Building and retaining our workforce

The West Yorkshire People Plan

Our West Yorkshire People Plan sets out our ambitions for our ‘one workforce’ which includes those working in health, social care, the voluntary, community and social enterprise (VCSE) sector, unpaid carers (approximately 400,000 people, as many do not access formal support) and recognises the contribution made by our education sector in developing the current and future workforce.

The People Plan is a published document, the detail of which can be found at: https://workforce.wypartnership.co.uk/people-plan

As well as the online version, you can read or download the People Plan as a PDF, or in a variety of accessible formats.

Evidence-based, integrated, inclusive workforce plans

To inform decision making in education and training, we develop a workforce plan that is based upon the demands of maintaining the right workforce, responding to change, new models of care and digital innovations. This plan is created following engagement across West Yorkshire NHS, Social Care and the Voluntary sectors and is practically developed in the following ways:

1. We are developing a strategic workforce planning cycle guidance document in 2023/24 for places and programmes. This will enable places to be better informed of the wider annual workforce planning cycle and events, as well as information that sets out key details and expectations from a West Yorkshire perspective. 

The process for the annual NHSE operational planning return includes collaboration with West Yorkshire ICB programmes and places. In working in this way, we have collated information for the narrative, ensuring all places are cited on information provided.

2. We are facilitating Multi Year Workforce Modelling workshops with each of our five places. These events are attended by staff from health and social care providers, the VCSE sector, education, and local authority. We recognise the need to continue to better understand the profile of our collective workforce by improving the quality and standard of data to inform decision making across sectors/roles. We have made a good start with this, with all five places having had a number of workshops so far, with further quarterly events planned throughout 2023/24. The workshops have identified the areas where improved data and scenario planning would be useful (e.g., in children’s care services, VCSE and primary care). The requirement to increase training placements in community settings was identified by all places. The output from these engagements has been to inform NHSE investment in education and training.

We recognise the complexity of working on multiple footprints and that demand must be informed by an understanding of the needs of the population and future models of delivering care, captured through sector, pathway/programme, and neighbourhood planning lenses. Building a consensus around the future size and shape of our workforce is key to supporting workforce and service transformation and to achieving our vision.

ICBs and the places within them, require a range of data and intelligence to inform their interventions and undertake their responsibilities with evidence-based approaches.

3. The ambition of the National Information System Pilot is to create a comprehensive range of information and dashboards which will fully support ICBs ability to monitor impact. The work is not limited to NHS workforce data and there is the potential to explore:

• User needs across workforce and education, finance, and activity data,
• Include primary and social care,
• Provide aggregation and benchmarking services,
• Focus on key questions,
• Develop new ESR (electronic staff record) data

Our ambition is that these initiatives will influence spending on education and training, allowing us to target key areas to build and develop our West Yorkshire workforce. West Yorkshire ICB is leading the National Information System pilot project nationally with NHS England.

4. The West Yorkshire Workforce Observatory is an exciting new interdisciplinary initiative, which has been running from January 2020, and involves researchers from higher education (HE) working in collaboration with the West Yorkshire ICS (Integrated Care System). The West Yorkshire Workforce Observatory takes an innovative approach to workforce planning across the system, that has been able to create innovative approaches to evidence-based workforce development. Examples:

• Recruitment and retention of care workers review
• Review of strategic workforce planning in health and social care
• Planning the radiology workforce for cancer diagnostics in West Yorkshire
• A review of the health and social care digital workforce in West Yorkshire

Current funding which supports operations of the Workforce Observatory ends at the end of March 2023. A business case has been developed to present options for investment in the West Yorkshire Workforce Observatory from 1 April 2023 for the medium term (next three years) as part of a system wide response, and in partnership with the five places, to ensure the continued prioritisation of an integrated system-wide approach to workforce planning and development that provides transformational results and aids decision making through evidence base research on how health and social care services are delivered across the sector, shaping our future workforce.

5. Transformation Plan: A workforce transformation plan that describes and tracks/ evaluates specific investment in new roles and new ways of working defined within the planning process.

