1. Lincolnshire LETC Annual Report 2013/14

2. Contents Introduction...............................................................3 Year in brief…………………………..………………..4 Key achievements……………………………………..5 LETC aims and objectives……………………………6 LETC/ Team deliverables……………………………..7 People…………….…………………………………….10 Finance………………………………………………….11 Governance………………………………………….....12 Conclusion ……………………………………………..13 2

3. Introduction This document provides a summary of the work undertaken by the LETC and the HEEM Workforce Team for Lincolnshire in 2013/14. It describes our activities and progress towards delivering on our priorities and how our work relates both back to Health Education East Midlands (the LETB) and to the HEE Mandate 3

4. April 2013 saw the formal establishment of Health Education England (HEE), Health Education East Midlands (HEEM) as the Local Education & Training Board (LETB) and the Lincolnshire Local Education & Training Council (LETC). As part of the changes, the employment of the workforce team transferred from NHS Lincolnshire to HEE. The year commenced with a number of challenges, notably and a large reduction in education funding and external concerns about mortality rates at Lincolnshire’s hospitals As the financial year progressed; additional funding was released both from HEEM and HEE; Lincolnshire was able to take some advantage of this funding – although it is acknowledged that monies being released in the final quarter is not helpful to the organisations in terms of planning expenditure or release of staff for training. During the year, the LETB acknowledged that Lincolnshire was a priority area and this has supported a number of activities in the county including a workforce summit. 4 2013/14 in Brief

5. Consultation and input into LETB activities e.g. medical workforce redistribution project, sonography, strategic education reviews Workforce Events e.g. care pathway events, workforce summits Increased commissions at University of Lincoln to meet additional demand for nurses Increased Learning Beyond Registration provision within the county 5 Key Achievements

6. Primary aim and objectives of the Lincolnshire LETC Aim To develop a high quality, safe and sustainable workforce to meet the healthcare needs of the people of the Lincolnshire Overall Purpose Work with the Lincolnshire Health & Care Programme Board as part of the formal governance structure to lead the workforce element of LHAC To work with stakeholder partners to ensure their input is gained as appropriate To develop and approve workforce plans To commission workforce education and training as outlined in the plans To oversee accountability, quality and risk management To operate in the best interests of the system, even when those interests conflict with the interests of members’ own organisation 6

7. Workforce Team Key Deliverables (Corporate) 7 Produce a county wide workforce development plan that provides evidence to directly influence LETB investment priorities, commissioning plans and local workforce development programmes Achieved. The plan supported increased nursing commissions locally and increased availability of CPD provision locally Engage locality stakeholders in developing the workforce development plan to ensure commissioners, providers and staff have the opportunity to contribute to key messages Achieved. The team held a series of care pathway workshops and met with workforce leads from key stakeholders Engagement with CCGs and Area Team to provide workforce development expertise building awareness of the workforce agenda in service planning and integration into the county wide workforce plan Partially achieved. Whilst we have a number of links with CCG and Area team – this area requires further development and will be supported through the Director of System Development at HEEM Facilitation of partnership working between commissioners, service providers and education providers to ensure responsiveness to service requirements Ongoing. The team continues to work across service, education and commissioners e.g. development of MSc in Advanced Clinical Practice to support development of advanced practitioners Establish and manage the Local Education & Training Council governance structures to ensure effective decision making, engagement and communication Achieved/Ongoing. The LETC has been established and membership widened to include a broader group of stakeholders. The group is effective in debating the issues facing Lincolnshire and in providing a conduit to and from the LETB governing body. Development will continue to ensure that the LETC remains effective and that governance arrangements are strengthened particularly around finance. A number of partnership groups were established during the year including the Workforce & OD programme board, Strategic Professional Education group and Widening Participation Strategy group

8. Lead a programme of work to deliver local workforce transformation that supports service change and quality improvement Achieved/Ongoing. The LETC and the workforce team have led or supported various pieces of work including: widening participation, workforce mapping of A&E pathways, integrated diabetes care, medical workforce strategy and advanced practitioners. The team are supporting various aspects of the Lincolnshire Health and Care Programme Coordinate delivery of HEE Mandate deliverable ‘Talent for Care’ – non-registered support workforce Ongoing. Some apprenticeship activity has taken place in Lincolnshire and there is a desire by organisations to increase the numbers of apprentices in the workplace. A feasibility study is underway to recommend pathways for apprentices with a view to them being introduced into clinical areas and also estate/hotel services. The health community has continued to support the practice based learning programme for physiotherapy and occupational therapy and there is demand to increase the number of ‘grow our own’ opportunities for support staff to access pre-registration training. Coordinate delivery of HEE Mandate deliverable – dementia awareness training for all staff Achieved in 2013/14. The delivery of this mandate area was supported by the team commissioning local delivery of the Stirling train the trainer programme. Work continues on the delivery of the mandate in 2014/15 Co-ordinate delivery of HEE Mandate deliverable – minimum training standards for HCA and Care Certificate Ongoing. A member of the Lincolnshire team has been part of the national discussions in relation to the care certificate. A local working group has been established across health and social care to develop core systems and process and prepare for the delivery of the certificate Manage local investment of devolved funding to deliver specific programmes of work and evaluate impact Ongoing. The funds that were allocated to Lincolnshire were allocated based on investment plans and business cases agreed by the LETC. Evaluation of return on investment and benefits realised needs to be strengthened and metrics have been developed to support this 8 Workforce Team Deliverables – Corporate (2)

