1
Version 7 June 2014
Birmingham and Solihull Local Education and Training Council
WORKFORCE DEVELOPMENT PLAN
1.0 EXECUTIVE SUMMARY
The LETC Workforce Development plan represents an aspirational 5 year strategy for the
development of the Birmingham and Solihull workforce. It is a live document that will be
refreshed annually, updating progress on previous years’ work and developing detailed action
plans for subsequent years. Regular review will allow capacity for inclusion of new priorities to
take place in response to changes in national service priorities and the changing local
landscape, as well as celebrating and building on successes. The plan seeks to articulate the
practical workforce implications and action plans arising from each of the identified
programmes of work.
Strategic Drivers:
The plan is driven by key service priorities for Birmingham and Solihull and has been
developed through a robust iterative process with LETC members, who comprise a range of
healthcare providers, commissioners and Higher Education Institutions (HEIs). It is
underpinned by 4 Strategic Drivers which are fundamental to the development of an effective
workforce and apply across all 5 years of the plan. They are:
A. Implementation of Francis review recommendations
B. Integrated Care and implementation of the Integrated Transformation Fund
C. Future hospital commission
D. Out of hospital care
Programmes of Work:
Six programmes of work, some of which are core annual deliverables, were formally agreed by
the LETC in summer 2013. Each of these programmes contains a series of specific workforce
development needs that have been identified as a priority area or highlighted from the 2013/14
workforce planning round.






Workforce Planning (core, annual)
Workforce Development across care pathways
Support for the existing workforce
National HEE Mandate priorities (core, annual)
Education Commissioning and Quality (core, annual)
Effective delivery
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Version 7 June 2014
Other Core Deliverables:
There are a number of other core annual deliverables not included but implicit within the
LETC’s annual business, including:



Annual refresh of the Workforce Development plan
Deliver Birmingham LETC Leadership priorities in collaboration with the Local Delivery
Partnership (LDP)
Deliver an Organisational Development plan for the LETC.
Annual Projects:
The remainder of the plan has been divided into annual project deliverables. Some of these are
discrete projects, whereas others reflect multi-year programmes or where preparatory work
takes place in one year before delivery in subsequent years. Formally updating the plan
annually will allow recognition of the work delivered in previous years, set a clear expectation
for what the LETC will deliver in the following year and allow identification of the resources
required to deliver the priorities. This will also allow for inclusion of national HEE Mandate
deliverables on a yearly basis. Some workstreams are specific to the LETC, others are regional
or national priorities where the LETC is required to develop a response and some are regional
priorities where Birmingham is the lead LETC.
Projects currently in progress for 2013/14 include:
 Primary care
 Older adults workforce integration programme
 End of life
 Widening participation - access
 Widening participation - progression
 Recruiting for values – pre-degree care pilot
 Leadership
 Dementia
 Learning disabilities
 Emergency medicine
 Simulation
Project deliverables 2014/15:
 Older adults nurse registration
 Advancing practice
 Physician’s associates
 Changes to the medical workforce
 Nursing shortages
 Theatre staffing
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Version 7 June 2014


Sonography
Widening participation - apprentices
Project deliverables 2015/16:
 Integrated care
 Maternity & new-born service review
 Children’s service review
 Upskilling
 Healthcare science – practitioner workforce
Headline information only is available for priority deliverables in 2016/17 and 2017/18. Current
projects included in this section are at present continuation from previous years; however the
annual plan refreshes will allow more detailed development of these sections in preceding
years.
Resources Required:
Specific resources will need to be identified for each of the projects, over and above any
regional resource. Given the need for effective governance around any spend, considerations
around resourcing could be summarised into three areas:



Collaboration between providers, building on existing knowledge and good practice and
establishing sustainable working partnerships
A different approach to using existing resource, for example a consensus approach to
using CPD / LBR monies
Clarity around use of awarded funds, for example
o To pump-prime activity
o Undertake scoping activity to develop proof of concept
o Large scale rollout at pace of an existing exemplar project
Summary:
This outlines the rationale, structure and content of the 5 year Skills and Development strategy,
which the LETC is fully signed up to deliver. A précis of work currently taking place and
planned for 2014/15 has been presented, along with a summary of resources required to
deliver this.
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Developing
people
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healthcare
www.wm.hee.nhs.uk
[email protected]
@HealthEd_WMids
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Version 7 June 2014
Contents
1.0 EXECUTIVE SUMMARY .......................................................................................................................... 1
2.0 CONTEXT ............................................................................................................................................... 6
3.0 BLETC Business Plan Matrix .................................................................................................................. 8
3.0 CONCLUSION AND NEXT STEPS........................................................................................................... 15
Core Annual Deliverables 2013-2018 ....................................................................................................... 16
Summary of BS LETC Deliverables 2013/14 .......................................................................................... 17
PRIMARY CARE (GENERAL PRACTICE) ............................................................................................... 19
OLDER ADULTS WORKFORCE INTEGRATION PROGRAMME ............................................................. 21
END OF LIFE ....................................................................................................................................... 24
WIDENING PARTICIPATION - ACCESS................................................................................................ 26
WIDENING PARTICIPATION - PROGRESSION .................................................................................... 29
RECRUITING FOR VALUES – PRE-DEGREE CARE PILOT...................................................................... 32
LEADERSHIP....................................................................................................................................... 36
DEMENTIA – led by MHI LETC ........................................................................................................... 39
LEARNING DISABILITIES – led by MHI LETC ....................................................................................... 42
EMERGENCY MEDICINE..................................................................................................................... 45
SIMULATION...................................................................................................................................... 50
Summary of BS LETC Deliverables 2014/15 .......................................................................................... 52
OLDER ADULTS NURSE REGISTRATION ............................................................................................. 54
ADVANCING PRACTICE – Regional proposal led by AHW LETC ........................................................ 55
CHANGES TO THE MEDICAL WORKFORCE ........................................................................................ 57
ADVANCING PRACTICE – BS LETC ..................................................................................................... 60
PHYSICIAN’S ASSOCIATES.................................................................................................................. 62
NURSING SHORTAGES ....................................................................................................................... 66
EVERY STUDENT COUNTS PROJECT .................................................................................................. 76
THEATRE STAFFING – Regional group ............................................................................................... 78
SONOGRAPHY – Led by BC LETC ....................................................................................................... 80
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Version 7 June 2014
WIDENING PARTICIPATION – APPRENTICES (Medical Engineering) ................................................. 82
WIDENING PARTICIPATION – Talent for Care: Supporting the delivery of Apprenticeships in
Birmingham and Solihull ................................................................................................................... 85
WIDENING PARTICIPATION - Extending the Role of MSWs in Maternity Care Project .................... 88
WIDENING PARTICIPATION – RISE Pilot Project ............................................................................... 90
WIDENING PARTICIPATION - Youth Academy Project ...................................................................... 92
Summary of BS LETC Deliverables 2015/16 .......................................................................................... 95
INTEGRATED CARE ............................................................................................................................ 97
MATERNITY & NEWBORN SERVICE REVIEW ................................................................................... 100
CHILDREN’S SERVICE REVIEW ......................................................................................................... 101
UPSKILLING...................................................................................................................................... 102
HEALTHCARE SCIENCE – PRACTITIONER WORKFORCE ................................................................... 105
Summary of BS LETC Deliverables 2016/17 ....................................................................................... 107
Summary of BS LETC Deliverables 2017/18 ........................................................................................ 108
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2.0 CONTEXT
The Birmingham LETC is in a unique position within the West Midlands. It comprises a
number of specialist providers which are being commissioned to deliver increased growth in
services as well as commissioned service developments, reflecting a picture of growth
unique to the region. Some of the proposed growth is contingent on regional or national
specialised commissioning outcomes and therefore timelines are uncertain, but generally
mainstream growth is seen in adult and children’s nursing, tertiary and maternity services to
2017. Some of the projected growth is expected in a short period of time, meaning that
increasing education commissions is not a solution and therefore more innovative solutions
must be created. The workforce development plan consequently takes into consideration
options other than increasing education commissions. Implicit within the plan is also the
LETC response to underpinning strategies from NHS England and Health Education
England (Fig. 2).
Figure 2: National NHS England and Health Education England priority areas
There are clear synergies between many of the different workstreams, particularly where
there are opportunities to benefit from regional work taking place. Examples of this include:
 Physician’s associates will benefit a number of workstreams not simply in
emergency medicine but also where there are other proposed changes to the
medical workforce supply including potential for extension in to primary care
services.
 Work on advanced practitioner frameworks will facilitate the development of
common competencies and expectations of the roles, supporting career progression
for staff and allow planned rather than reactive workforce planning and
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

development. Identification of required competencies could allow fast-tracking of
specialist practitioners into advanced practitioner roles by completing the
competency areas they are lacking rather than undergoing a full programme.
A sustainable physician’s associate and advanced practitioner workforce would
participate in medical rotas, offering the possibility of freeing up junior doctors to
focus on shortage specialty areas.
Work on the older adult workforce integration programme will support the vision for
integrated care. This can be extrapolated to other areas pending large scale service
review, for example in maternity services across Birmingham, Sandwell and Solihull.
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3.0 BLETC Business Plan Matrix
Key
A/B/C/D- Indicates how the priority will support delivery of one of our strategic drivers
Green = Annual Tasks are identified in Green (these may expand with increased devolution
to LETC)
Orange = Direct Delivery by BLETC
Blue = Areas where it is Regional /another LETC is taking a lead at the LETC would need to
participate e.g. Sonography. Some of these are awaiting clarity on lead arrangements.
Please note the timeframes for some of the later pieces of work need to be scoped and
therefore they may go into the final 2 years of the Business Plan.
With the matrix approach to delivery there is capacity in the final years of the plan to
accommodate delivery of workforce implications for current strategic drivers, priorities
identified in future workforce plans, changes in national policy.
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Strategic Drivers to be considered directly and as a critical element for all Programmes of Work and Individual Priorities below:
A- Implementation of Francis Review Recommendations
B- Integrated Care and implementation of the Integrated Transformation Fund
C- Future Hospital Commission
D - Out of Hospital Care
Programmes Workforce Planning Workforce
of Work /
Development across
Year of
Care Pathways
Delivery
2013/14
Improve workforce
Create workforce
planning intelligence development plan
to underpin decision 2013-18, with
making- DH
associated investment
priorities - GD
 Maintain a
sustainable,
 Deliver Innovation
quality and safe
Programmes and
service
ensure governance
Refresh skills and
 Identify risks
development strategy
(A/B/C/D) Q2
(A/B/C/D) Q3
Understand specific
workforce needs in
Older Adult Workforce
primary care- AHW
LETC Karen Storey, Integration
Programme – DH
HEWM
(A/B/D)
(A/B/C/D)
Support for the
Existing Workforce
National HEE
Mandate
Priorities
Education
Commissioning
and Quality
Effective Delivery
Support Leadership
Delivery Partner and
deliver BLETC
leadership priorities
on Medical Train the
Trainer- TN
(A/C)
Emergency
Medicine –
Regional Matt
Aiello
(A/C)
Shape multi
professional
approach to
quality of
education
provision
Maintain a
sustainable,
quality and safe
service –LB
(A/B/C/D) Q3/4
LETC OD Plan- NS
Widening
Participation
Partnership
Forum –
Regional- GD
(A/B/D)
Widening
ParticipationAccess and
Progression- GD
(A/B/D)
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Contribute to
development of
WM Simulation
Strategy- IB
(A/C)
10
Recruiting for
values
(pre-degree care
pilot)- LB
(A)
Identify the workforce
requirements and
ensure delivery of
service transformation
in Dementia and
Learning DisabilitiesMHI LETC Faith
Nwolisa / Chris Oakes
(B/C/D)
End of Life Projects NS,DH, TN, HG
(B/D)
2014/15
Improve workforce
Refresh workforce
planning intelligence development plan
to underpin decision 2013-18, with
making -DH
associated investment
priorities - GD
 Maintain a
 Deliver Innovation
sustainable,
quality and safe
Programmes and
service
ensure governance
 Identify risks
 Refresh skills and
(A/B/C/D) Q2
development
strategy
Understand
(A/B/C/D) Q3
Changes to Medical
Workforce Supply – Older Adult Workforce
PB
Integration
(C/D)
Programme Older
Adult –DH
Support Leadership
Delivery Partner and
deliver BLETC
leadership priorities
on Medical Train the
Trainer -TN
(A/C)
Nursing ShortagesAdult General
Nursing/ Paediatrics
– TN (A)
SonographyBCLETC- NS
(C)
Emergency
MedicineRegional
Physician’s
AssociatesRegional Matt
Aiello
(A/C)
Widening
Participation
Partnership
Forum –
Regional- GD
(A/B/D)
Widening
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Shape multi
professional
approach to
quality of
education
provision
Maintain a
sustainable,
quality and safe
service – LB
(A/B/C/D) Q3/4
Contribute to
development of
WM Simulation
Strategy- IB
(A/C)
LETC OD Plan - NS
Increase effectiveness
of working within
system focusing on
primary care and social
care – NS
(B/D)
11
Bespoke Workforce
Plan in TheatresRegional- Sarah
Harrison (HEWM),
IB
(C)
(A/B/D)
Postgraduate Older
Adult Nurse
Registration
Programme- DH
(A/B/D)
Identify the workforce
requirements and
ensure delivery of
service transformation
in Dementia and
Learning Disabilities
Faith Nwolisa / Chris
Oakes, SW
(B/C/D)
Advancing Practice
Framework
(including nonmedical
prescribing)(bands
7-8) - AHW LETC
Jane Emson, Mark
Radford
(A/C/D)
ParticipationIncrease
Apprenticeships,
Access and
Progression- GD
(A/B/D)
Recruiting for
values
(pre-degree care
pilot) – LB (plus
others if pilot
extended)
(A)
Develop strategic
approach to
supporting primary
care workforceRegional?
(A/B/C/D)
End of Life ProjectsNS,DH, TN, HG
(B/D)
2015/16
Improve workforce
Create workforce
planning intelligence development plan
to underpin decision 2013-18, with
making
associated investment
priorities
 Maintain a
 Deliver Innovation
sustainable,
quality and safe
Programmes and
service
ensure governance
 Identify risks
 Refresh skills and
(A/B/C/D) Q2
development
strategy
(A/B/C/D) Q3
Support Leadership
Delivery Partner and
deliver BLETC
leadership priorities
-TN
(A/C)
Theatre Staffing (C)
Healthcare
Science/PTP (C)
Emergency
Medicine
(A/C)
Shape multi
professional
approach to
quality of
Widening
education
Participation
provision
Partnership
Maintain a
Forum – Regional sustainable,
GD
quality and safe
(A/B/D)
service
(A/B/C/D) Q3/4
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LETC OD Plan - NS
Increase effectiveness
of working within
system focusing on
primary care and social
care
– NS
(B/D)
12
Workforce response
to:
 Maternity &
neonates service
review
 Children’s service
review
(C/D)
Identify the workforce
requirements and
ensure delivery of
service transformation
in Integrated Care
(B/D)
2016/17
Improve workforce
Create workforce
planning intelligence development plan
to underpin decision 2013-18, with
making
associated investment
priorities
 Maintain a
sustainable,
 Deliver Innovation
quality and safe
Programmes and
service
ensure governance
 Identify risks
 Refresh skills and
(A/B/C/D) Q2
development
strategy
(A/B/C/D) Q3
Workforce response
to:
 Maternity &
Advancing Practice
Implementation
(including nonmedical
prescribing)(bands
7-8)
(A/C/D)
Physician’s
Associates outside
of Emergency
Medicine
Upskilling the
existing workforce
(bands 5-7)
(A/C/D)
Support Leadership
Delivery Partner and
deliver BLETC
leadership priorities
-TN
(A/C)
Healthcare
Science/PTP (C)
Advancing Practice
Implementation
(including nonmedical
prescribing)(bands
7-8)
Emergency
Medicine
(A/C)
Shape multi
professional
approach to
quality of
Widening
education
Participation
provision
Partnership
Maintain a
Forum – Regional sustainable,
GD
quality and safe
(A/B/D)
service
(A/B/C/D) Q3/4
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LETC OD Plan- NS
13
neonates service
review
 Children’s service
review
(C/D)
Identify the workforce
requirements and
ensure delivery of
service transformation
in Integrated Care
(B/D)
2017/18
Improve workforce
Create workforce
planning intelligence development plan
to underpin decision 2013-18, with
making
associated investment
priorities
 Maintain a
sustainable,
 Deliver Innovation
quality and safe
Programmes and
service
ensure governance
 Identify risks
 Refresh skills and
(A/B/C/D) Q2
development
strategy
(A/B/C/D) Q3
Workforce response
to:
 Maternity &
neonates service
review
 Children’s service
review
(A/C/D)
Physician’s
Associates outside
of Emergency
Medicine
Upskilling the
existing workforce
(bands 5-7)
(A/C/D)
Support Leadership
Delivery Partner and
deliver BLETC
leadership priorities
-TN
(A/C)
Advancing Practice
Implementation
(including nonmedical
prescribing)(bands
7-8)
(A/C/D)
Emergency
Medicine
(A/C)
Shape multi
professional
approach to
quality of
Widening
education
Participation
provision
Partnership
Maintain a
Forum – Regional sustainable,
GD
quality and safe
(A/B/D)
service- LB
(A/B/C/D) Q3/4
Physician’s
Associates outside
of Emergency
Medicine
Upskilling the
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LETC OD Plan - NS
14
(C/D)
Identify the workforce
requirements and
ensure delivery of
service transformation
in Integrated Care
(B/D)
existing workforce
(bands 5-7)
(A/C/D)
Underpinning Themes to be considered in delivering all the Programmes of Work and Individual Priorities above:
Lead workforce change to support service delivery in future years, with particular reference to:
 Understand specific workforce needs in specialist service provision
 Support and promote health and wellbeing to reduce health inequalities
 Support the strategic intent to develop out of hospital care alternatives
 Ageing workforce
Understand and model the impact of system-wide changes that are likely to impact on how the bLETC works:
 Changes to social care funding
 Changing demographics of the Birmingham population
 Changes to balance of care provision across providers
Consider how we can maximise the use of CPD monies/ Discretionary Spend
Review learning from previous investment and potential for large scale adoption
Names: TN – Theresa Nelson, NS – Neil Savage, GD – Gerry Dryden, PB – Phil Bright, LB – Louise Banks, DH – David Holmes, IB – Ian Blair,
SW – Stuart Wix, HG – Hazel Gunter
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3.0 CONCLUSION AND NEXT STEPS
Partnership engagement and collaboration across the LETC area has supported the
development of the Workforce Development plan. The LETC has developed a Workforce
Transformation subgroup comprising education leads, workforce planning and development
leads and widening participation leads from provider trusts and HEIs. The group has been
authorised by the LETC to develop solutions to workforce priorities and has resulted in the
development of the key workstreams. The delivery of each of these workstreams is
supported by a LETC sponsor and a task and finish group. These groups will meet to ensure
delivery and report regularly back to the LETC, liaising with the senior LETC lead and
workforce development specialist(s).
The workforce development plan will be reviewed following the submission of Trust
workforce forecasts and HEE mandate to recognise potential new workstreams for inclusion.
In Q3 there will be a formal review of the following year’s priorities which will then be
developed into full proposals including costings and timelines for commencement in Q1.
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Core Annual Deliverables 2013-2018
The following deliverables are annual activities that inform the core business of HEWM and
HEE:





