East Midlands Personalisation Programme
Workforce Development Workshop
Joseph Silva
(iMPOWER)
Marie Lovell
Christine Collymore
(Skills for Care)
14/05/2009
The contents of this document are © iMPOWER Consulting Ltd unless otherwise stated
Registered office: 14 Clerkenwell Close, London EC1R 0AN Registered in England and Wales No: 3876501
Agenda
Introduction and objective setting
How big is this change?
What shapes the future workforce?
New types of working – how others have approached it
Lunch
Case studies from participating LAs
Group exercise
Practical next steps
2
Timetable
Introduction and objective setting
1015 -1030
How big is this change?
1030 -1115
What shapes the future workforce?
1115 -1130
New types of working – how others have approached it
1130 -1230
Lunch
1230 -1315
Case studies from participating LAs
1315 -1345
Group exercise
1345 -1445
Next steps
1445 -1500
3
Agenda
Introduction and objective setting
How big is this change?
What shapes the future workforce?
New types of working – how others have approached it
Lunch
Case studies from participating LAs
Group exercise
Practical next steps
4
How big is this change?
Workforce challenges emerging from SDS
 The implications of SDS on the workforce are wide ranging and there will be few
sections of the organisation which will remain unaffected by its implementation.
Organisations previously considered external to councils will also be affected by these
changes.
Scope of workforce affected:
 Assessment and care management workforce.
 In-house service provider workforce.
 Private sector provider workforce.
 Voluntary sector provider workforce, and volunteers.
 Commissioning and contracting.
 Procurement workforce.
 The implementation of SDS provides authorities with the opportunity to now develop
their workforce in order to respond to individual need and required outcomes and a
process where there is a new emphasis on the citizen having real choice and control .
5
Agenda
Introduction and objective setting
How big is this change?
1. Organisational structure challenges
2. Potential for efficiency savings
3. Workforce challenges
What shapes the future workforce?
New types of working – how others have approached it
Lunch
Case studies from participating LAs
Group exercise
Practical next steps
6
Organisation Structure:
Challenges emerging from SDS
 SDS implies a new organisation structure which delivers
a new balance between control and delegation:
 Enabling and supporting individuals to make their own choices
and take control, while retaining safeguarding responsibilities.
 Managing transparency – managing expectations of customers,
a focus on equity, and clearly separating advice about choice,
from delivery of care.
 Market management techniques and encouraging innovative
supply, and less on managing contracts and providers.
 Financial and performance reporting based around outcomes
and overall spending, and less on unit costs and input
measures.
7
Organisation Structure:
Recommended organisational change
(SAMPLE)
Structural change
Rationale – why consider?
Separate out inhouse provided
services from
assessment & care
management.
 Clear split between care navigation and care provision, greater impartiality.
 Enables more focused operational management on performance
improvement / commercial-style delivery of in house services.
 Clearer budgeting approach with in house services are a cost and revenue
centre under SDS.
Locate duty teams
in expanded
contact centre.




