Transforming the workforce l horton


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  • Bid successfully submitted to the Leadership and Innovation awards earlier this year and we received an amount of money to fund a workforce development programme. Amanda Wilcock Dir HRis the Senior Responsible owner/Project Sponsor, Rachel Ingham –Jones is the commisiioning lead (just with dental services) and I will lead both projects for CMHS – reporting to Andrea Robinson An initial steering group meeting was set up and there was an agreement to use the Calderdale Framework.
  • Need to adapt to National and Local demands; Talks about developing career pathways, apprenticeship and the skills gap – aging population and a shrinking pool of people at a younger age Right person in the right place at the right time Competency based workforce –Career pathways skills escalator Qualified service, experienced staff Improving Quality and safety, positive experience and effective service improving service quality and value for money
  • Ageing Workforce, Reduction in investment, Increased demand for Community based services TCS Services are safe, effective, sustainable and capable of meeting the needs of the community they serve.
  • Blurring of boundaries and delegation of Tasks. Example – support workers often work in silo’s 1 for nursing 1 for physio etc……………… The CF works towards having the right person in the right place at the right time! Wide variety of roles undertaken – supervision given dependent upon a qualified staff workloads.
  • Across the services/teams there is a great deal of variation in what is delegated ways of tasks being carried out varies.
  • Training is often inconsistent and not always based on best practice Examples sitting next to nelly……………….. Need to know when to STOP
  • There are 7 stages 1 Focus on engagement 2 Service Analysis – Focus on Change who, what, where and When – the when and where the service is delivered and current staffing Who does which functions in delivering the service and breaking these functions into the tasks Including office work. 3 Task Analysis – Focus on risk management, which tasks are safe to delegate or share across professions, what training is required, ensuing frequency –to maintain competence. Standardise best practice, risks and accountability 4. Competency Identification – Focus on Quality, agreeing best practice 5. Supporting systems – Focus on Governance arrangements, role boundaries, feedback and knowing when to stop etc 6. Training – Focus on Staff Development, setting up what ever training is required, assessing the individual and then assuring that they are competent and signing them off 7. Sustaining – Focus on embedding, linking the competences and the work into the Appraisal system and KSF Audit
  • Level 4 is Assistant Practitioner Level
  • Transforming the workforce l horton

    1. 1. Transforming the Workforce with the Calderdale Framework Lesley Horton Dental Services Manager Shaun Raval Associate Dental Director 24 th March 2011
    2. 2. Calderdale Framework <ul><li>Recognised workforce planning tool focusing on tasks rather than jobs </li></ul><ul><ul><li>Skills to plan workforce as vacancies arise </li></ul></ul><ul><ul><li>Skill sharing, blurring boundaries </li></ul></ul><ul><ul><li>Skills in delegation, delegating tasks safely and effectively </li></ul></ul><ul><ul><li>Competency based workforce </li></ul></ul>
    3. 3. WHY BOTHER ! ?
    4. 4. National Context: <ul><li>Leitch Report - The skills agenda </li></ul><ul><li>High Quality Care for All – Darzi review </li></ul><ul><li>Skills for Health </li></ul><ul><li>Health & Social Care Bill 2007 </li></ul><ul><li>A High Quality Workforce 2008 </li></ul><ul><li>Transforming Community Services 2009 </li></ul>
    5. 5. Local Context : <ul><li>Demographics of workforce </li></ul><ul><li>Reduction in investment </li></ul><ul><li>Increased demand for community based services </li></ul>
    6. 6. Reasons for delegation and skill sharing : <ul><li>Improves patient experience – ‘right person at the right time with the right skills’ </li></ul><ul><li>Increasing demand on services </li></ul><ul><li>Maintain service quality whilst controlling costs </li></ul>
    7. 7. Risks in delegation (professional) <ul><li>Variation in what is delegated </li></ul><ul><li>Variation in how task is to be delivered </li></ul><ul><li>Variation in documentation </li></ul>
    8. 8. Risks in Delegation (assistants): <ul><li>Lack of skill/training to fulfil task (unknown competence) </li></ul><ul><li>Unable to understand /follow written plan </li></ul><ul><li>Unsure when to seek help/abort task </li></ul><ul><li>Boundary not clear </li></ul>
    9. 9. Potential Benefits of The Calderdale Framework <ul><li>For Organisations </li></ul><ul><li>Consistency & Safety </li></ul><ul><li>Reduction in Risk </li></ul><ul><li>Efficient & Effective </li></ul><ul><li>Improved Productivity </li></ul><ul><li>Flexible Competent Workforce </li></ul><ul><li>Improved Patient Experience </li></ul><ul><li>Employer of Choice </li></ul><ul><li>Provider of Choice </li></ul><ul><li>For Teams & Individuals </li></ul><ul><li>Builds Effective Teams around the Patient </li></ul><ul><li>Personal & Team development needs-Links to KSF </li></ul><ul><li>Clear Roles & Responsibilities </li></ul><ul><li>Safe Skill Sharing </li></ul><ul><li>Transferable Skills </li></ul><ul><li>Job Satisfaction </li></ul>
    10. 10. So, How do You do it……?
