Integrated Workforce Planning Submission
Public Health Wales 6:11
INTEGRATED WORKFORCE PLANNING SUBMISSION 2010-2016
Health Economy plan and guidance
Name of Organisation/Health EconomyPublic Health Wales NHS Trust
I confirm that this Integrated Workforce Plan reflects the organisation’s service delivery plan for the entire workforce, and is a realistic and affordable projection of the workforce implications of those plans, based on our understanding of current workforce intelligence and knowledge of future developments and financial projections.
I confirm that we have worked in partnership with trade unions, social care, education, independent and voluntary sectors in the local health economy
I confirm that approval and validation of the information has occurred together with alignment to service and financial plans for all participants.
I confirm that all planning occurred in multi professional teams and not by professional group
Signed ______(Chief Executive)
Name in full ___Mr. Bob Hudson______
Date ___/___/_____
The organisation’s aggregated plan must be submitted to the Welsh Assembly Government (WAG) by 31st March 2010.
INDEX
STAGE / TITLEContext of the workforce plan.
Stage 1: / Define the future service provision and plans.
Stage 2: / Analysis of current service and workforce configuration.
Stage 3: / Forecasted workforce requirements and configuration to meet service need.
Stage 4: / Planning for delivery.
Stage 5: / Proposals for performance management and review.
Stage 6: / Recommendations for workforce development within the wider Health Economy.
Guidance.
CONTEXT OF THE WORKFORCE PLAN
Outline the services covered by this workforce plan.This workforce plan covers the following services
Health Intelligence
Health Improvement
Health Protection (including):
All Wales Health Protection teams
Clinical and diagnostic microbiology services
All Wales Food water and Environmental Services
National specialist and reference services
Epidemiological and surveillance services (CDSC)
National programmes for:
Health Care Associated Infection
Blood Borne Viruses
Vaccine Preventable Diseases
Antibiotic Resistance
Respiratory Infections(including TB)
National workforce development for public health, including professional and organisational development
Local Public Health Teams (NPHS)
Health and Social Care Quality (NPHS)
Healthcare Improvement (WCfH)
Public Health Networks (WCfH)
Screening Services (including
Current Programmes:
Breast Test Wales
Cervical Screening Wales
Newborn Hearing Screening Wales
Antenatal Screening Wales
Bowel Screening Wales
Proposed New Programmes;
Abdominal Aortic Aneurysm Screening
Newborn Blood Spot Screening
Possible:
Inclusion of Diabetic Retinopathy Screening Services
Wales Cancer Intelligence and Surveillance Unit
Wales Centre for Health
Insert organisation chart.
Due to the recent establishment of Public Health Wales NHS Trust and the imminent appointment of the Executive Board the organisation is in a state of flux and the final organisational structure has not been confirmed.
Please outline details of the people involved in developing this plan.
Mr Mark Dickinson
Mr Nathan Jones
Ms. Anne Bath
Ms. Sharon Atkins
Mr. Steve Murphy
Mrs. Gillian Jones
Mr. Steve Jenkins
Members of Senior Management Teams
Main Lead Contact Details:
Name:Gillian Jones
Telephone:01443 824170
Email:
Fax:01443 824174
Public Health Wales 6:11
STAGE 1:DEFINE THE FUTURE SERVICE PROVISION AND PLANS
This stage will assist organisations to develop an understanding of the future service activity and associated issues that could affect the profile of the workforce.
1.1 / Define the national forces/drivers for change that will impact on the organisation in the future.Response
1.1 / NHS Wales Reorganisation
Recent reform of NHS Wales has led to the previous 22 Local Health Boards (LHBs) and seven NHS Trusts being replaced with seven integrated Local Health Boards, responsible for all health care services in Wales. In addition to the new Health Boards three Trusts remain. These are; Velindre, Welsh Ambulance Service and the newly established Public Health Wales.
Public Health Reorganisation
Public Health Wales, which became fully operation in October 2009, incorporated the functions and services previously provided by the NPHS, WCfH, WCISU, CARIS and Screening Services Wales. Since the organisation became fully operational interim management arrangements have been put in place, until the Executive Director appointments are made.
An early priority for the organisation will be to restructure its services into an integrated suite of services able to meet the needs of a new configuration of stakeholders, including the Welsh Assembly Government, LHBs and Local Authorities.
