Empower your staff to lead workforce change through Functional Analysis

1. Empower your staff to lead workforce change through Functional Analysis Pippa Hodgson Regional Director, Skills for Health

2. Functional Analysis – What is it? A methodology for competence based workforce design based on quality provision of care along a patient pathway. It supports: Service improvement Workforce redesign Education design and commissioning Workforce planning Requires high levels of expert engagement and builds consensus

3. Functional Analysis Functions / Competences Level of Skill Context x x =

4. Health Functional MapPromote, maintain and improve health

5. Health Functional Map Organises functions required for effective health care Groups and increasingly differentiates between functions. Lowest level is a reference competence that represents one function that is done by a individual.

6. Functional Analysis Functions / Competences Level of Skill Context x x =

7. 9 More Senior Staff 8 ConsultantPractitioners 7 Advanced Practitioners 6 SeniorPractitioners 5 Practitioners 4 AssistantPractitioners 3 Senior Assistants/Technicians 2 Support Workers 1 Initial Entry Level Jobs Career Framework

8. Functional Analysis Functions / Competences Level of Skill Context x x =

9. Context The ‘extra’ ingredient: The predictability of the situation / individual The availability of others with higher/different levels of skill Volume v. risk Frequency Complexity …….. Your service

10. Context OneIntegrated Trauma Services Major Trauma > 45 minute journey Rehabilitation Major Trauma Centre Transferred to major trauma centre if required Injured patient < 45 minute journey Rehabilitation Trauma Unit

11. Three steps …. Step One:

12. Step Two:

13. Step Three: Page 12

14. It’s all about the individual …

15. Context two: National End of Life Care Programme • Final Year of Life – Service Improvement approach • Functional Analysis: • 5 trajectories • Organ Failure • Cancer • Frailty • Other terminal • Sudden death • plus dementia • 9 points on the pathway, • 39 health and social care professionalsinvolved

17. Step Four: Skill level: Generic Enhanced Specialist Common Core Competences Assumptions/notes = richness Timings

18. Care After Death: Point 7 on Pathwayone-off event, timed in minutes(no separately identified dementia figures)

20. National End of Life Care Programme...what they said…. Good to feel part of a process which will affect the way care is delivered in the future Community Nurse Health and social care working together Clinical Education Lead, Hospice Being able to look at things in a much more structured way so that nothing was missed Domiciliary Care Provider Being involved! Respiratory Nurse Specialist Pioneering ….. PCT QUIPP Lead Looking atthe pathway from different points… Local Authority Carer

21. Context 3:Long term Neurological Conditions 1) New cases presenting (incidence) 2) Empowering people with low level needs 5) People admitted to hospital with a primary diagnosis of LTnC 6) People admitted to hospital with a secondary diagnosis of LTnC 3a) People transitioning to more complex needs 3b) People whose needs are complex - care co-ordination Progress of the condition 7) People supported at home as an alternative to hospital admission with a primary diagnosis of LTnC Crisis/acute event 9) People transitioning to palliative care 8) People supported at home as an alternative to hospital admission with a secondary diagnosis of LTnC 4) Supporting people with palliative needs 10) Last days of life

23. Generic Skills - Education Basic Information Common/Core Competences:

24. Long term Neurological Conditions 1) New cases presenting (incidence) 2) Empowering people with low level needs 5) People admitted to hospital with a primary diagnosis of LTnC 6) People admitted to hospital with a secondary diagnosis of LTnC 3a) People transitioning to more complex needs 3b) People whose needs are complex - care co-ordination Progress of the condition 7) People supported at home as an alternative to hospital admission with a primary diagnosis of LTnC Crisis/acute event 9) People transitioning to palliative care 8) People supported at home as an alternative to hospital admission with a secondary diagnosis of LTnC 4) Supporting people with palliative needs 10) Last days of life

25. LTnC Indicative Workforce Shifts No baseline – built on best practice 10 year time period Apply policy shifts Specialist care early on Reduce crisis admissions to hospital Increase deaths out of the acute sector Results in Much less generic capacity than first anticipated A small amount less of enhanced capacity required Less specialist capacity in hospital More specialist capacity in the community 25

26. Functional Analysis Functions / Competences Level of Skill Context x x =

27. …builds on existing skills Functions / Competences Level of Skill Context x x = Existing Skills & Knowledge Education Content & Level Qualification

28. How it all fits together….. Nationally Transferable roles Team Skills & Gaps Career framework roles Functions / Competences Level of Skill Context x x = Defining and creating roles Employability Matrix Workforce Planning Steps 3 & 4

29. How it all fits together (2) Functions / Competences Level of Skill Context x x = Existing Skills & Knowledge Education E-learning Literacy & Numeracy Assessment Content & Level Qualification Learning Design Principles Apprenticeships Core standards Assistant Practitioner Skills Passport

30. Functional Analysis 9 More Senior Staff 8 Consultant Practitioners 7 Advanced Practitioners 6 Senior Practitioners 5 Practitioners 4 Assistant Practitioners 3 Senior Assistants/Technicians 2 Support Workers 1 Initial Entry Level Jobs 100% would recommend the process to a colleague.

31. Functional Analysis - So what service do we offer? A facilitated process over 3 months with high levels of clinical & expert engagement (3-4 workshops) to reach clinical consensus Workbook used by: • Service Commissioners • Education Commissioners • Service Improvement Leads • Workforce Leads …….TALK TO US

32. www.skillsforhealth.org.uk