Deliver a robust workforce plan for BLETC that maintains a sustainable, quality and
safe service, identifies risks and works to constantly improve workforce planning
intelligence to underpin decision making
Review and update the 5 year workforce development plan for BLETC, identifying
key activities and actions required to ensure the availability of the current and future
health and care workforce across Birmingham and Solihull
Support the Leadership Delivery Partnership and deliver BLETC leadership priorities
Shape multi professional approach to quality of education provision through the
delivery of core components of the HEWM Quality Strategy
Deliver a comprehensive OD plan for the LETC, with a particular focus on increasing
the effectiveness of working within system focusing on primary care and social care
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Summary of BS LETC Deliverables 2013/14
Below is a summary of the key BLETC Deliverables in 2013/14, these are in addition to the
core annual deliverables identified above.
Headline Deliverables for BLETC
The following deliverables relate to where the BLETC are undertaking work either solely
within Birmingham or as a lead LETC:




Deliver year 1 of the Older Adult Workforce Integration Programmes (details of which
can be found in 2013/14). For subsequent years this includes supporting the regional
delivery of the Postgraduate Older Adult Nurse Registration Programme
Delivery of the 3 End of Life Projects across the locality and identify lessons learned for
other providers
Focusing on progression and access to healthcare careers as part of the Widening
Participation Partnership Forum
Recruiting for values - understand the LETC/LETB wide implications from the pre-degree
experience pilot
Contribute to Regional/ Other LETC Deliverables
The following deliverables relate to priority pieces of work across HEWM that are either
regionally led or led by other LETC where BLETC has a responsibility to feed into the
development and/or implement recommendations:





Identify the workforce requirements and ensure delivery of service transformation in
Dementia and Learning Disabilities
Contribute to the workforce planning in response to the identified shortfall of
sonographers across the West Midlands
Contribute to the workforce planning to identify the workforce needs of the primary
care workforce
Contribute to the Emergency Medicine Taskforce in particular the development of the
Physician’s Associates role
Contribute to development of West Midlands Simulation Strategy
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healthcare
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Resource Allocation
Workstreams
Older Adult Workforce Integration Programme
2013-14
£188,750
Progression Scoping Work on behalf of LETB (funded through Widening
Participation Partnership Forum)
£30,000
Healthtec Proof of Concept (Funded through Widening Participation
Partnership Forum)
£82,721
Leadership- Medical Train the Trainer (Funded through LDP)
End of Life Training Programmes (Funded through End of Life monies)
£50,000
£100,000
Approved Totals
£451,471
Advancing Practice
£125,000
Physician Associates
£50,000
Fast track skills development to address nurse experience gaps
Review and development of of mentorship and supervision models
Leadership
Upskilling the workforce in management skills
Apprenticeship development
Proposed Totals
£100,000
£0
£0
£25,000
£0
£300,000
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healthcare
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Birmingham and Solihull Local Education and Training Council
Workforce Development Plan
PRIMARY CARE (GENERAL PRACTICE)
Issue we are trying to address:
The primary care workforce (general practice) is poorly understood. Pilot work is currently
taking place in AHWLETC to define the workforce and this can then be rolled out across the
LETCs. This will allow areas of training development need and workforce gaps to be identified
and the development of appropriate mitigation plans.
Links with best practice/previous projects or work and how the priority adds value:
The integrated care agenda supports working across multiple sectors to reduce duplication
and manage patient care more effectively. In primary care this is likely to mean that more
patients who would previously have been seen in a hospital environment are managed within
primary care. Many of these patients are likely to have more complex needs due to this shift
and it is important to support the continued delivery of high quality and safe care to manage
conditions more effectively.
Desired outcomes:

To identify the primary care workforce and understand their specific training and
development needs to support changes to current models of care delivery.
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
NHS England Commissioning Mandate
Delivering high quality, effective, compassionate care: Developing the right people with the
right skills and the right values, A mandate from the Government to Health Education
England: April 2013 to March 2015 – section 2.1.1 – break down the barriers between primary
and secondary care to support integration.
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):
 Action plan awaited following learning from pilot project in AHW LETC
Approach to evaluation and benefits realisation:
 Evaluated through numbers of staff reporting confidence in delivering care
Risks:


Lack of engagement from stakeholders
Difficulty in identifying the workforce and their training needs
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
Need to align with commissioning service intentions
Resource Implications:
Awaiting detail and learning from outcomes of pilot project in AHW LETC
Description of the collective benefit to Trusts and patients:

Delivery of joined up care for patients, making it easier for them to access high quality
care in the right setting, only attending hospital when clinically necessary rather than
for routine follow-up
 Establishing confidence and good working relationships between hospitals and
general practice to support patients
Sponsor and partner organisations (working in partnership):
 This is being led by the Arden, Hereford and Worcester LETC
 Pilot sites will be identified in the Birmingham LETC area
Timelines:
Awaiting information following the outcomes of the AHW LETC Pilot
Sustaining the Project:
Over time this will become established practice, with staff working in general practice
becoming confident and competent in delivering care to patients who may previously have
been managed in hospitals. We recognise that this is a process of transition which will take
time to become embedded across general practice and is to a certain extent reliant on
commissioning intentions.
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Birmingham and Solihull Local Education and Training Council
Workforce Development Plan
OLDER ADULTS WORKFORCE INTEGRATION PROGRAMME
Issue we are trying to address:
The development of a workforce equipped to meet the challenges of multi-disciplinary working
across organisational boundaries in an integrated manner and with the right skills to safely
manage patient care in a variety of settings.
Older adults are also becoming an increasing proportion of activity within the healthcare
system and future-proofing the system to support delivery of best care is crucial. The
Department of Health has engaged in a consultation exercise around vulnerable older people
(http://betterhealthandcare.readandcomment.com/) and the outputs of this will be used to
formulate a strategy of best practice.
Links with best practice/previous projects or work and how the priority adds value:
The initial stage of the process is to undertake scoping and critical evaluation of areas of best
practice (local, national and international), with recommendations. This will act as a baseline
for developing future work streams.
The work stream adds value by supporting :



Shift to out of hospital care
Reducing inappropriate admissions
Skills development in managing increasingly complex conditions in patient homes
Desired outcomes:

Development of multi-disciplinary integrated older adult care workers with the right
skills needed to support key stages of the patient pathway
 Regional support for embedding this across the LETC in the first instance and wider in
due course
 Collaboration and sharing learning with other LETCs to upscale roles and training
across the region
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
Clearly cited as a priority in both the HEE Mandate and the HEWM 5 year skills and
development strategy.
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There is significant value in aligning this to national workstreams including minimum training
standards and development of an Older Adults NMC sub-register.
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):




Engage consultant to undertake scoping and evaluation of current evidence
Identify and confirm pilot sites to leads on key workstreams
Pilot sites to deliver work, reporting back July 2015
Sharing of learning to take place regularly across a wide audience
Approach to evaluation and benefits realisation:


Regular progress reports to Programme Board and LETCs
Development of communication and sharing strategy for programme
Risks:
 Lack of interest in organisations to become pilot sites
 No clear commissioner service vision on integrated care or Older Adult services
Resource Implications:
How important is it – weighting if resources are required?
This has been identified as a national priority area and has received separate HEWM funding
and approval for the scope of the Innovation fund project. Further detail is available as
required. This work has also been agreed by the LETC as a baseline for the wider rollout of
integrated care services, particularly with regard to the current service reviews in maternity
and new-born services and children’s services.
Description of the collective benefit to Trusts and patients:
 Developing a sustainable workforce with the right skills to support their roles
 Embedding bands 1-4 roles clearly within the workforce planning process
Sponsor and partner organisations (working in partnership):
 Birmingham Community Healthcare trust (sponsor)
 Pilot sites agreed across Birmingham and Black Country LETCs
Timelines:
Workstream 1 - Scoping work taking place December 2013 – March 2014
Pilot sites identified – December 2013
Programme manager in post January 2014
Continued delivery of programme 2014/15
Sustaining the Project:
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Explain how the project’s benefits will be maintained after funding has ceased.
It is envisaged that the learning from the pilot sites will be disseminated across the LETC and
region by September 2015 at the latest, although regular progress updates will be widely
communicated. Spreading success stories will allow other organisations to benefit as well as
incorporating their learning from independent projects. At this time there should be a clear
strategy for the integration of health and social care in order to meet the national timeline of
2018 in support of full integration.
This will also be used in alignment with the proposed Department of Health plan for
vulnerable older people: http://betterhealthandcare.readandcomment.com/
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Birmingham and Solihull Local Education and Training Council
Workforce Development Plan
END OF LIFE
Issue we are trying to address:
The national strategy on end of life care was developed in 2008. This emphasised
the need to:



identify people approaching the end of their life and involving them as much as
they want in plans around their death - including their preferences for care
planning, co-ordinating and providing high quality care
manage care and support in the last days of a person’s life, at the point of
death and beyond
provide support to carers, including after the person they have cared for has
died
Projects have been approved for funding in the Birmingham LETC region which will:



Support training and development for staff in different settings to deliver
effective end of life care
Deliver specialist care in children’s and neonatal services
Share learning across organisations through partnership working (hospice,
care homes, acute hospitals)
Links with best practice/previous projects or work and how the priority adds value:


Supports the delivery of the national end of life care strategy
Builds on existing work that has taken place previously across the region and
nationally
Desired outcomes:
 Supporting staff to deliver best care to patients at the end of their lives
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
DH Strategy on End of Life Care Pathway (2008), revisited in Commissioning
Mandate (2012).
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):
 Work is in progress and will be completed by end of March 2013.
Approach to evaluation and benefits realisation:
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
Learning from each project will be shared through the LETCs and end of life
networks
Risks:
 Failure to deliver according to agreed timelines and resources
Resource Implications:
Resources have already been allocated to the three projects (Acute x 2, Locality x 2). Total
value £100,000
Description of the collective benefit to Trusts and patients:

Supporting staff to deliver best care to patients at the end of their lives, including
support to families
Sponsor and partner organisations (working in partnership):

Project sites have been agreed including Birmingham Children’s Hospital, Heart of
England FT and a joint workstream between the Neonatal Network and St Mary’s
Hospice
Timelines:
Projects are already underway at the time of the report (February 2014) and will be completed
by March 2014.
Sustaining the Project:
Training will be embedded into routine practice for staff.
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Birmingham and Solihull Local Education and Training Council
Workforce Development Plan
WIDENING PARTICIPATION - ACCESS
Issue we are trying to address:
By 2016, our replacement demand figures are significant (62% of clinical support staff and
58% of infrastructure staff). It is therefore crucial that we target our disadvantaged
communities and hard-to-reach groups to support those with low aspirations by raising their
awareness of the employment opportunities that exist within the health and social care sector
care with a view to preventing and reducing worklessness within our society.
Links with best practice/previous projects or work and how the priority adds value:
The Birmingham LETC ambition will build on the work already undertaken with employers and
education providers to focus on the SHA funded Health Tec and Learning Hub initiatives.
The UHB Learning Hub has a thriving and effective working partnership with Health Tec. The
Health Tec organisation has a track record of developing and embedded effective provision
across the Health sector. In the years since the first centre was opened at Harborne there
have been 12 centres introduced nationally with 10 within the West Midlands. The driving
force for the Health Tec initiative has been the commitment to a sustainable and fruitful
partnership between health and education.
The Health Tec at Baverstock Academy and the UHB Learning Hub are located to service all
areas across the city of Birmingham. In using the school networks it will be able continue to
access the targeted learners and their families and guarantee that progression pathways are
available to all ages, abilities, cultures and groups.
This project will create and embed centres of learning, opening gateways into health, and
employment opportunities to target individuals and communities that either are, or in danger
of, disengaged. It will through its innovative and interactive style of delivery ensure that the
interest of the target groups is stimulated across a number of age groups ensuring supply and
demand are established for future years. In using the triangle of learning centres it will ensure
that the flexibility required to adapt future provision is guarantee in established facilities,
networks and communities.
As a result of embedding provision from these centres it will ensure that the education
delivery team are an integral part of the institutions in which they are located enabling the
programme offered to be continued in the future.
Desired outcomes:


Improve access into healthcare careers by developing a streamlined consistent
process around the delivery of work related learning and work experience
opportunities for schoolchildren and the unemployed
Embed the ‘Making Every Contact Count’ ambition
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
Develop an understanding of Patient Choice and NHS reforms in both younger and
older citizens in support of the employer’s strategic commitment to reduce health
inequalities
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
Identified as a priority in the following two documents:
HEE Mandate



Increasing the proportion of entrants who have experience working providing care in
a care setting before they start their course
Improved levels of application to NHS funded courses from groups currently underrepresented in line with the widening participation goals
Ensure that metrics are developed that measure the performance in promoting
greater social mobility into medical training courses
HEWM 5 Year Skills and Development Strategy

Widening participation to healthcare careers and jobs focusing on reducing youth
unemployment
In terms of the HEE Mandate, there will also be an opportunity to influence and inform the
national HEE sponsored Widening Participation Project.
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):
Health Tec – Work related learning hub based at Baverstock Academy which also acts
as the referral centre for work experience requests. Where work related learning is not
appropriate, a referral will be made to the Trust Placement Co-ordinators. A peripatetic
service will be made available to deliver work related learning for those areas not
serviced by Baverstock Academy, i.e. North Birmingham.

Appointment of staff to support the establishment and development of this initiative –
band 6 (peripatetic provision), band 4 and an apprentice (Baverstock based). The
availability of existing Health Tec expertise is business critical to the success of this
development and therefore we would also require a 0.3 WTE expert resource.
(Immediate / Short-term)
Approach to evaluation and benefits realisation:
The success of the project will be measured by a number of factors:




Engagement –The provision of Careers Education, Information Advice and Guidance
to an increased number of learners
It is expected that there will be an increase in the self-esteem and willingness to enter
the labour market by disadvantaged groups
Co-ordinating, analysing and disseminating information on the impact of the project’s
interventions during and at the end of its life so as to inform future provision
The scale and sustainability of the project at the end of the period to become a
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








mainstreamed provision
Number of Accredited qualifications achieved
Learners being exposed to the common induction standards and minimum training
standards increasing their employability with partners
Availability of a health-related career progression pathway for school information
events developed by the Prince’s Trust and partners
Recruitment onto health and science related courses including apprenticeships.
Increase in the number of healthcare workers engaged in working with targeted
groups.
Increase in ability to navigate the NHS to become more health literate
Increase in engagement of family health related activities.
Increase in the number of people accessing the website
Improving Careers Education, Information Advice and Guidance to the wider family
e.g. family members that might be unemployed
Risks:








Lack of resources
This is a ‘pump priming’ exercise
The partnerships are not inclusive, robust and reliable
Lack of ownership by partners
Lack of expertise to deliver the project
An inadequate project plan
Do we have the capacity to meet demand
Developing a sustainable model
Resource Implications:
How important is it – weighting if resources are required?
See “Suggested approach/action plan, including key milestones/deliverables” section
Description of the collective benefit to Trusts and patients:

In 5 years, Workforce Commissioning and Education Development will not be limiting
factors in the creation of a skilled and flexible workforce providing safe, high quality
patient care delivered with expertise and compassion
Sponsor and partner organisations (working in partnership):
 The Learning Hub at University Hospitals Birmingham NHS Foundation Trust
 Health Tec at Baverstock Academy
 Partnership working with Birmingham Women’s Hospital but expectations of
collaboration with all Birmingham providers
Timelines:
The project will run for 12 months between Feb 2014 – Feb 2015.
Sustaining the Project:
Explain how the project’s benefits will be maintained after funding has ceased.
Sustainability will be via making best use of the pupil premium to embed sustainable working.
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Birmingham and Solihull Local Education and Training Council
Workforce Development Plan
WIDENING PARTICIPATION - PROGRESSION
Issue we are trying to address:
The development of a clear progression framework for band 1-4 workforce that meets service
need and allows for staff development, including potential for progression onto preregistration programmes (for clinical staff) and band 5 roles (for non-clinical staff), in a manner
that does not detract from the ability to deliver work or take significant time away from the
workplace. This workstream will support the delivery of a regional response to the national
workstream on Progression.
Links with best practice/previous projects or work and how the priority adds value:
Much importance is being placed on formalising the role of bands 1-4 health and care support
staff (both clinical and non-clinical roles). Key recommendations from the Francis and
Cavendish reports strongly support this agenda.
Francis (February 2013)
 National minimum standards of care – supports identification of outliers as per Francis
 Year to care pilot
 Values based recruitment
 Uniform description of healthcare support worker
 Registration of healthcare support workers
 National code of conduct
Cavendish (July 2013)
 Certificate of fundamental and higher certificate of fundamental care
 Caring experience before starting a nursing programme
 Innovative funding to support bridging programmes to access nursing and other health
and care programmes
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
Career development framework for health and social care support staff
This could also be aligned in due course with outcomes from the UHB pre-degree care pilot
work stream.
Developing a band 1-4 career progression framework may increase the desirability of entry to
healthcare careers for a wider range of people and includes the potential to attract retirees
and maximise opportunities for unqualified carers to access basic skills training.
Desired outcomes:



Scoping the West Midlands needs for career development for bands 1-4 staff. This
work will run in parallel with the HE EoE national workstream on bands 1-4
progression and will be used to inform the regional implementation of the national
strategy.
Support for embedding this across the LETC in the first instance and wider in due
course
Collaboration with other LETCs to understand what they are doing around supporting
the bands 1-4 Progression agenda and developing a regional consensus.
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
Clearly cited as a priority in both the HEE Mandate and the HEWM 5 year skills and
development strategy; “Widening participation to healthcare careers and jobs focusing on
reducing youth unemployment”.
There is significant value in aligning this to national workstreams including minimum training
standards and potentially supporting the older adult workforce.
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):

Scoping exercise to scope existing content of Access-type programmes, determining
fitness for purpose and what is needed for these programmes to be attractive for
entry, including the modular part time approach to minimise time away from work,
allow a ‘step on/step off’ approach and to support APEL (March-May 2014)
Approach to evaluation and benefits realisation:
 Learning from evaluation outcomes from the pre-degree care pilot
 Increased entry to pre-registration programmes
 Numbers of staff attaining baseline minimum training standards
 Staff mobility within and between organisations
 Evidence that bands 1-4 career progression forms part of trust workforce planning and
forecasting processes
Risks:


Need to align with national strategy, therefore dependent on the content of this
Lack of stakeholder engagement / willingness to share information.
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Resource Implications:
Funding of £30,000 has been agreed to undertake scoping of work between January and
March 2014.
Description of the collective benefit to Trusts and patients:


