Transcript Slide 1

Development of the Investment Plan
October 2013 Update
UPDATE ON PROCESS
Initial submission 1.9.13
Financial Model issued
Second submission 4.10.13
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CONTENTS
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4.
5.
Strategic direction
Recent findings
Training changes in 2014/15
Financial impact
Key risks
Strategic Direction: Transformation Themes
that cut across Spending Programmes
• Staff able to function in primary and community care settings
• New roles recognised alongside more familiar roles
• More integrated and team training with patient experience focus
• Full usage of flexible training routes so can be more responsive
• Build confidence and competence to work within high tech
service delivery alongside patients as experts in their own care
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Investment Plan: Our Strategic Direction
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a)
Investment Category
Future Workforce
FW Non-Medical
Strategic Direction
Increase current output of qualified nurses and others to maintain numbers due
to retirements or training for other roles, e.g. Health Visitors, Sonographers,
Advanced Practitioners to address gaps in medical staffing capacity in hospitals
and community, provide a higher quality of service to patients and maximise
staff potential
b)
FW Undergraduate
Placements – Medical,
Dental and Non-Medical
Continue to provide sufficient high quality clinical placements for current and
future student numbers; increased confidence in primary and community care
settings; continue transition to a standard national placement tariff
c)
FW Postgraduate Medical
and Dental
Increase the number of GP trainees and trainees in other shortage areas;
reduce in areas where there is evidence of oversupply due to widespread CCT
expansion; begin implementation of a standard postgraduate tariff
2
Workforce Development
Increase the quality and capability of support staff in order to ensure minimum
standards met and to take on assistant roles. Support team development; good
management and leadership; specialist post registration training, e.g.
dementia and other mental health issues, older people, use of technology
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4
Education Support
Running costs
Maintain capacity to effectively support and quality assure training
Reduced spend
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Cross cutting
Ensure focus on values and behaviours, skills development and primary care.
Quality of training. Deliver regional leadership development strategy.
Our Most Recent Findings: What Trusts have
been telling us (in relation to our Investment Plan)
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Confirmed overall strategic direction
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Medical workforce
gaps now at consultant level in Psychiatry, A&E, GP, Anaesthetics & Medicine
gaps now at specialty training level ( Acute & Emergency Medicine and medical)
high locum spend
extended training lengths (Paediatrics, Obstetrics and Gynaecology)
Non-medical workforce
seeking to increase advanced Nurse Practitioners but numbers not firm
gaps now in some areas in midwives, health visitors and nurses
skills gaps exist within specific services
particular challenges in providing physical and mental health care simultaneously and
patients that are older, more frail and more dependant
pharmacists and healthcare scientists areas of risk not always fully recognised
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Support staff – plans indicate intention to reduce number of clinical support staff despite
narrative and dialogue to the contrary
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Advanced Practice and Post Registration specialist training - priority in Acute Medicine,
Emergency Medicine, Paediatrics, Surgery and Anaesthesia
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* a more detailed feedback report is available from Jonathon Brown
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Investment Plan: Training Changes in
2014/15 - Work in Progress
1
a)
Future Workforce
FW Non-Medical
b)
FW Undergraduate
Placements – Medical,
Dental and Non-Medical
FW Postgraduate Medical
and Dental
What we are investing more in
What we are investing less in
Nursing (+182 or 9%) plus small
increases in ODP , Paramedics, IAPT
practitioners + Clinical Psychology,
Radiography, Scientists. Large
increase in
advanced practitioners (circa +150)
Health Visitors
(-98, because the national target is on
track)
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Workforce Development
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4
Education Support
Running costs
Approx 50 fewer medical student
More placements in primary care
placements as prior year over
and other community settings
recruitment peak works through
52 additional GP trainees, ACCS
Circa 70 fewer hospital posts across
Emergency Medicine, Intensive Care core and higher anaesthetics, surgery
Medicine, Radiology
and higher medical specialties
Increased leadership investment
Some reduction maybe required –
work in progress
Maintain current levels
Work to 15/16 lower target
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National activities
Implications of changes in training GPs, pharmacists and HCS
c)
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Specifics
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Range of course lengths and entry points into nursing to increase flexibility with aim to
get all nurses more adaptable and flexible so first post can be anywhere
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Consideration of demand for return to practice + secondments to training
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New models of induction into first roles in primary and community care
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Run through training from radiography qualification into sonography
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Change to degree level ODP training (with paramedics to come)
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Better idea of what schools require from health input to link with increased IAPT activity
(rather than just school nursing)
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More detailed work with primary care on competences for practice nurses and support
staff and associated training available to fulfil these requirements
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Groups looking at range of HCS and pharmacy developments required / possible
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Investment Plan Key Risks –
as at October 2013
Financial
• Costs: tuition fees (BMP) and pay and prices
• Total Funding: 14/15 Allocation: for HEE
• How the cake is cut • impact of activity-based Financial Model on ability to fund ‘new roles’ and reallocate
resources
• Postgraduate tariff
• Impact of national formula for education support
• Impact of tariff transition on HEYH
• Leadership
• Ability to implement the plans (recruitment, take up of new roles, etc.)
• Medium term cumulative impact of GP expansion and national training model changes
• Tuition fee support to medical students, including the intercalated year
Service and outcomes
Posts reductions, transformation challenges
Service delivery does not change and new posts not created to take up advanced and
associate practitioners and other new roles
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