Agenda item

Report attached. Lisa Crichton Jones, Director of Workforce Transformation for NE and Cumbria and Ian Renwick, SRO for Workforce Workstream will also provide the Joint Committee with a presentation on the above.

Lisa Crichton Jones, Director of Transformation for NE and Cumbria and Alex Glover, Locality Director, Health Education England provided the Joint Committee with an update on current and emergent work in relation to the NE and North Cumbria Workforce Programme.

 

The Joint Committee received information on the current context, opportunities and challenges faced.

 

It was noted that current service delivery models are struggling to meet the demographic challenge of people living longer often with complex co-morbidities and the increasing demands on the health and care system. In addition, it was noted that we are experiencing a multi-factorial workforce crisis, caused by challenges in recruitment, retention and lack of specialist skills, affordability and a preference for shorter work time commitments. Workforce funding has also reduced significantly. Demand, specialisation, reducing numbers of trainees, staff retirement and the intensity of modern working practice all contribute to complex and often difficult work environments. There is also a reliance on expensive locum and agency staff contributing to making the existing configuration of services unsustainable. The workforce is also fragmented in silos and divided by organisational and professional boundaries. Social Care shares similar challenges and whilst there is huge untapped potential in the community and voluntary sector this requires investment and development.

 

It was noted that there is now an opportunity through the STP/emergent ICS arrangements to develop a co-ordinated regional workforce strategy, across health and care to meet these challenges, to facilitate planning the future workforce on a whole systems basis, allowing for greater innovation and new models of care.

 

Early successes to date have been:-

 

·         A large-scale Workforce Summit event, held in February 2018.

·         Briefings to Health HR Directors and regional Trade Union colleagues at the North East Social Partnership Forum.

·         Beginning to establish links with Directors of Adult and Children’s Social Care and Local Authority Heads of HR.

·         Scoping the opportunity to build on the many examples of good work, already underway within the region.

·         A regular meeting of colleagues from across the system to drive this work forwards; the Workforce Scoping Group, whose membership comprises colleagues from health, local authority, CCGs, Health Education England and a regional trade union representative in their role as Joint Chair of the North East Social Partnership Forum.

 

 

Since the Workforce Summit was held in February 2018 a number of priority actions have been progressed.

 

One of the main actions was the appointment of a Director of Workforce Transformation and Lisa advised the Committee that she was delighted to be in post and would now be focusing on scoping the workforce programme and exploring what could be achieved in partnership with others. Lisa indicated that there was an opportunity to shape a regional workforce strategy for health and care on a whole system basis and to work innovatively to develop new models of care and pathways and explore opportunities to work at scale once for the NE and Cumbria to build resilience and quality and address the needs of the population

 

Other priority actions underway were :-

·         the creation of a Strategic Workforce Board.

·         the establishment of a Workforce Programme Board to maintain oversight of all areas of work/report progress and risks to Strategic Workforce Board.

·         the development and implementation of a regional workforce strategy with the following emerging themes:-

o   Recruitment and retention

o   Preparing people for change and supporting the workforce

o   Workforce development and innovation

o   Education and training

o   Leadership development

o   Development of primary care workforce and employment experience

 

It was proposed that the Strategic Workforce and Programme Boards would be established by August 2018 with the initial work streams and lead officers to be agreed by September 2018 and high level objectives for each workstream set in October 2018. It was also proposed that a draft regional workforce strategy would be in place in October 2018.

 

The Joint Committee was advised that the work progressed would build on the good practice already in place and involve working in partnership with others including Social Care, HR and the trade unions.

 

Councillor Hall thanked Lisa for the presentation but considered that there was a greater need to link with social care. Councillor Hall indicated that it was disappointing that there had not been any home care providers at the Workforce Summit in February. Councillor Hall stated that if any inroads are to be made in terms of integrating health and social care involving homecare providers is key as this is one of the areas where the greatest savings can potentially be made.