Developing a sustainable workforce with the right skills to support their roles
Embedding bands 1-4 roles clearly within the workforce planning process
Sponsor and partner organisations (working in partnership):
Sponsored by BWH but with partners across the LETC:
Timelines:
Scoping project to take place March – May 2014.
Sustaining the Project:
This is a short life project that will be used to inform the regional response to the national
standards on career progression that are being led by HE EoE.
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Birmingham and Solihull Local Education and Training Council
Workforce Development Plan
RECRUITING FOR VALUES – PRE-DEGREE CARE PILOT
Issue we are trying to address:
Health Education England requested expressions of interest in becoming pilot sites for ‘Year
to Care’ – a recommendation alluded to in the Francis report and detailed further in the
Cavendish report. In response to this University Hospital Birmingham is a regional pilot, in
partnership with Birmingham City University.
Links with best practice/previous projects or work and how the priority adds value:
This project links with the ambition of ‘Recruiting for Values’ as well as supporting the
development of a progression pathway for bands 1-4 health staff for entry into pre-registration
programmes. In future links may be established with retention of staff, on the basis that staff
with the correct values are entering the workforce in the first place.
The learning from the pilot programmes will facilitate the development of a cohort of
registered nurse practitioners (in the first instance) who are aware of the values required
when working in a health
care environment.
Desired outcomes:
Trainees will:

be a pioneer in a new learning opportunity for people who want to go to university to train as a
nurse;

get paid to gain vital experience of caring for patients on the front line of the NHS;

find out whether a caring career really is right for them so they can make the right choice;

have support in their application for university to train as a nurse; and

be part of a drive to widen participation in the NHS and encourage people from a wide variety
of backgrounds, no previous care experience necessary to apply.
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
HEE has been mandated by the government, in its response to the Francis Inquiry into the
failings at Mid Staffordshire Hospital NHS Foundation Trust, to work with partners across the
NHS and higher education to pilot a scheme whereby aspirant student nurses spend up to a
year on the frontline prior to receiving NHS funding for their degree.
Suggested approach/action plan, including key milestones/deliverables (quarterly
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review of progress will be expected):
The pilot programme commenced in September 2013 and will run for a year. Initially 20
students were recruited, with an expectation that they will gain a range of supportive clinical
and academic experience to allow them to apply for entry onto the pre-registrations degree
programme at BCU.
First 6 months
It is proposed the HCA’s will be allocated to a general ward area to allow them to develop
confidence and experience in the HCA role and gain exposure to care of the older person in
an acute setting.
Assessment and Support
It is proposed that all of the HCA’s on the pilot will commence the Auxiliary Nurse
Development Programme (ANDP) with all other new starters in the Trust, this programme is
competency based and incorporates seven study days over 6 months
Whilst on the programme the HCA will have a band 5 mentor who will formally review their
progress every 3 months. In addition they will continue to have support from the corporate
Clinical Education Support Worker (CESW). The CESW is a band 4 educator who has
extensive experience as a HCA.
During the first 6 months they are expected to achieve several competencies; these include
skills such as phlebotomy and ECG taking. They will also have a “Dignity in Care”
assessment which assesses their delivery of total care to a patient; this assessment includes
assessing their use of the 6 C’s.
Assessments will take several forms:
 Observational
 Reflection and discussion
 Written work in workbook
The assessments will be carried out by either:
 The Clinical Education Support Worker
 The Band 5 Mentor
 A Band 3 or 4 who has received additional training in supervision and assessment
If the HCA is unable to complete competencies support will be provided by the Band 5 Mentor
and the CESW, action plans will be provided with additional support as required, this process
will follow the Trust poor performance policy.
During the first 3-6 months the candidate will also receive support from the Practice
Placement Team (PPT) who will provide the HCA support and education in:
 The University application process.
 Reflective practice.
 Interview practice.
They will receive an interview between April/May 2014 for a place on the Undergraduate
Nursing BSc in September 2014.
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Second 6 months
Subject to the successful completion of the ANDP, the HCA will then have the opportunity to
undertake a series of “taster days”, across different care settings including the Women’s
Hospital Birmingham and Birmingham and Solihull Mental Health Trust, enabling them to
gain further insight into healthcare delivery and the needs of patients and their carers across
a wider range of settings.
HCAs will continue to have a Band 5 mentor and the CESW to support them during this
period and there will be a formal review of their progress every 3 months.
End of 12 month “year to care pilot”
Upon completion of the programme the HCA will either take a place on the Nursing BSc at
BCU. If they were unsuccessful in obtaining a place or they do not wish to progress to
undergraduate education they will offered an existing HCA vacancy in the Trust.
Approach to evaluation and benefits realisation:
Evaluation and benefits realisation will be available at the end of the pilot programme. A
second cohort of pilot sites is currently being agreed.
Risks:
The project has a dedicated risk register, which will be managed via the HEE steering group
process. Key risks include:



Inappropriate applicants
Attrition before programme completion
Recruits not wishing to progress to BSc
Resource Implications:
How important is it – weighting if resources are required?
Currently finding and resource allocation has been agreed as part of the pilot, with funding
being transferred to UHB to manage directly. This is to the value of .
Description of the collective benefit to Trusts and patients:
 Increased staff satisfaction and retention
 Improved quality of compassionate care for patients and families
Sponsor and partner organisations (working in partnership):
University Hospital Birmingham , Birmingham City University
Timelines:
Activity/Objective/Deliverable
Due Date
Recruitment of up to 20 healthcare assistants (HCAs)
September 2013
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to participate in pilot
HCAs attain key competencies as specified in
Appendix D of project specification
HCAs undertake ‘taster’ placements, subject to
achieving key competencies as above
HCAs receive interviews for entry onto September
2014 Undergraduate BSc Nursing programme
Final project evaluation
Sustaining the Project:
March 2014
March-September 2014
April / May 2014
September 2014
Explain how the project’s benefits will be maintained after funding has ceased.
This is being run as a pilot programme. Learning from this will determine how this works in
future years, including duration and content of training, resources required to support it,
whether this is a mandatory requirement for entry into pre-registration programmes and which
healthcare professions are included.
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Birmingham and Solihull Local Education and Training Council
Workforce Development Plan
LEADERSHIP
Problem we are trying to solve:



Lack of consistency in medical leadership models applied across provider trusts
A new approach required to enable medical trainers to identify leadership talent,
nurture leadership qualities and develop a culture that encourages appropriate
leadership behaviours and values
Improve working relationships across professional boundaries
Desired outcomes:



Establishment and embedding of a culture of good leadership values and behaviours
through the nurturing and development of medical trainees at all levels
Better patient outcomes through comprehensive multi-disciplinary working
Medical trainees work closely with and communicate well with other professionals
throughout the healthcare organisation
Suggested approach/action plan, including key milestones/deliverables:
The programme is aimed at developing a comprehensive, consistent and transferable
medical leadership model. This will give medical trainees from foundation to consultant level
the required skill set to lead and inspire colleagues across a multi-disciplinary arena in the
delivery of best patient care. Delivery of the programme will be through a bespoke ‘train the
trainer’ Medical Leadership programme methodology, using current training structure and
methods as appropriate and implementing a series of facilitated learning sets to post
graduate trainers across Birmingham. Programme methodology to be underpinned by
Leadership fundamentals and the core elements of the ‘Healthcare Leadership model’
There are a number of phases to the programme, not all of which will be covered in the first
year.
Phase 1:- Scoping of current medical leadership activity and programmes in the West
Midlands, identifying the medical staff levels they are aimed at and degree of uptake. This
could be undertaken in liaison with medical directors and tutors as well as current doctors in
training.
 Cross referencing with current models of best practice and undertake a skills gap
audit to identify where training needs to be focused.
 The scoping should also cover the different leadership knowledge, skills and
competencies required at all levels of post-graduate training from foundation to
consultant, as well as what may be required in acute vs. specialist providers and
reflecting differences between different specialities.
 Recommendations for the development of a bespoke, transferable matrix of Medical
Leadership training to be developed and applied to all Birmingham LETC provider
trusts (excluding BSMHFT which will be covered under the MHI LETC’s programme).
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
The approach to be aligned with current models of training with a development of the
programme based on the National Leadership Academy Healthcare Leadership
Model.
Phase 2:- Development of a bespoke Medical Leadership programme that covered the gaps
and which would initially be delivered to speciality trainees (but would be cascaded to postgraduate medical trainees in later phases). The programme would need to be transferable
across a range of provider organisations so that as trainees rotated round they could build
on their initial learning and it would be applicable and transferable across Birmingham trusts.
Programme components will include the nine dimensions of the Healthcare Leadership
Model:
 Inspiring shared purpose
 Leading with care
 Evaluating information
 Connecting our service
 Sharing the vision
 Engaging the team
 Holding to account
 Developing capability
 Influencing for results
Phase 3:- Delivery of the new Medical Leadership programme cascaded through the ‘train
the trainer’ route and developed to ensure cultural change and a sustainable approach to
embedding leadership learning within the core components of the existing learning curricula.
Phase 4:- Evaluation and recommendations – Production of a training programme
guide/handbook with evaluation of programme and recommendations for next steps to
ensure sustainability of the programme and measure evidence of positive impact on
collegiate working and improved care for patients.
Timelines:
Phase 1: 0 – 3 months
Phase 2: 2 – 6 months
Phase 3: 6 – 12 months
Phase 4:12 - 24 months
Risks:
Lack of stakeholder engagement
Time to attend learning sets
Trust agreement to recognise transferability of learning
Resource Implications:



Education & training provider to draw up programme for delivery in partnership with
Post Graduate trainers in Birmingham (identified through Post Graduate Schools)
There are c4000 trainers across the LETC, requiring a focus on trust-based delivery.
There are 6 BLETC trusts (excluding BSMHFT as their training would be delivered
through the MH LETC) and this would require a number of learning sets.
Delivery of facilitated programme of learning to include peer support mechanisms
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and learning set methodology ensuring links to existing GMC policies
 Evaluation of impact upon trainer confidence and trainee experience
Description of the collective benefit to Trusts and patients:
 Improve communication across professions within organisations
 Improve efficiency through highly skilled professionals providing fully integrated care
 Deliver training experiences that ensure newly qualified workforce are supported to
challenge cultural values and norms
 Embedding a culture of healthcare leadership resulting in an positive impact on staff
morale leading to improved patient care
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Birmingham and Solihull Local Education and Training Council
Workforce Development Plan
DEMENTIA – led by MHI LETC
Issue we are trying to address:
The Mental Health Institute (MHI) LETC has developed a 5 year strategy for focused
development of the West Midlands Mental Health and Learning Disability workforce. The plan
is driven by key service priorities identified through a robust iterative process undertaken by
LETC members. The plan articulates the key workforce development needs arising from
agreed priorities and contains 4 key workstreams:
Advanced Practitioners:
a. Understand the benefits of introducing Advanced Practitioner roles
b. Perceived under-utilisation of Advanced Practitioner roles
c. Perception that the career and education pathway for non-medical healthcare
professionals does not retain sufficient high level clinical skills within clinical settings
d. Increase in demand for mental health services and psycho-therapeutic interventions
e. Reduce dependence on an unstable Staff-Grade Doctor labour market
Assistant Practice:
a. Increase capacity, capability and quality (including recovery focus) of mental health
services
b. Expand utilisation of Agenda for Change Band 4
c. Development of appropriate foundation degree programme/s in partnership with
higher education
d. Enhanced Career and Education Framework for staff in Bands 1-4
Upskilling:
a. Deficit in understanding the required psychological practice contribution of each
element of the specialist clinical mental health workforce
b. Deficit in understanding the role existing programmes of Learning and Development
have in developing required psychological practice skill-sets
c. Enhancing the regional psychological practice learning and development offer
(including the offer to non-mental health specialist workforce)
d. Delivering a cost-effective model of mainstreaming psychological practice/ therapies
across the specialist clinical mental health workforce
Primary Care Mental Health:
a. Increase G.P Practice staff capability and competence to effectively recognise and
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manage people with Mental Health problems
b. Understand impact of CSIP G.P. Mental Health ‘First Aid’ programme on G.P Practice
staff capability and competence to effectively recognise and manage Mental Health
problems
c. Understand the effectiveness of G.P Trainees learning to enable effective mental
health recognition and management skills
Links with best practice/previous projects or work and how the priority adds value:
The programme will draw on prior significant levels of investment in developing primary
care Mental Health Recognition and Management skills. In addition, the products and
outputs of these programmes will be innovative, as they will be approaches that have not
to date been employed within the Region.
Desired outcomes:
Advanced Practitioners:
a. Increased clarity on the business benefits of Advanced Practice roles and skills
transferability
b. Increase the number and range of Advanced Practitioner roles
c. Enhanced Career and Education pathway for non-medical healthcare professionals
d. Increased capacity and capability of mental health services (including improved access to
psycho-therapeutic interventions)
e. Decrease in dependence on Staff-Grade Doctor roles
Assistant Practice:
a. Enhanced evidence-base of the benefits of utilisation of Assistant Practitioner roles for:
 Service-users
 Staff Members
 Organisations (including cost-benefit analysis, Increased workforce flexibility, Workforce
sustainability)
b. Agreed framework for the development and deployment of Assistant Practitioners in
Mental Health and Learning Disability services
c. Increased number and range of Assistant Practitioner roles
Upskilling the workforce:
a. Differentiation of psychological practice/therapeutic skill-sets required by all elements of
the specialist clinical mental health workforce
b. Identification and development (where required) of targeted Learning and Development
opportunities that support acquisition of required skill-sets
c. Deployment of Learning and Development opportunities that support the wider healthcare
workforce to work in ways conducive with underpinning psychological principles of
practice
d. Deployment of Learning and Development opportunities that deliver required skill-sets
e. Demonstrable evidence of effective use of spend on psychological practice/ therapies
Learning and Development
Primary Care:
a) Increased awareness of the impact of G.P. Mental Health ‘First Aid’ programme on G.P
Practice staff
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b) Enhancement of the G.P. Mental Health ‘First Aid’ programme and scoping of any further
development needs
c) Enhancement of Learning and Development offer to support G.P Trainees to develop
effective mental health recognition and management skills
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
The programme directly relates to Health Education England Mandate section 2.2.2
‘HEE will also need to focus on the mental health workforce more widely and ensure sufficient
numbers of psychiatrists, other clinicians and care staff are trained to meet service needs. It
will need to deliver a mental health workforce with the skills and values needed to continually
improve services and promote a culture of recovery and aspiration for all of their patients.’
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):
This will be managed by the Mental Health LETC
Approach to evaluation and benefits realisation:
This will be managed by the Mental Health LETC
Risks:
This will be managed by the Mental Health LETC
Resource Implications:
Finances are allocated and managed via the Mental Health LETC
Description of the collective benefit to Trusts and patients:
 Development of practitioners with the right skills to provide best patient care
Sponsor and partner organisations (working in partnership):
 Mental Health LETC, All MH service providers
Timelines:
This will be managed by the Mental Health LETC
Sustaining the Project:
This will be managed by the Mental Health LETC
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Birmingham and Solihull Local Education and Training Council
Workforce Development Plan
LEARNING DISABILITIES – led by MHI LETC
Issue we are trying to address:
Increasingly LD service provision is being provided by a wider range of caregivers than the
NHS. HEE has a responsibility to ensure the provision of staff who are fit for purpose and are
equipped with the right knowledge and skills.
Links with best practice/previous projects or work and how the priority adds value:

The programme will incorporate clinical champions from all healthcare settings, and
will deliver return on investment by building a sustainable framework that is owned
locally by clinicians and practitioners that builds upon previous investments made by
the WMSHA but which reflects changes in regional structure.
Desired outcomes:
The objectives of the programme of work are to:
 Establish systems to access real time data on demand across care providers
within the local authority and across private, voluntary and independent sectors.
 Agree and adopt a shared model of service delivery and the implications for the
workforce
 Identify the prevalence of need in relation to increases in demand for service in
specific areas, such as dementia and autism.
 Identify the specialist skill set and competencies required to deliver healthcare to
people with a learning disability, utilising the care pathways model.
 Undertake a targeted awareness campaign across wider healthcare settings to
improve knowledge and awareness of the needs of people with a learning
disability.
The programme will incorporate clinical champions from all healthcare settings, and will
deliver return on investment by building a sustainable framework that is owned locally by
clinicians and practitioners that builds upon previous investments made by the WMSHA but
which reflects changes in regional structure.
Project 1; Cross sector workforce planning.



Establishment of an agreed mechanism for sharing workforce planning
information across NHS trusts, local authorities, voluntary, independent and the
private sectors that transcends and identify potential solutions to systems and
data challenges.
Establishment of an agreed process for feeding this information into the
workforce planning cycle for healthcare commissions at the LETB from January
2014 onwards.
Delivery of evaluation of success of the process and impact upon workforce
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planning data quality at end of planning process September 2014
Creation of a repository of resources available including web based tools and
education packages from all sectors, and an associated marketing campaign to
signpost people to these
Project 2 ; Awareness training across healthcare settings




Delivery of an education resource in a range of accessible formats to equip all
staff across healthcare settings with the necessary awareness, knowledge and
insight of the needs of people with a learning disability to enable them to provide
high quality care.
Delivery of a marketing campaign to ensure spread and adoption across the
West Midlands
Delivery of an evaluation that reports impact of training upon perceived levels of
awareness and knowledge
Project 3; Workforce modelling for the specialist LD services

Establishment of an agreed learning disability care pathway model across the
West Midlands, to include an associated interventions framework, with aligned
competency map.

An agreed strategic view of future service models across the service user care
pathway and underpinning workforce model utilising competency and values
based approach

Delivery of a gap analysis of training needs across the entire specialist workforce
from primary care to specialist inpatient services

Creation of a repository of resources available aligned to competency framework,
including existing web based tools and education packages, and commissioned
bespoke resources.

