Research for All: Now is the time for innovation and collaboration
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Professor Ged Byrne's presentation from when he spoke at the Conference on Friday 16th September
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Research for All: Now is the time for innovation and collaboration
- 1. Research for All: Now is the time!! Ged Byrne DDEQ (North)
- 2. Research: what are we trying to do? The Quadruple Aim: •Improving the health of populations •Improving the individual experience of care •Reducing the per capita cost of care •Improving the experience of providing care - Increasing joy and meaning for the workforce The Quadruple Aim: care, health, cost and meaning in work; BMJ, 2 June 2015; Sikka, Morath, Leape http://qualitysafety.bmj.com/content/early/2015/06/02/bmjqs-2015-004160.full.pdf+html
- 3. Never has there been a better time? • Demographic change • The NHS is amazing • System change • Technology • Research emphasis change/ bench to bedside to policy • System resources • Research funding opportunities • Globalisation
- 4. Demographic change • Ageing population • 2.8 million with diabetes rising exponentially • Male obesity 13.2-24.3% between 1993 and 2014 – Boys aged 2-10 up 10% in 9 years – Girls aged 2-10 11% in same period • Complex morbidity but slowing mortality
- 5. The NHS is amazing • £113.3 Bn 2015-16 and 1.31M workforce – 209 CCGs, 154 Acute trusts, 56 MH Trusts, 10 Ambulance Trusts, 7,875 GP practices – 149,808 docs, 314,966 nurses, 146,792 scientists • 1 million people every 36 hrs – 22.923M ED/yr – 85.632m outpatient apts – 250M GP/population interactions/yr
- 6. Life Sciences • Analytical Toxicology • Anatomical pathology • Blood transfusion science/transplantation • Clinical biochemistry including paediatric metabolic biochemistry • Clinical genetics/Genetic Science • Clinical embryology & Reproductive Science • Clinical immunology • Cytopathology including cervical cytology • Electron microscopy • External quality assurance • Haematology • Haemostasis and thrombosis • Clinical Immunology • Histocompatibility & immunogenetics • Histopathology • Microbiology • Molecular pathology of acquired disease • Phlebotomy • Tissue banking Physiological Sciences • Audiology • Autonomic neurovascular function • Cardiac physiology • Clinical perfusion science • Critical care science • Gastrointestinal physiology • Neurophysiology • Ophthalmic and vision science • Respiratory physiology • Urodynamic science • Vascular science Physical Sciences and Biomedical Engineering • Biomechanical engineering • Clinical measurement & Development • Clinical Pharmaceutical Science • Diagnostic radiology & MR physics • Equipment management & clinical engineering • Medical electronics & instrumentation • Medical engineering design • Clinical photography • Nuclear medicine • Radiation protection & monitoring • Radiotherapy physics • Reconstructive Science • Rehabilitation engineering • Renal dialysis technology • Ultrasound & non-ionising radiation Bioinformatics including • Clinical Bioinformatics and Genomics • Computer science and modelling • Health Informatics Apr 2013 Themed Healthcare Science Divisions
- 7. System change STPs and LWABs 7
- 8. Sustainability and Transformation Plans • The NHS Five Year Forward View Shared Planning Guidance required every local health and care system in England to create a Sustainability and Transformation Plan (STP). • These will be place-based, multi-year plans built around the needs of local populations. • STPs will drive transformation in health and care outcomes between 2016 and 2021. • They will help strengthen local relationships and better enable a shared understanding of how we can best deliver the FYFV. @NHS_HealthEdEng #HEELKS http://tinyurl.com/zfwu7p6
- 9. HEE strategic direction To enable our discussion about focus for efforts in workforce transformation we believe our work in HEE is organised in 3 interrelated domains: •Workforce observatory (planning, modelling) •Quality (education frameworks) •Transformation (including culture, leadership, OD) We need to ensure that work in these 3 domains is aligned so there is a cumulative positive impact Workforce observatory Quality Transformation
- 10. A changing landscape… Within the wider NHS: Introduction of sustainability and transformation partnerships Development of new care models • Supply • Up-skilling • New roles (Nurse associate) • New ways of working (greater community involvement) Within Health Education: September 2016
