Evidence submitted by Lincolnshire Health
Community (WP 37)
1. INTRODUCTION
The Health Select Committee is undertaking in
inquiry into workforce planning, the terms of reference are How
effectively workforce planning, including clinical and managerial
staff, has been undertaken and how it should be done in the future.
The Health Select Committee has asked specific questions and this
response is structured around those areas.
2. BACKGROUND
In April 2005 Trent SHA devolved responsibility
of workforce development planning to its local health communities
and integrated the existing Workforce Development Confederation
into its Directorate of Strategic HR and formed a Multi-professional
Deanery. The Lincolnshire Health Community developed the Lincolnshire
Workforce Modernisation Service (LWMS) in order to carry out the
devolved functions. LWMS is accountable to the Lincolnshire Workforce
Modernisation Group (LWMG), which is made up of representatives
of health and social care organisations and chaired by the Chief
Executive lead for workforce across the Community. In 2004 LWMG
produced a Workforce Strategy for 2005-10, a Business Plan for
2005-06, a Commissioning Plan and an Investment Plan. These documents
are attached in order to provide additional background to our
response. 74[74]
This response has been prepared and agreed by the LWMG.
3. RESPONSE TO
HEALTH SELECT
COMMITTEE QUESTIONS
3.1 In considering future demand, how
should the effects of the following be taken into account:
— recent policy arrangements, including
commissioning a patient-led NHS
In Lincolnshire workforce development planning
and identifying demand is undertaken on a health and social care
community basis, working with individual organisations but identifying
need across organisational boundaries recognising that in a rural
health community recruitment is from a limited pool and therefore
the employment practices of individual organisations impact on
one another. Over the past two years the approach to workforce
development has been on a health community basis with demand being
identified by strategic care group themes, ie long term conditions,
integrated unscheduled care, etc Commissioning a patient-led NHS
seems to reinforce organisational boundaries and for workforce
development planning there is a need to work across health and
social care communities.
The Implications for the workforce of changes
to service delivery as a result of technology change must be considered.
The Integrated Service Improvement Programme focuses change programmes
around people , process and technology. This should be embedded
into planning processes.
Health and Social Care Communities must have
detailed information on the health needs of its population and
workforce planning should be integrated into the service and financial
planning decisions being made to meet the population's needs.
— the increasing use of private
providers of services
Local Health and Social Care Communities can
work across organisational boundaries and should ensure they are
identifying the workforce development needs of all employers.
There will be significant benefits to employers if their employment
practices complement each other and the ability to train professional
staff and provide them with different practice learning experiences
will benefit the workforce in the future.
3.2 How will the ability to meet demands
be affected by:
The recent financial constraints within the Lincolnshire
Health Community as a result of needing to achieve financial balance
has meant workforce planning to reduce the workforce rather than
increasing the workforce to meet nationally set workforce targets
over the past couple of years. This change of approach can be
demotivating for staff and does not reflect good planning at national
and local level. There is much work that can and should be done
about ensuring a more efficient and effective workforce and realising
the benefits of pay reform and modernisation.
The current funding processes for education and
training are not helpful and hinder the ability to plan for the
workforce. There is a need for a longer-term planning framework
and increased flexibility to train the workforce differently.
— the European Working Time Directive
Although there are examples of good practice
and innovative ways of working established to date in order to
meet EWTD targets, more work is required commencing now to support
the workforce for 2009. This has to link to training plans for
the whole workforce and the need to use the Multi-Professional
Education and Training levy in a more flexible way to support
advanced and assistant practitioner roles.
— increasing international competition
for staff
This is a source of recruiting staff that needs
to be controlled carefully at a national level in order to support
the workforce in this country and other countries. However, it
has value for individuals and employers and should continue.
Local Health Communities will have detailed information
on their staff and should workforce plan accordingly.
3.3 To what extent can and should the
demand be met, for both clinical and managerial staff, by:
— changing roles and improving the
skills of existing staff
The Lincolnshire Health and Social Care Community's
current workforce planning is based entirely on the need to do
this rather than recruiting new staff and the ability to move
staff from secondary to primary care. However, this is only achievable
if the MPET funding levy is available to support advanced practice,
assistant practice and ensuring the workforce is able to access
the skills and competency it needs from accessible quality education
providers.
Workforce development for Lincolnshire will be
planned and co-ordinated on a health community-wide basis and
will support the vision outlined in the Lincolnshire Workforce
Strategy document 2005-10. The workforce development plans will
ensure:
(i) Collaborative working and workforce planning
with employers across health and social care including the independent
and voluntary sector.
(ii) The workforce capacity needed to deliver
services.
(iii) Productivity and skill mix will increase
to boost capacity.
(iv) Development of new roles and working differently.
(v) Innovative commissioning of training based
on planned future need that supports new ways of working.
(vi) A competent, flexible workforce within a
clear career framework.
(vii) Development of model employment practices
that improve staff well-being and deliver better patient outcomes.
This recognises the need for model employment
practice is a key element of planning the workforce.
— the recruitment of new staff in
England
Local Health Communities should have a clear
understanding of the labour markets that their workforce operates
in. Lincolnshire has a low skills economy and therefore we have
a priority of "growing our own" as part of our Workforce
Strategy that will enable local people to access the skills they
need to move into NHS Careers. However, there is a need for national
overview of workforce need and national initiatives to ensure
sufficient supply and jobs for newly qualified staff.
— international recruitment
(See increasing international competition
for staff)
3.4 How should planning be undertaken:
— to what extent should it be centralised
or decentralised
In order to ensure workforce planning integrates
with service and financial planning it has to be decentralised
to LHC level. However, it has to inform and complement the national
planning processes and recognise workforce supply is a national
and international tool.
— How is flexibility to be ensured
By ensuring flexible use of funding streams with
clear monitoring and performance management systems.
4. CONCLUSION
The Lincolnshire Health and Social Care Community
has responded positively to a devolved approach to workforce development
planning and is working towards an integrated approach with service
and financial planning across all organisations. It is recognised
that there will need to be clear responsibilities for workforce
at a national and SHA level and that there should be a partnership
with LHCs. Workforce capacity and capability should be increased
across all levels of the service. The key issues the Lincolnshire
Health Community would wish the Health Select Committee to consider
as part of this inquiry are:
— Increased flexibility in MPET funding
in order to develop the whole workforce.
— Longer-term financial planning frameworks
for workforce development.
— Increased knowledge of national processes
and ability to influence decisions.
Lincolnshire Health Community
15 March 2006
74 Not printed here. Back
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