East Midlands Personalisation Programme Workforce Development Workshop Joseph SilvaMarie Lovell...

East Midlands Personalisation Programme Workforce Development Workshop

Joseph Silva Marie Lovell

(iMPOWER) Christine Collymore

(Skills for Care)

14/05/2009

The contents of this document are © iMPOWER Consulting Ltd unless otherwise statedRegistered office: 14 Clerkenwell Close, London EC1R 0AN Registered in England and Wales No: 3876501

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Agenda

Introduction and objective setting

How big is this change?

What shapes the future workforce?

New types of working – how others have approached it

Lunch

Case studies from participating LAs

Group exercise

Practical next steps

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Timetable

Introduction and objective setting 1015 -1030

How big is this change? 1030 -1115

What shapes the future workforce? 1115 -1130

New types of working – how others have approached it 1130 -1230

Lunch 1230 -1315

Case studies from participating LAs 1315 -1345

Group exercise 1345 -1445

Next steps 1445 -1500

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Agenda


How big is this change?



Lunch


Group exercise


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How big is this change?Workforce challenges emerging from SDS

The implications of SDS on the workforce are wide ranging and there will be few sections of the organisation which will remain unaffected by its implementation. Organisations previously considered external to councils will also be affected by these changes.

Scope of workforce affected: Assessment and care management workforce. In-house service provider workforce. Private sector provider workforce. Voluntary sector provider workforce, and volunteers. Commissioning and contracting. Procurement workforce.

The implementation of SDS provides authorities with the opportunity to now develop their workforce in order to respond to individual need and required outcomes and a process where there is a new emphasis on the citizen having real choice and control.

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Agenda


How big is this change? 1. Organisational structure challenges

2. Potential for efficiency savings

3. Workforce challenges



Lunch


Group exercise


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Organisation Structure:Challenges emerging from SDS

SDS implies a new organisation structure which delivers a new balance between control and delegation: Enabling and supporting individuals to make their own choices

and take control, while retaining safeguarding responsibilities. Managing transparency – managing expectations of

customers, a focus on equity, and clearly separating advice about choice, from delivery of care.

Market management techniques and encouraging innovative supply, and less on managing contracts and providers.

Financial and performance reporting based around outcomes and overall spending, and less on unit costs and input measures.

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Organisation Structure:Recommended organisational change (SAMPLE)

Structural change Rationale – why consider?

Separate out in-house provided services from assessment & care management.

Clear split between care navigation and care provision, greater impartiality. Enables more focused operational management on performance

improvement / commercial-style delivery of in house services. Clearer budgeting approach with in house services are a cost and revenue

centre under SDS.

Locate duty teams in expanded contact centre.

More consistency of assessment processes. More efficient use of staff time, assumes phone and web based first

contact. Easier provision of self-assessment and mediated (phone) assessment. Greater synergies with in touch team.

Create generic locality-based care management teams.

More of the assessment process taken by contact centre. SDS model is equitable across different client groups (single SAQ & RAS). Does not exclude potential for some specialist support for particularly

complex / difficult cases.

Locate some commissioning staff in area offices.

Commissioning function will rely on local intelligence and knowledge of local solutions.

Can have a clearer focus on supporting local innovation / flexibility in supply.

will provide clear conduit of information through to centre where this informs strategic issues.

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Organisational change:In house service split options (SAMPLE)

Structural change No change Incremental Significant

Separate out in-house provided services from assessment & care management.

No change. Split not required / seen as beneficial.

Separate in-house services and make direct report to Director.

Create new ‘Head of’ role to run new division.

Pros Reduces amount of change at a challenging time.

Provides separation without additional cost.

Provides absolute clarity and accountability.

Opportunity to bring in commercial skill set.

Cons Does not recognise the potential conflict of interest issue.

May simply defer the problem.

Requires Director to take too operational a focus.

May cost more at a time of reducing management headcount.

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Organisational change:Contact centre / duty teams (SAMPLE)


Locate duty teams in expanded contact centre.

Keep separate duty teams.

Move some staff into contact centre, retaining some cover in area offices

Move all duty teams and most assessment processes into contact centre


Provides separation without additional cost.

Clear focus for teams moving and for teams remaining in area offices.

Larger efficiency opportunity.

Cons Does not meet corporate direction of travel.

Reduces efficiency opportunity.

Muddies focus of respective teams

Could lead to process / accountability confusion

Will areas offices be viable in their reduced scale?

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Organisational change:Generic locality teams (SAMPLE)


Create generic locality-based care management teams.

Preserve existing specialist model

Retain reduced number of some specialists in areas

All area teams generic


Provides local cover for specialist / complex cases.

Consistency and clarity of role and process.

Flexibility / cover between area offices when capacity issues.

More efficient use of time.

Cons Reinforces existing inequalities between different client groups.

Limited efficiency opportunity.

Small scale may prove difficult to justify a hybrid team

Risks losing specialist knowledge at local level.