- 11. @NHS_HealthEdEng HEE transformation offer Developing a menu of ‘products’ to support workforce transformation, mapped to the triple aim requirements
- 12. The clinical learning environment: the gateway to team learning Broad multi-professional education support infrastructureBroad multi-professional education support infrastructure Consistent and comparable view of quality Consistent and comparable view of quality National and local level National and local level High quality patient care High quality patient care Supporting learnersSupporting learners Quality improvementQuality improvement September 2016
- 13. What are clinical learning environments for?? Student Current workforce Wider impact September 2016
- 15. 2005 Didn't exist Still a sound Still in the sky Parking space A prison Sent to college Typo Thomas Friedman, World Economic Forum, Quoted by http://ayeletbaron.com TEL: simulation m-Learning e-Learning
- 16. Key research priorities for 2015/16 are: • Big data/Medical Bioinformatics; by 2015 MRC will be consolidating links between molecular and clinical and population level data; links with industry; and strengthening training and research programme opportunities built on medical bioinformatics infrastructure. • Capacity, infrastructure and skills; MRC recently announced the Clinical Research Infrastructure Initiative, following a £150M provided by the Department of Health41. The initiative will enhance translational capability, partnerships with industry and existing strategic clinical research infrastructures. At least £50m of additional funding is sought from potential partners in the public, charity and private sectors to add value to all aspects of this work • Dementia; MRC will maintain a portfolio of high quality research to deliver greater understanding of neurodegenerative diseases and design new interventions that may prevent the later devastating impact of dementia. • Antimicrobial resistance; MRC will lead a cross-funder initiative to support new research in this important area. The work will involve the integration of novel chemistry with biology and extensive collaboration across research councils, Research priorities are changing: e.g. MRC
- 17. E&T Reform Programmes HEE lead focus on structure & delivery of E&T ~ time bounded 10 plus years • Medical E&T reform (incl. Shape of training) • Shape of caring • Pharmacy reform • Paramedic training • Advanced Clinical Practice National HEE strategic reviews •TEL •Patient safety •Primary care Research emphasis change Workforce transformation programmes These are nationally lead, usually linked to a ministerial priority, often jointly owned and delivered with other ALBs and sometimes with E&T funding coming from NHS England. • Primary Care • Diagnostics • Children & Young People • Urgent & Emergency Care • Public Health • Mental health • AMR & Sepsis E&T Policy
- 18. Resources: We are broke!! • Currently trajectory predicts £22Bn financial deficit year on year by 2020 • The NHS net deficit for the 2014/15 financial year was £471 million (£372m underspend by commissioners and a £843m deficit for trusts and foundation trusts). This year £2.2Bn • 80% of NHS Trusts declared a deficit We MUST innovate to survive
- 19. TEL: simulation m-Learning e-Learning “Healthcare in the UK is underpinned by world-class life long education and training that is enhanced through innovation and RESEARCH and the use of evidence-based, existing and emergent technologies and techniques.” Originates from the Department of Health’s A Framework for Technology Enhanced Learning (2011) and other key reports.
- 20. Leadership Leadership Teamwork Teamwork communication communication Value for money Value for money Empathy Empathy ‘M aking do’ ‘M aking do’ Cultural competence Cultural competence Equality & diversity Equality & diversity Public healthPublic health wellness wellness Infectious diseases Infectious diseasesPatient safety Patient safety Personal effectiveness Personal effectiveness Managing riskManaging risk
- 21. The characteristics of the future workforceThe ‘workforce’ will need to... •Continue to help people prevent ill health and manage their own care •Have the skills, values and behaviours required to provide personalised care •Have adaptable skills, responsive to innovation to enable ‘whole person’ care •Have the skills, values and behaviours to provide high quality care •Deliver the NHS Constitution: “able to bring the highest levels of knowledge and skill at times of basic human need when care and compassion are what matters most”.
