Empowering partnerships 17 th July 2014 Julie Screaton, Managing Director

1. Empowering partnerships • 17thJuly 2014 Julie Screaton, Managing Director Health Education South London

2. An overview Who we are • Health education in the reformed NHS Click to edit Master text styles Second leve Third level Fourth level Fifth level Why partnerships matter • The LETB model is built on collaboration and shared stewardship of the workforce system • Sustaining partnerships in challenging times Building for the future www.hee.nhs.uk www.southlondon.hee.nhs.uk

3. Our vision Click to edit Master text styles Second leve Third level Fourth level Fifth level To design, develop and deliver a workforce that will lead to sustainable improvements in the health and well-being of the population of South London www.hee.nhs.uk www.southlondon.hee.nhs.uk

4. A delicate balance….. The scale of the task • Over 1.3m staff in +300 roles in +1000 organisations • Treating 1m patients every 36 hours • Boundaries of health and social care Click to edit Master text styles Second leve Third level Fourth level Fifth level Lead in time • 13 years to train a Consultant, 10 years to train a GP, 3 years for a newly qualified nurse • Doctors in training now will still be working in 2060 • Our investments in the future workforce have to be based upon assumed future models of care • c60% of staff will be in the NHS in 10 years • But patients also rely on trainees to provide care today Today & tomorrow www.hee.nhs.uk www.southlondon.hee.nhs.uk

5. We are planning in a changing context Population-based healthcare • Patient at the heart of care delivery • Communities, families, individuals • Distribution of health and wellbeing within populations • Predict, prepare, prevent • Proactive care for those at risk Population-based healthcare • Patient at the heart of care delivery • Communities, families, individuals • Distribution of health and wellbeing within populations • Predict, prepare, prevent • Proactive care for those at risk Workforce values aligned to population values • Health and wellbeing • Community engagement • Patient empowerment • Care across continuum • Compassionate care; dignity and respect Click to edit Master text styles Second leve Third level Fourth level Fifth level Population-based healthcare Workforce values aligned to population values sustainable service delivery Workforce planning, new ways of working, research & evaluation, culture & environment recruitment & retention lifelong learning workforce at the forefront of change www.hee.nhs.uk www.southlondon.hee.nhs.uk

6. This is set against a backdrop of significant financial challenge Click to edit Master text styles Second leve Third level Fourth level Fifth level www.hee.nhs.uk www.southlondon.hee.nhs.uk

7. London has unique challenges Inequalities in health and quality with 17 years life expectancy difference between boroughs Inner London has higher levels of adults who smoke and drink, while obesity is a bigger problem in outer London London is the childhood obesity capital of Europe A mobile and transient population in some communities makes continuity of care difficult A diverse population with 42% of people from a minority ethnic group and 100+ languages Click to edit Master text styles Second leve Third level Fourth level Fifth level www.hee.nhs.uk www.southlondon.hee.nhs.uk

8. A truly transformational approach is needed to ensure the care system is sustainable Click to edit Master text styles Second leve Third level Fourth level Fifth level www.hee.nhs.uk www.southlondon.hee.nhs.uk

9. We therefore need to develop the workforce to focus on new skills, including supporting citizens to self care The model for managing care of mostly healthy adults will be based on enabling patients to play a role in their own care… • …whereas providers will need to work very differently for managing care of elderly patients with LTCs • Other providers in the network (e.g., social care) • Other GPs in the network • Named GP Click to edit Master text styles Second leve Third level Fourth level Fifth level • Home care team • Personal network • Local community • Other providers in a network • GPs in a network • Individual • Individual • Skills needed • Skills needed • Supporting citizens to self care • Generalist skills • Ability to work in multidisciplinary teams • Skills bridging the boundary between health and social care www.hee.nhs.uk www.southlondon.hee.nhs.uk

10. We are managing competing priorities HEI planning? • Shortage of senior nurses in specialist areas £7.5m extra cost over 3 yrs for N&M expansion • Foundation changes - psychiatry Click to edit Master text styles Second leve Third level Fourth level Fifth level Placement Capacity? • Consultant vacancies Attrition, retention, ownership? • 8% reduction • RMN (last year saw growth) • Foundation changes - • to community by 2017 Cost of Living • Urgent & emergency • Care gaps Safer Staffing • GP Expansion by 2015 Reduced CPPD budget, further changes to funding • Shape of Training/Caring Cost ofGP expansion is £1.1m (-42 acute posts) • Radiology staffing www.hee.nhs.uk www.southlondon.hee.nhs.uk

11. We know that London nursing vacancies are higher than England average RCN Safe Staffing: average 11% nursing vacancies in London vs. England average of 6% Click to edit Master text styles Second leve Third level Fourth level Fifth level London average 11% England average 6% London trusts SOURCE: RCN London Safe Staffing report www.hee.nhs.uk www.southlondon.hee.nhs.uk

12. And many of the health and care workforce choose to come to London to train and subsequently move away Only 37% of graduates in Subjects Allied to Medicine remain in London 6 months following graduation • Retention of staff by local education commissioners in London is low: e.g. AHPs Click to edit Master text styles Second leve Third level Fourth level Fifth level Destination of leavers from London Higher Education Institutions in England (2009/10) AHP retention % London LETBs with lowest retention of AHPs SOURCE: London LETBs call for evidence submission; HENWL migration analysis www.hee.nhs.uk

13. What will it take to build a workforce that can deliver for patients and populations? • Skills and careers • Training where care is delivered • Changing perceptions of community facing careers • Educating for flexibility and confidence at the outset Click to edit Master text styles Second leve Third level Fourth level Fifth level • Making the best use of limited resources • Learning across boundaries and professions • Not just for the few • Lifelong learning Retention • Supporting staff through change • Keeping our brightest and best • Making the best use of our assets and resources www.hee.nhs.uk www.southlondon.hee.nhs.uk

14. We can only succeed by working in partnership; the LETBs can be a focal point • With employers, • commissioners and social care • Building ownership, commitment and careers • Ensuring education settings align with service needs • Blurring boundaries, planning for populations Click to edit Master text styles Second leve Third level Fourth level Fifth level • Getting and keeping the best • Supporting continuous development • Research and innovation – ‘mainstreaming’ agility • With universities • With our staff, students, patients and citizens • Forming resilient communities • Embracing self management • Adapting to changing models of care • Harnessing potential www.hee.nhs.uk www.southlondon.hee.nhs.uk