 

Lisa advised that this was a really helpful point and she would be holding further discussions with both health and social care colleagues going forwards.

 

Councillor Caffrey advised that Gateshead Council was well advanced in its work in relation to integrating care systems and removing the commissioner / provider split.

 

Councillor Robinson noted that information provided in the presentation showed that 68% of carers are under 65 which is around 218,000 of the adult workforce who are not working because they are caring for relatives and who are forgotten about. Councillor Robinson also noted the figures also appeared to suggest that there are nearly 50,000 individuals due to retire and he queried how the NHS was going to be able to fill these vacancies on top of meeting the additional numbers of GPs and nurses that the Government has committed to recruiting. Councillor Robinson acknowledged that the Committee had received information on the Find Your Place Campaign and queried whether it had been successful.

 

The Joint Committee was advised that the campaign had been successful although they would like it to be even more successful. There had been some challenges relating to the campaign as some of the workforce coming to the NE came with additional challenges which the NHS was keen to support.

 

The Joint Committee queried what these challenges were.

 

Alex advised that some of the challenges related to educational and language needs which needed to be worked through.

 

The Joint Committee was advised that when it received a further update in September it would be provided with further information on the Find Your Place Campaign.

 

Councillor Schofield noted that she had asked for a definition of what was meant by the whole workforce and what is meant when the phrase” in partnership” is used.

 

Lisa stated that when she used the phrase “ in partnership” she meant “ working together “ with the workforce and others such as trade union colleagues.

 

Councillor Schofield considered that further clarification was needed as there are public and private partnerships and she was concerned that some private partnerships were accessing publicly funded training for their workforce and she queried whether they were going to be required to contribute financially towards workforce training going forwards.

 

Lisa stated that work was only at its early stages at this point.

 

Councillor Taylor queried whether NHS colleagues were in discussions with the Royal College of Nursing in relation to training and what work was going to take place to address the situation whereby significant numbers of junior doctors did not remain part of the UK workforce.

 

Alex stated that a significant amount of work was being carried out to improve the working experience of junior doctors in order to retain them in the workforce and she was happy to share further details about this work (at a future meeting). Initiatives were focused on areas improving the position in relation to the study leave allowance which was funded by Health Education England. This allowance had been funded  via employers but now the funding was being held by Health Education England so that junior doctors could access this funding at appropriate times.

 

Clare Williams, Unison, stated that she considered that everyone at the meeting would agree that no one wanted to see privatisation of the NHS and would like to see a repeal of the Health and Social Care Act. However, the national agenda was not in the control of those present. Clare noted that the NE as a region has the highest rate of unemployment and the highest rate of young people not in work or accessing training so delivery of a health and social care workforce in the region was very important.

 

Clare indicated that the NHS in the region had been impacted by migrant workers leaving and returning to the country of their origin. Large numbers had told Unison that they were uncertain if they would be able to remain in the country and continue working.

 

Clare considered that the report provided to the Committee was a good starting point and she considered that both Unison and the BMA were two key stakeholders going forwards.

 

Clare acknowledged that skill levels needed to be raised and she advised that Unison provides a significant amount of training across the workforce and this could be part of future discussions. However, there was a need to be clear about the needs of the population and the skills that were needed by the workforce to address these needs.

 

Clare considered that a good starting point would be for future discussions to focus on the development of quality apprenticeships for health and social care and the unions would be able to contribute. Clare indicated that Unison has been working with a few key Social Care providers in relation to education and training support.

 

Clare agreed that it was important to attract individuals with specialist skills to the NE and she considered that more needed to be done in terms of promoting the NE as an area to work.

 

Clare also considered that it was also important that roles in social care needed to be better promoted and shown as highly skilled and these roles needed to be properly rewarded for providing a quality service.

 

Clare considered that a way forward between now and September would be to get a smaller group together to focus in more detail on the emerging themes and Unison was keen to be involved in this work.

 

Clare also considered that it would be important to come back to this Joint Committee later in the year to update on further progress. Clare considered that exploring whether it was possible to bring some services back into direct provision would also be a way forward.