Delivery of an associated marketing campaign to signpost people to resources
Project 4 ; LD Nursing Commissions Review
 An agreed model across specialist trust providers and Higher Education providers
for the delivery of learning disability nurse education programmes
 An agreed timeline for revision of current provision and commissioning of agreed
programmes
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
Workforce Plans and commissioner service intentions report a move of care provision away
from NHS providers.
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):
This will be managed by the Mental Health LETC
Approach to evaluation and benefits realisation:
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This will be managed by the Mental Health LETC
Risks:
 This will be managed by the Mental Health LETC
Resource Implications:
This will be managed by the Mental Health LETC
Description of the collective benefit to Trusts and patients:
 The delivery of consistent quality and safe care across all providers of LD services
Sponsor and partner organisations (working in partnership):
 Mental Health LETC, all LD provider organisations
Timelines:
This will be managed by the Mental Health LETC
Sustaining the Project:
This will be managed by the Mental Health LETC.
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Birmingham Local Education and Training Council Workforce Development Plan
EMERGENCY MEDICINE
Issue we are trying to address:
An identified shortage, nationally, in the EM Workforce. This shortage has led to an inability to
meet 4 hour targets, identified instances of poor patient care, increased attrition in ACCS EM
training and poor retention-to-specialty amongst practitioners who see preferable working
conditions in other specialties.
The work-streams discussed below aim to:
-
Stabilise the EM workforce.
Prevent admission to A&E through development of alternative care pathways.
Enhance primary care capability.
Discover new and innovative ways of tackling workforce demands – both in primary and
secondary Acute and Urgent care.
Links with best practice / previous projects or work and how the priority adds
value:
Of the five EM Taskforce mandated work-streams, the Independent Prescriber (EM) Pharmacist
and Post-CCT Fellowship are identified as UK firsts and therefore have scant workforce / practical
basis for comparison. However:
-
The Post-CCT Fellowship programme was developed in line with (and justified by) the
2013 Hunt recommendations for “improving joined up care, spanning GPs, social care,
and A&E departments - overseen by a named GP.”
The Pharmacy project was inspired by a regional (West Midlands) consultation period
and survey (organised through Aston University school of Pharmacy), where a need for
ED-based Pharmacists was identified in the majority of Trusts engaged. The role
boundaries of the Independent Prescriber Pharmacist are unclear however, so this
project seeks to define and develop the role through a controlled pilot study, using agreed
baseline competencies and robust clinical supervision, consistent with agreed best
practice.
How do the projects add value?
1) Post-CCT Fellowship:
-
Expanding the knowledge and skills of GPs, to effectively develop a special interest and
confidence in the application of Emergency and Acute care in community practice.
Utilising the up-skilled GP in a manner which captures patients who would otherwise
attend their nearest A&E – Community A&E Avoidance.
Bridging the cultural and skills gap between primary and secondary care.
2) Physician Associates (PA):
-
Introducing a new role to the workforce, avoiding a risk of filling existing workforce gaps
by creating gaps elsewhere.
Creating a sedentary role, free from the short-term rotation issues experienced with
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-
-
-
clinician equivalents – workforce stabilisation.
The PA is a generalist practitioner, trained to the medical model and capable of highly
specialised working at the employer’s discretion. There are currently PAs working (proof
of capability) in areas such as general surgery, general practice, paediatrics, mental
health, obstetrics & gynaecology and EM.
Graduating PA salary is currently (AfC) Band 7 – therefore value for money compared to
the Locum Doctor alternative (a role which the PA model seeks to replace).
A strategy has been implemented by Health Education West Midlands at a national level,
to gain statutory registration for the PA profession and, consequently, independent
prescribing rights. When registration occurs, the value of the PA role will increase
exponentially, allowing for greater autonomy and cross-role versatility.
The PA programme was rolled out from 2009 in a selection of national HEIs and
employers, with limited success. Lessons learned from this “first attempt” have informed
strategic planning for the 2014 tranche.
3) SAS EM Training:
-
Encouraging retention to specialty by offering top-up / refresher training in key areas
identified by practitioners.
Improving patient safety by maintaining fitness to practice of staff and associate
specialist-grade doctors.
Improving practitioner and employer confidence in key skills.
Various previous ad hoc training sessions have been organised by regional LEPs. There
has as yet been no HEWM mandated portfolio of events – the philosophy of this project is
to consider the viability of a structured portfolio of events, with backfill support to remove
this identified financial blocker to SAS training (September 2013 SAS West Midlands
Survey – Trusts polled commented that prohibitive cost of backfill could be a blocker to
releasing staff into training).
4) Independent Prescriber EM Pharmacist (IPP):
-
To introduce an Independent Prescriber Pharmacist into clinical practice within the EDs
“Minors” team – minor injuries and minor illness.
- To use the pilot study to evaluate the viability / usefulness of such a role in the ED.
- To work within agreed stage boundaries to test the clinical boundaries and development
potential of the IPP role.
To expand the role into paediatric primary care cover – children up to age 10 initially with
possibility to increase.
To consider developing the model to encompass elderly care “front door cover.”
To consider how the role could be developed to encompass pre-discharge drug
management and drug therapy / medicines optimisation and the creation of care plans (to
be continued by primary-care practitioners thereafter).
The pilot will take place in three phases, with phase 1 underway at HEFT (Heartlands Hospital
ED), Phase 2 to take place at Birmingham Children]’s hospital (to test the viability of the role in
specialist practice) and the third Phase at Shrewsbury and Telford Hospitals Trust (to complete a
regional cross-section of culture and geography).
5) Advanced Clinical Practice:
Currently, there is considerable variety in training (academic and clinical), nomenclature, salary
banding and career progression of Advanced Practitioners regionally. This variation and lack of
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47 governance / quality assurance has led to the HCPC refusing (to date) to acknowledge the
role of Advanced Practitioner.
The HEWM ACP project aims to address this disparity by introducing a standardised, regional,
multi-disciplinary Advanced Practice training programme (academic and clinical). The training
programme will comprise a standardised core structure and naming convention and sympathetic
“bolt on” modules, relative to the disciplines taking part (eg. EM nurses / community nurse /
paramedic / physiotherapist / pharmacist etc).
The development of a regionally standardised ACP programme has been identified as a priority
for both regional LETC groups, Health Education West Midlands and Health Education England.
Desired outcomes:
To re-invigorate / sustain / develop the existing medical and non-medical workforce’, both in
primary and secondary care, while also introducing new and innovative medical / non-medical
roles to fill identified gaps in primary and secondary care. Projects such as the Post-CCT
Fellowship also seek to bridge the cultural and skills gap between primary and secondary care.
Patient care will be improved by:
-
Effecting change to a disparate, overwhelmed and fractured workforce, generating a
complimentary “non-medical” workforce to develop a multi-specialty “team medicine”
approach.
Developing GPs, Physician Associates and Advanced Practitioners within primary care
practice, to bridge the gap between primary and secondary care and improve access to
A&E avoidance / treat-at-source options.
Providing a portfolio approach to west midlands EM workforce challenges – a recognition
that there is no “one size fits all” solution to this problem.
A sustainable and consistent workforce will have a positive impact on waiting times and
quality of care and, ultimately, satisfactory outcomes for the patient.
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
Emergency Medicine and the addressing of workforce issues within regional EDs has been
identified as a priority in the HEE Mandate, DH Accountability Agreement and HEWM Portfolio, as
well as workforce planning processes cross-organisation.
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):
The West Midlands Emergency Medicine Taskforce first met in January 2013. The taskforce,
chaired by Professor Elizabeth Hughes (Director of Education & Quality and West Midlands
Regional Postgraduate Dean), comprised a membership of individuals representing the interests
of Emergency Medicine across the West Midlands. The West Midlands Taskforce followed the
nationally agreed mandate for the development of work-streams intended to provide a portfolio of
solutions to the national EM Workforce crisis. The Taskforce commissioned a Project Manager to
develop and oversee the implementation of the project portfolio, which includes:
-
A Post-CCT EM Fellowship programme (A&E Avoidance / Community Medicine)
2014 re-launch of the Physician Associate programme (workforce stabilisation)
Independent Prescriber Pharmacist – clinical ED Pilot (workforce stabilisation)
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SAS EM Training Portfolio 2013-14 (retention to specialty)
Regional Framework for standardising Advanced Practice Training (A&E Avoidance,
workforce stabilisation, workforce re-organisation)
st
All projects are due to initiate before April 1 2014, with staggered starts as discussed below (see
“Timelines”). Stage planning and agreed milestones are in place for each project. Measures of
success and best practice have also been determined.
Approach to evaluation and benefits realisation:
Post-CCT Fellowship, IPP Pilot will be critically evaluated in the final phase of the project –
external evaluation report and published study will follow.
Fixed stage boundaries have been agreed and set for all projects, to manage data flow, ensure
project stability and follow best practice (maintained standards of care for practitioner, patient and
organisation).
Risks:
Comprehensive risk management plans and “Lessons Learned” surveys have been completed for
all work-streams, based on:
Regional surveys of Trusts / HEIs / User Groups / practitioners.
Regional and localised consultation periods.
Feedback from targeted events – eg. September 2013 SAS Careers summit, July 2013
EM Workforce Summit, December 2013 Physician Associate symposium.
Evidence of similar previous practice (lessons learned).
Risk will be mitigated by:
Robust clinical supervision (SAS, PA, ACP, IPP, Post-CCT Fellowship).
A universally accepted initiation benchmark and intensive stage boundaries (IPP pilot).
Trust acceptance of proposed recruitment, retention and training strategies (PA / ACP).
- Pre-Initiation identification of project board, project management, clinical supervision
(where appropriate), project change authority, data collection and investigation and
contingency planning.
Resource Implications:
The West Midlands LETB agreed funding / commissioning for the described work-streams, which
are all currently within budget (no anticipated slippage at this time).
Description of the collective benefit to Trusts and patients:
See “Links with best practice”
Sponsor and partner organisations (working in partnership):
1)
-
Post-CCT Fellowship: Sponsor is HEWM – partner organisations are:
st
West Midlands “1 5” GP Group;
South Worcestershire CCG.
Worcester Acute Hospitals Trust.
West Midlands Ambulance Service.
Regional GP Practice’
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492) SAS Portfolio: Sponsor is HEWM – Partner Organisations are:
-
Heart of England Foundation Trust.
University Hospitals Coventry and Warwick.
3)
-
Advanced Practice Framework: Sponsor is HEWM – Partner Organisations are:
Heart of England Foundation Trust.
Warwick University (project planning and support)
Other HEIs / LETC groups TBD.
4)
-
Physician Associate: Part-Sponsor is HEWM – Partner Organisations are:
University of Birmingham.
University of Wolverhampton
University of Worcester.
St Georges University.
UK Association of Physician Associates.
Aberdeen University.
5)
-
Independent Prescriber EM Pharmacist – Sponsor is HEWM – Partner Organisations are:
Heart of England Foundation Trust.
Walsall Manor Hospital – Pharmacy Department.
Aston University School of Pharmacy.
University of Birmingham Pharmacy School.
Timelines:
st
th
1 Phase (HEFT) Pharmacy Pilot: December 9 2013 – January 10
rd
Post-CCT Fellowship Pilot: 3 February 2014 – February 2
nd
th
2015.
th
th
SAS Regional EM Training Portfolio: From December 18 2013 – December 8 2014.
Advanced Clinical Practice (regional model): project start date April 2014.
st
th
Physician Associate training: 1 cohort from January 15 2014
Sustaining the Project:
For all projects in the EM portfolio, funding has been allocated to either pump-prime the launch of
the project (PA / SAS / ACP), fund pilot studies to test the viability of a future role (IPP, ACP,
SAS) or develop a model for evaluation and approval (IPP / Post-CCT Fellowship) prior to a larger
regional roll-out.
The project manager is substantively employed and tasked solely with the continued development
– pre / post and during projects.
Project Teams have been developed and confirmed for all work-streams.
Project Sustainability is identified as a low-level risk for all work-streams, with contingency plans
in place to protect the integrity of the project teams.
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Birmingham & Solihull Local Education and Training Council Workforce Development
Plan
SIMULATION
Issue we are trying to address:
HEE are undertaking a review of national access to simulation as part of its Technology
Enhanced Learning (TEL) workstream, in which they propose to showcase technology to
enhance education, training and patient care.
Links with best practice/previous projects or work and how the priority adds value:



http://www.heacademy.ac.uk/news/detail/2013/HEA_HEE_announce_alliance
http://www.aspih.org.uk/aspih-hea-simulation-project/
https://hee.nhs.uk/2013/11/18/tel-showcasing-technology-to-enhance-educationtraining-and-patient-care/

Desired outcomes:
The DH published ‘A framework for technology enhanced learning’ that is grounded in six key
principles to underpin world-class education and training.
• Patient–centred and service-driven
• Educationally coherent
• Innovative and evidence-based
• Deliver high quality educational outcomes
• Deliver value for money
• Ensure equity of access and quality of provision.
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
From performing surgery, CPR or re-enacting a serious incident, simulation and simulated
tasks have been used in medical, nursing and dental education for at least the last 50 years.
Simulation is a reproduction or approximation of a ‘real’ event, process or set of conditions
or problems and students and trainees are expected to evaluate and act in the same way as
they would in the real situation.
Not only are important lessons learnt in a ‘patient safe’ environment, but competence can
be improved by deliberate and repeated practice.
What we want to do is find out what type of simulation is being used and what works
well, and bring it all together so that educators can choose what simulation activity has the
greatest impact on enhancing education and training in their organisation.
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):
 This is yet to be developed
Approach to evaluation and benefits realisation:
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 This is yet to be developed
Risks:
 Section to be developed
Resource Implications:
This is yet to be developed
Description of the collective benefit to Trusts and patients:
 This is yet to be developed
Sponsor and partner organisations (working in partnership):
 Ian Blair, Birmingham City University
Timelines:
This is yet to be developed
Sustaining the Project:
This is yet to be developed
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Summary of BS LETC Deliverables 2014/15
Below is a summary of the key BLETC Deliverables in 2014/15, these are in addition to the core
annual deliverables outlined on page 2 and 17 and in some instances build on work done in 2013/14.
Headline Deliverables for BLETC
The following deliverables relate to where the BLETC are undertaking work either solely within
Birmingham or as a lead LETC:





Understand the changes and implications to medical workforce supply across Birmingham, in
particular the implications for advanced practice, upskilling the existing workforce and Physician
Associates. LETC Sponsors Phil Bright, Karen Camm
Deliver year 2 of the Older Adult Workforce Integration Programmes (details of which can be
found in 2013/14). For 2014/15 this includes supporting the regional delivery of the
Postgraduate Older Adult Nurse Registration Programme. LETC sponsor David Holmes
Delivery of the 4 End of Life Projects across the locality and identify lessons learned for other
acute providers – LETC sponsors Karen Camm, David Holmes, Theresa Nelson.
Work to address the nursing shortages for both adult general nurses and paediatric nursing –
LETC Sponsor Theresa Nelson
Focusing on increasing apprenticeships, progression and access to healthcare careers as part of
the Widening Participation Partnership Forum – LETC sponsor Gerry Dryden
Contribute to National / Regional/ Other LETC Deliverables
The following deliverables relate to priority pieces of work across HEE / HEWM that are either
regionally led or led by other LETCs, where BLETC has a responsibility to feed into the development
and/or implement recommendations:




Recruiting for values - understand the LETC/LETB wide implications from the pre-degree
experience pilot – LETC sponsor Louise Banks
Contribute to the development of a bespoke workforce plan in Theatres – LETC sponsors
Louise Banks, Ian Blair
Identify the workforce requirements and ensure delivery of service transformation in
Dementia and Learning Disabilities – led by MHI LETC
Respond to the identification of the shortfall of sonographers across the West Midlands –
led by BC LETC
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



Actively contribute to the development of the Advancing Practice Framework (including
non-medical prescribing) (bands 7-8)- AHW LETC – LETC sponsor Phil Bright
Develop a strategic approach to supporting primary care workforce – led by regional group
Contribute to the Emergency Medicine Taskforce in particular the development of the
Physician’s Associates role – LETC sponsor Phil Bright
Contribute to development of West Midlands Simulation Strategy – LETC sponsor Ian Blair
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Birmingham & Solihull Local Education and Training Council Workforce Development
Plan
OLDER ADULTS NURSE REGISTRATION
Issue we are trying to address:
Further to the recommendations of the recommendations from the Francis report, there
is a national workstream currently being developed by Heath Education North East.
Links with best practice/previous projects or work and how the priority adds
value:
This will build on the work of the Older Adult Integration programme and will be managed
as a sub-group of this.
Desired outcomes:
The development of a post-graduate registration programme for nurses undertaking care
of the older adult. Possibly leading to an additional NMC registration.
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
Developed as a response to the Francis report
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):
Initial meeting held in London November 2013 in order to scope current practice and
identify potential next steps. Outcomes from the meeting are awaited.
Approach to evaluation and benefits realisation:
Likely to be informed by a national process led by HENE
Risks:
No detail yet available from HENE
Resourcing of local implementation
Release of staff to undertake additional training
Resource Implications:
Not yet known, as no programme detail is yet available
Description of the collective benefit to Trusts and patients:
The identification and specific training of a defined staff group with the specific values
and skills required to support the safe and quality delivery of care to the older adult
population
Sponsor and partner organisations (working in partnership):
All organisations providing care of the older adult
Timelines:
To be confirmed
Sustaining the Project:
TBC
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Birmingham & Solihull Local Education and Training Council Workforce Development
Plan
ADVANCING PRACTICE – Regional proposal led by AHW LETC
Issue we are trying to address:
There is a regional interest in the development of a core framework to support
organisations in development of advancing practice, using best practice examples and
the development of role definition, competencies etc. in order to enable professional
advancement and to support workforce redesign and modelling that enables
organisations to fill the gaps by lack of supply.
Links with best practice/previous projects or work and how the priority adds
value:
As outlined in the context, this will bring together best practice from a number of
organisations, link with previous projects undertaken regionally and add value through
the development of a simple overarching framework which will prevent organisations
‘starting from scratch’
Desired outcomes:
Development of a framework and best practice principles which are supported and
implemented regionally.
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
Many organisations reported a plan to increase numbers of advanced practitioners in a
number of specialty areas in the Summer 2013 workforce plan / forecasts. This is likely
to reflect a relationship with the changes to the medical workforce and Emergency
Medicine workstreams.
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):
 Establish a regional stakeholder group – Jan/Feb 2014
 Establish and quantify demand across HEWM area, building on the mapping
work currently taking place in Arden, Hereford & Worcester LETC, course
provision as part of the Emergency Medicine workstream (Advanced Clinical
Practice) and dissemination of a survey to establish a narrative around demand
and expectations – Jan 2014
 Agree regional framework and definitions, including mapping and crossreferencing core elements across existing frameworks – Feb 2014
 Agree funding model – Feb 2014
 Explore potential for a strategic commissioning approach to ensure best value for
money – Feb 2014
Approach to evaluation and benefits realisation:
Successful implementation in organisations
Retention of practitioners
Ability to workforce plan and skill more effectively
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Risks:
Development of gaps further down the skills chain
Cultural integration into the workforce
Retention of practitioners
Resource Implications:
The development of the framework is not critical but will be supportive
Organisations will need to have their own resources to implement and develop
practitioners
There should be no significant resource implications in the framework development
Description of the collective benefit to Trusts and patients:
A differently skilled and efficient workforce that can meet the changing and complex
needs of patients
Development of professional groups
Sponsor and partner organisations (working in partnership):
All organisations within the BS LETC, including general practice and HEIs.
Timelines:
It is anticipated that the background preparation will take place between March 2014 –
May 2015, although there is an expectation of delivering non-medical prescribing training
in February / March 2014 which will act as a preliminary measure of Trust or General
Practice interest in developing advanced practice posts.
Sustaining the Project:
Explain how the project’s benefits will be maintained after funding has ceased.
Changes to the medical workforce, the proposals for 7 day working and the increasing
pressures on the health services mandate that this becomes embedded in future
practice. This may require trust agreement to apportion an element of their LBR monies
in the continued support of advanced practice roles. Benefits realisation is likely to be
achieved through improved delivery of care, for example:
 reduction in prescribing errors,
 reduction in inappropriate admissions and delayed discharges,
 appropriate referrals to hospitals
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Birmingham & Solihull Local Education and Training Council Workforce Development
Plan
CHANGES TO THE MEDICAL WORKFORCE
Issue we are trying to address:
National mandated changes to medical training numbers have mandated a shift from
traditional medically-driven models of care. The drive to deliver increased numbers of General
Practitioners has caused a decrease in the number of hospital speciality training posts to
achieve the desired 50:50 split between hospital doctors (all specialities) and GPs.

