Workforce Strategy & Non Medical Consultants – The National Picture

1. Workforce Strategy & Non Medical Consultants – The National Picture Dean Royles, Director of Workforce & Education Healthier Horizons

2. Outline • Ten years ago… • National workforce drivers • National development of NMC’s • Some national evidence • The future • Better Care Better Health Better Life

3. Ten years ago……… • The new Millenium and the Millenium bug • Best film, Gladiator • Top singles, Bob the Builder, Who let the dogs out? Spiller Groovejet • Reality TV show ‘Big Brother’ started • Olympics in Sidney, 28 medals for Team GB • Wimbledon, record 7th win for Pete Sampras • Premier league champions, Manchester United • Celebrity wedding, Michael Douglas & Catherine Zeta-Jones

4. National workforce drivers • The NHS Constitution • Transforming Community Services • £15-20 billion efficiency savings (David Nicholson 2009) • The QIPP challenge • Revised NHS Operating Framework (July 2010) • Medical Workforce Planning –emerging challenges • Equity and Excellence: Liberating the NHS, New HR Framework

5. NHSConstitution The NHS belongs to the people. It is there to improve our health and well-being, supporting us to keep mentally and physically well, to get better when we are ill and, when we cannot fully recover, to stay as well as we can to the end of our lives. It works at the limits of science – bringing the highest levels of human knowledge and skill to save lives and improve health. It touches our lives at times of basic human need, when care and compassion are what matter most. Better Care Better Health Better Life

6. Staff Pledges • To provide all staff with clear roles and responsibilities and rewarding jobs for teams and individuals • To provide all staff with personal development and access to appropriate training • To provide support and opportunities for staff to maintain their health, well-being and safety • To engage staff in decisions that affect them Better Care Better Health Better Life

7. What will it mean for NHS spending?

8. The QIPP Challenge ‘QIPP will be successful if we relentlessly tell the story of why it's crucial to the future of the NHS.  This narrative is best brought to life by evidence from the front line’ Jim EastonNational Director for Improvement, Department of Health

9. Equity and excellence:Liberating the NHS • Empowering frontline staff • Autonomy • Health outcomes not processes • Evidence based practice • Increasing use of NICE guidance

10. National Development of Non Medical Consultants DH Guidance for the development of NMC Posts • Nursing 1999 • AHPs 2001 • Pharmacists 2005 • core focus areas of the role; expert practice, leadership and service redesign, research and education • To improve services & quality • To strengthen leadership • A new career opportunity to help retain experienced and expert practitioners in practice

11. MORE SENIOR STAFF - LEVEL 9 More senior staff with the ultimate responsibility for clinical caseload decision-making and full on-call accountability 9 CONSULTANT PRACTITIONERS- LEVEL 8 ‘Consultant Practitioners’ are staff working at a very high level of clinical expertise and/or have responsibility for planning of services 8 ADVANCED PRACTITIONERS- LEVEL 7 ‘Advanced Practitioners’ are experienced clinical professionals who have developed their skills and theoretical knowledge to a very high standard. They are empowered to make high-level clinical decisions and will often have their own caseload. Non-clinical staff at Level 7 will typically be managing a number of service areas 7 SENIOR PRACTITIONERS/SPECIALIST PRACTITIONERS- LEVEL 6 ‘Senior Practitioners/Specialist Practitioners’ who would have a higher degree of autonomy and responsibility than ‘Practitioners’ in the clinical environment, or who would be managing one or more service areas in the non- clinical environment. 6 PRACTITIONERS- LEVEL 5 ‘Practitioners’ – most frequently registered practitioners in their first and second post-registration/professional qualification job. 5 SKILLS AND COMPETENCIES LEARNING AND DEVELOPMENT ASSISTANT PRACTITIONERS/ASSOCIATE PRACTITIONERS- LEVEL 4 ‘Assistant Practitioner/Associate Practitioners’ – probably studying for Foundation degree, BTEC higher or HND. Some of their remit will involve them in delivering protocol-based clinical care that had previously been in the remit of registered professionals, under the direction and supervision of a state registered practitioner. 4 SENIOR HEALTHCARE ASSISTANTS/TECHNICIANS - LEVEL 3 ‘Senior Healthcare Assistants/Technicians’ – this is a higher level of responsibility than support worker, probably studying for or have attained NVQ level 3, or Assessment of Prior Experiential Learning (APEL). 3 SUPPORT WORKERS - LEVEL 2 Support Workers – frequently with the job title of ‘Healthcare Assistant’ or ‘Healthcare Technician’ – probably studying for or has attained NVQ Level 2. 2 INITIAL ENTRY LEVEL JOBS - LEVEL 1 Initial entry level jobs such as ‘Domestics’ or ‘Cadets’ requiring very little formal education or previous knowledge, skills or experience in delivering, or supporting the delivery of healthcare. 1 National Development of Non Medical Consultants • Career Framework for Health Level 8 Consultant Practitioner (SfH 2005) • The height of a clinical career • Very small numbers, currently 0.2% of total registered N/M workforce in the NW

12. National development of NMCs National headcount of NMCs • Nursing & Midwifery 983 • AHPs 176 • Pharmacy 42 • Total 1201 National Workforce Census 2009

13. Evaluating the NMC Role- some national evidence • A few studies in the first five years • Key Themes • Importance of Organisational Culture (Kim Manley 2000) • Engagement in the 4 key role functions (Guest & Redfern 2004) • Key attributes of successful NMCs (Woodward et al 2005) • An increasing number of small studies since 2005 • More detail from Chris and Ann later…

14. some national evidence… ‘The review has confirmed that these roles, although in their infancy, have all made a significant difference in each of their speciality areas. Numerous service improvements and clinical developments have resulted from the appointment of Nurse Consultants and their involvement in longer term projects will also bring significant improvement in clinical outcomes and improved services to patients.’ Review of the Nurse Consultant Role DH, Northern Ireland 2005

15. The Future, some issues… • Looking forward: Clearly articulating the role of NMCs in delivering QIPP • Developing pioneering services to improve patient outcomes • Providing safe, high quality advanced clinical practice and managing risk • A strong model of clinical leadership, engaging with and influencing GP consortia • Importance of empowering others (staff & patients) as per the NHS Constitution • Making a difference: NMCs ideally placed to lead research in clinical practice • Moving forward: career opportunities for Non Medical Consultants, workforce & succession planning • Consultant Healthcare Scientists, the impact of Modernising Scientific Careers

16. Thank you Any Questions?