Social and economic development

As part of our wider work on workforce integration, we need to consider and address the ongoing economic effects the current cost of living crisis, industrial action, and the impact these may have on our colleagues whose households may be impacted in these challenging times, and the additional anxiety this will bring. We need to further scope how the health and care sector can contribute to social and economic recovery, ensuring that as we plan our future workforce requirements, we maximise the potential of our anchor institutions to support growth and job opportunities within our local communities. (Anchor Institutions are large organisations able to support smaller organisations in a local geography)

Social care

The West Yorkshire ICB People Directorate working with social care colleagues is developing an International Recruitment infrastructure, the exploration of enhanced placement capacity into social care and collaborative work to enhance the access to training for social care colleagues available within the health sector.

Education and training

Supported by the Integrated Care Board, workforce development examples, which respond to the improvement / development of local services include:

The Calderdale Framework and STAR model HEE Star: Accelerating workforce redesign | Health Education England are simple but effective methodologies to support workforce transformation, enabling those responsible for delivering healthcare services to explore workforce challenges in more detail, and develop bespoke action plans to address them. Continuing support for facilitation of workshops and training of staff in these models are key to enabling engagement with the staff and the specifics of their local challenges.

Examples of the Calderdale framework:

• Leeds Children’s Hospital are working with clinical teams in the children’s day surgery unit to help to maximise the effectiveness of the workforce, ensuring that the registered staff perform tasks only they can do, supported by a skilled, safe, and competent support workforce, benefitting staff, patients, and their families.
• Airedale NHS Foundation Trust working with the breast surgery and breast imaging teams, we have identified elements of the service that can be delegated to other professions and skills that can be shared across professions to create resilience in the service and free up clinical nurse specialist time to focus on more complex cases. Through competency framework mapping, upskilling opportunities have been identified for assistant practitioners. There are plans to develop a proposal for how the Genomic testing service can be delivered.
• Creative Care: SWYPFT are trialling the recruitment of 8 full time creative practitioners across acute psychiatric wards to expand the workforce on wards, leading group and 1:1 activities, developing creative care plans for inpatients and linking to Social Prescribing and cultural/ community assets on discharge. Aiming to increase capacity of existing staff, reduce incidents on wards and, long-term, to positively impact average length of stay and readmission rates.

Examples where STAR has been utilised:

• Pharmacy – Workshops have been held that have identified a clear action plan for increasing supply, upskilling the workforce, developing new roles, introducing new ways of working and strengthening leadership. Specific actions include:
• Reducing student attrition
• Developing a plan to clearly articulate and define roles in all settings
•  Introduction of pharmacy roles to services that do not traditionally employ pharmacists
• Scoping and promoting dual/cross sector roles
• Introduction of pharmacist roles in virtual wards
• Maternity - Supporting the West Yorkshire and Harrogate Local Maternity and Neonatal System (LMNS) workforce group in pre-workshop awareness raising and information gathering from a wide range of staff involved in the delivery of maternity and obstetric care, ahead of a Star workshop to be held with Heads of Midwifery (HoMs), Directors of Midwifery (DoMs) and service leads to explore effective solutions to the priority workforce challenges across the service.

Service redesign

WYAAT (West Yorkshire Association of Acute Trusts) has a well-established Theatre Forum group with representation from all six West Yorkshire and Harrogate Trusts. Created in March 2022, this group provides a platform for theatre staff to come together on a regular basis to engage and discuss current workforce issues. We have made progress on several workforce initiatives, which has recently led to us forming three subgroups focused on recruitment, retention (including education, health, and wellbeing) and transformation.

The WYAAT forum offers an opportunity to discuss ideas and generate unique and constructive solutions to address some of the workforce issues collaboratively as well as celebrate some of the amazing work that is happening across our hospitals.

We have representation from regional NHSE at this group who provide support, advice, and guidance and recognised the WYAAT theatre model as an exemplar. WYAAT are also part of the ‘National Building Outstanding Theatres Team’ (BOTT) who are keen for this group to play a significant part in the key deliverables of the national programme.

New ways of delivering care and service delivery

We recognise the value that students bring to service delivery and have been working to ensure that our students play a contributory role in service delivery in an environment that is safe for them and our patients. We have several initiatives that support this:

The Multi-professional student-led clinic project aims to increase placement capacity across all practices, whilst maintaining, and sometimes improving, quality. It significantly supports capacity issues by targeting waiting lists, and in turn this is contributing to patient safety and satisfaction. This moves towards greater focus on work in the community and a greater attraction for students to want to work in the community following their experience with patients.