Identify and deliver staff in different workforce roles to address the reduced availability
of junior and middle grade doctors
 Identification of the “difficult to recruit” medical workforce specialities e.g. care of older
people, mental health, emergency medicine, psychiatry, radiology and neonates.
 The establishment of solutions to address the workforce challenges of changing
medical supply and the requirement for seven day per week delivery of all services.
 Understand and identify solutions for the challenge of the ageing medical workforce
across the BLETC.
 Understand the available medical workforce supply by year across specialties in order
to build a supply model for medical workforce specialties
 Through LETC provider implementation of the recommendations from the Regional
Emergency Medicine Taskforce and AHW LETC workstream- understand any
transferable outputs, lessons learned across other challenged specialties
Links with best practice/previous projects or work and how the priority adds value:

This links with other priority workstreams, including emergency medicine, physician’s
associates, advancing practice and Upskilling.
 Best practice/previous projects to be scoped looking at non-medical solutions to
medical workforce changes.
 Identification of successful and unsuccessful implementation of new roles, with
particular consideration given to the sustainability of solutions
Desired outcomes:







The development of a non-medical workforce with the advanced and specialist skills
required to continue the safe and effective delivery of quality care.
An understanding of the alternative roles to address service and patient needs.
Scope of the “difficult to recruit” roles and action plan to address those identified areas
Identify worked up and piloted solutions to the identified shortage areas
Scope the ageing medical workforce across the Health and Social Care, identify the
gaps and proposals in place to deliver these gaps
Understand solutions to successful reduction in locum and agency spend
Ensure Birmingham is represented on the Emergency Medicine Taskforce to ensure
engagement and implementation of the recommendations once agreed as well as
identifying lessons learned for other specialties
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
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Skills and Development Strategy / Workforce Planning Process
Relates directly to HEE mandate sections 2.1.4, 4, 5 and 9

“In order to tackle historical shortages in doctors working in EM, HEE will need to
ensure that the existing medical taskforce working group continues to work and that
progress is maintained”
o “Excellent Education including 50% of specialty trainees chose to enter GP
speciality training”.
o “Start the implementation of tariffs for postgraduate medical training
programmes and primary care medical education and training”.
o “Support efforts to reduce the level of spend on agency staff”

HEWM 5 Year Skills and Development Strategy – BLETC priorities

Changes to medical workforce supply and implications of tariff changes are cited in a
number of the trusts 5 year Workforce Plans.
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):





Understand the implications to the medical workforce of the changing population
demographics across Birmingham
Clarity on alternative roles, understanding of numbers available for new ways of
working
Scope difficult to recruit roles and expanding specialties
Obtain clarity on seven day working, implications, and gaps
Scope the ageing workforce, identify gaps and solutions to address the gaps
Approach to evaluation and benefits realisation:



There will be no specific evaluation methodology for this piece of work as it is a
platform for informing 3 future workstreams
Use of quantitative and qualitative intelligence gathered in a variety of formats /media
to inform the evidence base for decision making
Data and key metrics identified to support measuring of outcomes and benefits
realisation in particular around quality metrics as part of a baseline data collection to
inform evaluation of the future workstreams
Risks:






Lack of engagement and ownership
Short term rather which may result in a lack of focus on the strategic issues
Skills available to deliver new ways of working
Trusts not wanting to share workforce information
Commissioners lack of clarity on future service development
Some of the solutions are not within the control of the BLETC as medical recruitment
is often national determined
 Financial affordability of new models
Resource Implications:
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How important is it – weighting if resources are required?
This has been identified as a priority area for the BLETC and will be able to utilise intelligence
and information held within HEWM
Description of the collective benefit to Trusts and patients:


Safe and quality service
Ability to provide HEE and HEWM with evidence based information on the needs of
medical workforce and alternative roles to provide the service of the future
Sponsor and partner organisations (working in partnership):
 Phil Bright – Associate Post-graduate Dean
Timelines:
 Initial workshop is planned with the LETC and Workforce Transformation Group in
January 2014
 Scoping the outline of what the LETC would like to focus on in terms of specialties and
outcomes – January- March 2014
 Building on the outcomes of the survey undertaken on Advanced Practice as part of
the development of the Advanced Practice Framework between January – March
2014, the LETC will identify the implications of medical workforce changes for the
wider workforce including the numbers, areas and educational requirements for
advanced practice, upskilling and physician associates this may require – April- June
2014
 Utilise outcomes from the project to inform the development of the Advancing Practice
Implementation, Upskilling the Existing Workforce and Physician Associate priorities June- March 2014
Sustaining the Project:
N/A
The outcomes from this project will be used to inform the advanced practice implementation,
physician associate and upskilling the existing workforce BLETC priorities within subsequent
years of this plan.
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Birmingham & Solihull Local Education and Training Council Workforce Development
Plan
ADVANCING PRACTICE – BS LETC
Issue we are trying to address:
Advanced practice has been identified in LETC workforce plans as an area of need
Links with best practice/previous projects or work and how the priority adds
value:
As outlined in the context, this will bring together best practice from a number of
organisations, link with previous projects undertaken regionally and add value through
the development of a simple overarching framework which will prevent organisations
‘starting from scratch’
Desired outcomes:
Supporting staff development in areas of advanced practice to bring direct patient benefit
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
Many organisations reported a plan to increase numbers of advanced practitioners in a
number of specialty areas in the Summer 2013 workforce plan / forecasts. This is likely
to reflect a relationship with changes to the medical workforce and Emergency Medicine
workstreams, as well as the proposed development of a regional advanced practice
common framework that is being led by the AHW LETC
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):
 Establish local task and finish workstream – July 2014
 Scope current desire and capacity for staff in BS LETC to undertake advanced
practice training – Sept 2014
 Confirm actual skills needed and map against current course provision and
scheduling – Sept 2014
 Agree principles for uptake, including trust support for return to work in an
advanced practice role following demonstration of competences – Sept 2014
 Confirm numbers and places and enter into training –Sept / Oct 2014
 Evaluate benefit to patients / service / staff, including longer term evaluation (12
months) for role sustainability.
Approach to evaluation and benefits realisation:
Successful implementation in organisations
Retention of practitioners
Ability to workforce plan and skill more effectively
Risks:
Development of gaps further down the skills chain
Cultural integration into the workforce
Retention of practitioners
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Resource Implications:
The funding is available for the specified purpose of supporting pump priming in
response to identified skills demand by organisations. Trusts will be responsible for
embedding advanced roles in practice, and ensuring practitioner sustainability and
maintenance of competences.
Description of the collective benefit to Trusts and patients:
A differently skilled and efficient workforce that can meet the changing and complex
needs of patients
Development of professional groups
Sponsor and partner organisations (working in partnership):
All organisations within the BS LETC, including general practice and HEIs.
Timelines:
July 2014 – March 2015
Sustaining the Project:
Explain how the project’s benefits will be maintained after funding has ceased.
Changes to the medical workforce, the proposals for 7 day working and the increasing
pressures on the health services mandate that this becomes embedded in future
practice. This may require trust agreement to apportion an element of their LBR monies
in the continued support of advanced practice roles. Benefits realisation is likely to be
achieved through improved delivery of care, for example:
 reduction in prescribing errors,
 reduction in inappropriate admissions and delayed discharges,
 appropriate referrals to hospitals
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Birmingham & Solihull Local Education and Training Council Workforce Development
Plan
PHYSICIAN’S ASSOCIATES
Issue we are trying to address:
Integration and mainstreaming the role of the Physician Associate / Assistant (PA)
Links with best practice/previous projects or work and how the priority adds value:
The development of new roles and in particular advance practice roles is key to the future
longevity of the NHS, this has been acknowledged in the recent RCP ‘Future Hospital
Commission’ Report (2013). In particular the role of the PA lends itself to being a potential
answer to some of the significant staffing issues in Emergency Medicine, as identified in the
recent Emergency Medicine Summit held by HEWM.
The role is now established in 34 NHS Trusts across the UK and is slowly consolidating into
Primary Care also. The PA is seen as a direct support of the medical team, adding value to
the patient journey by providing a degree of junior/mid-level support which remains a
constant, in a system where junior doctors are rotating through specialities and institutions,
with very steep learning objectives.
Desired outcomes:



Support for NHS Trusts to take students on clinical placements;
Support for a consistent internship/induction programme for the newly qualified PA;
Structured CPD programme identified
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
Directly supports the shortage of skills across emergency medicine and potentially within
surgery due to the reduction across medical trainee numbers.
Potential to support more timely discharge of patients if role incorporated into junior doctor
ward based teams
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):





Work with universities providing programmes
Development of quality clinical placements
Development of Internship materials for qualified PAs
Development of CPD Portfolio for qualified PAs
Steering group for all Birmingham & Solihull organisations providing PA placements
.
Approach to evaluation and benefits realisation:
 Skills based assessment
 Mentor reports and structure log book of clinical exposure
Risks:
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

Failure of Trusts to invest in the PA role
Failure to provide PAs with appropriate CPD to ensure they both develop into the role
following graduation and continue to develop the requisite skills and experience to
both undertake the full PA role and to revalidate
Resource Implications:
How important is it – weighting if resources are required?
PA programme at UoB is due to re-commence in January 14, failure of Trusts to invest in this
programme following past failures will threaten the progression of this intake and future
sustainability of the programme
Description of the collective benefit to Trusts and patients:



Sustainable workforce
Safe change over periods of junior doctors
More bedside time spent with patients and subsequent increase in communication and
safety.
Sponsor and partner organisations (working in partnership):



University Hospitals Birmingham NHS Foundation Trust
University of Birmingham
Other trusts within the bLETC area
Timelines:
Please see table below
Sustaining the Project:
Explain how the project’s benefits will be maintained after funding has ceased.
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Proposed Timeline – Physician’s Associates
Year 1 –
2013/14
Objective
Deliverables
Capacity
Establishment
of new
programmes
Clinical
Develop
Placements placement
capacity
Year 2 – Workforce
2014/15 Planning
Awareness
Outcomes
Timescale

Re-opening of University of
Birmingham PG Dip in PA Studies
Jan 2014

Potential second iteration of UoB
programme, to upscale outputs
April
2014

Work with other universities
hoping to develop programmes
TBA

o Wolverhampton University
o Worcester University
Confirmation of level of response
to Professor Liz Hughes letter of
July 2013 requesting Trusts to
offer placements and potential
employment opportunities;
TBA

Develop a central data base of live
register of placements;
TBA

Develop a quality monitoring
system for placements with
universities.
TBA
Annual
workforce
planning
cycles for
Trusts

Trusts to project demand and
capacity for PAs in the workforce;

Mapping demand into programme
outputs
Employers
conference to
raise
awareness
and assist in
forward
planning

UoB and UHB to organise an
employer’s event in the spring of
2014 to have national leads and
champions discuss the use of PAs
and their experiences in
embedding PAs into their
workforce
March
2014
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Internship
Planning
Employers led
working
group to
design a
formalised
internship
programme
for newly
qualified PAs
Year 3 – Review and Programme
2015/16 forward
Reviews
planning

Working group representative of
all Trusts, with clinical
engagement to design a 1 year
programme similar to FY1/FY2
teaching for newly qualified PAs
and to look at having it accredited.

Review of the Midlands
Programme(s) similar to an ECQ
type review, looking at value,
outputs and employability of the
students;
Employer engagement;
Recruitment methods;
Attrition.



Jan 2015
April
2016
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Birmingham & Solihull Local Education and Training Council Workforce Development
Plan
NURSING SHORTAGES
Issue we are trying to address:
1. There is currently a high level of vacancies across the BLETC
2. Current workforce across BLETC as at 31st October 2013:
Adult General Nurses: 4,764 FTE
Paediatric Nurses: 1,182 FTE
(Neonatal nurses not identifiable on ESR)
Total Vacancies as declared on 18th December 2013 to deliver current March 2014 plan
Adult General Nurses: 363 FTE (mainly experienced band 5 and band 6- in Community/ ICU/
Renal Dialysis, Theatres)
Paediatric Nurses: 84.2 FTE (the specific service are gap identified- Band 5 – PICU/ HDU/
Oncology/ Neonatal
Neonatal Nurses: 12.65 FTE (Band 5 & 6 Neonatal nurses posts)
3. Further recruitment is planned for most trusts, this is currently not quantifiable as trusts are
currently part way through their business planning and outcomes are expected between FebApril 2014. The planned recruitment will encompass the recommendations of the Francis /
Berwick / Cavendish and Keogh reports, with the aim of ensuring that nursing establishments
are evidence based and align to the key recommendations. In particular the implementation
of the Francis review recommendations looking at the publication of safe staffing levels twice
yearly (including skill mix reviews by the Board across Nursing and Midwifery) has the
potential to have significant funding and training issues and continue to further increase the
demand for nursing and midwifery staff.
4. HEE Workforce Plan outlines that the Nursing and Midwifery Council data shows that there
are 23,000 nurses have ‘lapsed’ in their registrations, with many more registered but not
employed. It suggests as a system need there is a need to actively manage the investments
we have already made in individuals and think creatively about how we might encourage
qualified and registered nurses to return to work.
HEE has therefore agreed to lead a campaign on behalf of the system to provide support to
employers in meeting their current workforce needs for nursing and investing not just in a
three year course, but in the life-long career of a nurse. This will include support for
registered nurses to return to and stay in employment,
5. During the last year some trusts have experienced issues with newly qualified nurses not
meeting numeracy and literacy standards at recruitment and having insufficient exposure to
working in a clinical setting, having a lack of understanding about shift working and issues. In
addition some HEIs appear to be applying lenient criminal records standards for entrants onto
programmes/ students who obtain criminal convictions whilst on the programme.
Links with best practice/previous projects or work and how the priority adds value:
 Link to HEE National work as details emerge
 HEFT, BCU and Education Collaborative including UoB – national published work on
strengthening mentorship, preceptorship and supporting leaders to support staff
 Discussions are already underway between the Birmingham Directors of Nursing and
University of Birmingham regarding the fitness for purpose of new graduates with specific
reference to delivery of core clinical skills across the following skills which are currently having
to be taught and assessed post qualification
andLocal
during
the preceptorship
period:
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