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Organisational change:Some commissioning based locally (SAMPLE)


Locate some commissioning staff in area offices.

Commissioning staff all located centrally

Rotation / regular local visits for some commissioning staff

Permanent location of local commissioning staff in area offices

Pros Concentrates skills at centre.

Not as disruptive as full scale change.

Opportunity to build real local knowledge and intelligence

Gets closer to communities and customers.

Cons Lose local knowledge and opportunity for innovation.

Lack development of market management skills

Neither one nor the other; could be worse than no change.

Would not be easy to ensure a team feel to commissioning function.

Is there sufficient scale in the team?

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Agenda







Lunch


Group exercise


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Professional and administrative support: context (SAMPLE)

Included The opportunity to streamline the

assessment and care management process.

The opportunity to shift the ratio of qualified social workers to non-qualified care workers.

The opportunity to reduce how much support planning the council will pay for under the new model.

Not included Assessment of opportunity to

reduce size of strategic commissioning, performance, supporting people or business improvement. Strategic commissioning has recently been redesigned, and will need to change role again, but does retain a vital function in market management.

Assessment of opportunity to reduce costs of home care and day care services. These services are considered as costs of care and are both currently under review.

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Drivers of efficiency in Professional and Administrative support

Transition may require higher investment in

process before savings can be realised

Likely to cost a lot in redundancy and pensions strain and will take time to

transition

A possible area for longer term cost reduction but

unproven and risky in the short term

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The individual budgets process enables a more efficient use of staff time (SAMPLE)

Current process High level of qualified time involved in

verifying referral information, initial contact with client and data collection.

High level of paper based assessments by qualified staff.

High number of separate steps in customer journey, and a higher volume of decision points.

High percentage of qualified social worker time required to provide info/advice and guidance following Contact Assessment.

Qualified time in preparing care purchasing paperwork and transfer to Care Purchasing Coordinators.

Proposed process Skilled Contact Centre staff provide

initial screening of initial contact. Direct input of non-qualified staff onto

case management system. Reduced number of steps within

process. Initial screening addresses the

provision of advice and guidance prior to Contact Assessment by unqualified Contact Centre staff.

Only complex decisions requiring need for qualified input.

CPCs are non-qualified roles which would undertake the majority of these tasks.

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More efficient processes will be reinforced by other important initiatives (SAMPLE)

Opportunity CommentsShift contact

staff to contact centre

Assumes phone and web based first contact – requirement to encourage clients to use web-based self-assessment and mediated (phone) assessment

More efficient use of staff time. Greater synergies with ‘in-touch’ team

Create generic locality-based care management teams

More of the assessment process taken by contact centre

SDS model is equitable across different client groups (single SAQ & RAS)

Does not exclude potential for some specialist support for particularly complex / difficult cases

Implement Mobile working

Pilot demonstrated opportunity to reduce assessment process from 4.5hrs to 2hrs on average

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Assessment and Care Management Workforce modelling: illustrative changes (SAMPLE)

QSW

Faster process

Qualified staff ratio

Less support planning

10% reduction in process time

= 10% reduction in

staffing costs

Change in ratio from 1.5:1 to

0.75:1 = 6.4% reduction in

staffing costs

10% reduction in NQSW = 4%

reduction in staffing costs

NQSW

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Workforce modelling: scenario planning (SAMPLE)

Assumptions

Faster process

(affects all staff)

Ratio(Q) to (NQ)

Reduce support

(affects NQ only)

No change 0.0% 1.5 : 1 0.0%

Moderate 5.0% 1.25 : 1 5.0%

Significant 10.0% 1 : 1 10.0%

Radical 15.0% 0.75 : 1 20.0%

Staff implications

Qualified staff

Non-qualified

staff

Total A&CM staff

Cost reduction*

96 64 160 0.0%

83 66 149 -8.6%

69 69 138 -17.2%

53 70 123 -28.0%

*iMPOWER analysis using sample council salary data only

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What is the appetite for risk? (SAMPLE)

Moderate Significant RadicalKey points

7% reduction in ACM staff numbers

Process improvement of 5%

Small shift in ratio of Q staff to NQ staff

Reduction in 5% of staff doing support planning

14% reduction in ACM staff numbers


Shift in ratio of Q staff to NQ staff of 1:1


23% reduction in staff numbers


Shift in ratio of Q staff to NQ staff of 0.75:1


Risks Could be achieved through natural wastage

May not focus enough attention on key changes required

May not allow opportunity to hire / relocate appropriate staff into new roles

Reduction in social workers (-27)

Redundancy and pension costs may be prohibitive

Will be difficult to deliver combined changes in short term

Could place other goals (reduced care costs) at risk if delivered too quickly

Radical reduction in number of social workers (-43)

Unclear whether safeguarding responsibilities for vulnerable client groups will be covered

Redundancy and pension costs may be prohibitive

Could place other goals (reduced care costs) at risk

Long term direction of travel?

