much 40,000 60,000 24,340 13,760 Is it Recurrent Yes No No No Yes Yes HENWL additional Where is it From HCCG PMCF 2014-5 BHH CCG allocation 2014-5 HENWL HENWL What is it For Monthly themed masterclasses for primary care clinicians Nurse mentor Nurses Forum and training and PCN Network IT training evaluation First5 GP Forum NWL GP practice staff CPPD training Who is it For GP practice clinical staff GP practice nurses and administrative staff GP practice nurses and Bucks evaluation team Newly qualified GPs in their first 5 years of work NWL GP practice staff - mostly practice nurses
Workforce Actions (See attached Workforce Action Plan for more details) Workforce Role Priority Action Dependencies GPs: Newly Qualified Set up First5 forum Support career pathways to partnership or with portfolios of work GPs: Enhanced Skills Provide training for care management / MDT chairing Select / bespoke training courses Decide on numbers and funding stream/s GPs: Leaders Provide training for leadership and business skills Nurses: Student Placements Provide training for nurse mentors Provide GP practice placements for student nurses Nurses: Core Skills Select / bespoke training courses Decide on numbers and funding stream/s (including HENWL Indirect CPPD) Nurses: Care Management Define role/s functions and competencies Design training course Decide on numbers and funding stream/s GP practice or CCG opportunities WSIC / ICP models of care Bucks bespoke mentorship training Bucks student nurse placement bid GP practice opportunities WSIC / ICP models of care Integrated nursing redesign
Workforce Actions (continued) Workforce Role Priority Action Dependencies HCAs: Care Certificate Communicate and support Care Certificate requirements HCAs: Clinical Skills Define role/s map competencies Select / bespoke training course Decide on numbers and funding stream/s Managers: Business and Network Managers Define role/s functions and competencies Select training course Decide on numbers and funding stream/s Pharmacist Prescribers Define role/s functions and competencies Support deployment in GP practice London-wide work London-wide work GP practice opportunities HENWL scoping GP practice opportunities Care Coordinators and PCNs Evaluate the roles Define new roles/s functions and competencies Select / bespoke training courses Bucks / ICP work GP network opportunities