 Phlebotomy
 Cannulation
 Recording of ECG’s
 IV Therapy Administration
Additional areas of taught and assessed practice are also required around drug assessment
and managing a group of patients all of which graduates should be fully competent at on
course exit.
There is a working group in place between BCH and BCU to address current issues with
paediatric nurse provision
HEFT run an in house Neonatal HDU and ITU courses- for nurses within the 1st 2 years- to try
to alleviate the issue with qualified Neonatal Nurses. There has been expansion of the criteria
for Neonatal Nursing and now take applications from adult trained nurses as well as
Children’s and Midwives.
Desired outcomes:
 Action plan to address the identified LETC wide shortage areas
 An understanding of the upskilling requirements to address skills shortages in specific service
areas
 Identify worked up and piloted solutions to address the identified shortage areas
 Understand any hotspots around the ageing workforce which may further exacerbate current
gaps identified
 Work with the LETC to identify the impact of changes to future nurse demand based on the
implementation of Francis/ Berwick/ Keogh/ Cavendish Reports
 High quality newly qualified nursing graduates
 Sufficient availability of nursing staff across Birmingham and the West Midlands
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
 Availability of the nursing workforce is identified as a priority in HEE and HEWM Workforce
Strategy
 Identification of the Adult General Nursing current shortfall in available workforce to meet
increased demand was seen in the Workforce Plans across Birmingham in June 2014.
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):
Adult General Nursing
In order of priority identified by the trusts:
Work with HEIs to reduce attrition on nursing programmes (Applies to Paediatric Nursing)
 Trusts to be better cited on the reasons and impact of attrition and any delays to progression
affecting student outturn across Birmingham Universities (currently underway with Directors of
Nursing).
 Work collaboratively to reduce attrition with consideration given to additional selection
requirements at entry onto programmes
 The evaluation of the pilot Year of Care programme will support work to minimise attrition
through better understanding the student perception and expectations of nursing as a career
particularly during their first clinical placement.
 Understand and make available first destination data, HEWM assumptions around the nursing
workforce behaviour e.g. retirement profile of the workforce, retention of new graduates within
NHS system as a whole
 Manage students expectations around the recruitment process and practices in the NHS,
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including rechecking numeracy and literacy of students in the final year of training
Increasing secondment opportunities for HCA into Nurse training (Applies to Paediatric Nursing)
 Increase screening of candidates pre-secondment
 Link to the progression Widening Participation workstream to ensure access courses are available
to support Healthcare Assistants (HCAs) to reach the right level of qualifications to access nurse
training at degree level
Co-ordinated recruitment on Return to Practice – there is limited confidence that effort will result in
significant additional nursing supply
 Understand how the BLETC can link into the National workstream and influence how RTP is
provided
Increase investment in CPD to address specific skills gaps
 Request for additional investment specifically across the difficult to recruit clinical specialities and
mitigating the impact of reduced junior medical workforce numbers through advanced
practitioners (see changes to medical workforce supply).
Conversion of staff currently at risk e.g. Learning Disability Nursing
 Share across the LETC an understanding of the overall regional nurse recruitment picture is across
all fields of nursing and where there is potential unemployment of nurses across different fields,
and how these nurses can be rapidly reskilled and deployed.
Once trusts quantify further nursing changes the LETC would need to understand the impact of
current recruitment on the available workforce and therefore the longer-term impact on education
commissions
 Feed in the impact of current short term recruitment strategies into nursing supply models at
HEWM and share the output with LETC
 There is rapid growth shown in Trust workforce plans in the next 2 years however, for the
following it is expected the increase will continue to be seen over the next 5 years due to:
 Increased level of acuity resultant from patient demography
 Impact of Francis recommendation /staffing recommendations
 Impact of junior medical workforce reductions
 Growth of specialised services
 Potential reduction of military personnel who contribute to the current UHB service delivery
Additional actions outside the above are:
 Shared understanding of the BLETC picture across all Trusts and how other Trusts are funding
solutions to the immediate nursing workforce issues
 An understanding of how the NHS Mandate / Operating Framework will summarise the
functions and duties required to demonstrate compliance (as required ) with the NHS Quality
Board and Chief Nursing Officers guidance document “ How to ensure the right people , with the
right skills , are in the right place at the right time “ Nursing, Midwifery and Care Staffing Capacity
and Capability.
 Work underway across Birmingham to understand the potential impact on recruitment and
retention in relation to revised nursing establishments using evidence based tools, which may
suggest additional requirements for Registered Adult Nurses.
 An understanding of successful approached to deployment (shift patterns), retaining staff and
current notice periods used
 Understanding of the mobility of the nursing workforce and the demographics of new recruits
 An understanding of the move to 7 Days a Week review
 Improve the awareness of opportunities in community nursing- through rotational aspect to
training as alternative to acute
 Target international recruitment for theatres and critical care
 There is a need for more close working with HEIs to set agreed and commonly applied numeracy
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and literacy standards, criminal record standards and some ‘real life’ exposure to ward based
nursing in order to reduce attrition and improve standards.
Paediatric Nurses
Re-establish the working group between BCH and BCU in January to look at both retention and
attrition issues for the under graduate programme but also to influence the changes required for the
revalidation of the nursing programme in early 2015
 look at undergraduate and post graduate routes to qualification plus the need for Return to
Practice and possible conversion opportunities.
 possible longitudinal study into support of clinical education and the development of
additional technical skills within the undergraduate curriculum, to help the newly qualified
staff nurses 'hit the ground running’, including reviewing the length of clinical placements
 write a proposal to identify the funding required for this initiative as the pace and scale is
such that the work needs to be carried as soon as possible to make an impact.
 Development of a specific program to look at RTP RNC
 Increase investment in CPD to address specific skills gaps
 Review the university academic timetable is not meeting our operational needs (80%
September output)
Neonatal Nurses
There is a National problem recruiting senior qualified in speciality Neonatal Nurses to meet BAPM
Standards for nurse staffing. Significant problems have been identified in securing with some limited
international recruitment from new EU member states. Action is needed for:
 additional postgraduate neonatal nursing programmes
 include aspects of neonatal nursing in HEI undergraduate programmes and placements in
such units
Approach to evaluation and benefits realisation:
1. Evaluation methodology to be agreed at planning stage.
2. Use of quantitative and qualitative intelligence gathered in a variety of formats /media
3. Data and key metrics identified to support measuring of outcomes and benefits realisation.
4. Systems and processes to be established to capture evidence ( metrics, data, quantitative
intelligent) to inform regular monitor and review of progress against outcomes
Risks:
 Lack of engagement and ownership
 Short term rather which may result in a lack of focus on the strategic issues
 Skills available to deliver new ways of working
 Trusts not wanting to share workforce information
 Commissioners lack of clarity on future service development
 Some of the solutions are not within the control of the BLETC as medical recruitment is often
national determined
 Financial affordability of new models
Resource Implications:
Investment is required to support:
 Increase the availability of secondments onto pre-registration programmes for HCA and
conversion of ‘at risk’ nurses to a new branch of nursing
 Additional investment in CPD for shortage specialities and advanced practice
 Adult General Nurse Return to Practice (RTP) – Identify if there is any central funding for this
initiative (acknowledging there is limited expectations in terms of numbers around this area)
 Paediatric Nurse – Awaiting proposal from the working group around the investments
required in this area
 Neonatal nurses- identify resources to fund additional neonatal nurse postgraduate
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programmes
The availability of the nursing workforce is vital to the delivery of safe and high quality services, and
addressing the availability of the nursing workforce in short-term is critical to the LETC.
In implementing the recommendations from the Francis / Berwick / Cavendish and Keogh reports,
trusts have identified the need for additional nursing staff. This is further compounded in delivery of
services with winter pressures and service expansion in a number of areas. Most trusts are expecting
a further demand for qualified nurses once they have completed the 2014/15 business planning
round.
The implications of short-term/ immediate recruitment responses needs to be considered when
looking at the long-term implications for education commissioning pre-registration nurse education.
Description of the collective benefit to Trusts and patients:
 Availability of nurses in sufficient numbers to deliver a high quality service without over
reliance on bank and agency staffing
 Confidence to deliver the skill mix reviews identified as part of the publication of nurse and
midwifery staffing numbers
 Newly qualified graduates equipped to meet numeracy and literacy tests set by trusts, and to
deliver care in a variety of care settings specifically understanding the availability of roles
within community services.
Sponsor and partner organisations (working in partnership):
 All BLETC members
Timelines:
 Questionnaire of the current critical issues on nursing shortages – December 2013
 Identification of a project sponsor to lead on the development and further coping of the
solutions identified- January- March 2014
 Work closely with Director of Nursing to identify the role of the LETC in taking forward some
of the proposed solutions. Understand the emerging national workstreams currently being
established to address the current nursing shortages
 Implementation of the recommendation April 2014- March 2015
Sustaining the Project:
It is anticipated that this piece of work will be time limited, as it will address the current recruitment
shortfall and therefore the longer-term implications for nurse education will be addressed through
pre-registration nursing commissioning and the education commissioning for quality process.
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Suggested Deliverables and Resources for Adult General and Paediatric Nurse Shortages
Timeframe
Output
Resources Required
Total Project
Requirements
Co-ordination of
the different
workstreams
Short Term
February 2014
- August 2014
Conversion of
Overseas Nurses
currently
working in the
UK but not
eligible for NMC
registration
Programme Manager
(Band 8a- FTE, plus
24% on-costs and
expenses)
Current numbers to
be confirmed
approximate 30
(£3000 per student
for training courses)
(15 each year)
Provision of short
education packages
to fill any NMC
identified
competences gaps,
completion of the
Overseas Nurse
Programme and 3
months supervised
practice. Support to
trusts for specific
training for mentors
and supervisors to
address specific
needs
Resource to explore
staff working in social
care, liaison with
NMC, Border Agency
Return to
Practice (RTP)link into national
work
International
best practice
Link into National
workstream led by
HEWM:
 Identify LETC view
on how the
current RTP
programme could
be enhanced
 Identify future
numbers for BLETC
trusts and
Acknowledgement
that many BLETC
2013/14
£
N/A
2014/15
£
62,000
2015/16
£
TBC
50,000
50,000
TBC
N/A
N/A
TBC
10,000
N/A
N/A
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recruitmentshare best
practice
Fast Track to
address
experience skills
shortage CPD
gaps
Decrease
attrition – link
into BCU and
UoB- regional
workstreams
trusts have/ exploring
international
recruitment there is
an opportunity to
identify and share
best practice on
effective brokers/
models/ strategies ,
support for recruited
staff and retention
strategies
Support provision of
additional training
programmes in the
current LETC priority
shortage and
expansion areas
(existing LBR funding
to be used to address
ongoing nurse
development):
 Community/ ICU/
Renal Dialysis/
Theatres
 Paediatric ICU/
HDU/ Oncology
 Neonatal
Contribute to the:
 Programme of
work between
University of
Birmingham and
UHB that is looking
to strengthen
learning across
academic and
work based
environments for
nursing students.
 Commencement
of work with BCU
on securing more
effective clinical
engagement into
their curriculum
review that will
100,000
50,000
TBC
N/A
N/A
N/A
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also look at
placement
learning outcomes
Medium Term
February 2014March 2015
LETC wide coordinated
international
recruitment
across LETC
Transformation
through
innovation in
placement
support
programme
(TIPS) Mentors/
preceptorship
Research
implications of
Collaborative OJEU
procurement of
brokers and central
co-ordination and
procurement advice/
support (some coordination cost
covered by Total
Programme Costs).
This may take some
time to get underway
due to the
procurement
timetable that would
be required
Working with practice
placement facilitators
and building on 2
streams of work
across University of
Birmingham and
Birmingham City
University to:
Support Trusts to
identify and address
ways to enhance
learner support in the
clinical environment
as identified in the
section above. This
also needs to link to
work at
Wolverhampton
University looking at
how attrition from
within programmes
can be used to
support the pipeline
of Healthcare
Assistants and higher
level apprentices
Identify what is
happening Nationally
N/A
20,000
(fees and
staff time
co-funded
by
Providers)
N/A
50,000
TBC –
dependent
on
outcomes
from
preliminary
work
N/A
N/A
TBC
TBC
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current and
future policy
direction on the
nursing
workforce
Long term
September
2014- March
2015
3 year HCA
secondments
into nurse
registration increase
secondments
1 to 2 year
Conversions of
nurses ‘at risk’
between
– link to CfWI,
possibly influence
HEE and HEWM wide
piece of work
including:
 Francis
recommendation
s around safer
staffing
 international
models of
nursing
 new models of
care
 implications for 7
day working
 changes to
special class
retirements
 understanding
the long-term
implications of
international
recruitment on
the availability of
nurses in England
Current LETC
allocation of 34
secondment Increase by 20
(£8,315 tuition fees
per HCA/per year plus
backfill costs 80%,
Band 3/pt 8 plus on
costs £17,286/ per
year). Look at
opportunities to
support Accredited
Prior Learning/
Experiential Learning
for HCAs from
elements of the
programme
Support nurses in
2014/15 (£8,315
tuition fees per
Nurse/per year plus
N/A
512,020
512,020
(plus
additional
starters in
2015/16)
N/A
Branch to
branch
conversion
N/A Branch
to branch
conversion
covered by
N/A
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branches
2 year Fast track
graduate
schemes
backfill costs 80%,
Band 5/pt 17 plus on
cost £21,840/ per
year)
Support 10 graduates
in 2014/15 (£10,394
per graduate/ per
year, no salary
backfill) Please note
this course may need
to be revalidated.
covered by
HEWM
budget
HEWM
budget
N/A
103,940
(plus
additional
starters in
2015/16)
797,960
512,020 *
TOTAL
210,000
* A number of workstreams to be confirmed costings in 2015/16
Funding requested 2013/14 £100,000, 2014/15 £50,000 – confirmed HEWM Board March 2014.
Establish Task and Finish working group
Develop Terms of Reference and provide governance through Workforce Transformation Group and
LETC Sponsor






Theresa Nelson (LETC Sponsor)
Louise Stewart (Senior LETC Lead)
Kay Fawcett (Professional Advisor) TBC
Clinical representation- HEFT/ UHB/ BCHC / BWH / BCH
Birmingham City University - Louise Toner, Tim Badger
University of Birmingham
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Birmingham & Solihull Local Education and Training Council Workforce
Development Plan
EVERY STUDENT COUNTS PROJECT
Issue we are trying to address:
Service changes, a shortage of Nurses and upskilling of staff to undertake new roles
means that Junior Nurses are now increasingly supporting learning of both the registered
and non-registered workforce. A re-invigorated approach to reducing attrition and
improving progression into employment, as well as retention in the early career period,
will be essential to deliver successful workforce outcomes
Links with best practice/previous projects or work and how the priority adds
value:
Shortages of Registered Nurses – project seeks to identify approaches that will reduce
attrition of student nurses and retain newly qualified nurses. This will increase the supply
of registered nurses independent of additional education commissioning.
Desired outcomes:
The assessment of risk points for attrition and turnover and understanding of the student
experience and the development of evidence based solutions should lead to the
maximisation of career progression, staff retention and support of student and Junior
nurses through a range of evidence based support mechanisms
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
HEE Mandate
 Need to be assured that preceptorship programmes are designed to provide
newly qualified nurses with the support and guidance to effectively make the
transition from being a student to a practising registered nurse
HEE Business plan
 Delivering additional nurses
 Work with partners to ensure preceptorship programmes are designed to provide
newly qualified nurses with the support and guidance – ongoing.
Workforce planning
 Supporting the maximisation of education commissioning outturns of registered
nurses to meet workforce demand
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):
A programme board will be established and:
 Identify a set of themes for the work programme - June 2014
 Map sources of data that can provide sustainable information on student and NQ
Nurse attrition and post qualifying presence in NHS - July 2014
 Report on analysis and contributing factors and risks for attrition and career
progression in student and NQ nurses - October 2014
 A set of metrics to measure baseline and improvements in key risk areas October 2014
 Scope existing best practice in student and NQ Nurse support and reduction of
attrition and turnover (locally, regional and national) and identify high impact and
best value interventions in key risk areas - October 2014
 Birmingham and Solihull Student Nurse Conference - November 2014
 Launch of ‘nursing student alumni’ - November 2014
 Scaling up of learning and good practice - November 2014
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 Evaluation of the impact of all of the deliverables - December 2014
Approach to evaluation and benefits realisation:
Evaluation and benefits realisation will be available at the end of the project.
A network or alumni to support student nurses utilising a range of communications
approaches – student feedback, quantitative evidence on utilisation of network
support/resources
Feedback on the student nurse conference
Providers develop Innovations based on the evidence and good practice identified during
the project in the form of proposals to the project board
Risks:
The long-term support of the student nurse alumni may require resources for technology
and face-to-face engagement
The depth and quality of information available to identify risks may not be available
Resource Implications:
£50k has been allocated and the funding will be held by Birmingham Children’s Hospital
NHS Foundation Trust
Description of the collective benefit to Trusts and patients:
Clearer understanding of the risk areas to retaining student nurses and NQ nurses and
their mitigation
A conference and alumni that supports the development of a community and a sense of
belonging for student and NQ nurses
Student nurses support staff working towards the extension of their roles effectively
Reduced attrition and better information to assist in enhancing placements and learning
experience to reduce attrition and increase the stability of workforce numbers and
preceptorship experiences of NQ nurses
Right numbers of staff in post so that workforce can be aligned to patent pathway needs
Sponsor and partner organisations (working in partnership):
Birmingham Children’s Hospital NHS Foundation Trust (sponsor)
Higher Education Institutes
NHS Trusts in Birmingham and Solihull
Timelines:
April 2014 – December 2014
Sustaining the Project:
Explain how the project’s benefits will be maintained after funding has ceased.
The project will produce: a mapping of key risks for attrition and turnover, identification of
good practice, and a set of metrics to measure the effectiveness of innovations.
This will enable organisations to develop proposals for improvements that will be
submitted to the project so that funding to take forward a selection of initiatives and their
evaluation can be proposed.
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Birmingham & Solihull Local Education and Training Council Workforce Development
Plan
THEATRE STAFFING – Regional group
Issue we are trying to address:
Provider workforce plan returns have indicated that there are challenges with the current
theatre workforce relating to numbers, quality, skills. In addition, 2013/14 workforce plans
indicate an aggregated 6% increase in Operating Department Practitioners (ODPs) in the
West Midlands by March 2018, with some LETCs planning increases that significantly exceed
this aggregated percentage.
There are also two factors that have workforce implications for demand and supply over the
next few years: Firstly, changes in service models, including seven day working; and the
potential transition of Operating Department Practitioner (ODP) training from a 2-year
Diploma to a 3-year degree.
There are also challenges around obtaining the fundamental workforce intelligence necessary
to understand workforce demand and supply, principally data quality for ODPs, and,
identifying theatre nurses because they do not have an occupational code.
Links with best practice/previous projects or work and how the priority adds value:

To be developed along the same lines as other bespoke workforce plans involving
multiple professional groups, for example sonography
Desired outcomes:

To gain a better understanding of the perioperative workforce current staffing and skill
mix and any service factors that influence this
 To understand the underlying causes of difficulties in securing theatre workforce in
sufficient numbers with the right skills
 To identify and understand other service models (for example, emergency care) that
draw on the staff groups traditionally associated with perioperative care
 Produce models, scenarios and recommendations for future workforce needs, taking
into consideration current and potential service models
 Develop solutions to mitigate a ‘fallow period’ for newly qualified ODPs due to a
transition from a 2 year diploma to a to 3 year degree
 Better understand the current and potential contribution that other healthcare
professionals, new roles and assistant roles make to perioperative care service
delivery
 Understand the ODP workforce and training arrangements in the independent acute
healthcare provider sector and implications for workforce demand
 Identify risks to current and future supply of staff
Identified as a priority in the HEE Mandate / HEWM Skills and Development Strategy /
Workforce Planning Process

Highlighted through provider workforce plan returns and identified as an area of
interest for all LETCs
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Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):

Development of a bespoke workforce plan template and narrative collection exercise (
to be collected February/March 2014)
 Recruitment of a project manager to manage the process in collaboration with HEWM
resources and support (Workforce Intelligence and Development team)
 Advise trusts of progress through agreed communication approach
 Data return analysis
 Engagement with clinicians, managers, workforce planners, HEIs. HCPC and
professional bodies through a task and finish group and focus groups to understand:
key workforce and service concerns including quality and supply issues, service
models, future landscape of perioperative care, issues and implications and
management of potential transition to 3 year degree to inform recommendations,
scenario and modelling
 Building scenarios and workforce modelling to support effective workforce supply and
mitigate fallow year should transition to a 3-year degree occur
Approach to evaluation and benefits realisation:
Risks:
Resource Implications:
Description of the collective benefit to Trusts and patients
Sponsor and partner organisations (working in partnership):
Timelines:
Sustaining the Project:
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Birmingham & Solihull Local Education and Training Council Workforce Development
Plan
SONOGRAPHY – Led by BC LETC
Issue we are trying to solve:
1. It was identified within Sept 13 workforce plans that we need to address the current
and future Sonographer workforce issues – demand for sonography is increasing (at
around 10% per annum).
2. There are difficulties in recruitment to this relatively small profession
3. There needs to be exploration as to the potential for introducing new ways of skilling
the current and future workforce including more effective training processes, up
skilling the current workforce and developing different roles
Links with best practice/previous projects or work and how the priority adds value:
Engagement and linkage to the bespoke regional work is necessary and has undertaken
best practice and previous project scoping.
Desired outcomes:
a. Pilot and evaluate creative approaches to providing these services in the future
b. Black Country engagement with the regional sonographer bespoke workforce
planning project
c. Fully understanding of the workforce gap
d. Propose solutions for the West Midlands to ensure future supply of sonographer
workforce
Identified as a priority in the HEE Mandate / HEWM Skills and Development Strategy /
Workforce Planning Process
Relates directly to DH Mandate sections 1-6.
Preventing people from dying prematurely
Enhancing quality of life for people with LTC
Helping people to recover from episodes of ill health or following injury
Ensuring that people have a positive experience of care
Training and care for people in a safe environment and protecting them from avoidable harm
Freeing the NHS to innovate.
Relates directly to HEE Mandate section 5 - Competent and capable staff
Relates directly to HEWM 5 Year Skills and Development Strategy – BC priority 6.
Suggested approach/action plan, including key milestones/deliverables:
Understand the sonographer workforce gap building on recent work undertaken with HEWM






Recruit Project Manager
Establish detailed project plan to pilot a number of potential schemes
Establishing a trainer role to support staff development – explore potential for a
regional training centre/centre of excellence
Explore creative approaches to enriching role and reward
Implement Assistant Practitioner role for DVT Screening
Create opportunities to broaden the specific areas of practice
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
Explore how roles could be created to cover both sonography and radiography to
minimise the potential for Repetitive Strain Injuries
Black Country to work intrinsically with the Sonographer bespoke workforce project that is
being undertaken regionally and will evaluate all of the propositions described above in order
to determine appropriate and sustainable solutions for the Black Country and wider region.
Approach to evaluation and benefits realisation:
The pilot projects will be evaluated on the basis of
 Sustainable solutions
 Ability to develop, attract and retain staff
 Quality and access of service to patients
Risks:
• Deficit in robust workforce information outside NHS
• Dependency on ESR data for NHS Trusts and queries of accuracy
• Lack of engagement and ownership (failure to develop partnerships) with the bespoke
project
• Trusts not wishing to share workforce information
• Funding resource implications
Resource Implications:
This has been identified as a priority area for the BCLETC.
Gap in workforce could result in significant cost implications if not addressed.
The proposal requires:
Project Manager Band 7 for 12 months
Sonographer Trainer Band 8a 12 months
Evaluation - £10k
LETB agreed £117,000 March 2014
Description of the collective benefit to Trusts and patients:
 Improve safety, quality, experience and patient satisfaction
 Enhance multi-disciplinary working, role clarity, staff satisfaction
 Enhance efficiency
 Deliver workforce sustainability and skills transfer and maximise value of spend
Sponsor and partner organisations (working in partnership):
Annette Reeves, Dudley Group of Hospital NHS Foundation Trust in partnership with the BC
LETC Trusts
Timelines:
A focused, time limited piece of work, working in conjunction with the Regional Bespoke
piece of work being undertaken by HEWM.
Sustaining the Project:
Trust will then need to consider the implications of the recommendations from the scoping
exercise.
We are the Local Education and Training Board for the West Midlands
Developing
people
for health and
healthcare
www.wm.hee.nhs.uk
[email protected]
@HealthEd_WMids
82
Birmingham & Solihull Local Education and Training Council Workforce Development
Plan
WIDENING PARTICIPATION – APPRENTICES (Medical Engineering)
Problem we are trying to solve:
CHALLENGES :
Key challenges are:

an imbalanced age-profile for medical engineering staff with a very high percentage
due to retire over the next few years;
insufficient resources at individual Trusts to pump-prime an apprentice programme;
the lack of an appropriate apprenticeship pathway which is truly related to health
service needs;
the lack of a large enough cohort for training providers.