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Agenda







Lunch


Group exercise


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WorkforceChallenges emerging from SDS

Change in Job Roles Councils will need to carefully consider the competencies and role of care managers

and other health and social care staff and also consider the change in culture and use an organisational development model of change management. There will need to be an extensive programme of consultation with staff alongside additional investment in training and development.

Some of the challenges which a change programme on this scale will need to address include:

Anxiety around new 'professions'. Shift of care managers to a more enabling role. Less control over packages of care. Development of multi skilled teams. Geographical location of teams currently (and possibly move to generic locality based

teams). Increased awareness and skills in risk management. The abilty of the worker to 'let go'. The ability to work within new structures, with new networks and partners.

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Agenda







Lunch


Role development exercise


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Workforce Development

Strategy

Workforce Development

Strategy

From Vision to Workforce Development utilising the Target Operating Model

Op

erat

ion

al b

luep

rin

tT

arg

et O

per

atio

nal

Mo

del

Service breakdown

Adult services

Community &Customer Service

Systems infrastructure

CTS

Customer channels

Contactcentre

Physical sites

Building 1000

Other Sites

People

Roles

Processes

Specialist

Skills

Leisure system

Organisational structure

AdultServices

Community &Customer Service

Galaxy

LSC’sContactCentre

LSC email Web F2F Home

GenericServices

Semi-Specialist

Culture &Tourism

Culture &Tourism

CareFirst

Vision for

Putting People First

Vision for

Putting People First

The Customer Journey

The Customer Journey

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Key recommendations (SAMPLE) 1

Area Key decisions (summarised)Customer channels

1. Move duty teams into contact centre2. Move majority of the new customer journey into the contact centre3. Enable self-assessment online4. Push all first assessments through the contact centre

Processes 1. Adopt the new customer journey2. Bring financial assessments forward in the process3. Replace ‘charging’ with ‘contribution’ netted off at source

Services & Commission-ing /

1. Customers will have no choice about use of block contracts (until places are filled)

2. In-house services will be traded for 2 years – customers have choice3. Commissioning function redesigned reflecting move to market management4. Some commissioning staff to be based in localities5. Develop / implement a strategic engagement strategy to ensure the effective

participation of service users in SDS

People / workforce

1. Form non-specialist, generic teams in area offices2. Shift ratio of social workers to care navigators3. Ensure sufficient support and training is provided to drive the cultural changes

required4. Ensure robust and targeted corporate communication plan for delivery of

workforce changes across ASC

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Key recommendations (SAMPLE) 2

Area Key decisions (summarised)Org structure 1. Separate in-house provided services from assessment & care management.

2. Locate duty teams in expanded contact centre.3. Create generic locality-based care management teams.4. Locate some commissioning staff in area offices.

Systems / IT 1. Non-technical solution for deployment of phase 1.2. Synchronise any major changes in systems around the SWIFT refresh date of

2011.3. Start planning now for requirements and re-procurement.4. Examine potential for an additional customer-based solution (e.g. S4S).

Physical sites 1. Ensure ASC is fully appraised of the economic value of in-house properties.2. Design a flexible workforce model capable of deployment regardless of

corporate plan for physical sites.

Financial sustainability

1. Adopt FSM as core planning tool for programme benefits realisation.2. Present FSM to COMT and corporate transformation team.

RAS 1. Adopt proposed RAS for phase 1.2. Implement further refinement and monitoring .

Implementa-tion plan

1. Sign off implementation plan and provide mandate for Programme Manager to commit resources to deliver.

2. Enforce adoption of all ASC project work as part of the overall programme.

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Agenda







Lunch


Group exercise


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Good practice examples

Background Skills for Care New types of worker programme

Areas Raising awareness New roles Practice development Provider market Strategic workforce planning

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New Types of Working

Local Authorities involvement Internal staff Micro employers Personal assistants Private, voluntary and independent sector Informal carers

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Future development

Personal Assistant - induction standards

- training

National Minimum Data Set to capture micro employers and personal assistant data

InLAWS – Integrated local area workforce strategies

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Key resources

Common core principles

Principles of workforce redesign

New types of working website – www.newtypesofworker.co.uk

Adult social care workforce strategy

Qualifications and Credit Framework

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Key resources

Leadership and management

National minimum data set – social care

National Occupational Standards

Knowledge Sets

Regional contact person

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Agenda







Lunch


Group exercise


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Agenda







Lunch


Group exercise


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Discussion by LAs

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Agenda







Lunch


Group exercise


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Group exercise

1. Break down into groups of 5 or 6.

2. Designate a reporter to feedback to the wider group.

3. Choose one of the five areas that have been discussed earlier (repeated below). Identify the issues and challenges in this area and provide one recommendation that you will need to undertake to ensure the successful delivery of this element. Raising awareness amongst social care providers Developing new roles Practice development Workforce changes within service providers Strategic workforce planning

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Agenda







Lunch


Group exercise


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Next steps

Regional Improvement and Efficiency Partnership

Regional workshops

Support to each Local Authority

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