Policies, Local and National Guideline: Approval Process

(Risk Management Workforce Demand)

Developed by: (Gerry Lawrie, Head of Workforce & Development)

Document Review Date (if appropriate): Ongoing as process is tested

Date approved: 14th April 2020

Is distribution required? YES Distribute to 1.Sector Control rooms x4 2. Clinical Directorate Control Room 3. Facilities and Estates Control Room 4. Admin Virtual Team

Final Version

Approved by the Silver Command/Tactical Response Group

Approved by Bronze

Operational Response

Date approved: 17th April 2020

Risk Management of Workforce Demand

Purpose

This paper summarise the approach that will be taken in NHS Grampian around the deployment of staff and how a risk assessed

approach will be supported by senior professional advice and a process of escalation.

The Staff Deployment Centre (SDC) will support this process by:

maximising the deployment of a temporary and supplementary multi-professional workforce across NHS Grampian

based on a risk prioritisation of unmet demand to maximise patient safety, care delivery and essential service

provision; and

reallocating the substantive resource released where there has been a downturn in non-essential activity i.e. staff not

currently utilised within their own sector/HSCP.

This model recognises that all sectors and Health and Social Care Partnerships utilising their own staff through the

reprioritisation activity to respond to the COVID pandemic and therefore, escalation will only come through to the SDC where

there is unmet workforce demand.

Across the Clinical Workforce, the professional governance and high risk decision making will be through the Clinical Directorate

on behalf of Executive Nurse and Medical Directors. For Facilities and Estates, this will be through Facilities Control Room and

for Administration Services this will be through a virtual team of admin managers.

If the SDC cannot meet all demands as escalated through the prioritised risk assessed process, then Silver Command, in

consultation with Accountable Officers, will make the decision as how staff can best be allocated using the risk information and

in conjunction with the Chief Officers.

To enable the function of the SDC (see appendix 1), each H&SCP, Sector and MHLD must articulate unused supply and unmet

demand (see Figure 1).

Deployment of NHS Grampian employees/workers for: Nursing

Midwifery HCSW AHPs

Medical Facilities & Estates

Admin

Supply & Demand considered at lowest level possible

Service

Division/locality

H&SCP, MHLD, Sector

Organisational

H&SCP, MHLD, Sector escalate unused supply or unmet demand to SDC

Unused supply – email to gram-uhb.nhsgdeployment@nhs.net with details

Unmet demand – email gram-uhb.nhsdeployment@nhs.net with accompanying request form detailing number, skill set, shift times and the risk prioritisation if this unmet demand is not provided or mitigated against.

Figure 1

Supply, Demand and Deployment

Local deployment and escalation will be managed through each service and department who are expected to identify staff

released from non-critical activities. Staff released should be redeployed to critical activities within their own area. Services

that have unused supply or unmet demand should record it and escalate this to the next level. Supply and demand should be

matched at the lowest possible level, with any mismatch escalated. Any supply-demand mismatch at Sector level will therefore

be escalated (via twice-daily workforce requests) to the Staff Deployment Centre. The SDC will report to either Clinical

Unmet Demand

Service to adjudicate

between competing

demands considering

Skill requirement

Unused Supply

Release from current

workplace

Generic offer of Additional

hours/Overtime (not just

this group

Temporary staff

Supplementary staff inc.

agency

Risk Management of Workforce Demand

Directorate, Facilities Control Room or virtual Admin Team, when supply cannot be used and/or demands that cannot be met,

allowing co-operation between sectors.

The deployment of staff to manage the increasing demands of COVID across departments or sectors provides a number of

challenges given there is no overview of service planning to cover predicted absence, maintain non-COVID essential services and

COVID activity.

Principles of Deployment

It is therefore recommended that the following deployment principles should apply across the organisation

Services must identify the critical non-COVID activity that is being undertaken, the resource required for this and the resource, if

any, that’s able to be released or already allocated to another service:

o Its recognised that a service may use their own more senior staff, or other professions in the service (e.g.

Clinical Nurse Specialists ), to release staff with a more versatile skill set (e.g. Consultant working in a more

junior role in own service to release a middle grade);

o This approach should allow for each level of the organisation to manage their own needs. e.g. department,

service, unit, sector;

o Any unused resource identified through this process would be considered at sector level and if not required for

critical functions, then these should be shared with SDC for organisational / cross Sector use; and

o Any staff identified will be deployed on a long-term placement (directly to a service based on their skillset) or

placed on short term rapid response position.

Sectors can submit twice daily request forms identifying workforce demands (including shift patterns) for the next 48 hours to

the SDC, ( see Appendix 2). This will enable placement of rapid response deployment workforce; and provide a narrative as to

the level of risk if demand is not met. This approach uses the NHS Scotland risk matrix (Appendix ii) and against 4 categories

(Table 1).