- 22. Paradoxically burgeoning sources of Research funding • Cash rich resource poor health economies • Pharma/ commercial • Third sector • Ring fenced UK funding
- 23. Globalisation: The UK is not alone • WHO: Global Health Workforce deficit to reach 12.9 million by2035 however………………………….. • Indian Healthcare skills Council: Demand for 6 MILLION new physicians/ 60 million healthcare workers in next 25 years • UK not immune • 29000 nurses • poor fill rates in some medical specialities
- 24. The NHS has its own global USPs • Systems • people
- 25. Now is the time •GO FOR IT!!
Editor's Notes
- Focus on prevention skills and capacity will help in the longer term to contain patient demand for services KSS Joint working with Public Health England in the preventative aspects of the STPs. Partnership working with Public Health teams in Local Authority, joint programmes to support eg MECC, already in place. Patient Leadership Programmes to be developed with KSS AHSN Wessex MECC Toolkit on website, developed following a pilot last year and evaluation by University Southampton now adopted nationally by PHE. Tells you What MECC is and How to implement it.
- Focus on prevention skills and capacity will help in the longer term to contain patient demand for services KSS Joint working with Public Health England in the preventative aspects of the STPs. Partnership working with Public Health teams in Local Authority, joint programmes to support eg MECC, already in place. Patient Leadership Programmes to be developed with KSS AHSN Wessex MECC Toolkit on website, developed following a pilot last year and evaluation by University Southampton now adopted nationally by PHE. Tells you What MECC is and How to implement it.
- Every part of England has been asked to produce an STP. Brings together every local health and care system, i.e. “placed based” A local blueprint for the acceleration of the Five Year Forward View. They identify concrete steps to be taken. Plans built around the needs of local populations 2016-2021. Local leadership and investment are vital. They will build and strengthen local relationships. Includes plans to secure and support general practice and enable it to play its part in more integrated primary and community services
- A changing landscape… Within the wider NHS: Introduction of sustainability and transformation partnerships Development of new care models Supply Up-skilling New roles (Nurse associate) New ways of working (greater community involvement) Within Health Education Student funding changes (tuition, maintenance and placements) Apprenticeship development HEE review of salary support
- HEE Quality Context HEE has a statutory duty to secure continuous improvements in the quality of education and training for the health care workforce including promoting skills and behaviours that will uphold the NHS Constitution – work-based learning environment crucial to this endeavour. In so doing, HEE also has a duty to improve the quality of patient care - the correlation between high quality education and training and high quality patient care is well understood. HEE Quality Framework is currently being introduced across England under leadership pf English Deans and their multi-professional Quality Teams. The Quality Framework is a multi-professional tool to measure, identify and improve quality improvement – focussed on the clinical learning environment A consistent and comparable view of quality at national and local level – core set of measures and metrics supported by a multi-professional learner survey A data-driven, risk-based and multi-professional approach to quality management and quality improvement Increased efficiency in the way we collect and utilise data and information – reduces burden on providers. HEE has a broad multi-professional education support infrastructure that supports learners and quality improvement in the above context.
- What are placement for? Enable the application and development of skills within high quality and safe practice learning environments which meet professional competencies, the requirements of regulators and curricula learning outcomes Exposes and socialises students to the cultures, values and behaviours of organisations where people are cared for Provides access to a breadth of roles, interprofessional learning, clinical and organisational experiences to support their development and preparation for employment Supports the delivery of NHS workforce plan and enables employers to attract and secure a future workforce supply Facilitates diversity and supports and enables widening participation Provides opportunities and motivation for the current workforce to develop and guide the future workforce The presence of students can have positive impact on patient care, improve recruitment and retention of staff, impacts on professional development, supports research & innovation Supports future sustainable and transformed of the health & social care workforce and services
- If that is making some of you feel a bit challanged in the age game don't worry as we don't even need to go that far back. In 2005
- Focus on prevention skills and capacity will help in the longer term to contain patient demand for services KSS Joint working with Public Health England in the preventative aspects of the STPs. Partnership working with Public Health teams in Local Authority, joint programmes to support eg MECC, already in place. Patient Leadership Programmes to be developed with KSS AHSN Wessex MECC Toolkit on website, developed following a pilot last year and evaluation by University Southampton now adopted nationally by PHE. Tells you What MECC is and How to implement it.
- Huge but this is what we are aiming for