Create generic
locality-based care
management
teams.
 More of the assessment process taken by contact centre.
 SDS model is equitable across different client groups (single SAQ & RAS).
 Does not exclude potential for some specialist support for particularly
complex / difficult cases.
Locate some
commissioning staff
in area offices.
 Commissioning function will rely on local intelligence and knowledge of local
solutions.
 Can have a clearer focus on supporting local innovation / flexibility in supply.
 will provide clear conduit of information through to centre where this informs
strategic issues.
More consistency of assessment processes.
More efficient use of staff time, assumes phone and web based first contact.
Easier provision of self-assessment and mediated (phone) assessment.
Greater synergies with in touch team.
8
Organisational change:
In house service split options (SAMPLE)
Structural change
No change
Incremental
Significant
Separate out inhouse provided
services from
assessment & care
management.
 No change. Split not
required / seen as
beneficial.
 Separate in-house
services and make
direct report to
Director.
 Create new ‘Head of’
role to run new
division.
Pros
 Reduces amount of
change at a
challenging time.
 Provides separation
without additional
cost.
 Provides absolute
clarity and
accountability.
 Opportunity to bring
in commercial skill
set.
Cons
 Does not recognise
the potential conflict
of interest issue.
 May simply defer the
problem.
 Requires Director to
take too operational
a focus.
 May cost more at a
time of reducing
management
headcount.
9
Organisational change:
Contact centre / duty teams (SAMPLE)
Structural change
No change
Incremental
Significant
Locate duty teams in
expanded contact
centre.
 Keep separate duty
teams.
 Move some staff into
contact centre,
retaining some
cover in area offices
 Move all duty teams
and most
assessment
processes into
contact centre
Pros
 Reduces amount of
change at a
challenging time.
 Provides separation
without additional
cost.
 Clear focus for
teams moving and
for teams remaining
in area offices.
 Larger efficiency
opportunity.
Cons
 Does not meet
corporate direction of
travel.
 Reduces efficiency
opportunity.
 Muddies focus of
respective teams
 Could lead to
process /
accountability
confusion
 Will areas offices be
viable in their
reduced scale?
10
Organisational change:
Generic locality teams (SAMPLE)
Structural change
No change
Incremental
Significant
Create generic
locality-based care
management teams.
 Preserve existing
specialist model
 Retain reduced
number of some
specialists in areas
 All area teams
generic
Pros
 Reduces amount of
change at a
challenging time.
 Provides local cover
for specialist /
complex cases.
 Consistency and
clarity of role and
process.
 Flexibility / cover
between area offices
when capacity
issues.
 More efficient use of
time.
Cons
 Reinforces existing
inequalities between
different client
groups.
 Limited efficiency
opportunity.
 Small scale may
prove difficult to
justify a hybrid team
 Risks losing
specialist knowledge
at local level.
11
Organisational change:
Some commissioning based locally (SAMPLE)
Structural change
No change
Incremental
Significant
Locate some
commissioning staff
in area offices.
 Commissioning staff
all located centrally
 Rotation / regular
local visits for some
commissioning staff
 Permanent location
of local
commissioning staff
in area offices
Pros
 Concentrates skills
at centre.
 Not as disruptive as
full scale change.
 Opportunity to build
real local knowledge
and intelligence
 Gets closer to
communities and
customers.
Cons
 Lose local
knowledge and
opportunity for
innovation.
 Lack development
of market
management skills
 Neither one nor the
other; could be
worse than no
change.
 Would not be easy
to ensure a team
feel to
commissioning
function.
 Is there sufficient
scale in the team?
12
Agenda
Introduction and objective setting
How big is this change?
1. Organisational structure challenges
2. Potential for efficiency savings
3. Workforce challenges
What shapes the future workforce?
New types of working – how others have approached it
Lunch
Case studies from participating LAs
Group exercise
Practical next steps
13
Professional and administrative support:
context (SAMPLE)
Included

The opportunity to streamline the
assessment and care management
process.

The opportunity to shift the ratio of
qualified social workers to nonqualified care workers.

The opportunity to reduce how
much support planning the
council will pay for under the new
model.
Not included

Assessment of opportunity to
reduce size of strategic
commissioning, performance,
supporting people or business
improvement. Strategic
commissioning has recently been
redesigned, and will need to
change role again, but does retain
a vital function in market
management.