Table 1: Risk type and risk descriptors

Risk Type Risk Descriptors

Staff Staffing and competence

Complaints/claims Care provision Patient experience

Injury (physical and psychological) to patient/visitor/staff

Service/Business interruption

Inspection/Audit

Business Financial (including damage/loss/fraud)

Objectives/Project Reputation Adverse Publicity/reputation

Where there are demands from sectors, which cannot be met, this will be escalated to the Clinical Directorate Control Room,

Facilities Control Room or Administration Virtual Team as relevant. If this cannot be agreed through these Control Rooms then,

the demand and associated risks will be raised via Silver Command and be addressed in conjunction with the Chief Officers

Recommendations

TRT are asked to agree that:

Workforce supply and demand will be matched at the most relevant operational levels in the first instance;

Any supply and demand mismatch (unused supply or unmet demand) will be escalated via the SDC to the relevant

Control room (Clinical or Facilities or Virtual Admin):

SDC will work with the appropriate Control Room when professional assessment is required for the deployment of staff

groups or individuals and also to help assess competing demands: and

Silver Command in conjunction with the Chief Officers will decide when demand requires for staff to be moved across

the system

Risk Management of Workforce Demand

Appendix 1

Functionality and Scope of the SDC

The SDC will provide the deployment function for new, existing, temporary and the supplementary workforce as well as

supporting the placement of released substantive staff resource. This can be through long term placement directly to the

service or through a rapid response roster deployment based on escalated demand.

The SDC:

Manages all staff on temporary contracts identified for rapid response deployment, unless identified as being directly

aligned to a specialised department due to their skill set (e.g. ITU, A&E, laboratories etc.);

Manages all Nursing and Midwifery bank and agency engagements and their bookings;

Receives and books all staff groups additional hours and overtime being offered for deployment where offered locally

and not required;

Identifies long-term placements of new temporary contracts who have a specialised skill set not suitable for rapid

response deployment, allowing the individual to be placed in tandem with the recruitment and on boarding process

through the staff bureau;

Supports the placement of substantive staff released from their normal working arrangements and not required within

their current management structures up to sector level;

Deploys all staff booked or rostered for rapid response deployment to sector control rooms or directly to departments

based on the risk assessed process;

Utilises all staff skill sets on Health Roster, as identified through the Skills deployment Questionnaire which supports

booking of training and any reporting required on skills sets;

Reports on any skills, workforce deficits and ongoing risks to Clinical Directorate Control Room and Facilities Control

Room as appropriate, and then to ORT for onward escalation to Silver Command;

The staff groups covered are Nursing, Midwifery, HCSW, Allied Health Professionals, Medical Staff, Facilities and Estates

and Admin Staff. It is anticipated Pharmacy and HealthCare Scientists are fully utilise within their professional groups.

Appendix 2

Staffing Deployment Centre- Staff Available (Supply) The Staffing Deployment Centre aims to deploy staff on a short (this week), medium (1 week – 1 month) or long term basis (1 – 3 months).

By submitting this form, you are confirming the following discussion have taken place:

Available staff considered at lowest possible point ahead of offer organisationally

Contact will be through line manager for staff notes as available

Employee(s) ae aware of “Policy for Management of the Workforce during and after Major Incidents Including Pandemic”

Date: Time: Control Room Name:

Please circle availability type: Short Medium Long

Availability type (medical/ nursing/ Facilities & Estates/ Administration/ Other)

Band / Grade type (RN, Band 3, FY1)

Name Days available

Hours available

Date available from

Primary Skill(s) (venepuncture, complex communication, TrakCare)

Preferred location Willing to travel/drive

Staffing Deployment Centre- Staff Available (Supply) Additional Information/Comments to support submission:

Appendix 2

Staffing Deployment Centre- Staffing Request (Demand) The Staffing Deployment Centre aims to provide staff on a short (this week), medium (1 week – 1 month) or long term basis (1 – 3 months).

Date: Time: Control Room Name:

Please circle request type: Short Medium Long

Request Type (medical/ nursing/ Facilities & Estates/ Administration/ Other)

Band / Grade type (RN, Band 3, FY1)

Primary Skill(s) (venepuncture)

Start date & time

Finish Time

Alternative request or grade

Day(s) requirement

Deploy to pool roster, specific department or team (name Health Roster location)

Risk level to support Priority Risk Demand & Reason

Staffing Deployment Centre- Staffing Request (Demand) Additional Information/Comments to support submission:

Appendix ii – NHS Scotland Core Risk Assessment Matrices

Care Provision

Care Provision

Business

Staff

Reputation

Business

Care Provision

Staff

Care Provision