The consequences of doing nothing are clear:




equipment not working properly
giving rise to health and safety and patient care issues
theatre lists being possibly cancelled
and ultimately going out to private sector firms with potentially higher costs to the
NHS.
OPPORTUNITY :
In order to address these challenges an appropriate apprenticeship pathway needs to be
developed almost certainly with a single provider. In the first instance this will act as a
pilot for those Trusts willing to be early demonstrators; and act as a catalyst to engage
other and provide sustainable training provision for the medium to long term.
Desired outcomes:
The project will be the first step in planning to deliver a consistent, high quality and
sustainable apprenticeship for medical engineering across the West Midlands.
It will provide for 10 NVQ level 3 apprenticeships over four years at the following Trusts:
University Hospitals Birmingham, Sandwell and West Birmingham, Heart of England and
Wolverhampton.
Year 1



Completion of NVQ Level 2 Diploma in Performing Engineering Operations units
delivered at external site.
Year 1 of a Technical Certificate: BTEC Diploma in Engineering Level 3 via day release.
Completion of Functional Skills to Level 2 [3 units].
We are the Local Education and Training Board for the West Midlands
Developing
people
for health and
healthcare
www.wm.hee.nhs.uk
[email protected]
@HealthEd_WMids
83
Years 2 to 4


Year 2 BTEC Diploma in Engineering Level 3 via day release.
Completion of NVQ Level 3 Engineering Maintenance Servicing Medical Equipment in
the workplace.
 Training, assessing and monitoring service.
Identified as a priority in the HEE Mandate / HEWM Skills and Development Strategy /
Workforce Planning Process
HEE Mandate 6.71 supporting flexible methods for entering training and employment,
doubling the number of apprenticeships in healthcare.
Suggested approach/action plan, including key milestones/deliverables:
Action Plan
The project would aim to:
 Finalise arrangements with participant Trusts in July 2014.
 Appoint a training provider by August 2014.
 Recruit apprentices for a September 2014 start with the appointed training provider.
 The full apprenticeship would last 4 years as described above.
Risks:
 Failure to engage participant Trusts - detailed and positive discussions have already
been held with the Trusts noted in this report.
 Failure to recruit apprentices - collaboration with partners such as the National
Apprenticeship Service and Health Tec means this is unlikely to occur.
 Failure of training providers to support an on-going programme – providers are
increasingly aware of the importance of flexibility and the importance of providing
support in line with demand even for small numbers.
Resource Implications:
Apprenticeship Provider Charges
1st Year
2nd Year
3rd Year
4th Year
£3500
£3160
£ 420
£3500
£3160
£840
£3160
£840
£840
Total £ 7375
£7500
£4000
£840
Registration / Examination
Fees
PPE / Workwear if
Applicable + tools
Technical Certificate
NVQ
Training Officer Service
£245
£ 250
Other costs
We are the Local Education and Training Board for the West Midlands
Developing
people
for health and
healthcare
www.wm.hee.nhs.uk
[email protected]
@HealthEd_WMids
84
Tools
£600
Specialist Training
£750
Total cost per apprentice
£23315
£750
£750
£750
Half of the apprenticeship training provider costs can be met from the Skills Funding Agency.
This amounts to £9,858 per apprentice. This leaves £13,457 to be found. It is proposed
that this is split equally between partner Trusts and HEWM ie £6728.50 per apprentice.
Consequently, it is proposed that HEWM fund £67,285 for 10 apprenticeships spread
over 4 years.
Description of the collective benefit to Trusts and patients:


Ensuring equipment is still being maintained safely.
Compliance with national standards e.g. CQC, NHSLA.
We are the Local Education and Training Board for the West Midlands
Developing
people
for health and
healthcare
www.wm.hee.nhs.uk
[email protected]
@HealthEd_WMids
85
Birmingham and Solihull Local Education and Training Council
Workforce Development Plan
WIDENING PARTICIPATION – Talent for Care: Supporting the delivery of
Apprenticeships in Birmingham and Solihull
Issue we are trying to address:
To address the strategic and system challenges to sustaining and increasing apprenticeships
across the Birmingham and Solihull area including how to rebrand apprenticeships so they
are perceived as relevant to existing workforce and how to integrate planning for apprentices
into the business and workforce planning activities of organisations.
Links with best practice/previous projects or work and how the priority adds value:
The project has links with the following projects and initiatives:
 The Birmingham and Solihull LETC Widening Participation portfolio of projects
 The HEWM building capacity and capability in workforce planning programme
Desired outcomes:
A roadmap for ‘enabling your organisation to have the talent for care’ which will also support
the rebranding of apprenticeships will be the principle resource through which the objectives
will be delivered:
Rebrand and market apprenticeships
 The road map and rebranding will promote the benefits of apprenticeships to
business, society and quality of care
 The development of a road map that is practical and ensuring that the process of its
development and promotion in itself support promotion and awareness.
 The re-naming and re-branding of apprenticeships using an approach that engages
with staff and enables them to be in the driving seat regarding the renaming
 Work with the HEWM Widening Participation Lead on how to promote and encourage
the introduction of the other key elements of apprenticeships (for example, the
apprenticeship framework)
Embed apprentices into workforce planning and business processes
 The road map will have sections that show how to include apprentices in workforce
planning and business processes.
 The project will also engage with other initiatives on workforce planning to ensure that
apprenticeships are included. For example, the HEWM Capacity and Capability
Programme
 Ensure that there is a corresponding inclusion of apprentices in the strategic level
activities of workforce planning. For example, in HEWM annual workforce planning
processes
Utilise Apprenticeship framework with existing staff
 Identify areas where the apprentice framework is being used to support existing staff
and analyse learning and good practice
 Work with key NHS provider’s experts in training and human resources and draw on
local evidence (for example, the career progression in bands 1-4 scoping findings) to
identify the range of reasons why the apprentice framework is not being utilised and
what would overcome the barriers
 Include in the roadmap recommended steps for introducing and utilising the
apprenticeship framework with existing staff
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
The HEE Mandate, HEWM Skills and Development Strategy identify supporting bands 1-4
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staff in their career progression and overall development as a priority. Also links to workforce
supply.
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):
A project steering group will be established.
 For Rebranding – consultation with key stakeholders, promotional materials and
inclusion in the roadmap – October 2014
 For roadmap – scope good practice, establish an expert reference group, develop
structure and populate key roadmap areas, develop a digital resource and launch
using a communications strategy – November 2014
 Evaluation – end of January 2015
Approach to evaluation and benefits realisation:
Evaluation and benefits realisation will be available at the end of the project.
 Apprenticeships perceived as important to the development of new and existing staff –
assessed by the numbers of apprenticeships and the number of existing staff being
developed using the apprenticeship framework
 A roadmap that provides practical steps and techniques for stakeholders to embed
planning for apprentices into their business and workforce planning – apprenticeships
clearly articulated and planned for in workforce planning process and this translates to
clear evidence in workforce plans
 Roadmap and its tools and resources utilised – feedback, workforce plans and apprentice
numbers,
Risks:
The project has a dedicated risk register, which will be managed via the HEE steering group
process. Key risks include:
 Potential project delay because of failure to secure project management and
analyst support
 Failure to engage with senior managers and the roadmap is not implemented
at a business and workforce planning level
Resource Implications:
How important is it – weighting if resources are required?
This project is key to the development of a system that supports the delivery of
apprenticeships. £30k has been allocated and the funding will be held by Birmingham
Women’s Hospital NHS Foundation Trust
Description of the collective benefit to Trusts and patients:
For Individuals
 The AF includes a wide range or competencies beyond service specific ones, which
means a greater range of progression options should be available to the individual
For Organisations
 The AF includes a wider range of competencies and therefore this may create a more
flexible workforce able to apply their learning in a wider range of settings
 To help fully realise the contribution that the apprenticeship framework can make to
creating and maintaining quality workforce supply
For Society
 Widening participation in education and careers in the NHS and social care
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

Enhancing practical skills, capacity and knowledge of local people
Supporting healthcare to work in partnership with other sectors and share learning and
innovations
Sponsor and partner organisations (working in partnership):
Birmingham Women’s Hospital (Sponsor)
Project Host – tbc
The Birmingham and Solihull LETC Widening Participation Subgroup
Timelines:






Rebranding of Apprenticeships in Birmingham and Solihull - 1st October 2014
A Roadmap – including launch - Mid November 2014
Apprenticeships planned for through an workforce planning process - Final evidence
in 2015/16
workforce plan returns and narratives
Utilise Apprenticeship framework with existing staff - January 2015
Evaluation of the impact of all of the deliverables - End of January 2015
Sustaining the Project:
Explain how the project’s benefits will be maintained after funding has ceased.
The approach to developing the resource has been designed so that existing widening
participation networks and other network can promote the road map. However, it is
recognised that the roadmap will need to be periodically refreshed and arrangements for this
will be considered as part of the project.
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Birmingham & Solihull Local Education and Training Council Workforce
Development Plan
WIDENING PARTICIPATION - Extending the Role of MSWs in Maternity Care Project
Issue we are trying to address:
Maternity services across the UK are at crisis and need to reconfigure and respond to
the robust evidence that indicates homebirth for low risk second time mothers is safer
and cheaper. This change will only come to fruition through a radical shift of services
and deployment of resources. Midwifery staffing currently provide two midwives at every
home birth, which will not be sustainable for homebirth services to grow to the extent
they need to in order to ensure that women have the choice to birth in a place which
optimizes their outcomes. The RCM supports the training of MSW’s to assume this
extended role provided appropriate training is given. Birmingham Women’s through this
initiative will be the first hospital to design a curriculum specifically for MSW’s to enable
extension of their role and are ideally placed to provide the practical placement, as they
have a new dedicated homebirth service, with secure funding until 2017.
Links with best practice/previous projects or work and how the priority adds
value:
The project has links with




The projects in the Birmingham and Solihull LETC widening participation portfolio
The Cavendish Report recommendations and local and national initiatives to
implement them
National campaign to promote healthier lifestyles, including every contact counts
Evidence and recommendations from: Birth Place UK, and the Royal College of
Obstetricians and the Royal College of Midwives
Desired outcomes:
Educate MSW’s to Foundation Degree Level, so that they can extend their current scope
of practice and safely and competently assume some specific and defined roles formally
undertaken by a qualified midwife at a homebirth and in a community setting.
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
HEE Mandate – developing personalised services for women and a continuing
professional education framework for the existing maternity and early years workforce,
the development of clearer and more effective career paths for healthcare assistants and
maternity support workers
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):
Establish an expert reference group and:
 Recruit students for the Foundation Degree Course – 20th March 2014
 All MSW to be at level 2 numeracy prior to starting the full FD in September –
15th July 2014.
 Design and Validate a new FD Course in Health and Social Care for MSW’s to
commence in September – 15th April 2014
 MSW students to pass their initial 60 credit core modules which were started in
March – 30th August 2014
 Evaluation of the impact of all of the deliverables – 31st March 2015
Approach to evaluation and benefits realisation:
Evaluation and benefits realisation will be available at the end of the project.
Six validated education modules that, along with a second year of modules will allow a
cohort of maternity support workers to extend their current scope of practice and safely
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and competently assume some specific and defined roles formally undertaken by a
qualified midwife at a homebirth and in a community setting
Assessment of results from Birmingham City University – including pass rate
New modules validated by Birmingham City University
Student feedback
The application of learning in clinical work
Risks:
Not getting the second year of funding for the course – funding is currently for one year
of a two year programme
Resource Implications:
The funding is available to reimburse Birmingham Women’s Hospital for the Tuition fees
for the cohort of 10 students.
Description of the collective benefit to Trusts and patients:
 Increased delivery of maternity care in different settings that are known to
produce better outcomes in terms of health and wellbeing
 Increased awareness of the importance of providing a sustainable homebirth
service and community maternity support services.
 More input from Healthcare Trust in supporting the transition to parenthood.
 Greater input around the public health agenda from maternity service
Sponsor and partner organisations (working in partnership):
Birmingham Women’s Hospital NHS Foundation Trust (sponsor)
Birmingham City University
Expert reference group to include: Representatives from University, trust, Royal College
of Midwives, Local Supervisory Authority of midwives
Timelines:
April 2014 – March 2015
Sustaining the Project:
Explain how the project’s benefits will be maintained after funding has ceased.
Commissioning intentions indicate that the delivery of maternity services in the
community, where evidence and recommendations support this, will take place.
Therefore the funding of services and the necessary workforce element to deliver this will
be supported by service commissioning process.
There is an annual allowance to cover a proportion of a foundation degree. The
remaining proportion of tuition funding will be met by the employer and/or student.
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Birmingham & Solihull Local Education and Training Council Workforce
Development Plan
WIDENING PARTICIPATION – RISE Pilot Project
Issue we are trying to address:
Youth homelessness is reported to be rising in many areas of England and there is a risk
this reported trend could continue, given the current context of youth unemployment
Most homeless people have multiple labour market disadvantages and almost all have
extremely low employability. However, the vast majority of homeless people want to work
either now (77%) or in the future (97%).
The pilot programme RISE aims to provide a bespoke specialised pre-employment and
pre-apprenticeship training programme support.
Links with best practice/previous projects or work and how the priority adds
value:
The project links with the Birmingham and Solihull LETC widening participation portfolio
of projects.
The project will also have potential links to initiatives in public health and reducing
inequalities.
Desired outcomes:
A maximum of 12 homeless individuals will make the transition from homelessness and
unemployment to employment supported by a range of accommodation and integrated
support options, including a strong focus on education, training and employment.
Those that do not progress to apprenticeships will have a period of support to maximise
their employability
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
Securing a workforce that is representative of the community which it serves
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):
There will be:
Regular (fortnightly) operational meetings between all parties to manage the project on a
detailed basis.
A Steering group that will meet on a monthly basis
Engagement of 30 young homeless
Cohort 1 March 2014
individuals through 3 pilot
Cohort 2 July 2014
programmes
Cohort 3 Sept 2014
Providing training to enable young
March 2015
homeless people to access 12
Apprentice opportunities.
Continued mentoring of those
Cohort 1 April 2014
successful in obtaining an
Cohort 2 August 2014
apprenticeship for up to 12 weeks
Cohort 3 Nov 2014
Continued support through 1:1 and
Up to March 2015
job clubs for up to 6 months for those
for those who complete the RISE
programme but are not successful in
obtaining an apprenticeship.
Approach to evaluation and benefits realisation:
Evaluation and benefits realisation will be available at the end of the project.
 Attrition rate of pre-employment programme
 The number of apprentices achieved
 Feedback – students, managers, trainers
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
For those not suitable to progress to apprenticeships – the type and length of
support they receive post programme, how many secure employment and the
nature and sector of their employment
Any other changes – health and wellbeing – that students experience

Risks:
The project will be working with individuals that have challenging backgrounds and the
transition that participants make during the programme may increase the likelihood of
attrition
There are currently 12 apprenticeships. The demand for apprenticeships may exceed
supply
If the preparation and support of trainers is not effective and appropriate
Resource Implications:
£44,406.00 funding is available for the delivery of three pre-employment and preapprenticeship programmes provided by the Learning Hub.
The evaluation of this pilot project will inform future decisions on roll out across the West
Midlands region
Description of the collective benefit to Trusts and patients:
 Improve the health and wellbeing of the young homeless;
 Ensure that the NHS workforce more reflects the clients that utilize its service;
 Improve the employment prospects of the young homeless;
 Establish greater partnership working with other NHS organizations;
 Better prepare young homeless people for activity within the NHS and minimise
the dropout rate during an apprenticeship by providing a better understanding of
NHS values and culture;
Sponsor and partner organisations (working in partnership):
Birmingham Women’s Hospital NH Foundation Trust (sponsor)
University Hospital Birmingham NHS Foundation Trust (Learning Hub)
Sandwell and West Birmingham NHS Hospital
St Basils
Timelines:
March 2014 – March 2015
Sustaining the Project:
Explain how the project’s benefits will be maintained after funding has ceased.
The evaluation of this pilot project will inform future decisions on roll out across the West
Midlands region.
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Birmingham & Solihull Local Education and Training Council Workforce
Development Plan
WIDENING PARTICIPATION - Youth Academy Project
Issue we are trying to address:
Young people with learning disabilities leaving education can face very limited options
and choices in terms of employment. This initiative will provide pre-employment support
that will impact the employment opportunities for young people who are currently
extremely disadvantaged, either through having an LD or for other reasons.
Links with best practice/previous projects or work and how the priority adds
value:
Extending the impact of employment and youth programmes that help to improve access
to employment
This BCH pilot will map out the template to support many organisations in implementing
this initiative.
Desired outcomes:
A virtual structure that supports young people (some with Learning Disabilities) in getting
the skills, knowledge and confidence to enter the world of work via a range of schemes.
It will be a central gateway and first port of call for young people with learning disabilities
to gain support and opportunities in 3 key areas, which are access, preparation for
employment and employment, and is supported by best practice evidence.
The project will produce a model which reflects learning from the project that can be
shared with providers.
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
Caring for and supporting vulnerable people – although the HEE mandate focuses on
providing services for vulnerable people, the idea from this project came from clinicians
that wanted to provide more holistic care to vulnerable patients.
The Green Paper ‘Support And Aspiration” (Department of Education, April 2011) –
improving employability
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):
A project steering group will be established.
 A minimum of 3 protected posts for young people with learning disabilities December 2014
 Validated training for managers and staff supporting young people with learning
disabilities - December 2014 Continuing throughout project
 Ongoing support for young people with learning disabilities and their host
departments - December 2014 Continuing throughout the project
 5 Apprenticeships - June 2014
 10 Trainees - September 2014
Approach to evaluation and benefits realisation:
Evaluation and benefits realisation will be available at the end of the project.
Trainee programme and Apprenticeships - Attendance records, progress and evaluation
forms
Number of disadvantaged young people employed
Peer support group feedback
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Staff and manager feedback – training and experience of having trainee/apprentice in
their service
Risks:
If the preparation of the organisation and staff to support disadvantaged young people
during their training is not informed by experts this could lead to detrimental experiences
for students and provider employees
Resource Implications:
The project has been allocated £45,000.00 funding.
Description of the collective benefit to Trusts and patients:
Benefits for individuals
• Offer ,through employment , an opportunity to establish social networks and
enhance physical and psychological wellbeing for those with an intellectual
disability
• Reduced the risk of poverty transition
• Increase self-confidence and self-belief to combat social exclusion and improve
health outcomes
• Increased level of qualifications amongst participants
• Increased engagement amongst hard to reach groups in particular those with a
learning disability
• A single progression route to NHS careers
• More opportunities to obtain practical work experience and paid employment
opportunities
• Improved access to appropriate and individualised learning resources and
facilities
• Easier access to employment opportunities through flexible and innovative
recruitment methods
• Access to development that supports healthy lifestyle choices
• Signposting to other support and educational/employment opportunities across
the city
• Role matching to individuals skills and attributes
• Support for greater independence
•
Organisational Benefits
 We will build on the strengths of diversity and inclusion to make BCH a great
place to work and a great place to be cared for
 To build an organisational culture that ensures we deliver care to children and
young people, together with attracting and developing a diverse workforce., to
ensure that we deliver our strategic priories and unlock untapped potential
 We will provide training for those staff who will be supporting the learning
disabilities programmes
 We will create enhanced diversity awareness in the workplace
 The development of an evidence-base that hosting students with a learning
disabilities can improve team working and reduce conflict
 Becoming the employer of choice for local young people
 Profile of the organisations in relation to being a model employer and an
advocate for children and young people
 Contribution to the wider public health agenda, sharing good practice regionally
and nationally.
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Societal Benefits
• Widening participation in education and careers
• Enhancing practical skills, capacity and knowledge of local people
• Empowering young local people giving them energy for change
• Establish a new line of communication, and create a community of interest built
through BCH, which we can work alongside for change in the wider determinants
of health across the city
• Reducing poverty transition in at risk groups
• Providing greater opportunities for young people from disadvantaged
communities
• Facilitating the local community and voluntary associations to work together to
improve outcomes for young people
• Supporting access to public, private and third sector organisations that are
available to support improved public health
• Provide access to physical and economic resources to enhance wellbeing
Help shape and develop the future workforce by engaging with young people at an early
stage of their life
Sponsor and partner organisations (working in partnership):
Birmingham Women’s Hospital NHS Foundation Trust (sponsor)
Birmingham Children’s Hospital NHS Foundation Trust
The Learning Hub
Walsall College
A range of local schools and college (such as BMET, Small Health Secondary School,
Hodge Hill Secondary School)
National Apprenticeship Service
Trust’s represented at the LETB’s and Widening Participation sub groups.
Linking with the HEWM Advisory Group (Social Care, Independent and Voluntary
sectors) - this will enable engagement with Skills for Care, National Carers Forum, Skills
for Health, Regional Action West Midlands (DH Strategic Partner for Voluntary Sector in
WM), and ADASS (and links into Directors of Children’s Services)
Timelines:
April 2014 – March 2015
Sustaining the Project:
Explain how the project’s benefits will be maintained after funding has ceased.
The project will be sustained via the commitment of the Birmingham Children’s Hospital
Trust Board
Other sources of external funding will be explored, and good practice will be shared
through the Health Sector both locally and nationally.
By producing and sharing a template of the model and evaluation it could be rolled out
throughout the West Midlands.
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Summary of BS LETC Deliverables 2015/16
Below is a summary of the key BLETC Deliverables in 2015/16, these are in addition to the
core annual deliverables outlined in page 2 and 17
Headline Deliverables for BLETC
The following deliverables relate to where the BLETC are undertaking work either solely
within Birmingham or as a lead LETC:







Understand the changes and implications to medical workforce supply across
Birmingham, in particular the implications for advanced practice, upskilling the existing
workforce and Physician Associates
Deliver year 3 of the Older Adult Workforce Integration Programmes (details of which
can be found in 2013/14). For 2014/15 this includes supporting the regional delivery of
the Postgraduate Older Adult Nurse Registration Programme
Respond to changes to medical workforce supply through:
o Implementation of the Advancing Practice Framework (including non-medical
prescribing)(bands 7-8)
o Support the development and training or Physician’s Associates outside of
Emergency Medicine
o Upskilling the existing workforce (bands 5-7)
Deliver the relevant workforce recommendations following the bespoke workforce plan in
Theatres
Healthcare Science/ PTP?
Deliver the LETC workforce response to the:
o Maternity and neonates service review
o Children’s service review
Identify the workforce requirements and ensure delivery of service transformation in
Integrated Care
Contribute to Regional/ Other LETC Deliverables
The following deliverables relate to priority pieces of work across HEWM that are either
regionally led or led by other LETC where BLETC has a responsibility to feed into the
development and/or implement recommendations:



Actively contribute to the Widening Participation priorities via the Widening
Participation Partnership Forum
Identify the workforce requirements and ensure delivery of service transformation in
Dementia and Learning Disabilities
Respond to the identification of the shortfall or sonographers across the West
Midlands
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

Develop a strategic approach to supporting primary care workforce
Contribute to the Emergency Medicine Taskforce
Further Work
Further work is required on the following areas during 2014/15, prior to finalising the 2015/16
annual delivery plan for BLETC

Project Sponsors are sought for the all headline deliverables for BLETC
 Further expansion of each of the workforce development priorities is required
including identification of resources required to deliver each project
Resource Allocation: - tbc
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Birmingham & Solihull Local Education and Training Council Workforce Development
Plan
INTEGRATED CARE
Issue we are trying to address:
Integration covers different ways of partnership working, both within the NHS and with
other sectors including social care and the private, independent and voluntary sectors.
Frequently this results in duplication or gaps in services and results in sub-optimal
delivery of care to patients. By working collaboratively to develop a shared agenda, care
will be improved, resources will be used more efficiently and there will be greater system
clarity focusing on a patient-centric model.
Links with best practice/previous projects or work and how the priority adds
value:
The priority adds value by supporting the development the health and care workforce in
readiness to deliver a commissioned suite of services across multiple stakeholder in both
health and care.
Desired outcomes:
Developing a workforce that responds to the requirements of an integrated vision for the
delivery of health and care services.
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
Confirmed as a priority in May 2013 with the National Collaboration for Integrated Care
and Support . The June 2013 spending round allocated £3.8bn to ensure closer
integration between health and social care, identified as the Integration Transformation
Fund, with 14 pioneer sites identified nationally, 2 of which are in the West Midlands.
Some unsuccessful pioneer site applicants in the West Midlands are proposing to
continue and could also be considered as sources of useful information.
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):
The Birmingham LETC is leading on a pilot programme for integrated workforce
development through the Older Adult Workforce Integration programme (qv OLDER
ADULTS WORKFORCE INTEGRATION PROGRAMME). A regional group is meeting in
January 2014, comprising West Midlands pioneer sites and other groups working on
integrated care. This group will consider the learning and sharing possible across
different programmes of work as well as how the Regional Advisory Board can support
them.
Approach to evaluation and benefits realisation:
Opportunities: Given that there is a clear national intention to move towards ‘integrated
care’, the bLETC must be prepared to respond to the workforce implications that will
support the commissioning of integrated care services, maintaining a realistic perspective
of what is possible, whilst not being constrained by localism.
Considering the whole patient pathway would facilitate the integrated care vision,
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supporting the development of a transferable and flexible workforce working across wider
sectors.
Further work remains to be done, pending the confirmation of service commissioning
intentions in Birmingham and Solihull and ultimately across the West Midlands.
Risks:
 Funding – cuts to social care budgets and ring-fenced NHS budgets have led to
the creation of the £3.8bn Integrated Transformation Fund, supporting the shift in
focus required by 2018.
 Public awareness and expectations – there is increasing recognition that to
support effective integration of care, patients and carers will need to take
increasing responsibility for managing individual health needs. Personal care
budgets allow some flexibility in who delivers care, meaning that there is a likely
skills gap requiring some supportive training / education for patients and their
chosen carers to manage their conditions themselves.
 Staff skills – moving care from hospital settings has implications for current staff,
especially those from non-acute settings who are increasingly required to care for
more complex conditions. Training for future staff will also require adjustment of
curricula that are focused on uni-professional care in an acute provider
environment.
 Information – recognising the complexity of different information systems and
communication requirements is the first stage to understanding where patient
information can be shared across systems. Not only are there challenges around
getting different IT systems to communicate but also information sharing
agreements will need to be formalised. Training needs for mobile staff and the
culture change associated with new partnership working across multidisciplinary
teams were also highlighted
Resource Implications:
Resources have been allocated to the Older Adult Workforce Integration programme and
further details can be found there.
Description of the collective benefit to Trusts and patients:
Developing the current and future workforce to work in an integrated manner will support
the seamless journey through a care pathway. Resource allocation will be clear,
depending on the stage of the pathway and the place and mode of delivery. Staff will
have the requisite knowledge, skills, experience and confidence to deliver appropriate
interventions for patients at each stage of the pathway.
Sponsor and partner organisations (working in partnership):
OAWIP workstream
Integrated care pioneer sites (Staffordshire & Worcestershire)
Learning from other exemplar sites
Timelines:
Older Adults Workforce Integration programme is due to complete September 2015.
The timeline for national integration is 2018.
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Sustaining the Project:
Explain how the project’s benefits will be maintained after funding has ceased.
The intention of the Older Adult Workforce Integration programme is to embed new ways
of working for the current workforce, so that in time this becomes an established way of
working for the future workforce. Some of this is beyond the scope of the project, for
example considering the content of undergraduate / pre-registration curricula, however a
scoping exercise to be completed by March 2014 will act as a knowledge resource to
identify what exiting provision looks like for education an learning around planning for
and delivery of integrated care.
Longer term, the national drive towards integration is due for completion in 2018, with an
expectation that the learning from the pioneer sites will be extrapolated to support and
embed system-wide engagement.
Ultimately it appears that this will become the new standard of care provision, replacing
the current divisions and steps in multi-agency working.
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Birmingham & Solihull Local Education and Training Council Workforce Development
Plan
MATERNITY & NEWBORN SERVICE REVIEW
Issue we are trying to address:
Understanding the workforce implications of any eventual change to the delivery of
maternity and new-born services in the West Midlands
Links with best practice/previous projects or work and how the priority adds
value:
The reconfiguration of maternity services (if agreed with commissioners and following
stakeholder consultation) will provide a range of different care options allowing women a
choice of where to deliver.
Desired outcomes:
To develop staff with the right skills and values to work in a variety of care settings
subject to the findings of the maternity services review
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
 A sub-regional strategic review across Birmingham, Sandwell and Solihull.
 Maternity Matters
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):
tbc
Approach to evaluation and benefits realisation:
tbc
Risks:
tbc
Resource Implications:
tbc
Description of the collective benefit to Trusts and patients:
tbc
Sponsor and partner organisations (working in partnership):
Workforce subgroup of the service review board
BWH
HEFT
SWBH
Timelines:
tbc
Sustaining the Project:
Dependent on commissioner strategy
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Birmingham & Solihull Local Education and Training Council Workforce Development
Plan
CHILDREN’S SERVICE REVIEW
Issue we are trying to address:
Understanding the workforce implications of the service change associated with
reconfiguration of paediatric and children’s services
Links with best practice/previous projects or work and how the priority adds
value:
The development of specialist centres of excellence for the delivery of high quality
specialist paediatric care, whilst
Desired outcomes:
Paediatric staff in the West Midlands having the right values, skills and competencies to
deliver high quality care, regardless of setting
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
Regional and national review of specialist care delivery
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):
tbc
Approach to evaluation and benefits realisation:
tbc
Risks:
tbc
Resource Implications:
tbc
Description of the collective benefit to Trusts and patients:
tbc
Sponsor and partner organisations (working in partnership):
BCH, other providers of paediatric care
Timelines:
tbc
Sustaining the Project:
Dependent on commissioner strategy
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Birmingham & Solihull Local Education and Training Council Workforce Development
Plan
UPSKILLING
Issue we are trying to address:
The transition for clinical staff into managerial roles is frequently identified as a challenge.
Anecdotal evidence suggests that band 6 staff appointed into band 7 roles associated with a
managerial responsibility are frequently appointed on the basis of their clinical skills, with a
presumption that their general management skills have already or will be picked up along the
way. This results in a steep learning curve for newly appointed staff and may lead to a period
of stress for them and inefficient working practices. Consequently it would be helpful to
develop a generic set of core managerial competencies, for example line management, PDR,
difficult conversations, budget monitoring, staff .
Development available and access is variable across the patch, varying from no formal
training, internally delivered courses to M-level programmes in Management Skills.
Links with best practice/previous projects or work and how the priority adds value:



Some trusts will already run in-house management development programmes. The
content of this will be evaluated with the expectation that a generic set of core
competence and knowledge could be developed to support new band 7 clinical
managers or band 6 staff expecting to transit into managerial roles within the next
year.
Knowledge of management skills is a precursor to developing as a leader but is
frequently bypassed. The region is addressing leadership development without being
underpinned by generic management skills. This would support the region’s
leadership strategy by preparing our future leaders with the generic management skills
required.
This would provide a firm foundation for staff prior to embarking on leadership
development training. Many of the recommendations from the Francis report also
relate to lack of effective staff management capability, which this scheme would
address. With the challenges of the new NHS we need to develop clinicians who are
strong managers to enable the benefits realisation of new ways of working in the
future.
Desired outcomes:




Development of band 6 staff with enhanced management capabilities to support
effective transition to band 7 managerial roles
Structure management development programme with a suite of core transferable skills
Acknowledgement of the value of clinically qualified managers with the right skills,
supporting staff to consider this as a career option other than specialist clinician
routes.
Increased supply of staff with a complement of transferable skills across different
professions
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Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
Identified by the Workforce Transformation subgroup as a key gap for bands 5-7 staff. This
supports the existing workforce through embedding sustainable service delivery.
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):





Background - Evaluate level of interest (LETC/ regional) interest in embedding core
competences and training for these staff
Step 1 - Agree core skills and competencies of a general management programme
whilst allowing flexibility to reflect local variation
Step 2 – Scope current availability of programmes in the region to determine the offers
available, developing and agreeing a programme structure
Step 3 – Run a proof of concept study for a multi-professional cohort to be evaluated
quarterly with full end of programme evaluation
Step 4 – Formalise the core programme and gain agreement for this as a mandatory
programme for band 6-7 transition.
Approach to evaluation and benefits realisation:


Practical exercises at regular intervals, related to real life workplace situations
Pre and post implementation candidate and employer interviews to measure
confidence levels
Risks:


Failure to agree core generic transferable competences
Failure of organisational sign-up to support transferability
Resource Implications:
How important is it – weighting if resources are required?
Project group to agree core standards, supported by all LETC organisations
Resource to undertake scoping of available courses in region / wider (different elements could
be offered by different organisations by developing a directory of learning like the PBC
network)
Cost of developing, accrediting and running practical CPD-level course (e.g. certificate)
Support for staff to undertake proof of concept exercise
Buy-in from Trusts to support the programme
Description of the collective benefit to Trusts and patients:


Talent management, with an expectation that some of these staff will then be well
placed for entry into Leadership programmes.
Sustainable workforce
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





Well managed organisations
Competent staff
Structured succession planning
Clearly identified career pathway in management
Reduction in hard to recruit to band 7 vacancies
Seamless transition from band 6 clinical posts to band 7 clinical / managerial
responsibility roles
Sponsor and partner organisations (working in partnership):



University Hospitals Birmingham NHS Foundation Trust
Birmingham City University
All BS LETC providers
Timelines:
Brought forward for delivery 2014/15
Sustaining the Project:
Explain how the project’s benefits will be maintained after funding has ceased.
Embedding a clear career progression pathway with regional agreement will establish this as
a new way of working, rather than a single non-transferable piece of work. Regional support
and appetite for this is therefore key to the success of the project.
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Birmingham & Solihull Local Education and Training Council Workforce Development
Plan
HEALTHCARE SCIENCE – PRACTITIONER WORKFORCE
Issue we are trying to address:
The implementation of Modernising Scientific Careers has altered the way in which this staff
group are trained and developed. The move to a HEFCE funded programme for the
Practitioner Training programme (PTP) has caused a degree of uncertainty amongst trusts
who do not have clarity and confidence about the skills and abilities of this new role. The new
training models are more generic and cover a wider range of disciplines that under previous
pre-registration training models. Consequently the output from the new programme has a
different range of skills and service delivery will need to take account of this.
Links with best practice/previous projects or work and how the priority adds value:
By understanding exactly what the issues are around implementing this staff group, trusts can
develop management plans for the implementation of new ways of working that are related to
the skills and knowledge of healthcare science practitioners.
Desired outcomes:

A better understanding of the skills of the healthcare science practitioner and how this
will impact on the current and future HCS workforce and service delivery.
 Supported implementation of new HCS roles into relevant departments
 Evidence that the new HCS roles have been taken into consideration in organisations’
workforce plans
Identified as a priority in the HEE Mandate / DH Accountability Agreement / HEWM
Skills and Development Strategy / Workforce Planning Process
Modernising Scientific Careers is a national programme that has been rolled out across
England. This has been identified as a priority area for the Birmingham LETC as a result of
concerns raised in organisational workforce plans submitted in June 2013. It may be that
other organisations in other LETCs have also expressed concern, in which case there will be
benefit from adopting a regional approach.
Suggested approach/action plan, including key milestones/deliverables (quarterly
review of progress will be expected):

Details of this are awaited and are dependent on understanding what trusts highlight
specifically as problems.
Approach to evaluation and benefits realisation:
 Awaited
Risks:
Failure to understand new ways of working in the healthcare science workforce will impact
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on existing staff, patients, service delivery and the new practitioner workforce.
Resource Implications:
How important is it – weighting if resources are required?
It is not currently possible to quantify the level of resource (if any) required to support this
priority.
Description of the collective benefit to Trusts and patients:
 tbc
Sponsor and partner organisations (working in partnership):
 tbc
Timelines:
tbc
Sustaining the Project:
Embedding the new workforce is essential and it is envisaged this this will be a short fixed
term piece of work. Over time this will become sustainable on the basis that this is how the
future health care science workforce will be profiled.
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Summary of BS LETC Deliverables 2016/17
Below is a summary of the key BLETC Deliverables in 2016/17, these are in addition to the
core annual deliverables outlined on pages 2 and 17.
Headline Deliverables for BLETC
The following deliverables relate to where the BLETC are undertaking work either solely
within Birmingham or as a lead LETC:







Deliver the LETC workforce response to the:
o Maternity and neonates service review
o Children’s service review
Identify the workforce requirements and ensure delivery of service transformation in
Integrated Care
Respond to changes to medical workforce supply through:
Implementation of the Advancing Practice Framework (including non-medical
prescribing) (bands 7-8)
Support the development and training of Physician’s Associates outside of
Emergency Medicine
Upskilling the existing workforce (bands 5-7)
Healthcare Science/ PTP
Contribute to Regional/ Other LETC Deliverables
The following deliverables relate to priority pieces of work across HEWM that are either
regionally led or led by other LETC where BLETC has a responsibility to feed into the
development and/or implement recommendations:


Actively contribute to the Widening Participation priorities via the Widening
Participation Partnership Forum
Contribute to the Emergency Medicine Taskforce
Further Work
Further work is required on the following areas during 2015/16, prior to finalising the 2016/17
annual delivery plan for BLETC:


Project Sponsors are sought for the all headline deliverables for BLETC:
Further expansion of each of the workforce development priorities is required
including identification of resources required to deliver each project:
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Summary of BS LETC Deliverables 2017/18
Below is a summary of the key BLETC Deliverables in 2017/18, these are in addition to the
core annual deliverables outlined in Section XXX.
Headline Deliverables for BLETC
The following deliverables relate to where the BLETC are undertaking work either solely
within Birmingham or as a lead LETC:



Deliver the LETC workforce response to the:
o Maternity and neonates service review
o Children’s service review
Identify the workforce requirements and ensure delivery of service transformation in
Integrated Care
Respond to changes to medical workforce supply through:
o Implementation of the Advancing Practice Framework (including non-medical
prescribing)(bands 7-8)
o Support the development and training or Physician’s Associates outside of
Emergency Medicine
o Upskilling the existing workforce (bands 5-7)
Contribute to Regional/ Other LETC Deliverables
The following deliverables relate to priority pieces of work across HEWM that are either
regionally led or led by other LETC where BLETC has a responsibility to feed into the
development and/or implement recommendations:


Actively contribute to the Widening Participation priorities via the Widening
Participation Partnership Forum
Contribute to the Emergency Medicine Taskforce
Further Work
Further work is required on the following areas during 2014/15, prior to finalising the 2015/16
annual delivery plan for BLETC


Project Sponsors are sought for the all headline deliverables for BLETC
Further expansion of each of the workforce development priorities is required
including identification of resources required to deliver each project
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