1. Cross Economy Case Study Cardiology Pathway Redesign Over the last few years England has been experiencing increasing demands on its urgent and emergency care services which has put unprecedented pressures on the NHS and its workforce. NHS England has commissioned a review into Urgent and Emergency Care which Health Education England (HEE) is supporting through its Emergency Medicine Workforce Implementation Group (EMWIG) and supporting programmes. Nationally, the focus has been on role development through Physician Associates, Advanced Clinical Physician Associates, ED Pharmacists, Medical Training improvements and Paramedics. The purpose of this pilot is to undertake a ‘bottom up’ approach engaging with frontline staff to understand the key processes across urgent pathways within a health economy, map out the skills and competencies needed to undertake those processes and then redesign workforce teams to deliver those processes. Following discussions with Warrington and Halton Hospitals NHS Foundation Trust executive team and unscheduled care management team, it has been agreed that the focus of this work will be on the Cardiology pathway. Defining the Data WRaPT is supporting this work by providing a mechanism for the collection and analysis of workforce and activity data across the pathway – with GPs, community teams and acute hospital teams. WRaPT will support initially with data collection, building a picture of the clinical workforce and the activity that they deliver. www.wrapt.org.uk This will be followed by an initial workshop to agree the primary pathway(s) to be reviewed and developed within Cardiology services, in July 2015. In future workshops, Health Education England aim to develop a future state pathway, which builds on the skills of those involved across the pathway. WRaPT will support this by modelling the suggested changes in real time, providing an immediate picture of workforce changes, cost and makeup, to aid in action planning.

2. Cross Economy Case Study WRaPT Support The WRaPT team are providing support to the Cardiology pathway redesign in the following ways: Benefits of Using WRaPT www.wrapt.org.uk Redesign will be done with a clear understanding of current workforce – which will ensure that the teams can identify ease of implementation Teams will be able to model the impacts of changes on all aspects of workforce A clear picture of all staff involved in a pathway should enable role redesign as well as pathway redesign Clarity of impact of changes on activity, cost and workforce. The WRaPT tool will support service redesign to demonstrate the real-time impact of activity and role changes on the workforce. WRaPT will enable the workforce modelling, that is integral to the service redesign process, to provide evidence based workforce planning for urgent & emergency cardiology pathway transformation. Suzanne Hughes, Urgent and Emergency Care Programme Lead Further updates will be provided on Cardiology Pathway Redesign as the WRaPT project progresses 1. Help to develop the existing picture of workforce through working with: 2. A shared, secure platform to share workforce 3. Supporting workforce redesign session facilitation 4. Functionality to model changes within sessions Emergency Department, Assessment Unit - medical, nursing & AHP Cardiology – medical (consultant and middle grade), specialist nursing, AHP & management Cardiac Rehabilitation – AHPs, nursing, psychological therapies Community Heart Failure Clinic nurse General Practice (Warrington and Halton) Pathology Pharmacy Data/Information team Trust based service improvement lead Urgent and Emergency Care programme lead (HENW)