For the learner, this project becomes an invaluable placement experience in building confidence with increased patient exposure, developing early leadership skills and gaining a sense of value from feeling part of a team. For general practice it is becoming a valuable resource in reducing service pressures, supporting staff wellbeing and feedback suggests it has had a significant success in tackling health inequalities:

• Primary care - multi-professional student led clinics are in the early pilot stages running across two large west Yorkshire PCN’s currently focussed on managing serious mental illness reviews. The West Yorkshire Primary Care Workforce and Training Hub have appointed a student led clinic manager who will support the roll out of the student led clinics across West Yorkshire.
• The Learning Environments and Placements Programme has worked alongside Leeds Community Podiatry and The University of Huddersfield in piloting a number of student-led Podiatry clinics - the first of 10 clinical sessions were piloted in January 2023. In the pilot, the areas focused upon were Heel Pain clinics, new assessments of patients who were placed on waiting lists in 2021, and clinics to reassess ‘at risk’ patients who had not had a face-to-face appointment for over 15 months. A thorough assessment was undertaken of each patient, which included additional Patient Education advice on how to safely manage their condition at home. Because of the Patient Education element within the clinics, we were able to extend review times and increase capacity. Generally, one registered Podiatrist would have around 45 appointment slots in a five-day period. Five days of student led clinics created 120 additional appointments, which is an increase in capacity of 166%.
• Urgent care - We are currently exploring the possibility of student led clinics within urgent care to help support waiting times for minor injuries.
• Elective care - we are also exploring the possibility of student led clinics to support rehabilitation to prevent deconditioning and reduce the length of hospital stays following surgery and those awaiting discharge.
• Students working as bank staff – Nursing and AHP (Allied Health Professionals) programmes across West Yorkshire now include the care certificate. This enables our students to undertake bank work as health care assistants, supporting service delivery as well as developing their competence and confidence.

Workforce priorities

During 2022 and 2023 to date employers, service providers, service leads across health and social care, the voluntary sector have come together in Wakefield, Calderdale, Kirklees, Bradford, and Leeds to identify workforce priorities that can be seen as “System Wide”, meaning that there are things that can be worked on for all of West Yorkshire. We call these ongoing events “Multi Year Modelling.”

The priorities gathered were presented to the Integrated Care Board in a specific Workforce section of the meeting in February and following endorsement by the Board, for this and at a later Board meeting the proposal for an approach to Dentistry, further work with providers, professional groups and Post Graduate Education leaders has shaped the 3 priority work streams as follows:

1. Dentistry

• We will develop a workforce strategy and plan
• We are developing a workforce response to the work endorsed by the ICB Board. This will include delivery of a range of solutions outlined in the paper presented to the Board:
• A new way of working where General Practitioners with a special interest in Oral Health will undertake activity, taking some pressure of community care in foundation practices, with upskilling, as part of the model.
• Local centres for dental development (possibly two in West Yorkshire, yet to be decided)
  • Provide a focus for specialised care
  • Provide training in community settings.
  • Delivers a mini specialist care centre which also provides.
  • Community based reason for people to work and develop their trade/career.
  • Support to overseas recruitment

2. Community / prevention / neighbourhoods workforce framework

• Identifying opportunity and the creation and utilisation of new roles, innovation in recruitment, retention, placement opportunities, career, and education/learning pathways.

3. Expanding community placements

This workstream will:

• enable effective learning environments
• expand clinical placements
• expand nursing and allied health professional roles

West Yorkshire Healthcare Science Workforce group

The West Yorkshire Healthcare Science Workforce Group is a newly formed group, in which there are 52 professional specialisms. Collectively West Yorkshire ICB and the Healthcare Science Workforce group will work together this year to:

• Undertake an analysis of current activity and demand for diagnostic service that require health care scientist’s input
• Undertake an urgent workforce review of the identified HCS hotspots and develop a robust action plan to mitigate current shortfall gaps, considering the age demographic and require growth of the workforce to meet service demand.
• Development of a longer-term training and education plan that is reflective of regional requirements for all HCS specialism

Digital staff passports / porting of staff across systems, places, and service providers

• Another priority identified as part of the Multi Year Modelling process was the ability to shift resources to the parts of the system that have the greatest need (e.g., social care, urgent care).
• The NHS Digital Staff Passport is an easy-to-use app that would assist the ability for staff to work across systems, places, and service providers. The App holds staff members’ essential information – including personal, employment (excluding pay), skills and occupational health. The passport will ensure the quick and secure transfer of information that’s required, for transfer between organisations.