With the exception of the Chief Executive, Executive Directors have not yet been appointed. Therefore, the above issues cannot be fully resolved.
Development of a Service Delivery Model
Following wider NHS Wales reform Public Health Wales’ existing arrangements for delivering both local and national services are no longer ‘fit for purpose’. Discussions have begun with LHB Chief Executives and newly appointed LHB Directors of Public Health over possible new service delivery models, which will better fit the newly configured NHS Wales. The development of the new service delivery model will have significant implications for the former NPHS Local Public Health Teams, which are currently structured around the old 22 LHBs.
Annual Operating Framework
The Annual Operating Framework and related documentation specify and imply a number of requirements of Public Health Wales, in terms of:
- Action that Public Health Wales must take as an organisation in its own right (direct requirements)
- Support that Public Health Wales will need to provide to Health Boards and WAG in meeting their requirements and commitments (requirements to support Health Boards)
In addition to the strategic framework for NHS Wales, a Public Health Strategic Framework, Our Healthy Future, has been developed. The framework will guide much of the work of Public Health Wales and is reflected in the content of the AOF.
Health Intelligence
NHS Reorganisation
The current reorganisation of the NHS and funding pressures will have an impact on Public Health Wales services. There is a need for Public Health Wales to consider how it will be structured internally to provide effective services to the Local Health Boards. This has potential to impact on the broad Health Intelligence community and specifically on the Public Health Wales Observatory. Need for decisions on reduced budget in health services will rely on good information – requirements will increase. Programmes currently receive consultant input and specialist public health support and advice from public health professionals. There is a need to review the specialise support to Health Intelligence to ensure that we remain fit for purpose and can rise to the expectations of stakeholders both internally and externally.
Support to Health Boards – DsPH who will have information needs for annual reports, HSCWB, NAs, CYPP, and other ongoing and ad hoc requirements. New information technologies/resource that should be exploited eg SAIL, Audit +.
Health Intelligence operates across the whole of Wales with some staff based locally. There will need to be a review of both the Observatory Analytical Team and the Library and Knowledge Management Service. As part of this work options to use resources to best effect will be reviewed but inevitably there might be demand for new resources
Requests from WAG for new or additional programmes
There have already been discussions on changes that are likely to take place. The Minister for Health and Social Services has agreed to transfer the All Wales Perinatal Survey (AWPS) and its budget to Public Health Wales from 1 April 2010. There are ongoing discussions relating to the WAG Health Promotion Library and a National Programme of Childhood Height & Weight Measurements
The Public Health Wales Observatory has a log of potential work as requests are received. There is insufficient capability to satisfy all requests and a prioritisation mechanism needs to be developed to enable decisions on which work to take forward to be negotiated with stakeholders.
Health ProtectionRe-structuring in NHS Wales, particularly within new Health Board structures and configurations will potentially alter relationships with health protection services and the way in which they need to be delivered
National Pathology network and Pathology modernisation agendas will affect future service models for microbiology service provision
Changes in the requirements of health protection services by WAG, particularly within Public Health Strategy and from NHS in Wales in supporting service delivery is likely to increase demands on Health Protection services
National programme for the replacement of Laboratory computer systems and development of the wider NHS IT infrastructure will directly affect laboratory services.
Health Improvement
General (affecting all or some of the Health Improvement programmes.)
NHS Reorganisation
The current reorganisation of the NHS and subsequent reduction in funding will have an impact on services. There is a need for Public Health Wales to consider how it will be structured internally to provide effective services to the Local Health Boards. This has potential to impact on the health improvement programmes. The programmes currently receive consultant input and specialist public health support and advice from public health professionals working within local public health teams. It is likely that the reorganisation will result in a reduction in support currently provided to the health improvement programmes.
Accommodation
A number of staff working for the health improvement programmes are based in the former Local Health Boards. Should the new Health Boards decide to relocate, then there may be a requirement for Public Health Wales to source new accommodation. This could have a financial impact if Public Health Wales is required to take on new accommodation.
Specific (drivers affecting the following Health Improvement programmes)
- Stop Smoking Wales
SSW has assumed a 10% increase each year in the number of clients accessing the service; however these projects, coupled with the roll out of brief intervention training and new methods of marketing could increase the number substantially beyond this amount. SSW is reviewing the way in which it operates to ensure that there is capacity in the service to absorb the potential increase in demand as a result of these developments.