9. Key Deliverables (Locally Agreed) 9 Medical Workforce Strategy and Implementation Ongoing. The medical workforce strategy and implementation plan are at final draft stage. The work closely links with the attraction strategy, but also includes plans for improving the quality of training and supporting the CPD for SAS doctors. Medical input into the development of the strategy has been issue that is now being addressed Attraction Strategy and Implementation Ongoing. The team are working with Lincoln University and will be procuring expertise to undertake market research into the perceptions of Lincolnshire by healthcare students in order to develop the appropriate response. Developing Workforce Planning Capability and Capacity Ongoing. A number of small scale pilots are underway and this piece of work will feed into the Lincolnshire Health and Care Programme. It is intended to commission a number of cohorts of workforce planning training via a suitable provider Education to support staff working with Frail Older People Ongoing. A specialist nurse has been seconded to Lincoln University to develop a suite of learning opportunities in relation to caring for older people with complex needs. A multi-professional, cross organisation group has been formed to oversee the curriculum development Developing the Health & Social Care Workforce Programme Ongoing. This workstream is closely aligned to the Lincolnshire Health and Care Programme; testing of the concept is underway via work with audiology and A&E and will be rolled out once additional resources to support early implementers are confirmed Supporting the Workforce Programme for Lincolnshire Sustainable Services Review Ongoing. The Lincolnshire Workforce and OD programme board has been established as a partner group to the LETC and as the leaders for the workforce element of the LHAC programme. The group is chaired by an HR director and is facilitated by the workforce team. The team are active participants in a number of pieces of work including workforce modelling and supporting staff engagement and early implementation activities. Developing Widening Participation Programme of Work(see also HEE Mandate) Ongoing. A Wider Workforce & Widening Participation Strategy group has been established. During 2013/14 activities included commissioning drama performances in Lincolnshire schools, holding apprenticeship events and supporting additional apprenticeship numbers in Trusts. Organisations have utilised funding to support the training of assistant practitioners and other support workers including the volunteer workforce. Developing Workforce Capacity in Primary Care Ongoing. The Local Medical Committee have become active members of LETB activities although further work is required to establish links into other primary groups e.g. dental and pharmacy. The workforce team will work closely with the LMC and the GP dean in 2014/15 to support increased capacity in primary care – especially given their role in the future service model for Lincolnshire and the risk of workforce supply in the sector particularly in regard to GPs

10. Lincolnshire Workforce Team Helen Smith Workforce Lead 1.0 wte Jeanette Shepherd Administrator 0.8 wte Sharon Baumber Administrator 0.6 wte Vacant from 30 th May Workforce Development & Planning Manager 1.0 wte Julie Seddon Workforce Development & Planning Manager 1.0 wte Sharan Watkinson Workforce Development & Planning Manager 1.0 wte 10

11. Finance Team –Pay budget£234,043 –Non pay£48,000 Health Community Allocations (received via the Workforce team) 11 Budget LineAmount Flexible LBR (opening balance)£52,262 Wider Workforce (in addition to LDA funding directly allocated)£70,000 Education in Emergency Departments£134,000 Scoping Exercise for Support Worker Qualifications£6,000 Additional Flexible LBR£54,365 Supporting Lincolnshire Programme£370,000 Frail Older People Education£189,850 In addition the team were successful in commissioning education for local delivery to the values indicated Education for Health NCORE Sheffield Hallam University University of Lincoln £41,700 £78,872 £24,211 £61, 884

12. Governance Risk management –The LETC has developed risk registers in relation to its programmes and projects –A Lincolnshire LETC risk register is in place and the team provides input to the LETB risk register through escalating risks as agreed in LETC meetings –Local risk owners and actions are agreed; with updates at agreed schedules Financial governance –The team works to Health Education England Standing Financial Instructions and receives budget reports from EM LETB management accountants –We consult with partners in relation to discretionary investment allocations and through our LETC Chair we consult and feedback to the LETB governing body in regard to overall investment plans for the organisation –Suggested that for 2014/15 the LETC agrees on a level of funding that can be allocated using the discretion of the Workforce lead IT systems –The IT system is managed through GEM Commissioning Support Unit (SLA yet to be developed) and we have a discrete shared drive for the team as well as individual drives on the Lincolnshire server. There is remote access to these drives to support flexible working. –An IT refresh for the team has recently been completed –The LETB has a shared drive, as yet there is no access to this from the Lincolnshire site Ruddington and in the other four localities –We are seeking an IT refresh for 2014/15 12

13. During 2013/14, the LETC has established a number of partnership groups to support the effective delivery of a workforce strategy for Lincolnshire that attracts and retains a workforce that meets local need for high quality, safe and sustainable services. Whilst there remain a number of workforce challenges for Lincolnshire; the infrastructure, partnership working and programmes of work are in place that will support the health and care community to deliver on it’s KPIs and achieve the aspirations in the vision for the Lincolnshire Health & Care Programme The health and care community were particularly successful in attracting additional resources during the year, particularly in supporting local delivery of education for our registered workforce. In 2014/15 we need to ensure that our programmes of work start to deliver their intended outcomes and that a robust evaluation framework is in place. 13 Conclusion