Assessment of opportunity to
reduce costs of home care and
day care services. These services
are considered as costs of care
and are both currently under
review.
14
Drivers of efficiency in Professional
and Administrative support
1. More efficient
assessment
process
2. Shift ratio from
qualified to nonqualified staff
3. Reduce
investment in
support planning
Streamlined process involving
contact centre
More focus on initial contact
(phone based)
Support planning requires
more time under the new
model
Some / all of assessment form
completed by individual
Less focus on assessment
process
Does not all have to be done
by the local authority
Generic teams allowing
greater flexibility
More focus on support
planning process (skilled but
not necessarily QSW)
Could be externalised
(funded) and or externalised
(not funded)
Mobile working enabling faster
/ accurate data entry
Less time on routine tasks,
more time on complex cases
and oversight, for QSWs
Most clients will draw on some
level of social capital in any
case
Transition may require
higher investment in
process before savings
can be realised
Likely to cost a lot in
redundancy and pensions
strain and will take time to
transition
A possible area for longer
term cost reduction but
unproven and risky in the
short term
15
The individual budgets process
enables a more efficient use of staff
time (SAMPLE)
Current process
Proposed process
 High level of qualified time involved in
verifying referral information, initial
contact with client and data collection.
 High level of paper based assessments
by qualified staff.
 High number of separate steps in
customer journey, and a higher volume
of decision points.
 High percentage of qualified social
worker time required to provide
info/advice and guidance following
Contact Assessment.
 Qualified time in preparing care
purchasing paperwork and transfer to
Care Purchasing Coordinators.
 Skilled Contact Centre staff provide
initial screening of initial contact.
 Direct input of non-qualified staff onto
case management system.
 Reduced number of steps within
process.
 Initial screening addresses the
provision of advice and guidance prior
to Contact Assessment by unqualified
Contact Centre staff.
 Only complex decisions requiring need
for qualified input.
 CPCs are non-qualified roles which
would undertake the majority of these
tasks.
16
More efficient processes will be
reinforced by other important initiatives
(SAMPLE)
Opportunity
Comments
 Shift contact
staff to contact
centre
 Assumes phone and web based first contact –
requirement to encourage clients to use web-based selfassessment and mediated (phone) assessment
 More efficient use of staff time. Greater synergies with ‘intouch’ team
 Create generic
locality-based
care
management
teams
 More of the assessment process taken by contact centre
 Implement
Mobile working
 Pilot demonstrated opportunity to reduce assessment
process from 4.5hrs to 2hrs on average
 SDS model is equitable across different client groups
(single SAQ & RAS)
 Does not exclude potential for some specialist support for
particularly complex / difficult cases
17
Assessment and Care Management
Workforce modelling: illustrative
changes (SAMPLE)
Faster
process
Qualified staff
ratio
Less support
planning
QSW
NQSW
10% reduction
in process time
= 10%
reduction in
staffing costs
Change in ratio
from 1.5:1 to
0.75:1 = 6.4%
reduction in
staffing costs
18
10% reduction
in NQSW = 4%
reduction in
staffing costs
Workforce modelling: scenario
planning (SAMPLE)
Assumptions
Faster
process
(affects all
staff)
No change
Moderate
Ratio
(Q) to (NQ)
Reduce
support
(affects NQ
only)
Qualified
staff
Nonqualified
staff
Total A&CM
staff
Cost
reduction*
0.0%
1.5 : 1
0.0%
96
64
160
0.0%
5.0%
1.25 : 1
5.0%
83
66
149
-8.6%
1:1
10.0%
69
69
138
-17.2%
0.75 : 1
20.0%
53
70
123
-28.0%
Significant 10.0%
Radical
Staff implications
15.0%
*iMPOWER analysis using sample council salary data only
19
What is the appetite for risk?
(SAMPLE)
Moderate
Key
points
Risks
Significant
Radical
 7% reduction in ACM staff
numbers
 14% reduction in ACM staff
numbers
 23% reduction in staff
numbers
 Process improvement of 5%
 Process improvement of 10%
 Process improvement of 15%
 Small shift in ratio of Q staff to
NQ staff
 Shift in ratio of Q staff to NQ
staff of 1:1
 Shift in ratio of Q staff to NQ
staff of 0.75:1
 Reduction in 5% of staff doing
support planning
 Reduction in 10% of staff
doing support planning
 Reduction in 20% of staff
doing support planning
 Could be achieved through
natural wastage
 Reduction in social workers (27)
 Radical reduction in number of
social workers (-43)
 May not focus enough
attention on key changes
required
 Redundancy and pension
costs may be prohibitive
 Unclear whether safeguarding
responsibilities for vulnerable
client groups will be covered
 May not allow opportunity to
hire / relocate appropriate staff
into new roles
 Will be difficult to deliver
combined changes in short
term
 Could place other goals
(reduced care costs) at risk if
delivered too quickly
Long term direction of travel?
20
 Redundancy and pension
costs may be prohibitive
 Could place other goals
(reduced care costs) at risk
Agenda
Introduction and objective setting
How big is this change?
1. Organisational structure challenges
2. Potential for efficiency savings
3. Workforce challenges
What shapes the future workforce?
New types of working – how others have approached it
Lunch
Case studies from participating LAs
Group exercise
Practical next steps
21
Workforce
Challenges emerging from SDS
Change in Job Roles

Councils will need to carefully consider the competencies and role of care managers
and other health and social care staff and also consider the change in culture and use
an organisational development model of change management. There will need to be
an extensive programme of consultation with staff alongside additional investment in
training and development.

