JOINT BRIEFING PAPER: HEALTH, SOCIAL CARE AND SPORT COMMITTEE

23rd October 2019

PROGRESS ON DEVELOPING A WORKFORCE STRATEGY

 

1.    BACKGROUND

 

Health Education and Improvement Wales (HEIW) and Social Care Wales (SCW) welcome the opportunity to update the committee on progress with the development of ‘A Healthier Wales - a Workforce Strategy for Health and Social Care’.

 

2.    INTRODUCTION

 

The workforce strategy will be a key enabler, in delivering the ambition of ‘A Healthier Wales,’ (AHW) for a seamless social care and health system, delivered through an engaged and motivated workforce that is competent, valued, flexible, digitally literate and able to respond with agility to future challenge and opportunities.

 

Significant activity has taken place since representatives of both organisations provided evidence to the Committee on 23rd January 2019.  Further details follow.

 

 

3.    THE AMBITION

 

The overriding aim of the strategy will be to ensure that by 2030:

·         We will have the right workforce to be able to deliver flexible and agile health and social care that meets the needs of the people of Wales. 

·         We will have a workforce that is reflective of the population’s diversity, welsh language and cultural identity, with the right values, behaviours, skill and confidence to deliver care and support people’s wellbeing as close to home as possible.

·         We will have a workforce that feels valued.

 

 

4.    THE APPROACH

 

4.1. Steering Group Arrangements

 

A robust governance process is in place to support effective and positive working relationships between HEIW, SCW and partners.  Jointly chaired by the CEOs of each, a steering group with membership across health and social care key stakeholders and Welsh Government officials is overseeing progress. Close working between HEIW and SCW has fostered healthy individual and professional relationships and deeper understanding of both sectors and organisations, as well as individual, and collective agendas.

 

 

 

 

4.2. Engagement with partners, stakeholders and the public

 

Our strong commitment to working in social partnership is evidenced by our inclusive engagement process to inform strategy development.  Partners have been encouraged to contribute through diverse mechanisms including 1-2-1 interviews, stakeholder events, peer group meetings, webinars and on-line.  The formal engagement events actively involved over 1000 people across all stakeholder groups.

 

The Institute of Public Care (Oxford Brooks University) was awarded the tender to support delivery of this programme.  We have applied a 7-step approach to the development of the strategy:

 

1.    Preliminary analysis of the workforce and its key challenges;

2.    Horizon scanning of current and future policy and legislative intent for health and social care;

3.    Engagement with a wide range of agencies and representative bodies;

4.    The development of key priorities and actions that would inform the strategy;

5.    Formal consultation with a broad range of stakeholders;

6.    The development of technical documents to support the final strategy; and

7.    Publication of a final strategy.

 

A key challenge in developing this strategy is the anticipated pace and extent of change over the next 10 years. For example, the increasing role of digital and other technologies, the impact of Brexit, the changing needs of the population and the changing expectations of our current and future staff. 

 

The consultation document and supporting materials were developed using the feedback received through the diagnostic and engagement phases.   This included:

·         14 workshops across Wales which attracted 401 people

·         2 webinars attracting 20 people

·         An online survey that received 512 responses

·         Further 33 interviews held involving 38 people

·         38 peer group and professional meetings attended involving over 350 people

There was substantial support for our proposal that the workforce strategy encompass employed and third sector workforce, volunteers and carers who provide health services, care and support to our population.  It was clear from the early engagement and feedback that enhancing the wellbeing of our workforce should be the underpinning commitment throughout the whole of the strategy. As well as this, we identified seven recurrent themes:

Valuing and retaining our workforce: Creating a stable workforce that feels valued, reflected by reward and recognition including opportunities for development.

Seamless working:Multi-professional and multi-agency working, to deliver excellent services to support new person centred models.

Digital: Developing the digital capability of the workforce to optimise the way we work, and the way we learn.

Attraction and recruitment:Establishing health and social care as a reputable brand and the sector of choice for our future workforce.

Education and learning:Ensuring a competent, capable and confident workforce who are supported to meet current and future service needs, and advance their careers.