    11. 11. 1 Awareness Raising 2 Service Analysis 3 Task Analysis 4 Competency Identification 5 Supporting Systems 6 Training 7 Sustaining 7 Stages to Successful Implementation
    12. 12. New Ways of working: Tasks mainly Knowledge & Skill based Tasks mainly Skill & Rule based Qualified staff; consider Blurring professional boundaries Allocate to Level 4 worker Tasks Knowledge & Skill based with protocols available Delegate to Level 2/3 worker
    13. 13. Risks Managed Through : <ul><li>Competences: </li></ul><ul><li>Reduce variation in WHAT tasks are </li></ul><ul><li>delegated & HOW they are delivered </li></ul><ul><li>Documentation: </li></ul><ul><li>Standardised </li></ul><ul><li>Communication: </li></ul><ul><li>Clarity re : when to seek help/stop </li></ul><ul><li>Feedback & supervision. </li></ul><ul><li>Validation </li></ul><ul><li>Professional review </li></ul>
    14. 14. So What…….??
    15. 15. Meeting the QIPP Agenda <ul><li>Quality – provides evidence based care </li></ul><ul><li>Innovation – new ways of working across professional boundaries </li></ul><ul><li>Productivity – freeing up specialists to provide specialist care </li></ul><ul><li>Prevention – patients not waiting for care/rehabilitation </li></ul>
    16. 16. Outcomes <ul><li>Competency based workforce </li></ul><ul><li>Consistency </li></ul><ul><li>Transferable, flexible workforce </li></ul><ul><li>Cultural changes </li></ul><ul><li>Improved patient pathway, reduced length of stay </li></ul><ul><li>Improved patient experience, less ‘hand offs’ </li></ul><ul><li>Valued workforce, clarity re roles and responsibilities </li></ul>
    17. 18. Dental service <ul><li>Staff awareness </li></ul><ul><li>Staff training </li></ul><ul><li>Champions </li></ul>
    18. 19. Role of Champions <ul><li>Ensure local core competences are created in your service area </li></ul><ul><li>Ensure local service specific competences are generated in your area </li></ul><ul><li>Ensure appropriate staff are trained in local core and service specific competences </li></ul><ul><li>Ensure all multidisciplinary staff are aware of their role in developing and implementing the Calderdale Framework </li></ul><ul><li>Ensure induction process for staff in each area includes local service specific competences </li></ul><ul><li>Feedback to steering group and contribute to evaluation of the implementation of the Calderdale framework via the Project Implementation Group </li></ul><ul><li>Raise the profile of the Calderdale framework both to internal and external markets </li></ul><ul><li>Lead the Dental implementation team in delivering the Calderdale framework and agreed outcomes </li></ul>
    19. 20. Dental service <ul><li>Dental Working Group, (re-training) </li></ul><ul><li>Complete Service analysis </li></ul><ul><li>Task analysis </li></ul><ul><li>Develop templates </li></ul><ul><li>Agree Competency Titles </li></ul><ul><li>Complete Competencies </li></ul><ul><li>Validate Competencies </li></ul>
    20. 21. Competency Title Is the probability of error occurring high? Are the consequences of error serious? Are protocols available to follow? Or could protocols be written to support the task? Is the task procedure complex? Is ongoing assessment & reasoning required throughout the task in order to adjust input? If clinical is this reversible? If clinical does the task require high levels of manual skill? If clinical – is response to the task immediate? Is the task carried out frequently? Is clinical reasoning involved ? (if YES, would a protocol make this safe?) Is information gathering +/- decision making involved ? Comments – Can this risk be managed ? Stop & Consider Risk Identified GO For each sub task discuss and gain consensus on the following statements.
    21. 22. Dental competencies <ul><li>GA paediatric exodontias </li></ul><ul><li>Plaque Indices </li></ul><ul><li>Topical Fluoride application </li></ul><ul><li>Domiciliary Assessment </li></ul><ul><li>Oral hygiene for nurses & hospital staff (cross over from community hospitals) </li></ul><ul><li>Oral health promotion </li></ul>
    22. 23. <ul><li>Contact details; </li></ul><ul><li>[email_address] </li></ul><ul><li>[email_address] </li></ul><ul><li>Further information; </li></ul><ul><li> </li></ul>