1. Educational support for Shifting the Balance of Care (SBC) Strategic Environment  Better Health Better Care 2007  A Force for improvement – Workforce response to Better Health Better Care 2009  Shifting the Balance of Care Improvement and Resource Framework 2009

2. Some of what NES does  Provides GPST, GP Dental training, Pharmacy and PMVTS – to National (UK) Regulatory Standards  Extensive programmes in Uni-professional areas, eg in GPST - 300 GPs per year – approx 1000 in training  Professional development support eg appraisal, CPD…  Project based activity

3. What NES Does Project based activity eg  CHP projects -5 funded  GPwSI/PrwSI Workstreams eg  OOH  Cancer/Palliative Care  Mental Health  18 weeks  Long term conditions

4. NES approach Community Health Care Education Strategy (2005)  Iterative Process  Ensure that NES is aligned to the Education/Training needs of the Community workforce  Initially profession based approach  Latterly CHP based

5. NES approach Issues  Main staff groups contract into the NHS – Drs, Dentists and Pharmacists  Contracts are national (UK)  Contracts not aligned to Scottish Government strategy  Terms and conditions of staff outside A4C  Dispersed organisational structure  Workforce data and planning are difficult eg GP and non NHS employed nursing

6. NES approach Issues (continued)  Workforce growth influenced by various factors eg 100% increase in GP nurses, 48% increase in GP practice staff since 2003  Majority of nurses now employed by contracting bodies  Distribution of resource not necessarily focused in areas of need eg deprivation  Variable engagement with CHPs or National Strategy

7. The NES principles  Supporting evidenced based educational interventions  Developing the concept of contextual education and training i.e. education and training that is relevant and focused on staff and patient needs  Generic educational interventions rather than disease or condition specific interventions  Supporting existing communities of practice e.g. existing nursing, manager and medical networks  Primarily supporting role development rather than new roles.

8. CHES and SBC  Community based view too narrow  Map existing activity to both 48 change areas within SBC improvement and resource framework and to 8 high impact change areas.  Special HBs should coordinate activity in relation to the 8 SBC high impact areas  Support innovation in CHPs and develop learning form existing projects  Identify CHP learning/training priorities  Enhance Uni/Multi/Inter - professional activity within NES

9. Future  Internal mapping and adoption of a systems approach to SBC  Ensure existing programmes (GPST etc) include SBC priorities  Greater Alignment with other Special HBs – includes individual and joint mapping matrices  Enhanced dialogue and engagement with CHPs