Leadership: Developing compassionate leadership with a focus on quality improvement

Workforce shape:Ensuring a flexible and sustainable workforce in sufficient numbers to meet needs.

 

During the initial phase we received significant input to this project, lots of comments and feedback, as well as identification of challenges. The number of firm proposals for actions that would achieve the ambition were however limited and so we took the decision to prepare a consultation document, to test support for the seven themes. We also developed with partners some proposed priorities and actions, with timeframes linked to the themes and included these in the consultation document.

 

 

4.3. The Consultation

 

The consultation opened on 23rd July 2019 and closed on 18th September 2019.  Further engagement continued during this period, through workshops, webinars and attendances at key meetings involving a further 350 people.  Formal responses to the consultation were submitted on-line, with arrangements in place to accept responses through the HEIW communications team, for people who may have had difficulty accessing the on-line version. Both organisations participated in a wide range of national and local events and meetings. These included the Wales NHS Partnership Forum, Welsh Government Health and Social Care Executive Team, the Health and Social Care Leadership Group, National Social Care Conference and the Welsh Student Forum. In addition, meetings were arranged with organisations such as Cymdiethas Yr Iaith and the Welsh Language Commissioner in which we were able to offer assurances on our commitment to ensuring that the Welsh language and workforce inclusion is integral to strategy.

The consultation document with accompanying questions, outlined the case for change, and our commitment to focus on the wellbeing of our workforce which reflects the quadruple aim of ‘A Healthier Wales’ and the findings of the Parliamentary Review of Health & Social Care.  This also emphasised that we remained in listening mode with significant opportunity to influence the final content of the strategy.

At the time of writing, 138 on-line responses were received, and with additional submissions, the total is expected to be around 170. These are currently being analysed and will be used to inform the draft strategy.

4.4. Priorities for the draft strategy following the formal consultation

 

As noted above we received a substantial number of responses and these are being considered at the time of writing this report. We would be happy to share our analysis with the Committee when we meet. However early observations are that:

 

The seven themes that emerged from the initial engagement phase, highlighted the need for early priorities to be set out clearly in the strategy, some of which were discussed when we met with the Committee in January 2019.  The themes have received broad support from respondents, as has the approach.

 

Throughout the engagement period we heard the importance of valuing and supporting the well-being of our workforce.  This has been reinforced through the recent consultation and is well supported by respondents. This will therefore underpin every element of the strategy and its subsequent implementation plans.

 

We heard overwhelmingly that parity of esteem was of vital importance.  We recognise that while this involves the differences in pay between independent social care contractors, local authority social care arrangements and the subsequent differences with the NHS, the strategy and/or subsequent implementation plan will need to encompass total reward, including career development, employment practices etc.

 

The recognition that our workforce data is in some areas very detailed and robust, particularly from the NHS’s electronic staff record (ESR), but in other areas such as primary care, there is significant work to do. Workforce data is essential to improving workforce planning.

 

Improving our workforce intelligence will enable more robust decision making on the shape of the workforce, and diagnose the underlying issues more effectively, for example in relation to the workforce model, shortage of people or skills gaps.  It also enhances opportunities to focus on competence-based roles, supported by access to flexible education provision, and underpinned with a need to ensure that our careers offer and supporting information, meets the needs of all ages and all stages of life.

 

5.    NEXT STEPS

 

Drafting will commence shortly will draw heavily on the consultation feedback. The draft strategy will be approved by the steering group, before formal sign-off by the HEIW and SCW Boards and submission to Welsh Government.  Subject to discussion with Welsh Government, the strategy will be soft launched into the public domain, in advance of a formal launch later in the New Year.  Delivery of the workforce strategy will need to align with other Welsh Government programmes, including the ‘A Healthier Wales’ Transformation Programme and the National Clinical Plan.

 

As set out in the consultation document, the strategy is intended to set the direction for the next ten years, with some clear high-level actions and will be supported by a series of implementation plans. Discussions are ongoing with Welsh Government as to where responsibility will lie for the leadership of the implementation phase.