Supporting workforce wellbeing

As an indicator of the value our system places on supporting workforce wellbeing, we have committed to build on the non-recurrent funding provided by NHS England to establish Staff Mental Health and Wellbeing Hubs, by recurrently supporting our ‘hub’ to continue as a permanent offer to staff across health, social care and the VCSE sector.

During 23/24 our priorities for the hub are to:

• Transition the temporary hub arrangements into a permanent structure – including continued deliver of direct therapy provision to those staff who refer into the service
• Develop the Critical Incident Support Model to align with Emergency Planning & Preparedness work
• Develop the West Yorkshire Health and Care Partnership microsite and social media presence to support staff mental wellbeing

Global Partnerships

The aim of our Global Partnerships programme is to establish West Yorkshire as a great Global Citizen.

A key element of this is working in close collaboration with NHSE on several small- scale pilots to develop new ethical, sustainable international recruitment pathways for roles in the collaborative West Yorkshire Mental Health, Learning Disabilities and Autism Programme (five psychiatrists and twenty-five mental health nurses) and Cancer Alliance (five medical oncologists) and Yorkshire Ambulance Service NHS Trust (five senior clinical advisors for the NHS 111 service). Once these pathways have been piloted and evaluated, they will then be usable at a larger scale by all organisations within the Partnership, which will reduce reliance on agency costs.

In 2022, the ICB established a partnership with the Government of Kerala in India that provides an ethical and sustainable supply of nurses to all West Yorkshire health and social care partners. This pathway for large scale nursing recruitment, along with all other ethical migratory pathways developed for other clinical specialties, will be fully evaluated in 2023, to establish an effective recruitment process and experience for staff and organisations, and that quality improvements to all recruitment pathways are ongoing.

Our Global team and partners are developing educational programmes in West Yorkshire and Kerala which will become part of the pathway of internationally nurses joining trusts in Mental Health roles. Similarly, we are developing a Social Care pathway with Kerala to bring nurses, Senior Care Workers, and Healthcare Assistant to the region.

These recruitment pipelines of internationally educated colleagues will continue to grow through 2023 and are likely to become sustainable workstreams over the next five years.

Global Partnerships such as the SCALE partnership between the West Yorkshire and Harrogate Local Maternity and Neonatal System (LMNS) and the Ministry of Health Uganda will continue to collaborate and improve the lives of mothers and babies, in West Yorkshire and in Uganda, through virtual learning programmes, observerships and fellowships. We will evaluate the impact of Global Health partnerships within West Yorkshire including those with St Vincent’s and the Grenadines, and Montserrat.

We will champion the role of our global workforce within West Yorkshire and create opportunities for internationally educated colleagues to use their global health knowledge and experience to bring new perspectives and innovations, contributing towards new ways of working and reducing health inequalities.

System leadership

The aim of the West Yorkshire system and leadership development work is to support the partnership to achieve our 10 big ambitions through enabling culture change, encouraging collaboration, and supporting our partners in fulfilling their potential by developing leadership capacity and capabilities.

The specific priorities of system and leadership development are to:

• Increase the diversity of our workforce so it represents our community through developing and continually improving an inclusive recruitment approach, and routes into employment from underrepresented groups e.g., via project search
• Increase the diversity of our leadership through delivering the fellowship leadership programme across WY, reciprocal mentoring programme, ILM coaching programme and the coaching hub, and developing a talent pool of diverse future leaders.
• Enabling our people to access health and wellbeing offers, particularly where there are no offers available e.g., social care, primary care, voluntary, community and social enterprise sector through implementing initiatives to address the research findings into the barriers in accessing health and wellbeing offers, supporting our organisations to achieve menopause friendly employer accreditation, providing system wide menopause awareness sessions, delivering a suicide awareness training pilot, measuring staff experience with the development of staff surveys beyond health and scale and spread of a compassionate leadership development programme across West Yorkshire
• Develop system leadership and OD capacity and capability across WY through developing the WY OD network and associated initiatives including an OD fellowship, curation, and hosting of resources on the WY website, and development of training and development offers
• Enable the development of our partnership into a system where the whole is greater than the sum of its parts through leading and facilitating OD and system development with the component parts of our partnership including places, provider collaboratives, programmes and the ICB, embedding values and behaviours development into our approach
• Enable the delivery of the five-year strategy and joint forward plan through facilitating and equipping the component parts of the partnership with OD tools and skills.