 

Adele Healey from the BMA stated that she agreed with a lot of the points raised by Clare but she noted that a lot of the concerns raised required legislation to change in order for them to be addressed and competition in the NHS to be removed.

 

Adele also considered that a lot of the changes needed require investment and pump priming.

 

Lisa noted that Clare had summed the situation up when she indicated that this was a starting point and she advised that things would take time but there is an opportunity to do this together.

 

Councillor Mendelson stated that there are huge opportunities in the area of the social care workforce which is key to the enablement agenda but which has the challenge of low pay. Councillor Mendelson queried whether it was being explored as to whether there is potential for those in the social care workforce to move across at some point into the NHS workforce.

 

Councillor Mendelson also queried whether the Joint Committee could receive further information on whether work to facilitate the integration between health and social care

 

Councillor Caffrey indicated that as Gateshead is moving quickly down the integration route it might be possible to share this work at an appropriate time.

 

Alice Wiseman advised that in Gateshead the Gateshead Care Partnership was carrying out work with a view to moving away from competition. The Partnership had therefore brought commissioners and providers on board to work together as far as possible except where legalities prevented this.

 

Councillor Caffrey noted that a key issue in relation to the social care workforce was around achieving parity of esteem with the health workforce.

 

Alice also noted that there is also an issue around how generalist skills are valued and how we can enable the workforce to be responsive to meet the needs of individuals.

 

Councillor Huntley queried how people with the right skills were going to be attracted and brought into the workforce. Councillor Huntley noted that the issue of not being able to get individuals with the right skills was often being highlighted to the OSC in South Tyneside and this had occurred recently and was one of the reasons why the Stroke Service had moved from South Tyneside Hospital. Councillor Huntley queried how the NHS was going to prioritise which hospitals had different types of personnel to stop the downgrading of hospitals.

 

Lisa stated that her focus was to work at scale for the region to see how she could better marker / make the NE more attractive as a place to work. The Joint Committee was advised that individual trusts would still be responsible for recruitment to their organisations.

 

Alan stated that a key element of partnership working would be to encourage networking between the workforce in hospitals in different geographic locations so that the NHS can retain as many services as possible and to avoid hospitals poaching staff from each other.  Alan stated that in the past there have been competing contracts for staff and pay and the focus on partnerships is to facilitate a move away from this and do things differently. It was hoped that this work would assist in making jobs more attractive and help retain staff.

 

Councillor Hall reiterated that she thought that it was important for health colleagues to engage with homecare providers as they were a really skilled workforce who could provide a variety of support to individuals in the home.

 

Alex indicated that Councillor Hall’s point was valid and advised that it had been recognised at the Workforce Summit that this was an area which should have been included. Alex stated that there has been some investment in upskilling the Care Home Workforce but it was acknowledged that much more needed to be done and they were keen to progress this work further. Alex advised that monies were being shifted from different funding pots with a view to supporting such training.

 

Councillor Hall considered that the employment statistics for the region demonstrated that there is a potential workforce out there. However, what was needed was to attract individuals to social care positions by providing parity of esteem.

 

Councillor Schofield stated that she considered that GPs could provide a key interface in bringing health and social care together. Councillor Schofield also considered that another positive move would be the introduction of a pay spine to encourage progression and queried whether this might be a possibility.

 

Clare stated that the latter point was something which would need to be addressed by government. However, Clare considered that it would be worthwhile having an event / briefing in relation to social care so that there could be clarity around what was meant by the social care workforce and who this involved.

 

Clare considered that it should be the public sector and the unions who provide the relevant training for the workforce and not the private sector and this would help to generate a growth in jobs. Clare stated that if individuals achieve decent salaries and good training then they will have a good employment experience.

 

Lisa thanked everyone for the points raised which she had found really helpful  and advised that it was planned to come back to a future meeting of the Joint Committee later in the year to update on further progress.