- Workplace Health/Workboost
There are a number of targets relating to the Corporate Health Standard/Workplace Health in the Annual Operating Framework (AOF) for 2010-11. This includes a requirement for all LHBs to engage with the Corporate Health Standard programme, with a view to achieving Platinum by 2013. The LHBs will require additional support from the Workplace Health Team to achieve the Corporate Health Standard.
- Welsh Network of Healthy Schools Scheme
- Alcohol Brief intervention project
- GP Engagement (including Welsh Backs)
- ASSIST
National workforce development for public health, including professional and organisational development
Annual Operating Framework
Public Health Regulation
Policy drivers from public health reviews e.g. Pennington Enquiry
Heads of Agreement
Resources (financial) – cost effectiveness
Screening Services
Policy requirements – if Screening follows same route as England there is a possibility of extending or changing the age ranges at which women are screened within both Cervical and Breast Screening Programmes. There is also a possibility that the length of cervical screening rounds may be extended. The inclusion of high risk women and MRI surveillance in the English Breast Screening Programme is also likely to result in increased demand for an equivalent service to be offered in Wales
Financial – there is an expectation that funding will be reduced and savings will be required
Clinical changes
National Screening Programme changes – requirement to implement digital mammography requires Breast Test Wales to replace equipment and provide additional training for staff. Ability to screen women with disabilities on new generation of mobile units will result in increased demand from previously unmet needs. BTW will require additional staff to meet this need, and the increased demand resulting from demographic change and the growth in the eligible population.
IT services – it is likely that there will be requirements to update national IT systems used within Screening Services during 2015
Review of provision of Breast Services within North Wales
Requests from WAG for new or additional programmes to be delivered by the Screening Services Division
NHS reorganisation
Technology – the cervical screening programme hopes to procure computer aided technology to improve the programme. This, combined with the protection offered by the HPV vaccination programme will, over time, impact on the need for cytoscreeners.
WCISU
Workforce changes due to retirement of key individuals and organisational changes within the NHS in Wales.
English Cancer Registries are likely to move away from the use of ONS and into more advanced information systems. This is likely to impact on the way that Wales delivers a service and there will be a requirement to develop alternative ways of working.
Increased requests for information due to the possibility of changes to the way cancer services are delivered.
Financial need to remain within budget
Changes in service to best utilise advances in technology and Information Technology
The implementation of new screening programmes or changes to age profiles in current programmes may lead to increased requests for information in order to inform how programmes should best be delivered.
1.2 / Define any local forces/drivers for change that will impact on the Organisation in the future.
Response
1.2 / Local Public Health Teams
Following wider NHS Wales reform Public Health Wales’ existing arrangements for delivering both local and national services are no longer ‘fit for purpose’. However, Public Health Wales, in partnership with stakeholders, has not yet determined key elements of its structure and service delivery models.
Discussions have begun with the LHB Chief Executives and newly appointed LHB Directors of Public Health over possible new service delivery models, which will better fit the newly configured NHS Wales. It is recognised that the development of a new service delivery model will have a significant impact on the way services are provided by Public Health Wales in the future.
Public Health Networks
The Public Health Wales Networks are specifically designed to support practitioners across all sectors in Wales who have a role in delivering, advising or influencing the specific subject areas. They also have a pivotal role in informing policy and practice at both the national and local levels by providing a crucial two-way conduit for information between policy makers and practitioners.
Health Intelligence
There continues to be a need to support locally both the Directors of Public Health of Local Health Boards and the local Public Health Teams operating across the 22 local authority areas. This will be done through planned work such as the needs assessment work for the revision of the 22 Health, Social Care and Wellbeing Strategies. There continues to be many demands for support which need to be prioritised both locally and nationally.
Shortage of skilled Public Health Intelligence staff across Wales.
Health Protection
Changes in demand, level and nature of health protection support required by the newly developed Health Boards.
Health Protection support for NHS Wales and WAG also needs clarification but it is likely to significantly influence the way in which health protection services are delivered, depending upon political, financial and patient services needs.
A number of different requirements to change or re-configure service delivery models have arisen through NHS re-structuring and from within the National Pathology modernisation agenda.
Financial restraints are known to be a significant feature of NHS wales now and expect to continue over future years, this will inevitably place pressures on maintenance and development of all services