Some of the challenges which a change programme on this scale will need to
address include:
 Anxiety around new 'professions'.
 Shift of care managers to a more enabling role.
 Less control over packages of care.
 Development of multi skilled teams.
 Geographical location of teams currently (and possibly move to generic locality
based teams).
 Increased awareness and skills in risk management.
 The abilty of the worker to 'let go'.
 The ability to work within new structures, with new networks and partners.
22
Agenda
Introduction and objective setting
How big is this change?
1. Organisational structure challenges
2. Potential for efficiency savings
3. Workforce challenges
What shapes the future workforce?
New types of working – how others have approached it
Lunch
Case studies from participating LAs
Role development exercise
Practical next steps
25
From Vision to Workforce Development
utilising the Target Operating Model
Contact
centre
F2F Home
Web
email
LSC
Customer channels
The
Customer
Journey
Adult
services
Culture &
Tourism
Community &
Customer Service
Service breakdown
Generic
Services
Model
Operational
Target
blueprint
Operational
Vision
for
Putting People
First
Semi Specialist
Specialist
Processes
Roles
Skills
People
Adult
Services
Community &
Customer Service
Culture &
Tourism
Organisational structure
CTS
CareFirst
Galaxy
Leisure system
Systems infrastructure
Contact
Centre
LSC ’s
Building
1000
Physical sites
26
Other Sites
Workforce
Development
Strategy
Key recommendations (SAMPLE) 1
Area
Key decisions (summarised)
Customer
channels
1.
2.
3.
4.
Processes
1. Adopt the new customer journey
2. Bring financial assessments forward in the process
3. Replace ‘charging’ with ‘contribution’ netted off at source
Services &
Commissioning /
1. Customers will have no choice about use of block contracts (until places are
filled)
2. In-house services will be traded for 2 years – customers have choice
3. Commissioning function redesigned reflecting move to market management
4. Some commissioning staff to be based in localities
5. Develop / implement a strategic engagement strategy to ensure the effective
participation of service users in SDS
People /
workforce
1. Form non-specialist, generic teams in area offices
2. Shift ratio of social workers to care navigators
3. Ensure sufficient support and training is provided to drive the cultural changes
required
4. Ensure robust and targeted corporate communication plan for delivery of
workforce changes across ASC
Move duty teams into contact centre
Move majority of the new customer journey into the contact centre
Enable self-assessment online
Push all first assessments through the contact centre
27
Key recommendations (SAMPLE) 2
Area
Key decisions (summarised)
Org structure
1.
2.
3.
4.
Systems / IT
1. Non-technical solution for deployment of phase 1.
2. Synchronise any major changes in systems around the SWIFT refresh date of
2011.
3. Start planning now for requirements and re-procurement.
4. Examine potential for an additional customer-based solution (e.g. S4S).
Physical sites
1. Ensure ASC is fully appraised of the economic value of in-house properties.
2. Design a flexible workforce model capable of deployment regardless of
corporate plan for physical sites.
Financial
sustainability
1. Adopt FSM as core planning tool for programme benefits realisation.
2. Present FSM to COMT and corporate transformation team.
RAS
1. Adopt proposed RAS for phase 1.
2. Implement further refinement and monitoring .
Implementation plan
1. Sign off implementation plan and provide mandate for Programme Manager to
commit resources to deliver.
2. Enforce adoption of all ASC project work as part of the overall programme.
Separate in-house provided services from assessment & care management.
Locate duty teams in expanded contact centre.
Create generic locality-based care management teams.
Locate some commissioning staff in area offices.
28
Agenda
Introduction and objective setting
How big is this change?
1. Organisational structure challenges
2. Potential for efficiency savings
3. Workforce challenges
What shapes the future workforce?
New types of working – how others have approached it
Lunch
Case studies from participating LAs
Group exercise
Practical next steps
29
Good practice examples
Background
 Skills for Care
 New types of worker programme
Areas
 Raising awareness
 New roles
 Practice development
 Provider market
 Strategic workforce planning
30
New Types of Working
Local Authorities involvement
 Internal staff
 Micro employers
 Personal assistants
 Private, voluntary and independent sector
 Informal carers
31
Future development
 Personal Assistant - induction standards
- training
 National Minimum Data Set to capture micro employers and
personal assistant data
 InLAWS – Integrated local area workforce strategies
32
Key resources
 Common core principles
 Principles of workforce redesign
 New types of working website – www.newtypesofworker.co.uk
 Adult social care workforce strategy
 Qualifications and Credit Framework
33
Key resources
 Leadership and management
 National minimum data set – social care
 National Occupational Standards
 Knowledge Sets
 Regional contact person
34
Agenda
Introduction and objective setting
How big is this change?
1. Organisational structure challenges
2. Potential for efficiency savings
3. Workforce challenges
What shapes the future workforce?
New types of working – how others have approached it
Lunch
Case studies from participating LAs
Group exercise
Practical next steps
35
Agenda
Introduction and objective setting
How big is this change?
1. Organisational structure challenges
2. Potential for efficiency savings
3. Workforce challenges
What shapes the future workforce?
New types of working – how others have approached it
Lunch
Case studies from participating LAs
Group exercise
Practical next steps
36
Discussion by LAs
37
Agenda
Introduction and objective setting
How big is this change?
1. Organisational structure challenges
2. Potential for efficiency savings
3. Workforce challenges
What shapes the future workforce?
New types of working – how others have approached it
Lunch
Case studies from participating LAs
Group exercise
Practical next steps
38
Group exercise
1. Break down into groups of 5 or 6.
2. Designate a reporter to feedback to the wider group.
3. Choose one of the five areas that have been discussed
earlier (repeated below). Identify the issues and
challenges in this area and provide one recommendation
that you will need to undertake to ensure the successful
delivery of this element.
 Raising awareness amongst social care providers
 Developing new roles
 Practice development
 Workforce changes within service providers
 Strategic workforce planning
39
Agenda
Introduction and objective setting
How big is this change?
1. Organisational structure challenges
2. Potential for efficiency savings
3. Workforce challenges
What shapes the future workforce?
New types of working – how others have approached it
Lunch
Case studies from participating LAs
Group exercise
Practical next steps
40
Next steps
 Regional Improvement and Efficiency Partnership
 Regional workshops
 Support to each Local Authority
41